The Reason . . .

. . . I can do this again--the shots, the hormones, the headaches, etc.


. . . I did not pass out after injecting myself this morning.

. . . we have hope.

All Is Well . . . I Think

I had the ultrasound this morning. It was scheduled for 8:20 am, and I was finally seen at TEN. My paperwork got misplaced somehow. I actually appreciated the quiet sitting for a while, but then it got a bit obnoxious. They were all very apologetic about it, so I just let it go and didn't complain.

I didn't actually see my doctor today. Interestingly enough, I saw the doctor on-call whom I talked to over the phone--I totally recognized her voice. She had a no-big-deal attitude about the situation. ??? This is why I get so frustrated with doctors sometimes; they all have different and perspectives and opinions on things.


Anyway, she said everything looked "great" and we could continue on as scheduled. I have to wonder what my doctor would say, but I guess the pictures don't lie.

When I got home, I went ahead and applied the estrogen patches and administered my own Lupron shot. Yay, me! I still have to do it very slowly, but I'm proud of myself for being able to do it . . . even though I did feel a little light-headed afterwards today.

I have to go in for a blood test Friday or early next week to check that I'm getting enough estrogen from the patches. I have no doubt that I will be getting plenty. Stay tuned for my adventures on estrogen. I'm praying for homeostasis.

Cash Money

Whilst I wait for the verdict on whether or not I have trashed this cycle by being confused (stupid, stupid!), I figured I'd break down the financials of this whole thing.

*It cost us 16K to have Noah. We paid him off last month with our tax return and cashing out a small 401K from Chris' old job in FL. Yes, we essentially financed our son. No, he would not be repo'd if we defaulted on the loan. We settled with the loan company for 1,000 less than we originally financed. Thanks, bad economy, for helping us out!

*The actual thawing and re-implant will cost $1,700 on the day we show up.

*That cost does not include the cost of the medication. Including the birth control, we have paid $240 in drugs.

*The $1,700 also does not include the co-pays we pay for every office visit. Ironically, by the time we're finished, we will also have spent $240 on co-pays.

*That brings the total cost to $2,180.

*We pay the cost of the drugs and co-pays out of our savings account. The $1,700 will be paid from the remainder of our tax return.

*Another cost--We essentially pay rent to Duke to house our embryos. We have a lump sum of money saved, but the lab director has yet to issue bills for storage. (Yay!) As of January, he was on the D's. He still has some ground to cover before he gets to us. If we get them out before he bills us, we'll be able to reimburse our savings account for the co-pays and drugs.

So there's the reality in dollars and cents.

I have no idea what it's like to say casually, "Hey, Chris, let's have a baby." We didn't speak these words to each other until we knew that we knew that we knew we were "in."

There's nothing casual about this. It's business. It's planning. It's accounting. And yet it's intimately romantic . . . in its own way . . .

Oops?

So I think I might have messed up our cycle inadvertently. The story is kind of long and confusing in my mind, but the short of it is I didn't have enough days of overlap on birth control and the Lupron shots. I thought that it wasn't going to be a problem because the doctor on-call told me it was better that I was bleeding early and that I could just continue on with the pills I had left and start the shots when I did. I must have misunderstood her? Or she must have misunderstood me?

Well, I talked to our nurse Soonja the other day who was kind of upset with me (in a cute way) that I didn't call her for more active pills. She talked to our doctor, and the doctor wants to see me on Monday for ANOTHER ultrasound. OOOPS. I'm so nervous I messed this up.

Dangerous

As promised, here is a quick glimpse of how I start my day. Isn't it romantic?

The rest of the day, I don't think so much about the process surprisingly. If I did, I might want to quit--I know what high estrogen does to me, I know how badly the progesterone shots hurt and literally cripple me, I know how long the two weeks until the pregnancy test feels, etc.

I think more about how the process' success will change us, our rhythm and routine. I guess that's the optimistic side of me, seeing as the papers we signed last week stated very clearly there are no guarantees. We both are guilty of hope--both kinds of hope I know of. One kind of hope: I hope for sunshine tomorrow. (In other words, "I want . . ."). Another kind of hope: I hope for heaven, a hope that will not disappoint.

If I'm totally honest, we say with our lips, "There are no guarantees." But, I don't think we truly believe that. At all. Our hope is of the not-disappointing strand. The dangerous strand.

All throughout my day, as I go through normal routines, I think about what the presence of another baby will mean for the routine: going to the gym, hitting the grocery store, loading up car seats, cooking, relaxing, etc. It will all take on a different form. We talk about how the house will be rearranged, what baby equipment we need to replace, etc. It's dangerous, I know.

Lupron Day 3

The Lupron seems to be OK. I haven't noticed any major side effects . . . YET. Chris is now doing the injections for me. There's no better way to start the day than being stabbed in the abs by your husband. I think I shall post a photo tomorrow . . .

Needles . . .

I hate needles. So much so that it took me 30 minutes to inject myself with the Lupron this morning. We are in SC visiting my sister in lieu of our ski trip (the resort closed down due to the economy), and I didn't want to have to draw attention to myself to get Chris to do it. SO I tried to be brave and do it myself.


I sat in the bed for about 30 minutes with the needle ready, and I couldn't bring myself to do it. I laid there with the needle suspended over my stomach, and the thought of me puncturing my skin with THAT . . . I couldn't do it. I prayed. I practiced stabbing the alcohol swab. I closed my eyes and breathed deeply. I determined that people who shoot up drugs (illegal ones, that is) MUST be crazy. I prayed some more.


Finally, I was able to do it very, very, very slowly. And thus, it hurt and left a nice red spot on my stomach. Around the nice red spot are a bunch of little red dots from my stabbing and stopping routine. Me and needles . . . not friends. And this is only the beginning . . .

And P.S --I'm coming down with Noah's cold; the one that gave him a raging fever. The one that sent us to the ER and got us a pneumonia diagnosis. Not fun.

Conception Cocktail

So our drugs arrived this week in two different shipments. Shipment #1 arrived on Wednesday in the middle of my drug-induced haze after the polyp removal. I know the FedEx man thought I was an addict by my appearance, signature, and his delivery. Oh well.Shipment #2 was shipped to my place of employment yesterday. Why two shipments? Insurance. The total cost to us was $180. We paid a co-pay for two of the drugs (progesterone and estrogen patches), but insurance declined one of them (Lupron). I hate insurance sometimes.

In case you're curious, here is the rundown of drugs I have to take to conceive a child:

(1) Birth control pills--I tried two kinds.

(2) Lupron injections--These aren't bad at all since the syringe is small. I will start these on Monday-one shot in the abdomen in the mornings.

(2) Estrogen patches--After 7 days of the Lupron alone, I will wear two of these on my abdomen and lower the dose of Lupron.

(3) Progesterone--This is the horrible stuff. I will have to have two injections of these each day in 12-hour increments (last time was 1x daily). I will start these three days before the transfer, which is now scheduled for April 21. I will also begin taking a Z-pack the day I start the progesterone shots.This is why these are so horrid. Check out the size of that syringe. The progestrone is drawn out with this one . . .. . . and injected with this one. It's not much smaller, but it's a thinner needle. The progesterone sits in sesame oil, and it's very painful going in. Where does it go in? Below is a diagram of my butt, drawn by our wonderful nurse Soonja. I will continue these for up to 10 weeks of pregnancy, God willing . . . We also have a lovely sharps container to accompany our drugs. Isn't it a lovely crimson color?
I'm going to have to get another one to keep at school because I'm going to have my friend Tisa give me the progesterone shot at school. With Chris' work schedule, the 12-hour windows we have to go with are 9 am and 9 pm. Let's just hope no one stumbles across my container, syringes, etc. That would definitely be an interesting parent conference.

So, there you have it! A delicate combination of drugs, my very own conception cocktail!

A New Kind of Intimacy

In spite of all the science and medicine that has inundated our world, Chris and I have moments of intimacy I would not trade for injection-free conception. The night before the polyp-removal procedure, we were driving home from dropping Noah off to spend the night with our friends Bobby, Katie, and Emory. Our conversation started off something like this:

[Silence, switching from the skunk song on Noah’s toddler songs CD to the radio]

Me: “You know . . . I never wanted this process to touch Noah.”
C: “It’s not your fault . . . but things are going to change when we bring a baby home.” [His certainty is so comforting.]
Me: “I just didn’t want his world thrown off this soon. And I didn’t want him to even know something was going on. Just like any other kid.”
C: “Yeah . . . I know . . .” [I love that he “gets” it.]

The gift of this whole process, in spite of all the shots and pills, is that we are ushered to a place where we share such true things with one another--

“I was terrified when . . .”
“I really thought that . . .”
“The deepest part of me knows that . . .”
“I’ve never felt ________ before . . .”
“I know what you mean.”
“Last time, I felt ______ . . .”

I am equally grateful that we have been able to laugh along the way as well. Chris and I laughed so hard when he told me some of what I was saying on the drugs Wednesday:

I tell him to get the cupcakes.
He, concerned, tells the nurse I was asking for cupcakes.
The nurse comes in and asks me about the cupcakes.
I tell her I want the pink ones.
Then, in a semi-lucid moment, I say, “No, that’s not true; it’s not real. There’s no cupcakes. It was a dream . . .”
I close my eyes and go back to sleep.

A few minutes later, I sit straight up with bug eyes and look around frantically for about 15 seconds. “Where is Noah????” I ask. Chris says, “He’s with Katie. He slept all night, and he’s playing trains with Emory.” I close my eyes and go back to sleep.

After telling me the stories and confessing that he walked away so as not to laugh in my face, I was grateful for this journey. Our experience and perspective are literally opposite sides of a needle; our ultimate hope, our souls’ desire is the same. We have been given a unique gift, a new kind of synergy, a new kind of intimacy.

Pink Cupcakes and Soccer Balls

Today I had the polpys in my uterus removed. Noah spent the night with his friend Emory since we had to leave to get to Duke at 8:30 this morning. He slept all night long (yay!) and had a BLAST playing with "Emy" today while we were at the clinic, I was under the knife (or whatever suction thingy), and then sleeping off the drugs at home.


Things were normal and familiar yet again. It was pretty much the exact same thing as the egg retrieval (down to the same room) except this was much less painful thankfully. I remember having crazy dreams and telling Chris to get the papers and the soccer ball. I apparently said something about pink cupcakes to the nurse? I vaguely remember the doctor showing me the polyps and her saying they found an extra one in there. She told Chris that my uterus looks very healthy as well, which is great. She's sending them off to the lab for testing but said nothing questionable has ever turned up.

I also have to say that I LOVE my doctor! She is not the same doctor that worked with us last time, but she is AMAZING. She remembers Noah's name, and always asks about him when we're there. Her nurse, Soonja, is equally amazing. She is the one who worked with us on Monday and the one who took my request for a pink cupcake.

Anyway, my energy level is low today, and I do have some pain. All is well, though I do wish I had a pink cupcake right about now.

A Picture of Romance

It is grey and drizzly.

It is cold.

My husband is standing outside of the clinic waiting for me . . . with a smile on his face, a hand to hold, and a "You OK?"

***************************************************************************************

Nurse (with a choppy Asian accent): You MUST call the day before the transfer to tell us you're coming. The lab will not even touch your embryos unless you CALL FIRST. Write that down. Call first.

Chris: Do people really not show up?

Nurse: All. The. Time.

Chris: Seriously? That's crazy. Why not?

Nurse: It's mostly the mens. They maybe drag their feets and go along with it until the last minute. Or they go home and think about it and talk about it and decide they no want to go through with it. Or they get di-vorced. Or separated.

Chris: Well, we'll be here for sure. You don't have to worry about that. We're here.

And so it goes . . .

So we got the official plan today, and it has turned out to be exactly what I expected with one big change. There were signatures, gowns, needles, discussions of Noah, octomom jokes, awkward men in the waiting room, etc. Typical. Familiar.

Things started off as we expected. A class about what medications we would have to get, how to give injections, a nice drawing of my butt separated into quandrants, several vials of blood drawn, etc. Here is the rundown--


(1) five days of birth control with Lurpon shots (1x daily into my stomach)
(2) Continue Lupron until my cycle starts
(3) Start estrogen patches on 3/28 with lower dose of Lupron
(4) Go in for blood draw after 5 days of the patch
(5) Start antibiotic and progesterone shots into quadrant one of my butt 2x a day, three days before transfer
(6) Target transfer date--April 15 (just realized that was tax day)
(7) Inject progesterone into butt-quadrant one 2x a day until pregnancy test
(8) Continue with progesterone injections depending on results of test


I had the 3D sonogram as well and determined two things:

(1) My ovaries are machines--the doctor was surprised at how many eggs were visible

(2) I have polyps in my uterus that have to be removed before I can progress with #1 above. The removal will occur on Wednesday. Joy, joy. It will be a lot like the retrieval process from the last IVF cycle, which I thought I would get to avoid this time around. Oh, well. I'm actually very gald that we know so that the embryo(s) have plenty of good space to attach and grow. I wonder how many people struggle with infertility and just don't know that they have these polyps preventing implantation. Thank God we know.

We talked about all the scenarios of what could happen when the embryos thawed and how many embryos they would put back. We are thawing to get at least two. We have two canes: one cane has a 7-cell, a 6-cell, and a 5-cell. The other cane has 3 5-cell embryos. They are going to thaw the cane that has the 7-6-5 combo first. If only one survives, they will thaw the 5-5-5 combo. We didn't get a clear answer on whether or not they would implant more than three, but our understanding is that they would have to if it came to that.

It's all very sciency and medical right now. And I imagine this will be the case for a while. I feel like it's a game of numbers that I get sucked into. I imagine it's rather romantic to get pregnant au nauturale. I guess this has an element of romance to it . . . I just have to look for it.

I Heart Yaz

I love this stuff. Sure, I have night sweats still. Sure, my patience level is close to zero at times. BUT, I can handle that as uncomfortable as it feels. Feeling nauseated is the one thing I cannot tolerate, and this pill is a miracle from the hand of God compared to what I was on. Thank You, Jesus!!!! I never knew birth control could be so horrendous until I swallowed orthocyclene for five days.


Anyway, right now, I feel like we are treading water until Monday. Monday is the day we get THE official plan, sign the papers, etc. The 3D sonogram is also Monday, which will determine if everything in there is clear for an embryo to attach. I've done this before so I know what to expect, which is why I will definitely down the 600 mg of ibuprofen they recommend. I didn't last time, and I don't remember why. Ignorance, I'm sure.

For now, I'm just so glad that Yaz has me feeling quasi-normal again. Lord knows, I'll probably have nausea a-plenty in the first couple weeks of the pregnancy. Lord willing.

Soundbites.

I got a new prescription today and am hoping for a peaceful night's sleep. I really loved how the nurse who finally called me back told me (with a supercilious attitude) to take the pill at night with food. When I told her I was already doing that, she (reluctantly) offered to give me Yaz after saying and I quote, "Well, there's no guarantee that this isn't going to make you nauseous either." I. Know. Just. Give me. Something else. NOW.

I guess I can't expect people to understand that I've already done some thorough (Internet) research and have conducted an unscientific poll on how to handle this issue. I wanted to tell Nurse Mimi that calling her was a last resort and that I'm not "that girl" who calls over every little thing.

**A soundbite of my internal dialogue on the phone with Nurse Mimi who called while I was sharing space with a classroom of teenagers**

"I know what I'm doing, lady. Well, sort of . . ."

So Sick

Last night was a rough night--the birth control has built up enough in my body to wake me up (multiple times, nonetheless) nauseated and sweaty. I'm pretty sure it's the estrogen. Duke will be getting a call today to get me on something else STAT. I'm now wondering . . . if this what's happening now, what in the world is next? The birth control was nowhere near this bad last time, so something's up.

Once again, I'm being called to total dependence on God. I was defnitely praying hard at 3:20 am for the most basic things--rest, physical homeostasis, etc. We've walked this path before, but so far, the terrain is totally different . . .

Knowing

I've been thinking a lot about the six embryos we have frozen . . . and the reality that all six will probably not materialize into people with arms and legs and beating hearts.

The notorious "octomom" probably had the same thoughts, which is why I'm not critical of her decision to implant six embryos. She wanted to use them all but didn't believe that all would survive the thaw. . . and then divide. Why she already had six children is another issue, but we are so "there," the place I imagine "octomom" was in her heart.

Before Noah, I didn't "get" "it". I often wonder why I did not photograh and chronicle more of our journey to Noah. Why do I not have pictures of him at 8-cells old? Where are my words from that era? I remember the physical symptoms, and I have general, vague impresions of my thoughts during that time. But that's it. I think it comes down to one fact:

I didn't know.

I didn't know what it all meant. And now I know. I know about the long nights, the laughter, the stress, the simplest of simple joys, the guilt, the hope, the mess, the good days, the bad days. I know it all.

We casually accepted six frozen embryos as great odds, based on science's statistics. I struggle to see it that way now, now that I know the end result.

In all honesty, I fear ending up with six children from the remaining six embryos we have. But at the same time, they are our children. It’s such a conflict of emotions that I don’t know how to handle sometimes. I guess there is no handling them; they need to just be right now.

In less philosophical terms, the birth control is really messing with me this time around. I feel really nauseated in the mornings in spite of my taking the pill at night. Added to that, this is the 2nd day in a row that I’ve woke up at 6:45 with 5 minutes to shower, dry my hair, dress, etc. Thankfully, I’ve made it work on time. I’m seeing that my body is going to get what it needs one way or the other, and I really desire to get the rest of me in sync with what my body is saying.

Yesterday and Today

3/2/09

Started birth control yesterday. Such the irony that birth control leads to life for us. The hormone headaches have already begun. Praying for strength to go the distance with joy and hope . . .