Twinkle Twinkle

So this week’s freak out was caused partially by being so close to deadline on these papers (I’m working through the final edits right now) and mostly by the fact that at Monday’s u/s we saw two sacs. Yes, I’ve been holding out on you. The news freaked us out more than it should have, and talking about it would have made it more concrete than I think we could comprehend at that point. I mean, it’s not like we didn’t know that was a possibility, and we transferred two excellent blasts, and did acupuncture, and everything else we were supposed to do, but I don’t think we really imagined that this is how it would end up. So we spent a couple of days adjusting, and freaking out, and researching, and eating lime popcicles (okay, that was just me), and slowly got used to the idea just enough to contemplate that it might really happen.

And then came today’s ultrasound, where we got to see two twinkly little heartbeats.

Ohmygodwhathavewegottenourselvesinto! I know that we are so incredbily blessed by this possibility and I don’t want to come across as an ingrate. But I also know that this complicates things now and in the future. That it raises some risks. That it increases the chances of having a complicated pregnancy, of gestational diabetes, of preeclampsia, of a premature delivery. I am not anticipating the worst, but I’m not trying to sugar coat the risks. I have watched too many people struggle with even singleton pregnancies - I know it’s not all just ginger ale and flowers from this point forward in any pregnancy, but especially so with twins. And a bit of me is in mourning - I’m not one of those people who looked forward to twins because then we’d be done with all of this. I definitely want more than one kid, but I always imagined them coming one at a time. We have an embarassment of riches 11 frozen blasts, and I was looking forward to using some of them. And yes, I know we still might (I just can’t think that far ahead right now). And I know that just because there are two now doesn’t mean I’ll end up with two in the end. But for all of these reasons, it’s complicated and I needed some time to process.

I have to say, I do so love the internets. First, for worrying about me and making sure I was okay when I didn’t post as expected. I feel so blessed to think that there are people out there thinking about me. And I love that there are other bloggers who have gone before me - that I can read through Persephone’s post at a similar point and be reassured that my internal conflict seems competely normal - at least based on my admittedly limited sample size. (In fact, Persephone said almost EXACTLY what I would have said if I could focus just a bit more. So go read it, and mostly that’s what I’m thinking.)

So, yes. We are still adjusting. My mom was in town this morning so we brought her back to the exam room to see the twinkles. Otherwise, we haven’t told anyone. I think we’ll tell J’s parents on Sunday after we get to DC. (And my dad too, at some point. I think he was hoping for twins, actually.) And then we wait.

I know it’s still early and things could change. But for now, my twinkles are doing fine. And that is a fabulous gift.

NBHH

For those of you who were wondering, I’m fine. (And thank you so much for caring. Really, I feel so lucky to have such fantastic friends in the computer. MWAH!) There’s no crisis. Just a bit of a freak out paired with my desperate attempts to finish these papers this week. I swear I will provide a report just as soon as I can - hopefully tomorrow if I can polish up the conclusion to the second paper tonight. But rest assured, NBHH.

Saying the words

Thank you all for your birthday wishes - it turned out to be a pretty good one. We went to LA to take my Grandmother to a cousin’s Bat Mitzvah, then spent a couple of hours hanging out at my mom’s house (even though mom was out of town) to rest and watch the Gilmore Girls episode where Rory has two birthday parties, and then we had dinner with my Dad and his girlfriend at this fantastic all-you-can-eat Mongolian BBQ, where you go through and get raw meat and veggies and all sorts of sauces, and then they cook it up for you on the big grill. Yummy! (And good for me, since I’ve been SO hungry lately. Seriously. I need to eat all the time. Except when I’m napping.)

So even though we saw family last weekend, we didn’t tell anyone any news. It was so new and fresh. If they didn’t know about the cycle, or the specifics of the timing, I think we could have waited another couple of weeks (at least until our first ultrasound, if not until we saw a heartbeat). But they knew, to varying degrees, the cycle timing, and so we figured it was about time to share. Which we did, by phone, last night. We managed to tell 4 people, in three phone calls, without actually using the “p” word. I mean, we used a different “p” word - saying that so far, our tests are “positive”. But no actual speaking of the big “P” word.

I’ve said it a couple of times, in passing, but J can’t seem to do it at all, yet. (He was also the one who REALLY wanted to wait another couple of weeks to tell anyone.) He says that it’s so fragile, and new, and he’s scared it will go away. And I completely understand, but I also think that right now things are okay, and we shouldn’t act as if we think things are going to go wrong (even though I don’t think we’ll ever be those hyper-enthusiastic uber-fertiles who start decorating the nursery at the first sign of a second line). And he agrees with me on this, too. So we’re slowly getting used to the idea. And crossing our fingers and everything else for our first ultrasound (this Monday) - it will probably be too early for a heartbeat (5w5d, I think), but it’ll be something concrete. I mean, I didn’t even get a follow-up beta, so I’m staring at my pile of HPTs and walking on eggshells until I have something more to hang onto.

I will share this, though: I’ve been switched from PIO to suppositories three times a day for the next 5 weeks or so. I’m not having huge amounts of discharge or anything as I’d been warned I might, but I’m really not such a fan of the suppository thing anyway. My vagina seems to find the prospect of things being shoved in it to be less than pleasant. Like, “Hey, I wasn’t even really involved in this process, except when I got a big needle poked through me that one day, so why are you shoving things in here now? I mean, really. Can’t a vagina get a rest?” So that’s been fun.

And in the meantime, I have all sorts of questions, and I can’t bring myself to ask them or to buy the sorts of books that might have the answers. Not until Monday, at least. And then we’ll see if we can say the words.

4w2d(?): Speechless

Beta was 459. Yes, 459.

No repeat beta scheduled, but ultrasound (twins?) on the 19th.

Shock and gratitude and speechlessness.

I still can’t quite say the “p” word, but I did think it once.

My birthday is tomorrow. Best birthday present ever.

That is all.

9dp5dt: I can’t think in weeks yet

The lines on my new best friend, FRED, were darker today than yesterday. Still fidgeting anxiously until Friday’s beta. This afternoon, I was so numbingly tired I cried. And I’ve been really hungry. But mostly just tired. Oh so tired. I could just sleep from now until the beta.

On the plus side, I think, I watched an entire commercial filled with babies, and instead of feeling bitter, I felt hopeful. And during one of those “talk to your kids about drugs” commercials, I thought - hmm, someday I guess we’ll need to do that.

I’ve been so focused on the process I haven’t been able to envision what comes next. Now don’t get me wrong, I’m still incredibly cautious about this whole venture. Incredibly. But for a few minutes here and there, I’ve been able to imagine a time beyond this one. And it felt good.

Please, universe, don’t let this all crumble away.

8dp5dt: Motivation

Okay, so I managed to do the PIO myself, with much coaching from J. It sucked, though. But I did it. Not sure how I’ll do alone, but success makes me a tiny bit more confident. (Of course, after I did the shot I had a huge meltdown and sobbed all over the couch. Hormones, right?) J has promised to be on the phone with me when I do the shots (on speaker phone, sillies - I certainly can’t imagine doing the shots while holding the phone - I don’t have enough hands as it is!).

Have I mentioned lately how much I lurve all of you? I told the nurse at the clinic that I knew it could be done because I had friends who had done it, and she asked if maybe one of these friends could just do my shots for me. Yeah, that would have been a nice option! Oh, how I wish we could all just drop in for snacks and shots any ol' time we wanted. (Gives new meaning to the phrase “body shots” doesn’t it!)

The one saving grace that I think will get me through the shots for the next couple of days is this: I took two HPTs today, and they were both positive. And not just in a squinting and hopping on one foot kind of way. J could even see the second line on the FRER in the somewhat dim light of the bedroom, with no coaching. So, um, I think maybe this worked? At least for now. Beta on Friday.

7dp5dt (still): Help!!

Internets, we have a problem. Or at least, a situation.

There’s been a death in J’s family, and he’d really like to go to the funeral, which is Wednesday. That’s not exactly the problem (neither the death, which we knew was coming, nor J’s ability to get to the funeral - assuming he can rearrange work obligations). I really liked this man*, but I don’t think I can make it to the funeral. The stress of the travel, my allergies, the tension of waiting for my beta, and the papers I desperately need to finish all make it seem like not the best idea right now. Although in some ways it would be the easiest option.

So here’s the problem: if J goes to the funeral, I will have to figure out another method of administering the PIO shots for several days. I see a few options, but none is ideal.

1. Do them myself. I know it’s been done, but I’m having trouble envisioning how I’d contort myself to do them, and it seems like it’ll hurt way more if I do them myself, and while I got over the self-stabbing with tiny needles, this just seems different.

2. Find someone we know to do them. If we lived closer to family, or if I had any really really close, medically-inclined friends, this might work. But right now, I can’t think of who I’d ask to do them.

3. Find a nurse to do them. I think that there are nurses at the after-hours clinic run by the Evil HMO. So, if I think they know what they’re doing, I could try to make appointments for each night J would be gone and then take my stuff over there. It seems on the surface like this would be the easiest option, but something about it isn’t sitting right with me. For one thing, I’d be around a lot of sick people (I mean, that’s who generally uses the after-hours urgent care clinic). For another thing, I don’t actually know if they know how to do these shots. I suppose that’s less of a hurdle, though, since J didn’t know how to do them either, and he’s been fine. And finally, where am I going to heat my little heating pad? And will I get to rest for a few minutes afterward? And will they be nice and use my Hello Kitty band-aids and sing to distract me while they do the shot? I suspect not.

Sniffle. Poor me. And, um, help?

* I didn't mean to be glib about the death part of this whole story. He was a dear, sweet, jokester of a man - J's great-uncle, or something. The sibling of a grandparent, I think. He was a jovial man - full of life. The last really nice memory I have of him is from Thanksgiving a year ago. He was playing with his new granddaughter (adopted from China, actually) and the look of joy on his face as he watched her was just fantastic. He was beaming. I’m sorry we didn’t get to see him while he was sick, but I’m glad the vision I have of him in my head is a healthy, happy one.

7dp5dt: Miscellany and distraction

So, I was crampy yesterday. And a bit nauseous. Though that might be from pondering the crampiness. And trying to decide what brand of HPTs to buy (FRED, I suspect, but since I won’t let myself buy them yet I’m keeping busy by exploring my options). Did I meantion the crampy nausea? Beta’s not until Friday (16 dp retrieval!) so I have a long way yet to go. And no, I’m not going to wait that long to do an HPT.

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On an entirely different, and totally trivial, subject, I said I’d review all the flavors of Ga.torade I tried. Here are the reviews so far: Lemonade was pretty good. Tasted about like how all fake lemonades taste. Not too sweet. Pretty drinkable. Watermelon Ice? Blech. Not sure why I finished it. (Oh yeah. Because I was on bedrest and J wasn’t around to bring me another flavor. Bah.) Orange/Tropical blend? Eh. Not bad. I’d drink it again, but wouldn’t seek it out. I think I’m not all that into orange. The big winner, though, was the Fruit Punch. First of all, it wasn’t claiming to be something it’s not (e.g. an actual fruit flavor), plus there’s that whole childhood fruit punch thing that made it seem rather pleasant. Especially since I pretty much wasn’t allowed to drink fruit punch as a kid. So that’s my new flavor - now I have two to mix and match. (I also tried another of the Frost flavors - the turquoise one. It wasn’t bad, either, though I still prefer the purple.) Only I have to drink it right out of the bottle - something about pouring icy blue liquid into a glass is just weird - it looks like anti-freeze or something. I am a big fan of the sport bottles though. Very satisfying. And the fruit punch looks okay in a glass (though I still prefer to drink from the bottle). But now I’m a little bit addicted, especially to fruit punch. In fact, yesterday I bought it in the gallon-size bottle, which might last me a couple of days.

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One more random point: I’ve always liked Australia in concept. I’ve never been, so I don’t know firsthand, but this seems like yet another reason to like ‘em. Basically, there’s a proposal that’s been put forth to add ART and IVF to the topics covered in school-based sex ed classes, since it’s an issue that has a wide impact. Their point is that there will likely be students in the classes conceived through the use of reproductive technologies (not that the students will themselves be in need of the technologies) but still - demystifying IVF and bringing it out in the open? Sounds good to me.

4dp5dt: Progesterone lullabies

I went in today for a progesterone check. Nurse Sweetie was there, as was Nurse Newbie, who I’d thought had experience in another office and just not theirs (but that might have been another of the army of new nurses). So Nurse Newbie did my blood draw. Or tried to, anyway. Here’s the thing - I’m an easy stick (except after a week of daily monitoring). My veins today were lovely. Honestly, I probably could have drawn my own blood (except I think that if giving myself shots made me squeamish, drawing my own blood would be even worse). So, Nurse Newbie poked, and didn’t get anything, and rooted around a bit, and still nothing, and Nurse Sweetie came over and maneuvered a bit until I said “ow” and then pulled it all and started over (at which point she managed to do the whole thing smoothly and without any fuss).

Nurse Newbie (the same one, I think, though again I really can’t tell - the first time I met one of them was at transfer when I was lying spread eagled, doped on Valium, and everyone in the room (J included) was wearing those paper jumpers, hair covers, and face masks - so I’m justified in not knowing which was which) was the one who did my callback this afternoon. Apparently, my progesterone was a bit low (18.5 today) - they like to see it above 20. Though what she actually said was that they like to see it in the 20-80 range, which made my paltry 18.5 seem dire. I think a different nurse might have anticipated my reaction and provided more reassurance. In fact, I think this may be one of those times when I’d be better off with fewer details. I’m trying to remind myself that it’s not that low, and that increasing the PIO should raise my progesterone levels, and that it’s normal for them to adjust the dosage. Breathe in, breathe out.

My mom called right before we did the shot tonight, so she provided my evening distraction. Usually, J sings to me to keep my mind occupied while he’s doing the shot (one day, he did the Jeapordy theme song!) so I asked mom to sing, and she sang me a simple little song with infinite variations - the same song she used to sing to me when I was little. And she was out shopping at the time, which made it even more special - my mommy sang me a lullaby while she was out in public. It’s the same thing I’ll sing to our kids someday (whenever that day comes) when they’re sleepy or fussy or getting a shot. It’s a good mommy thing to do.

2dp5dt: Transfer tales

We arrived at the clinic just before 10, as instructed. The waiting room was more crowded than I think I’ve ever seen it. At one point, there were two small children (one well behaved, one annoying - I think the well-behaved one is about to become a big brother). We sat, and waited, and waited, and sat. There seemed to be another transfer ahead of us (judging from her bloated, scruffy, water-bottle chugging presence). All well and good, but it was after 10:30 before we even met with the embryologist and at least 12 before the transfer prep (my transfer was scheduled for 11, of course). Due to a mix up with the nurses and my acupuncturist* (who was fantastic), I didn’t get my valium until after I was in the proceure room with my legs in the braces. It might have been nice to have been relaxed before that point, but whatever.

Transfer was fine. There was a bit of a thing with my bladder - we waited so long I had to pee like 5 times before we actually got in there, and just before it was time I had to, um, poo (and as the nurse politely acknowledged, “There’s no delicate way to say this, but I find it hard to go to the bathroom one way and not the other”) and then they decided my bladder wasn’t full enough and made me drink more, and then by the time they were ready to do the transfer, it was too full and they had to drain it a bit. Not the most fun ever, but more comfortable in the long run, I think. But otherwise, transfer apparently went very smoothly. Never having attended a transfer before, I have nothing to compare to, but Dr. Piles and Nurses Sweetie and Bruiser Positive (who I like loads more now that she took excellent care of me at both retrieval and transfer, and then mentioned that she went through IVF treatments herself, plus the thing about the poo) all seemed very positive.

And the best part was the embryologists report, which I think I’ve hesitated to share until this point due to some preliminary variation of survivor’s guilt. We transfered two 5-day blasts - one “perfect” and one “near-perfect” - and had 11 blasts to freeze. Yes, eleven. Even the embryologist was impressed. I am bowled over. This is better than even my fantasies of a good outcome for this cycle.

And now we wait, and hope that our ability to make lots of hardy embryos will translate to an ability to make actual babies. I mean, I’ve heard there’s a connection, but I’ve also heard you can get pregnant from having sex, so...

* The clinic usually works with this one local acupuncturist. Not my acupuncturist. I’ve been seeing my acupuncturist for about a year - starting after I gave up on my first clinic, all the way through the second, and now into the third. I think it’s great that the clinic has someone they like to work with, but the system shouldn’t rely on it. Apparently, the usual acupuncturist gets the gown and robe for the patient (from the nurses area, so I don’t really see how mine would have thought to do that) and somehow arranges the Valium (or tells the nurses when it’s time?). My acupuncturist (actually not my regular one, but another from the same practice who I’ve seen before) was just trying to go with the flow. If any of them had bothered to talk to each other, it would have been fine. But instead there was a bit of confusion. Oh well - it all worked out in the end.

A tale of two clinics, finally

I think I may give up on ever finding the perfect nickname for my RE. The closest I’ve come is Dr. Piles of Files, so named because when we had our first meeting with him (while we were in the process of choosing a clinic) I noticed that his desk was piled with files, and articles, and journals. It looked a lot like my office looks - cluttered with projects and ideas and research. And then we met with the second clinic and the RE’s office looked like it was straight out of a designer magazine - spotless, and beautiful, but with the air of being a showplace rather than a functional office. It was a lot like some other features of the Clinic That Wasn’t - Dr. FancyPants and the whole Fancy clinic were shiny, and pretty to look at, but it wasn’t clear how that would translate to my experience as a patient there. (The final straw, though, was a perky but completely clueless medical assistant/nurse who I learned would be our primary contact. Um, no thank you.) So back we went to the Clinic That Is - which is much more humble. No fancy pants decor, no shiny surgical suite with separate entrance, no staff of millions. But it means that I know all of the nurses, that my RE did all of my wandings (except once when the other RE did a baseline - but I haven’t seen him since), that I chat with the receptionist, that I don’t get lost in a maze of hallways or staffing issues, and that he actually reads articles, and journals, and patient files. In my current state of optimism, I’m pretty sure I made the right decision. I didn’t have a cookie cutter protocol. I had close monitoring. I saw my actual RE regularly. He waved at me on days when I was just there for bloodwork. The other clinic is very highly regarded, and proposed a totally different protocol that might also have worked well. Who knows? But I know for sure that I’d have had less direct contact with Dr. FancyPants than I have with Dr. Piles.

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On a totally unrelated note: I’m getting sick of G.atorade. I stocked up on what used to be my favorite flavor of G.atorade, and I’ve been faithfully staying hydrated. But it’s pretty much the only flavor I know, and I’m getting sick of it, and I have no idea what to get instead. The G.atorade labels can be so daunting - “Frost” and “Fierce” and “Xtreme” (oh my!). So, anyone have a favorite G.atorade flavor I should try? I’ll do a taste test and report on my findings, if you’d like.

Gratitude

Out of 20 retrieved, there were 15 mature, and 14 fertilized. We’re set for a 5-day transfer on Monday. I’m feeling better, though still a bit achy and bloated. Mostly, though, I’m just feeling incredibly thankful that we’ve made it this far.

Yesterday, when they came to take J back to contribute his part in all this, I was still pretty drugged and emotional. I said, “it’s not fair” which he took to mean it wasn’t fair that I was lying in a recovery room and he was going to jerk off. But really I meant it wasn’t fair that we had to do this at all when so many other people just get drunk one night and magically become pregnant. But when the embryologist called today I felt a huge wave of gratitude - that we were able to do IVF, that J’s parents were able to help us pay for it, that we had access to fertility clinics in our city, and schedules flexible enough to allow us to go through with it, and that we might actually have something to show for it. Every so often we look at each other, or hold hands for a moment, and whisper “fourteen.” It’s the magic number of hope, promise, potential. And I am incredibly thankful to have that to hold onto today.

More information than I can process

20 eggs retrieved. 12 are probably mature. The others are various categories of over or under maturity, but I couldn’t really tell you. J wrote it all down so maybe later I can make more sense of it. They also gave us some stats on his “specimen” which I completely ignored. For a girl who always wants all the info, all I wanted to hear was how many retrieved, and that the sperm were fine. So 20, and they are.

Soup, then bed.

Stims Day 12: Green light

Lining: 11mm
R: 20x20, 22x18, 16x16, and a bunch more that Dr. Smiles (hmm, maybe) didn’t measure
L: 17x15 and a bunch more

After what feels like forever, we’ve been given the green light. Circles have been drawn on my ass for the trigger shot tonight. Retrieval will be Wednesday (pending today’s bloodwork, of course). My body is looking forward to sleeping in tomorrow, and having one precious needle-free day. My left ovary was being shy, as usual. I asked if they were going to have trouble getting to it at retrieval and Dr. Jokester (nah, doesn’t have the right ring) said they’d charge extra. But then Nurse Sweetie admitted I’d probably feel the effects of the digging. Yeah, I figured.

Also, I have a cold. Dr. NoDrugs (just for this) doesn’t want me to take anything - not zinc, not Benadryl, not Sudafed, nothing. Oh, except Tylenol. And fluids. And rest. As I expected. It’s just a mild cold, but it’s the final straw in how crappy I feel. I spent the entire day yesterday lying on the couch, drinking liquids and napping, but I have to go to work today, since I’ll be out for a week after this.

Nurse Bruiser was incredibly perky and positive when she heard I was triggering. “Aren’t you excited?” she asked. I had to think about it for a minute - probably a minute too long. I guess I’m excited to be moving forward with this whole process, but I’m scared of the physical aspects of retrieval, and scared that my eggs are crap, and scared that J’s sperm will have a bad day, and just scared all around. I’ve heard that excitement and fear are two aspects of the same emotion, and if that’s true then sure, I’m excited.

Strap me in - the next phase of the roller coaster is beginning. Please keep all hands, arms, and syringes inside the vehicle at all times.

Stims Day 8: On the rise

My E2 has finally gotten with the program - it was up to 66 yesterday, and 159 today. I still have no idea what it’s supposed to be, but I know it’s supposed to be going up steadily - and it is - so I’ll just be happy with that for now. And this all almost makes up for the fact that I’ve suddenly become a hard stick - it took a couple of tries, a juice break, a heat pack, and a more skillful nurse to get blood today. Apparently I only have one vein in each arm - the right was bruised from a bad stick a couple of days ago, and the left was feeling okay but apparently felt the need to stage a revolt (and then I got dizzy and nauseated like I used to when I got blood drawn before it all became so commonplace).

I say all of this like it’s my body’s fault, but really I feel entirely comfortable blaming Nurse Bruiser, who gave me that first bruise a couple of days ago, and then tried and couldn’t get blood today. I have now reached the point in this process where I will demand that only certain nurses be allowed near me with needles - Nurse Bruiser is very nice, and she did a fine job of writing down Dr. StillHasNoNickname’s notes on my follicles (he’s still only measuring one on each side - at about 10mm each - though there are others that are a bit smaller that he’s not measuring), but she’s absolutely not going to do my bloodwork again. Nurse Fantastico, who finally succeeded (with little trouble, once I had some juice and felt better, and after she warmed me up because I was so cold my veins were constricted), can poke me whenever she wants - I’ll wait for her to be available, no matter how long it takes. And while I’m introducing (and naming) all the nurses, there’s also Nurse Coordinator (well, that’s what she is!) - she’s organized, and skilled, and businesslike - who is probably the only other I’d allow to stick me at this point, and Nurse Sweetie, who is very good at phone contact, and calling my meds in to the pharmacy, and answering questions. As long as they each get to do the thing they’re best at, it will all work out.

Did I mention that there’s something living in our attic crawl space? I know I wanted to hear the pitter patter of little feet, but this is not what I had in mind.

Stims Day 6: Low and slow

Six days of stims and my E2 finally broke 20 - now it’s a whopping 21. Talk about slow. Geez.

I seem to lack the focus for narrative, but here are the things I’m thinking about anyway:

Thing 1: My E2. Yeah, it’s low. But we’re hoping that now that they’ve ramped up my dosage I’ll start moving along. It does make my anticipated cycle calendar a lovely relic. No idea what the schedule will be at this point. This really is the most draining aspect - I anticipated mood swings and physical discomfort, but the emotional roller coaster of stims is something else entirely. And not particularly pleasant at this point (though better today than yesterday).

Thing 2: After waiting forever for instruction callbacks yesterday (I called 4 times, but the lab was slow, and then they had the numbers but didn’t have instructions, and then the doctor was on the phone so they still didn’t have instructions) I checked my email and found, of course, a birth announcement. I actually suspect there’s a story here, since the birthdate was mid-October, and the announcement just came yesterday? I think mid-October was maybe a month early. Who knows? All I can think about this right now is how it’s not fair that the lesbians were able to have a baby before me. (Disclaimer: As I’ve said before, I don’t have any problem with gays and lesbians and single people and whomever else having kids, but it’s really a kind of slap in the face that the lesbians who between them have two uteri but no penis managed to conceive more easily than us.)

Thing 3: I was reading over some of my past blog entries (somehow #100 came and went and I totally missed it) and I think I used to have more to say, and say it better. I’m just not feeling so satisfied with my ability to express myself.

Thing 4: I have been working on these papers forever, and they’re still not done, and I’m not getting a lot done because I’m trying to keep my stress down and the papers are stressful. Though really, it’s the not-being-done that’s stressful. But I just read that article on infertility and stress in Psychology Today and it reminded me that it’s really okay for me to try to keep my stress level down - at least the parts I can somewhat control - while we’re doing this cycle. But I don’t know how I’m ever going to finish my papers at this rate.

Thing 5: I am trying to come up with a nickname for my RE. I have a contender, but I have to see if it still resonates next time I see him, or if it was something specific to today’s visit. I’m sure you’re all anxiously waiting for this news, right?

Stims Day 3: At a snail’s pace

Today’s E2 was still under 20, so I’m off to a very slow start. They’re upping my Follistim to 75 and dropping the Lupron to a more normal 5 units. As long as the E2 goes up tomorrow, I think it’ll be fine - just slow. (Better slow than too fast, though.)

I’m going up to my grandma’s house tomorrow - my mom will be there and I thought it would be nice to just hang out. J is working a bunch this week (not the best timing, but he should be free next week between retrieval and transfer, which is what I was really worried about) and the other day I thought, “I want my mommy.” I suspect this won’t be as supportive as I’d hoped in that moment, but if nothing else I’ll get to show off my injection skills to my mother, who I think can’t quite believe that I’m actually doing this. Me, the one with the major needle phobia. So I’m strangely looking forward to doing an injection as if there’s nothing to it. I might even bring the mixing stuff for the Menopur, even though I won’t need it, so I can show her what that’s like (because the FolliPen, while a cool contraption, isn’t so iconic an image as a good ol’fashioned needle and syringe - if that makes any sense).

I read an academic article about IVF once that pointed out that while we use the phrase “IVF” to refer to the whole process, the actual aspect of in-vitro fertilization is just a tiny portion of the larger experience, and one of the few parts that doesn’t involve the woman’s body. The rest of the process - the blood draws and ultrasounds and injections - make up a large portion of the experience of going through an “IVF” cycle, but are largely invisible or unacknowledged in the medical perspective. I think my desire to show-off my injection skills is part of an attempt to get some recognition for this part of the process. I think people who don’t know anything about IVF end up focusing on the sexy medical aspects - the frankensteinian medicine, cutting edge technology involved in using donor eggs or gestational surrogacy - and largely ignoring the personal experience of the process. Like me, stabbing myself in the gut with three needles a day, for example.

Stims Day 1: Let’s get this party started - updated

Not that I feel like partying, mind you.

Baseline yesterday was fine. They were training a new nurse (she was just observing) so there was a bit of extra explanation from the doctor - why is it called E2 (the experienced nurse said, “Because it’s shorter than estradiol” which was cute) and the like. The injection training was also useful - I was worried that it would just be a description, but they had a fake cartridge for the pen, and they showed me how to use the Q-caps that came with the Menopur (only after I asked - initially, she showed me how to do the mixing with the needle). So that was good. And those Q-caps are very cool. Initially I scoffed - I’m not afraid of the mixing needle or anything - but they’re really nice to use. (See update below!)

Here’s the protocol: I’m staying on 10 units of Lupron (higher than their normal protocol) and adding 75iu (one vial) of Menopur and 50u (whatever those units are) of Follistim. I asked for an explanation of the Gatorade thing, and whether I should just stock up now (it’s on sale this week, y’know?) and Dr. HasNoNicknameButWillSoon chuckled at me like I was some cute paranoid freak and told me they’re trying very hard to keep me from needing it. Which is all well and good but given how crappy my response ever was to oral meds, and given that I have no history with injectables, I’m scared they’re going to end up being too cautious.

In any case, the shots today were okay. The Menopur hurt a bit going in - I think it’s just the volume of fluid. The Follistim really did sting as I’d heard about but forgotten. But I didn’t ice for the Folli so maybe that will help for next time. Getting the pen all set up was a bit daunting, but once it was all assembled I can see how it’ll be much easier to use.

Nothing much else to report. Though maybe tomorrow I’ll share what Dr. Groovy had to say about my current state of mind.

Updated to add: Here’s a link to instructions on using the Q-cap, since I didn’t seem them in the package with the Menopur. Basically, the device screws on to the syringe - so you screw off the big mixing needle that probably came attached to the syringe (at least mine did) and screw on the Q-cap. It has a sort of poky-needle thing in a kind of collar. You push it down over whichever vial you’re working with, and it pokes through like a needle and the collar sort of clicks over the rim of the vial to hold it on. It looks weird the first time, but I think I like it - not for any fear of the mixing needles, but it’s easier to hold. Let me know if you need more guidance (and the link above lets you download instructions with pictures, too.)

Anticipation and anxiety

Tomorrow morning is our baseline scan (Again. I had what I thought was a baseline before starting the BCPs, but I guess this one checks that I’m actually suppressed now?) and injection training (hopefully) and then I’ll probably be starting stims on Thursday. At least according to the original cycle calendar, though I’m trying not to get very attached to it, because it could change and all that.

I tried to recreate the clinic’s calendar in a better format, so I could have a space to write the dosage for each day and check off when I’ve taken various meds, but I couldn’t make it work. Which is unfortunate, since this morning I almost left the house without doing my Lupron injection, and at bedtime I always have to double check that I’ve taken my evening meds. I can’t imagine what it’s going to be like when I add in all the injectables.

I opened back up my big box of needles and potions, and maybe I’m weird, but I’m not sure I like the Follistim pen. Sure, it comes in a snazzy case and all, but it’s hard to pull it out of those elastic straps, and I don’t really understand the needle-in-a-cup thing, or the spinning dosage thing, and I’m sure I’ll be convinced with how easy it is later on but right now it seems far more complicated than just mixing the powder with the water the old fashioned way.

Apparently, over the past couple of years I’ve developed a fear of the unknown. Sometimes I get really anxious about finding my way someplace I’ve never been, or calling someone I’ve never met, or knowing how to inject the medication properly. (Okay, maybe that last one would happen regardless, but otherwise I didn’t used to be so fearful.) You can imagine how great IVF is in this regard - one big bundle of unknowns. Most of the time I cope pretty well - I think watching this process through so many other blogs makes it feel much less unknown. But when I confront something and don’t already know what to expect, I get anxious.

Also, while I really like that my clinic knows that I’m a control freak (Hi Heathers!) and is willing to give me the numbers instead of just telling me that things are “fine” - I’m worried that they’re being a bit too lax sometimes. It’s fine right now, because I take good notes and I follow up on things that don’t match up (the prednisone I’m on, for example, didn’t make it onto my cycle calendar until I asked when I was supposed to start taking it - maybe they would have noticed in time, but maybe not), but what if I slip one day and forget to follow up on something that they really should be taking care of? At some point I’ll have to let go and trust that they know what they’re doing, but that’s so hard to do.

Basically I’m feeling overwhelmed. And a little bit dazed. And my heart is racing. And I think all this general anxiety has rendered me unable to write anything more substantial than this mindstream of a post. Hopefully I’ll have something more coherent (or even, dare I hope it, prosaic) soon.*

* Maybe I’ll even be able to get some of my actual academic writing done, since I’m supposed to be finishing a draft of one of my papers this week. Ha!

I really missed you guys too...

...only this had nothing to do with Disneyland.

I went to a screening of a film about menstruation. It was interesting, I guess. I’ll hold off on critical analysis for a moment, but I’ll start with an observation - people in the “real world” are not used to talking about the nitty gritty of their bodily functions in public. The number of times I had to restrain myself from saying things like “I need to run to the bathroom and see if I’m still spotting” was boggling. (Actually, I was restraining myself from having any sort of deep conversation - I was trying to be in small-talk mode. Didn’t completely work, though I only shared my deeper analysis with a tiny group of people, two of whom I don’t even know that well...)

The film is, as I said, about menstruation. Specifically, it centers loosely around the question of menstrual suppression - using Depo Provera or continuious BCPs to reduce the number of bleeds. My first bafflement of the evening was the realization that lots and lots of women don’t understand how their bodies work. Women don’t realize that the period they’re having when they’re on “regular” BCPs isn’t really a period at all, but just withdrawal bleeding. They don’t investigate the future health ramifications of Depo. Many of them wish they could just stop getting their period all together.*

What I found most disturbing was the absense of attention to the concept of fertility. I don’t just mean that they failed to mention the potential after-effects of something like Depo on a woman’s fertility, but that the notion that menstruation is tied to reproductive functioning seemed like it was missing from the film. How do you talk about menstruation without acknowledging its link to fertility and reproduction? Many (most?) women use BCPs and other forms of monthly or longer menstrual control/suppression not to rid their bodies of menstruation, but as contraception.

Another angle on the same point: Getting a period means (in most cases... there are exceptions... standard disclaimers apply... blah, blah, blah) that you’re not pregnant. If you’re 17, that period after you missed a pill is probably a big relief. If you’re 27 (or whatever) and TTC, that period is like a punch in the gut. Both mean you’re not pregnant, but not being pregnant signifies different things to different people.

Obviously, I don’t expect the filmmaker to have incorporated every aspect of menstruation in the film. That just wouldn’t be feasible. But I do think that some general reference to the notion that periods are inherently linked to women’s reproductive functioning might have been in order. I’m just saying.

Now I need to run to the bathroom and see if my period is really starting so we can get this show on the road.

* I certainly understand that there are circumstances (fibriods, endo, and the like) that would warrant menstrual suppression. But lots of women just don’t want the bother, which seems very different to me. Not inherently bad (though I fought so hard to get my body to have periods that it’s a bit foreign) but very different.