Helpful Statements That Are Gut Punches

I had a great lady lunch with some friends yesterday that had one bump in the road. It occurred when I talked about starting our final IVF while also seeing an adoption process on the horizon. My dear friend, in trying to show she cared used one of “those phrases” that seem harmless but are in fact, full of harm:

“You know that once you adopt you’ll get pregnant.”

Because she’s my close friend I didn’t feel the need to mask anything and just said, “well actually all this testing is showing us why we’re likely not getting pregnant and it’s because I have a number of things that can affect implantation so as awesome as it would be to just get pregnant, it just doesn’t look like that would happen.” We talked it out and it’s fine, but it definitely showed me that when the time comes that we “go public” I can likely expect more of these statements.

Oof.

I did a quick google search of the phrase “what not to say to an infertile couple” and I got some juicy ones. Here are thoughts on just a few.

“It could be worse, it could be (insert awful disease here)”

Um, thanks? Why don’t we make a Pie chart of other things that could be worse: pooping my pants on an airplane, having 14 mosquito bites for a year in places I can’t itch, falling into a cactus while my naked lady bits are exposed…. This is a fun game!

“just relax and you’ll get pregnant”

I laugh alot, professionally and personally. I also knit, which is my own form of meditation. I like to cook and chop and stir, all very zen activities. Re. Laxed. And hey look, not pregnant.

“at least you’re having fun trying”

Am I? Infertility makes “trying” into math: when to try, when to abstain, when to try alot. Pee on this stick or take your temperature every day to check for ovulation. Plus, you’re tired! Tired for normal life reasons AND there’s something you really want that you’re not getting and that makes you more tired. So no, we’re not rampantly running amok “having fun trying” on top of all the tables and chairs and in closets morning noon and night. (Not that we were before….who do you think I am?)

There so many more ridiculous things that get said by the way – Google them and have a giggle (or a cry). Don’t get me started on the ones that involve God/supreme beings/what the universe wants.

Honestly, we dodged a big bullet by getting married in our 40s – I can count on one hand two fingers the folks who’ve blatantly asked “so, when are we gonna see some kids?” Apparently, getting married late = implied automatic shut down of parental endeavors?

I’ve been at wedding receptions and seen people walk up to the bride and ask “when are you having kids.” I wanted to throat punch on their behalf. (for the record: I didn’t). Btw, it’s usually a craggy old aunt who does the asking. Don’t be the craggy old aunt.

This is second friend who used the “once you adopt you’ll get pregnant” on me. My friends absolutely wanted to help, wanted to show that they cared (alot!), wanted to show that they were hopeful for my success….but just didn’t think about the fact they were saying these phrases to someone who’s been trying too long.

The sad thing is….before I was in this muck, I likely used these phrases, or at the least wouldn’t have thought about the full impact.

So, before you go throwing what you think is a helpful phrase around, consider:

Do you know if they’ve been trying? Do you how long? Do you know them well enough to deal w/the potential anger/sadness you might trigger w/your pretty friggin personal question?

No one MEANS to be insensitive, but man we all step in it sometimes without thinking.

Maybe just have the balls to say, “I’m really sorry. It must be hard to face all this. I don’t really know what to say.”

It’s likely gonna make you an even better friend.

But if I see you at a wedding and you walk up to the bride or groom and ask them….I will find you.

IVF 2: Now With ICSI and Tiny Purple Numbers

So we found out last week that on September 1st the company that handles what’s covered for our fertility treatments made a change in that now ICSI is now included in our “package.”

I feel like we got re-bundled.

ICSI = Intracytoplasmic Sperm Injection

icsi

ICSI is an IVF procedure in which 1 sperm is injected directly into an egg. Usually this is used in cases where sperm count or motility needs a boost – but that’s not where we’re at.  That’s all fine. Yay hubbo.  In my case it’s likely due to help us because of my age.

Yesterday I was in for my first scan (following 5 days of stims)  so I was able to ask why we should use ICSI when we know hubbo’s swimmers are okay.  The Russian’s Right Hand explained that sometimes the exterior of older eggs can be more viscous and harder for the sperm to penetrate – everything inside is likely fine, happy and peachy keen but that shell can be…..crotchety.  So, in our case, hopefully this will up the percentage of eggs that fertilize.  In IVF #1 we had 7 eggs but only 3 fertilized…..there’s no real telling WHY they didn’t fertilize, but if it was due to the viscous crunchy outer layer…..this ought to help.

As for the scan it looked like there are lots of follicles growing on my left ovary and only a couple on the right….though the tech that ran the scan said that perhaps they were just “sleepy” and we’d see more action in a few days.

I head back on Friday my next scan.

In other news: for stims shots, I was told to make four quadrants around my belly button and rotate between them each night. For fun this time around I’ve used a surgical marker (the one I was given to mark my fanny for progesterone shots) to make a small number in each quadrant each time that I take a shot to keep track of where I do the shots each night.  So now, circumnavigating my belly button I have small purple 1-2-3-4-5-6. (Current quadrant markings are 1&5, 2&6, 3 and 4 respectively).

Last time I did 13 nights of stims…..if I go the distance again that’ll be alot of belly numbers.

I will not be documenting this with a photo…..at least not one that I will share.

I have to keep an ounce of dignity.

Needle Rant and Updates to Protocol

Last night was my first night of shots for this cycle – stims as we say in the biz, short for stimulation meds/stimulation cycle.

syringes

That’s Menopur on top, Lupron in the middle and Follistim on the bottom.

The mixing of the Menopur is what takes the longest and though they’ve told me to use 1ml of water I always put a bit extra in there, like another .1ish.

My little 3 shot cocktail went peachy keen fine and yet again it’s all about LETTING THE NEEDLE DO ALL THE WORK!!!!  I cannot emphasize this enough – just rest it on your skin, press gently and the needle will quite literally sink into the skin, (and for me is) almost pain free.  All this jabbing and getting a running start is all movie show – the needle’s so tiny and sharp – just let it do it all.  I read all about the pressure and build-up ladies are putting on themselves to do these shots and for reals the anticipation is the WORST – so just skip that part and don’t over-think it. Prep those shots, rest the needles on the skin, gently press and it’s in.

Alright, rant done.

Oh, and for me, doing these shots myself is very empowering and now that I’m used to them, it’s a fairly quick process.  My hubbo always yells, “I’m proud of you!” from the other room and though he’s always said he’d help with the shots, I’m glad he doesn’t.  I think he’d be far more worried about hurting me and the shots would end up taking longer and hurting more.  I had to get myself over the psychological hurdle of doing the shots and I am now flat out proud of myself every time I do them.  I know it’s a way for husbands to be involved in the process, but I do wonder if it ends up making it harder.

Alright, rant done.

Also, I’m genuinely sorry if these shots are super painful for you or maybe you just can’t do them alone.  That blows.

Alright, rant done for real this time.

There’ll be some subtle differences to this next protocol, at least for starters. I’m adding dexamethasone (which is a steroid) in pill form once a day. There’s limited information on its use on the interwebs, so this is what I’ve pieced together from the internet and also from talking with The Russian’s Right Hand.

  • it doesn’t so much do things specifically by itself but enhances how the other drugs work
  • it can hopefully lead to better quality eggs and more of them by tempering how the body responds to the introduction of all the other drugs. i.e. the drugs can do what they do while the dexamethasone waves it’s arms around and says, “hey look over here for awhile, pay no attention to what those drugs are doing, look at this shiny object instead!” (I like to imagine the dexamethosone shaking a tiny set of keys as a distraction).
  • perhaps helps the body to not react to the re-introduced embryo as “foreign matter” i.e. the body can reject those things that it feels shouldn’t be there…. so basically the dexamethosone says, “hey don’t be a bitch about this, just leave that little emby be.”

I’ve read that it can cause insomnia in some folks so I’m taking that pill in the morning.  It’s not something that everyone needs, but after reviewing how I responded to everything last cycle The Russian feels I’m a good candidate.

I will also start off with a lower dose of Follistim this time….I may still get bumped up over the course of the stimulation cycle, but we’ll see how it goes.

I’m curious to see the differences between this cycle and the last. Old glass-half-full McGee here is hoping for a) very few side effects yet again and b) a bit better output on the eggs collected vs eggs fertilized ratio. I was also pretty slow and steady last time on the follicle growth so I wonder again if I’ll go 13 days of stims or more/less.

I’m back to knitting a bunch which is VERY therapeutic – right now I’m making some socks for me, some boot toppers, a baby blanket for one of my besties who’s due in December (so I’ve some time on that) and a scarf that a pal commissioned me to make.  Since it’s Chicago, winter could come at any time so I ought to get on that.

Sorry about that needle rant…..but don’t make it awful if it doesn’t have to be!!!!

Clearly I can’t let this go…..

IVF Scan #1: A thank you to Dick Van Patten

Last night was my 6th night of stims (I do all 3 shots around 11pm) and that’s all going pretty well.  The shots have been easier than I thought and there’s very little discomfort – thank goodness.  I’ve had very few side effects thus far (though I’m no fool, I know they’re coming and will likely sneak up like little ninjas) – day 2 I had a dull headache, day 3 a bit of a stomach ache and there’s been some minor bruising from the needles in my belly.  I’m affectionately calling these bruises “Gut Shiners.”  They don’t hurt, but they’re these dime-sized purple circles circumnavigating my belly button.

Had my first scan yesterday (after 5 nights of stims) to see how my body’s responding to the drugs and how eggtown is percolating.  She found 8 follicles worth measuring, though said there were many more that were smaller and might catch up by the time I have my next ultrasound on Friday.  I didn’t know how to feel about 8.  I didn’t know if that’s good or crappy. I mean, I’m no spring chicken in this game so I’m not looking for crazy numbers, and the internet is has a broad spectrum of who’s got how many but I drove home wondering…”what’s 8?”

I wasn’t feeling bad about the number but I wasn’t feeling great and I am trying to fight the good fight to remain positive.  Lest you think I’m full of rah-rah all the time, you’re definitely wrong.  I love/hate those people. They’re right up there with folks who wake up chipper and expect me to do the same.  I have my crapass days like anyone else….but I try not let them keep the upper hand.  Also, I am hyper-analytical and can OVER-THINK the slightest details…..so you put something like a first IVF scan and 8 follicles in front of me and the hamster on the wheel inside my brain just starts running.

The negative started to tip the scales a bit….and then an odd thing happened:

The theme to Eight is Enough popped into my head.

Eight is Enough? The 1970s tv show? Haven’t thought of it in years? Yeah, well neither had I.  Oh, you haven’t heard of it? Well, maybe you’re not in your 40s.

The show followed patriarch Tom Bradford (played by Dick Van Patten) through the adventures of parenting his eight growing children, 3 boys (Willie Aames, Grant Goodeve and Adam Rich) and 5 daughters, whose names I could Google, but so could you.  It was a family-comedy-drama, they got into all sorts of mischief and they got through everything together.

My point is: the lyrics to the theme song are supes cornballs, but the main hook is “eight is enough to fill our lives with love.”

And it made me feel better.

I had an improv teacher who often told us “energy is a choice.”  Well, so is perspective.  So for right now, or for the 48 hours between my first and second scan, eight is going to be enough. Eight potential follicles. Eight chances for a healthy egg. Eight chances at a baby.  

So Dick Van Patten? Thanks for doing me this tiny solid by having that song pop in my head and making me feel better about my first IVF scan.

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

There’s a magic in the early morning we’ve found
When the sunrise smiles on everything around
It’s a portrait of the happiness that we feel and always will
Eight is enough to fill our lives with love

We spend our days like bright and shiny new dimes
If we’re ever puzzled by the changing times
There’s a plate of homemade wishes on the kitchen window sill
And eight is enough to fill our lives with love

Just keep silent during the mammogram, ma’am.

CD3 (Cycle day 3) today and had an ultrasound and bloodwork.  The ultrasound confirmed that the small cyst I’d developed last month had been reabsorbed, so yay to that….it hadn’t really been a concern, but you know…..who wants a cyst?  I sat down with my coordinator, The Russian’s Right Hand, and she went through my whole drug protocol: what to take, how much, when to take it, how to take it.  She’s really great – very supportive, always positive, and is getting used to the fact that sometimes I just blather, especially if I’m the least bit fidgety, and often end up saying really random things.

Example:

Before I could start IVF, I had to get a mammogram – turns out ya gotta make sure everything’s good up top before you get things going downtown. So there I am, puttin’ ’em on the glass when I try to make some small talk with the nurse person, who is very resistant to chatter.  This really only pushes me further to fill the awkward space. Now, if you’ve ever had a mammogram you know the machine is HUGE and that you have to put your body in Cirque du Soleil positions while your boob tissue is mashed between a few glass panels. There’s alot of silence, repositioning and waiting.  I think it was after 2-3 pictures that I posed a simple question:

Me: “You work with this machine all the time?”

Her: “mm-hm”

Me: “Do you have a nickname for it?’

Her:  ….No answer.

Me: “You know, like a little pet name?”

Her: …..awkward uncomfortable shrug.

Me: “You don’t ever….”

pause

more pause

Me: “So just hold right here?”

Her: “Yes please.”

Since we’re here, another example:

The first day I met The Russian she gave me an ultrasound since we knew I was likely about to ovulate.  I’ve just met her, she’s already got me on the table and is all up in my business and of course I get the urge for antsy small talk.  So, I asked her if she’d ever consider putting random pictures on the ceiling so that whilst a lady was getting ultrasounded she’d have something to look at….something like the classic kitty cat “Hang in There,” a Where’s Waldo, the August page from a Fireman-of-the-Month calendar, whatever…anything to look at as a distraction to the awkwardness of a trans-vaginal ultrasound. (Am I right, ladies?)  Random random blather.

Back to the present.

I’ll start my stims tonight – I’ll do approximately 10 days of Follistim, Menopur and Lupron, a total of 3 shots a night.  All three are with pretty small needles so fairly low on the discomfort scale, mid-range on the psych-yourself-up-to-shove-3-needles-into-your-belly scale.  I’ll go back next Wednesday at which point they’ll do some bloodwork and I’ll get another untrasound – where yes, I’ll still be looking at a blank ceiling.  They’ll get a gauge on how I’m responding to everything and adjust my dosages if need be.

A quick note on my dosages, which for the moment I won’t divulge. Why? Because a 30-second look around the internet told me that most people either a) freaked out at people saying they were on this level or b) were on the other side of treatment ragging about it.

Because it’s alot.

I’m taking alot.

It feels just higher than “throw the kitchen sink at it” and slightly less than “holy shit.” I started to let the chatboards psych me out, so I closed my browser, got a tad worked up and then decided I likely will need to resist researching this particular subject until I’m done with treatment.  For now I gotta let the doctor be the doctor.  I’ll put the numbers in writing soon enough but I’m letting them sink in right now, putting my trust in The Russian and continuing to chill out.

Luckily I have very little to do over the weekend aside from walking the dog, catching up on Mad Men and finding random YouTube clips which I’ll pass along to you in my next post.

IVF Suppression: The Calm Before the Stim Storm

So before you start shootin’ yourself up with IVF meds to turn your reproductive system into a hyperdrive, you’re often initially put on suppressive meds.  When you suppress your system, you shut it down, you calm it, you tell it to take a snooze so that you can then reboot it and turn each of your ovaries into something that is highly trained, efficient, innovative, and overachieving, yet cool and stoic under pressure: i.e. you’re aiming for the Nadia Komaniche of reproductive systems.

Suppression starts with birth control pills – yep, before you know why it sounds like the most asinine idea on the planet – stop trying to get pregnant in order to get pregnant. WTF, right?  Anywhos, you take The Pill so that your ovaries stop ovulating and so that your doctor can take over, time things very very specifically and get them to do tricks like circus animals.  Also, you are often synched up with other patients at your clients for quality control purposes in the lab.  It’s a team effort in many many ways.

I’ve taken the long road on The Pill and only this week did it start to feel long. Too long. You see, all over the internet are ladies in IVF talking about being on The Pill for a week, two weeks, a whopping 3 weeks. The internet can tell you that what you’re currently doing is wrong.  The internet can tell you you’re on the perfect protocol. People on the chatboards can tell you that what you’re doing is good/bad for you.  People can tell you that if you’re on The Pill for too long or too short you’re going to blow the whole deal.

Because everyone on a chat board has complete knowledge of what YOUR RE is trying to accomplish with your body.

Three words for you:

Grain.

Of.

Salt.

Because if I believed everything the internet and the chat chains told me, I would be rocking back and forth in the corner sucking my thumb and thinking that I was a complete idiot who was in the midst of a fool’s errand.  And yet it’s important to read that stuff – it’s how we education ourselves, have a sense that there are other folks in the same boat, figure out what questions to ask (and I suppose, figure out if your RE is potentially bonkers and full of poo).  The internet is ultimately good, if you keep it in perspective with that delicious tiny granule of sodium.

See – I’ll end up having been on The Pill for 5 weeks total (all active pills).  The first three weeks, just the pill and then these past two I’ve added estradiol and the androderm patch.  When you are eager to get going, five weeks can feel like Mother Effing Forever…..especially when you’ve been trying to get pregnant for a long time already.

But you know what? In the end, it’s what my RE is trying this time and I trust her.  If we have to do it again maybe I’ll have a different protocol, but for this first IVF The Russian wanted my system to have time to calm down, time for my body to absorb a small cyst that had developed from the follistim I took for the April IUI (coinkydink: The Pill is often what’s prescribed to help your body reabsorb small cysts, who knew), and time to add testosterone (androderm) and estrogen (estradiol) – both of which have been shown to be beneficial to older gals before kicking the system into high gear.

In reality, the suppression itself didn’t suck – the amount of time did, because I’m eager to get this action started.  And next week I will.  I’ll take ganirelix Monday and Tuesday, then get all the baseline business knocked out a few days later and then on to stims.

If you had told the 8yr-old version of myself that I’d one day be looking forward with eager anticipation to giving myself shots for a few weeks, my 8yr-old self would have kicked you in the shins, called you a big fat doodie and thrown tropical punch Kool-Aid in your face.

But here I am, counting the days until I can shoot myself up.

What have I become?