New Supplements, Tests and Fran Drescher

Dr. Hail Mary puts all his patients on the same supplement regiment…..and then adds to it as necessary once test results come in. So, I’m now on the following supplements:

Prescription Prenatal with DHA (continued with pregnancy)
Pregnitude Reproductive Support Dietary Supplement (includes folic acid 200mcg & myo-inositol 2000mg) – it’s a powder that’s mixed with 8oz. water and taken twice a day. (it’s stopped with pregnancy)
CoQ10 – 600mg/day (stop with pregnancy)
Calcium – 1000-1300mg per day (stop with pregnancy)
Vitamin D – 200-400IU per day (stop with pregnancy)

I’ve been asked to stop all other supplements (Royal Jelly and pycnogenol, which I only took during IVF3)

Yesterday I went  in for Day 3 bloodtest and ultrasound (and I met the most entertaining person even to put an ultrasound wand up my nethers)

Yesterday’s tests covered:

estrogen level, LH, FSH, TSH, thyroid, pituitary, prolactin, DHEAs, Testosterone and something that I can’t read…..because he’s a doctor, and his handwriting is…..stereotypical.
 

When I got there, my IVF nurse took me in to take some blood and asked if I ever fainted. I said no and asked if she had patients that did. She looked at me and emphatically nodded yes, then added, “most often it’s the men.” She then proceeded to take 4 vials of blood and explain when I’d be able to get results and how (calling in to a voicemail network).

And then I was greeted by my new U/S (ultrasound) tech….who for some reason reminded me of Fran Dreshcer, minus the accent and nasal laugh….I think it was the hair and no-nonsense attitude. I was on the table and she started the ultrasound – said everything looked fine as she counted my follicles and checked my lining. I asked her something and she went on an amazing run of an answer about how great Dr. Hail Mary is, how he’s very aggressive with his treatments and straight-forward with his patients, how she’s seen him get people pregnant that had everything against them, how/where/when I’ll get all my information, what the hysterosonogram will be like that I have to get soon, how she’s going to try her best to schedule it because the doctor’s schedule is full and he’s at conferences in February, how her mother had a straight-forward doctor and she didn’t like him but he was the best and something and something and something.

Somewhere in the midst of that she dropped a well-placed F bomb and it was then that I knew we’d get along just fine.

OH – and that entire conversation took place while she was holding the U/S wand as I’m on a table in a dimly lit room….so it was hard not to laugh at the ridiculousness of the scenario.

She was great though, she was so encouraging and I look forward to seeing her many times throughout these next few months….must remember not to call her Fran.

By day’s end I had some of the results:

my once slightly elevated Prolactin is now in the normal range at 17.07, TSH 2.57 and DHEAS 83 (I didn’t write down estrogen and progesterone but they were both normal). I will have to call in next week to get results on ovarian reserve and autoimmune stuff…..and I’m now waiting to hear if I can be squeezed in for that Hysterosonogram early next week. It has to be done Day 6-12 and I’m out of town Days 10-12…..and the doc’s schedule is packed. So, fingers are crossed that Fran (must remember not to call her Fran) will indeed make something work.

Since this is a “test” cycle to see what’s happening in there, I started estradiol (estrogen) last night and will do progesterone shots the 2nd half of the cycle. I’ll talk about the various tests as I have them this month….the hysterosonogram, a couple of biopsies, etc.

And yes, I could harp on “why didn’t some of these tests happen before” but why do that to myself.

For reals. Why.

Instead, we’re excited to do them now and rock out IVF4.

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I May Stim Forever

13 nights so far – tonight will make 14, every possibility there’ll be a few more.

Stimming slowly…steadily it would seem, but slowly.  My ultrasound tech has used the work “blossomed” in regards to my right ovary following some early sleepiness with said ovary, and it’s now cranking on quite a few follicles. Though left ovary is now only really working on a few follicles, so my how the tables turn.

However, lowering my follistim and progressing slowly has all been on purpose in hopes of having a better result than last time. Quality over quantity seems to be the name of the game…..or at least that’s what I’m telling myself. (It’s all about what we tell ourselves, right?)

Saw The Russian (for any new readers, that’s my RE)…..(because she’s Russian) who did today’s ultrasound and could not find my right ovary which led to alot of shoving, prodding and general discomfort due to the fact that I thought that probe was likely bumping up against my lower lung cavity.  NOT COMFORTABLE.  Anyway, she wants more time for the growings, so likely another night or two of stim meds.  I go back tomorrow morning for another look.

At this point we’re hit the day-to-day portion of our IVF fun.  Trigger…..soon.  Retrieval…..also soon?

IVF Scans 3, 4 & 5 An Ambling of Tortoises

Three days, three scans – thank goodness The Russian’s office downtown is only about 20 minutes away (depending on what Lake Shore Drive looks like) and I’ve found a sneaky free parking scenario at a nearby grocery store that offers 90 minutes parking with purchase….I think you see where that’s going.  It’s Chicago, you learn to break the rules a little.

Following last Friday’s bummer scan I was very hopeful that Monday’s scan would a) show progress and b) be done by my regular tech.  I got both my wishes, was told I’d likely be on stims for a few more nights and to make an appointment for Tuesday, as The Russian was going to be in the office and wanted to have a look herself.  One change to meds for Monday night: done with the Lupron and adding Ganirelix – maintaining dosages of Follistim and Menopur.

Tuesday’s appointment (scan 4) with The Russian also went well, though there wasn’t much progress from the day before, the largest follicles were around 15.5 or so….but The Russian seemed happy enough and said “I think we’ll get 8-10, they just need a little more time to grow.”  How can I doubt The Russian?

I was asked to come back already today for scan 5, as we’re getting super close to hitting that lead follicle 18mm mark that signals time to trigger.  I was back with my regular ultrasound tech, who totally laughed at the way The Russian had taken her measurements and got down to business.  We’re looking at lots of follicles – likely to be 8-10 mature-ish for ER and a bunch of “little squeakers” as the tech calls them.  

In the end they’re having me stim again tonight – day 13 (lucky 13!) and I’ll go in again tomorrow, where likely a few of these little guys will have hit the 18mm mark and we can move forward.  I joked to The Russian’s Right Hand regarding the fact that these guys seem to be taking their sweet-ass time and she said that that’s just fine, as long as they’re growing and growing steadily, and that this (hopefully) ups the chances that the eggs will be healthier.

And to boot, I’ve been fighting one of those highly annoying summer colds. I’m trying not to take anything internally, even though they told me I could, it just seems like one more thing.  It’s not awful awful and it’s only a cold so it won’t kill me, and as long as it’s gone by whenever we do embryo transfer, it’ll be a win.  Two nights ago I DIYed the saline solution in my Neti Pot — oh the burn, y’all, the burn — imagine eating the biggest wad of wasabi and you’re close.  Last night and tonight I’ve been smearing on a mentholatum mustache – so sexy….so….so….sexy.  I also have some eucalyptus oil so I’ve been adding that to a bowl of hot water and inhaling the steam.  

I mean, I was doing way too well with the stims….feeling very few side effects – I pretty much asked to catch a little somethin’ somethin’.

So that’s that…..just sitting here chuggin’ along, full of snot, my abdomen host to a race where our contestants are  sauntering towards the finish line.  

Hopefully some news on next steps at tomorrow’s scan.

IVF Scan #2: Be a brave little soldier

Had my second scan yesterday with an ultrasound tech I’d never met before as I think everyone I knew had the day off due to the July 4th holidays.  Little did I know I was about to be emotionally blindsided.

Let me be clear: she wasn’t mean, she wasn’t brusk, she wasn’t rude.

She was….nonchalant.

Nonchalant is a tough one to counter given the complete lack of control and lack of specific medical knowledge I have concerning this very pivotal quest that I’m on.

I get that nonchalant can mean “feeling or appearing calm and relaxed.” That’s fine. I want that from my practitioner.

However, there’s the dark-side of nonchalant: there’s the indifferent side.

First she acted surprised that I asked for the measurements (so I could compare them to my first scan) and made a point of oh-um-well-umming her way into rattling off the numbers.  She rounded them all to the closest full number – my regular gal gives me the decimal points (which maybe is something special – I don’t know – I’m not the one who went to school for this shit).  But, in rounding them to the closest number it really looked like there’d been very little progress.  I asked about this and she just shrugged. SHE SHRUGGED. She then said something to the effect “well, they’re small but they did grow a little.”  I don’t know, I was still having a what-the-what moment over the shrug.

And then, the coup-de-grace: I inquired as to why there was one less follicle than before and she kind of make that psscht mouth-sound thing that’s the equivalent of “fugittaboutit.”

Um.

What?

A shrug AND a psscht?

I need you to know that I’m a grown-up.  I’ve been through my share of crap in life and come out the other side. I don’t need my hand held. I don’t need my hair stroked like I was a small child. I don’t need you to bring over a tuna-noodle casserole.

But from the gal interpreting my ultrasound results mid-IVF cycle, I do need for her to clue in to the fact that I am the medically naïve one in this scenario and therefore: deliver the news with a bit of grace.

I have half a mind to send her a card that reads:

Empathy: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also : the capacity for this

A cross-stitch sampler for the wall would be better, but why give her that kind of time.  I’ll likely say something to The Russian’s Right Hand, not to rat anyone out, but hey maybe this gal could learn a little something.

I left the office confused and discouraged, not knowing if any of this was working or if there was any point.

In the car, I let myself be upset for awhile (who doesn’t love a good car cry?) and then had to get to work.  Luckily, I’ve been teaching improv to kids these past few weeks and they are masters at making me laugh.  On my way into the theater, I talked to my husband who was as usual understanding, patient and honest.  He talked me out of my tears and had me laughing, and in the end reminded me that I’ll likely meet other folks who are not as hip to my “keep hope alive” mojo as I’d like them to be.  He also said that I shouldn’t be a victim in this and that we have to be empowered as patients. This is but a bump in the road.

Essentially: buck up little camper and soldier on.  

I of course thought of Coach Taylor from Friday Night Lights, because I’m likely always going to think of something from tv or film.  He always told his team: Clear Eyes. Full Hearts. Can’t Lose.

I just have to forget about that ultrasound tech, keep my eye on the prize, keep hope in my heart, and in doing so, I can’t lose.

I also need to keep shooting myself full of hormones, eating right, and watching terrible(fun) movies.

But mostly, I need to keep being a brave little soldier.

 

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.