I'm PREGNANT!

Yup, I'm pregnant.  Queue the tears of joy...  I went for my follow up from my hyperstimulation, which I feel much better by the way, and as soon as we walked into the office Dr. C said "Congratulations, you're pregnant!  I never get to tell anyone."  I'm so happy, but it does feel a little surreal right now.  We will find out in two weeks if its one or two babies.  My Mom is convinced it will be twins...

IVF and Hyperstimulation

First and foremost...  The actually implantation, that happened on Tuesday last week, went very well.  These two beautiful embryos were implanted and I hung out on the table practically upside down for thirty minutes, all the while having to pee really badly.

If all goes well, our first baby picture

I spent the next two days being waited on hand and foot by my loving husband and helpful Mom.  I seriously was waiting for someone to slap me and tell me to get it myself.  I am not used to not being able to just get up and go get myself a drink, but I was good and called for help.

Then on Thursday and Friday I took it easy and stayed home, except for brunch with my Mom on Friday.  I slept a lot those four days, but considering those two little embryos it was probably for the best.

Saturday morning things changed a bit.  I woke up with sharp pain in my back localized in my right shoulder blade area and a bloated stomach.  At this point I didn't know what was going on, I thought it was gas as I'd been a little constipated.  Tony stayed up with me until the pain subsided enough to sleep and we decided to see how I felt in the morning.

Come morning I felt fine.  Sunday passed without any symptom except a little loose stools.  Perfectly normal after being constipated.  But this morning I woke with that same damned shoulder pain and bloating.  And this time I experienced vomit fest 2011 too.  At this point I woke Tony.  I was in pain, extreme discomfort.  My belly from belly button to right under my rib cage was bloated and hurt, especially if I touched it with anything, from my pj pants waist to my hand.

I called the doctor as soon as they opened and they sent me in for lab work at 9 am.  At 1pm I headed in for my appointment.  Sarah had suggested I get and drink something containing electrolytes so 3/4's of an orange Gatorade later and the drive to the doctors office wasn't nearly so bad, my stomach wasn't soooo painful.

The first thing Sarah told me is that my labs were abnormal.  Hallelujah!  I'm not imaging things.  Second, I have Ovarian Hyperstimulation Syndrome.  And ultrasound later and Dr. C was talking about my swollen ovaries and the slight risk that they might twist!  Yikes.  Guess who's not working for a few days more...

Apparently the the follicles that they ruptured to get to my eggs filled with fluid, aka blood, and that fluid is leaking into my abdomen.  They could even see it on the ultrasound.  They gave me a medication called cabergoline to take every night at bedtime until they tell me otherwise.  It will help lower my prolactin level which is partially responsible for this problem.

The shoulder pain is from a nerve that runs from my abdomen to my shoulder and is called deferred pain.   Bottom line is I can't do much for that extreme discomfort.  Drink lots of electrolytes, at least 1 liter a day, eat a diet high in protein, and take my medicine. 

I have a follow up on Wednesday.  I will also find out if the IVF worked that day.  Cross your fingers for me that everything works like it should!

8 is my lucky number

So 8 is my lucky number.  My birthday is 8-8-78 so I kinda always felt a certain kinship with the number 8.  Today I got a follow up call about the status of our growing embryos and guess how many we have?  You got it!  EIGHT!  Out of the original 18, which is actually pretty good.  They will call me tomorrow morning to give me another update but it looks like we will still be going in on Tuesday for the transfer.  Its happening so fast now!

Retrieval

I don't feel so great so I'm going to make this brief.  I had my retrieval yesterday at 12 pm.  It went well and they got a whopping 18 eggs.  As of this morning 7 were immature, 2 were irregular with extra chromosomes, and 4 were fertilized perfectly.  The remaining 5's status has yet to be determined.  They will call tomorrow to follow up but it looks like I will go in for my transfer on Tuesday this coming week. 

I can only take Tylenol for the pain, which is pretty mild but very uncomfortable.  It does hurt to laugh and put any pressure on my lower stomach, not too surprising.  In the end, its all worth it.

The final follow up

Tonight at 1am Tony gets to give me the time sensitive hCG shot, in the butt, in the muscle... Ouch...  This means that 35 hours later I will be on my way into the operating room to have a bunch, hopefully, of follicles release their perfect, hopefully, eggs!  I gave myself one shot tonight, one vial of Menopur, and now I am done with the belly shots.  Heal poor belly, heal.  And I am also done with daily and every other day lab doctor and lab visits.  And after Thursday, in three to five days, I will be going back for implantation!  Wow.  So excited/nervous/scared/hopeful/etc...  Keep me in your thoughts and cross your fingers!

U/S-BT Follow Up Visit #4

Tuesday is more than likely going to end in a shot to the ass.  I'm not quite there yet so Dr.C has me using one vial on Menopur tonight and another fifty units of Follistim tomorrow morning. 

 I have a 7:45 am appointment to check my ovaries and bloodwork. My endometrial layer looks good.  If all goes well tomorrow I will be in for retrieval Thursday morning!!!!  How did this get here so soon?!

U/S-BT Follow Up Visit #3

I feel pretty horrible at this point.  Friday night I had acid reflux so badly that I threw up.  Every couple minutes I this intense burning sensation in the back of my throat.  I decided that I can not eat anything spicy.  And Saturday night I didn't.  But apparently garlic mashed potatoes is too spicy and I was miserable last night too.

Sarah suggested at my follow up today taking one teaspoon of baking soda and mixing it with a cup of warm water.  Apparently this is a great way to soothe reflux even if it tastes horrible.  This makes tons of sense as we make infant reflux medication out of sodium bicarbonate, which is basically baking soda in water.

My appointment went well.  Dr C didn't tell me how big my follicles where this time but the ultrasound screen showed 1.38 cm!  Friday I was at 10 mm.  Is that even possible!?!  If it's true it explains my intense backache and my tender tummy.  Dr C told me I need to be careful and take it easy because my ovaries are so large.  And so close to over stimulation.  He wants me back tomorrow morning at 8:45 am.  I don't have to use any Menopur tonight and only 50 units of Follistim tomorrow morning.  Sounds like I am very close...

I'm also noticing a bit of overemotional outbursts.  Over the last three or four days I keep finding myself tearing up at stupid stuff.  Today I balled my eyes out over this.  Yes it is sweet, but I could not stop sobbing.  It was kind of funny actually.

U/S-BT Follow Up Visit #2

My follicles are developing!  Right now they are at about 10 mm.  No wonder my ovaries feel like they are too big for my belly!  My blood work came back great too.  I will be using 50 units of Follistim for the next two mornings, no Menopur (the diarrhea inducing devil of my fertility cocktail) tonight, and only half a vial tomorrow night.  I will have my third follow up Sunday at 8 am.

Dr. C thinks that I should "go," as in go in for retrieval, no sooner than Wednesday but more likely on Thursday or Friday.  Today I played the scramble game trying to find coverage for Friday, (I'd already covered Wednesday and Thursday per my original schedule.)  Thankfully I found help in the form of a traded shift with my co-worker R.  He's been awesome about being flexible through all of this.  Well actually all of my co-workers are pretty awesome about my ever changing moods and IVF schedule. This day or two later schedule means that my implantation will also probably be later by a few days.  But only time will tell. 

My latest and far from greatest side effect...  I'm breaking out like I'm a sixteen year old teenager again.  It seems like overnight my neck, back, chest, and face are covered with small red bumps that don't exactly look like acne, but really can't be anything else.  Out of all the things I wish I could recapture from my teen years, my troubled complexion is not the one I'd pick.  How about my ability to sleep in any position, no matter how uncomfortable, and not wake up stiff and achy.  Or my super metabolism that let me eat all I wanted without gaining a pound. But no, I get the acne of my teens...

Thanksgiving and needle tracks

The title of this post is slightly misleading.  It should read Thanksgiving and a quick word about injections, but that's so wordy and boring.  Sorry for misleading you :)

I don't think I've mentioned that I had Thanksgiving here at our house.  We had six guests, including my good friend A and my Mom.  I put my Christmas decorations up a few days before.  Its earlier than I normal do, but I love Christmas trees and their twinkling lights!  (Forgive the backlighting, it was very bright outside.)

Our dining room table only seats four, so we had to set up the card table.  It worked out well enough with three at the dining room table, and three at the card table, despite the height difference.

The dinner menu included:  turkey (of course,) cheesy potatoes (a family favorite,) green beans and almonds, brown sugar and honey glazed carrots, orange walnut sweet potato casserole, homemade cranberry sauce, cornbread stuffing, and herb garlic pull-apart bread. 

The spread

It was my first attempt making this particular dish, orange walnut sweet potato casserole.  It was very tasty and different than the usual sweet potatoes and marshmallows.  Here's what you need:
8 sweet potatoes
2/3 cup packed brown sugar
4 teaspoons cornstarch
1/2 teaspoon salt
3/4 teaspoon ground cinnamon
1 cup orange juice
3 tablespoons butter
1 tablespoon grated orange peel
1/2 cup chopped walnuts
honey

I used a bag of pre-peeled, pre-sliced sweet potatoes.  I boiled these for about twenty-five minutes until they became soft.  Then I drained them and placed them in a 1 1/2 quart baking dish.  Then I combined the brown sugar, cornstarch, salt, cinnamon, orange juice, butter, and orange peel in a sauce pan until well blended and boiling.  Mixture should get a little thick.  Pour mixture over potatoes.  Sprinkle walnuts on top and drizzle honey over the whole thing.  Bake at 350 for about 30 minutes, keep an eye on the walnuts so they don't burn!

The other new menu item was herb pull-apart bread.  I don't have a picture of this but it was soooooo good!  Melt 1 stick of butter in sauce pan, stir in two cloves of garlic, chopped,1 tea of dried basil, and 1/2 tea of dried thyme. Take a bag of frozen white dinner rolls and dump half of them into the bottom of a bundt pan.  Brush half of the butter mixture over the top.  Dump the rest of the rolls into the pan and brush the remaining mixture on top.  Cover with dish towel and set in a warm place for 4 hours to rise.  The recipe said it should double in size, that didn't happen for me but it still came out great.  Bake at 350 for 45 minutes.  This was a hit!

For dessert I filled fillo shells with pumpkin mousse, chocolate mousse, and cranberry cherry lemon tarts.  They were light and gave everyone a choice, seeing we have some picky eaters in the group.  And of course, I doctored up a bottle of apple cider.  Cinnamon sticks, allspice, cloves, dried cranberries and apricots, YUM!

I love cider!

I'm trying to figure out what to do for Christmas dinner now.  I'm leaning towards ham but it all depends on what ideas I come across in the next few weeks.


On a side note, I mentioned bruising in my last post.  Check out my colorful abdomen!

I think I might have found a better way to inject the Menopur.  The syringe I'm using is quite vacuum-y and its difficult to depress the plunger, I wind up letting go of the skin I've pinched to inject.  Don't do that.  Ever.  I have managed to find a way to depress without letting go of the skin and the bruising is much more slight.

The difference is clear; the large bruise on the bottom, to the hardly visible one just above the right side of it (in the red circle.)  But my tummy is starting to look like a connect the dots puzzle.

As far as the injection experience.  It's really not so bad.  It's surprisingly difficult to actually stab yourself with the needle.  I had quite a few false starts for the first week, I lacked the conviction to actually stab myself, it's kind of a self-preservation instinct.  You want to insert the needle fairly quickly, in a darting motion, or it will hurt.  If you do it quickly you won't even feel the needle going in.  Pulling the needle out causes me a slight sting, but that only lasts for a second.  Not so bad.  Not so bad at all.  I'm not looking forward to the up-coming butt shots, but hopefully they won't be so bad either.

My follow up is tomorrow morning.  I have the crampy, pressure feeling I had during my Clomid rounds, so I think my ovaries will be in better shape tomorrow, but we shall see...

U/S-BT Follow Up Visit #1

My first follow up didn't go quite as well possible.  Dr. C said that my ovaries aren't showing much development.  Apparently this is pretty common with PCOS and I shouldn't worry, which is easier said than done.  My blood work came out better than my ultrasound.  The conclusion.  I need more medication.  I upped my Menopur inject tonight and my Follistim amounts will go back up to 125 units for the next two days.  I won't have a follow up until Friday due to my slow start.  Sarah told me that this is perfectly normal and shouldn't impact our odds or time line.  Here's hoping.

On a side note, I have been keeping a spreadsheet of the fertility bills.  So far we are at about $1,500.  This includes my surgery and all its related expenses, like the anesthesiologist's bill.  This is more than we were expecting at this point in the process, but we hadn't accounted for all of the lab work.

PS:  Menopur is my least favorite medication.  It leaves me with awful looking bruises and terrible diarrhea.

Racking up the frequent flyer miles

Tuesday was my baseline appointment.  This was a preview of my life for the next two weeks.  The appointment lasted all of fifteen minutes.  Sarah was running the ultrasound machine as Dr. C was out of the office for the holiday.  It took her quite a bit of maneuvering to find both of my ovaries.  Apparently one of them was hiding, hehe.  I then headed down for my blood test. 

Sarah called me about four hours later and told me I was good to start my medications on Saturday.  She also scheduled my next appointment, Tuesday at 7:15am, which is far too early in my opinion.  This will be my life for the then week or so.  Starting Tuesday I will go in every other day.

I started my Follistim and Menopur on Saturday.  So now I get up in the morning and take my Vitamin D and my Levoxyl, then I inject myself with Follistim.  Then at dinner I take my Metformin ER, prenatal vitamin, and my low-dose aspirin.  And before bedtime I inject myself twice, once with Luprion and once with Menopur.  Three shots a day!  My abdomen is starting to look like a connect the dots page.

I will be making a brief post after every follow-up.  These are going to be very short posts just intended to keep you up to date on the latest in the saga of my developing follicles. 

Insert foot into mouth and chew

Recently I dealt with an extremely rude and thoughtless human being.  One of my regular pharmacists is on vacation and thus I have had a week of unfamiliar faces filling in.  One of these fillers isn't so unfamiliar. I have worked with her three or four times a year for the past three years.  Not to long ago I ran into her outside of my store and brought her up to speed on operation baby, so it wasn't surprising that her first question when I came in what about how the IVF was going. What was surprising was her complete and utter lack of good judgment in her next comment. 

Picture this short, loud, and almost 30 year old woman pretended to listen as I explained in a brief couple of sentences what our timeline is.  She nods impatiently and then launched into a statement that can only be described as rude and thoughtless.  "Would it upset you if I said I was pregnant!?" Insert big shit eating grin.  What a bitch!  I understand being excited about a little one, I don't understand the apparent need to try and make me feel like shit.  I wasn’t about to let her see how much her statement hurt me, so I answered, “No, of course not,” with a sincerity I didn’t feel.

Do I understand that my fertility challenges aren’t her fault?  Yes.  Do I understand that people will not stop getting pregnant just because I haven’t been able to?  Yes.  Do I feel the sting with others around me seemingly get pregnant just by looking at a penis?  Yes.  And do I resent it when a woman presents her good news to me with the subtly of a shotgun?  Why, yes I do.  I have made it through several pregnancy announcements without wanting to deck the woman, but this presentation, this “in your face you infertile chick, I’m better than you” na-na-nah-bo-boo approach left my palms itching with the urge to slap the bitch.  But I resisted the urge and tried to remind myself that this particular woman has no brain to mouth filter.

She then spent the next three hours telling me about all of her pregnancy symptoms.  From her sudden fondness for bagels to her aversion to Alfredo, from her slightly crampy tummy to her inability to touch her toes anymore, from her frequent cries to her irrational anger, and from her tender breasts to her increased cup size. Yup. I got all these details and more.  Then I asked a question, how far along she was.  I had a hard time not laughing my ass off when she said five weeks.  Five fucking weeks and she would have you believe that she has experienced every symptom imaginable. 

I asked if she had made the big announcement.  She has not told anyone but her husband and her sister.  So why then am I lucky enough to have her joyful news rubbed into my raw nerves?  It turns out she’s having some problems with her progesterone levels and she knows how much research I’ve done of fertility challenges so she wanted to pick my brain.  Unfortunately I don’t know that much about progesterone levels, only that a level too low can cause a miscarriage and that it’s normally treated with progesterone oil injections, progesterone suppositories, or Prometrium taken orally or inserted vaginally.  She is using the latter vaginally so I had no new information for her.

I can’t imagine what she must feel like, to be so close to one of her dreams but teetering on the verge of losing it.  Terrifying.  Rudeness aside, I’ll be praying for her and her precious little one.

Surgery went fine

My surgery went fine.  We got to the Surgery Center at 6:30 am, uggg, so early!  My surgery was scheduled for 7:45 am, and while I don't know exactly what time I went in, I know it was pretty close.  The scariest part was walking into the operating room.  The room was bigger than I imagined and after laying on the table the flurry of activity around me was very disconcerting.  One person was attaching sensors, another person was getting my arms and legs in the correct positions.  And the anesthesiologist was talking to me the whole time, asking me questions about Tony.  I really appreciated the distraction.  The last thing I remember is asking the Dr if it was normal to feel kind of strange.  Then I woke up in recovery.

Dr. C told Tony that I was only under for 15 minutes and that things went wonderfully, he even showed Tony pictures.  He didn't anticipate any trouble, and there really hasn't been any.  I hardly had any pain or discomfort yesterday, just some mild cramps and lingering fatigue.  I napped on the couch from 10 am until 2 pm and still went to bed at 9 pm.  I apparently was catheterized and that's been the source of most of my discomfort, a burning sensation during urination.  I upped my water intake and had Tony get me some cranberry juice and that sensation has mostly passed now.  I bled a little the first day, today its mostly discharge from the Betadine they used on my cervix.

All in all the experience wasn't bad at all.  The procedure I had was called a hysteroscopy with polypectomy in case anyone wants the official name.

I also gave myself my very first injection today.  10 units of Lupron in the belly.  I was a little hesitant at first, its one thing to read about injections and quite another to actually do it.  My first try wasn't quick enough and didn't have conviction, so I didn't break the skin at all.  So I tried again, with feeling.  And it didn't even hurt!  Not until I pushed the plunger did I feel anything, and that sensation was just strange, not painful.  The needle was so tiny.  I draw up flu shots at work from time to time and those needles are huge compared to these.  I could barely even see the bevel on the needle, that's how tiny they are.  I didn't bleed from the injection site at all.  Quick and pretty much painless, a good first experience.

Frankie has been my constant companion for the last two days.  He's napped with me and napped on me and been a great help making me feel better.  Everyone should have a sweet kitty like him after surgery to help you get better faster!

IVF update: Surgery and steps

Last Thursday Tony and I headed over to Dr. C's office for our IVF and Injection class. For the first hour one of the nurses, Sarah, sat down with us and went over the results of my ovarian assessment report. The results were good folks. Better than they had anticipated. This means that it should be easier to simulate to ovulation but more difficult in that they have to be careful not to over-simulate. She also went through our time table and stressed that all of those dates (that I put up in my last post) are just estimated and I only have a 50% chance of hitting them. Odds are that I will be close to those dates, but they will proceed according to how my body is responding to the medications.

What this means is that I will start my medication on schedule next week Tuesday, the 15th. I will stop my birth control as scheduled on the 20th. And on the 23rd I will go in for my baseline ultrasound and bloodwork. This will be the guideline of how my ovaries are reacting to the medications once I start them three days later on the 26th. I'll inject as directed by my calendar for four days and then I will head back to the office for another ultrasound bloodtest combo (which I will refer to as U/S-BT from now on to save myself from typing that everytime). Later that same day they will call me and tell me how things are going and direct me further on my medication. I will continue on the Follistim and Menopur, I just won't know at what the doses are until the 26th. Then two days later I will head back in for another U/S-BT. And later that day they will call with my new doses. And two days later I do it all over again. Lather, rinse, repeat...

Now this can change. If I'm developing slower than normal, I won't go every two days, I'll go every three days. And conversely, if I'm developing faster than normal, I'll go in every day. Sarah explained that these appointments are going to be super quick. I'll probably only be there for 15 minutes. Because of that, these are not appointments where you can ask questions about anything that isn't urgent. Its in and out. She said that they can feel hurried and impersonal and that's only because of how many they have to get through. Picture 15-20 ultrasounds from 8 - 10 am. With a nursing staff of two and one Dr. C. That's a busy morning for sure. She told me that later in the day, as they make the phone calls, they will be in a better position to field any non-urgent questions.

So, here I am, earning some serious frequent flyer miles at Dr. C's office and they get to U/S-BT to their hearts content. And all the while I'm injecting this and that, taking this and that. So one day, after one of my short and sweet progress report appointments, I will get a phone call telling me I am ready. This means that my ovary's follicles look nice and my bloodwork confirms it. When this happens I'll have about 36 hours until my retrieval.

They will schedule my surgery and 35 hours beforehand Tony will get to take out any of any frustrations he has with me by giving me an hCG intramusclar injection in the ass. Yes, you heard that right, my husband gets to shoot me in the ass. (The day of my retrieval he'll also start injecting progesterone in oil in my soon to be very tender hiney.) hCG will help mature the eggs for retrieval. Timing in this is super critical. Too soon and I'll ovulate the eggs they want to collect and my ovary will be empty. Too late and my eggs won't be ready for retrieval. So this is not a shot I will be able to put off until its more convenient. This one will have to happen exactly on schedule.

If I'm in the 50% of the population that sticks to schedule, this will happen on December 7th. But there is a strong possibility that is could happen anytime before or after that, probably within a few days. This poses a little bit of an issue with my work schedule. Retail and last minute day off do not go well together, but it can't be helped and we will just cross our fingers that the timing works. And if it doesn't... I'm going to have bigger things on my mind. Like making a baby :-D

At this point Sarah sent us to the lab end of the practice. The guy that actually will introduce Mr Sperm and Miss Egg. Mr. LabGuy has been doing this for over 30 years and said that Dr. C is as good as anyone he's ever worked with and has fantastic success stimulating the ovaries. He talked to us about what happens during the retrieval. Dr. C will aspirate a follicle and collect all of the fluid. This fluid will (hopefully) contain and egg and the cells that "feed" it. Everytime he aspirates a follicle the fluid retrieved will be turned over to Mr. LabGuy. He will then verify that there is an egg by doing a simple visual inspection, these guys are large enough to see without assistance.

This egg, and all eggs successfully retrieved, will be labeled with my name and date of birth and a color that will be assigned to me. They will aspirate all the follicles that have developed. Not all of these will contain viable eggs. But hopefully we will get enough. Once everything is collected they will place Tony's "sample" and my eggs on our own shelf in an incubator. After a few hours Mr. LabGuy will introduce them in a plastic petry dish with a growth medium. After about a day they will check them. At this point normal fertilized eggs should have two nuclei visible. If there are three in any they will discarded for having extra chromosomes. If they have not fertilized, they will be discarded. And someone at the lab will give us a call to let us know how our future possible babies are doing.

Sometime between day three and day five it will become obvious which embryos are the best. Either through process of elimination, or just from experience with their appearance. At that point they will book me for the implantation procedure. This will be another mystery date, but could fall on the 12th of December. I will not be allowed to work for four days. Again, this is not ideal in retail, but this is my baby we are talking about.

We both left with a better understanding of the process. I can't help but feel even more excited! Its getting so close, its starting to feel so real! It felt really real on Tuesday when I went if for my saline ultrasound. This was needed to really "see" the uterine lining. The process was simple. A vaginal ultrasound using the wand, which I've already begun to hate, and a catheter attached to a very large syringe of saline. Sarah had warned me to take 800 mg of ibuprofen before my appointment so I was sure it wouldn't be a fantastic experience. Personally I thought it sucked and was one of the most uncomfortable things I've ever had done.

First Dr. C inserted the catheter, which was also kind of a dry run for my implantation as a similar instrument will be inserted in the exact same place. Then Dr. C inserted the ultrasound wand and they added a small amount of saline. This caused a bit of pressure and cramping but worked to open the uterine cavity so the lining was visible. After about ten minutes of uncomfortable crampiness it was over. And they'd found two areas that could be a problem. Both of them were at the top of the ultrasound screen in little "clusters." One on the right the other towards the center. Neither were very big, and 99% of the time are completely harmless. But, the fertility medication can make these small, harmless polyps grow and become a problem. So I have to have them removed.

Sarah wanted to schedule this on Thursday, two days later. That was not going to be possible so we compromised and I will be going in for my first ever surgery on Monday at 6:45 am. I'm trying to focus on the positive in this. I get an extra day off that week. It's and outpatient procedure. It shouldn't hold up my IVF in anyway. And most importantly, its going to very similar to what will happen the day of my retrieval so that part of my stress from not knowing will go away. So wish me luck for Monday the 14th! On a completely side note, Tony and I might be moving. A friend of his family is a realtor and she has a client that is looking for a two bedroom, two bath condo in our area and he will be coming by to take a look on Sunday. Talk about a lot going on!

ps.  They had to reduce my dosage of Metformin to just one a day thanks to ALWAYS being nauseous and diarrhea like I've never had in my life.  For a month I dealt with that.   No longer!

I have drugs!

We received a very large box today containing all of the "goodies" I will required over the next couple months.

I sat down and laid everything out.  It still looks like a lot, but a little less intimidating.

The large red thing in the back is my needles disposal box and almost everything in the left two rows are needles and syringes (with the exception of the two amber vials and the bottom of the second row.)

I received my Lupron.

Lupron (aka Leuprolide) $5.00

I received my Follistim and Menopur.

This is just the injector, the drug is placed inside the pen.  Follistim $30.00

Menopur $283.96 (The expensive one!)

I also receive hCG.

hCG $$5.00

And my progesterone in oil.

Progesterone in Oil $47.00

And then the more normal things like the Doxycyline, diazepam, Prometrium, and methypredisolone pills.

All together my medications were $385.22.  Add that with my metformin, pre-natals and birth control and my total medication costs for IVF are $407.22.  Considering most people pay upwards of $3000, I don't think that's half bad at all.

I will be learning how to use all of these tomorrow.

The date is set!

I received my information packet with my all important IVF calendar.  This will be my road map to everything from medications to appointments.  I still have questions but those will be addressed in my IVF and injection class on Thursday.  One of the questions I have is "Where the hell are my prescriptions!"  The mail order pharmacy Dr. C's office sent my medications to never sent them to my pharmacy.  Dr. C's office never resent my medications to my pharmacy either.  Its not that hard, why can't this one thing get done!  Okay so there's my tangent, moving on.

So my information packet.  I have a stack of forms that I need to sign and have notarized.  There are three that seem pretty standard for any kind of surgical procedure.  One for the retrieval which includes the wording "ultrasound guided vaginal ovarian aspiration."  Yikes, that sounds scary.  And the image I found looks a little scary and a LOT uncomfortable.

The second one is for embryo transfer, and the third is the anesthesia consent.  Then the last consent form is a freaking book!  "Informed Consent for Assisted Reproduction: In Vitro Fertilization, Intracytoplasmic Sperm Injection, Assisted Hatching, Embryo Cryopreservation."  Now that's a mouthful.  The document is 26 pages long and has releases for each component of IVF including an okay for the implantation for two embryos.  

In addition to these things there are two injection instructions, one for subcutaneous injection and one for intramuscular, and instructions on mixing one of the medications.  I'm pretty comfortable with the sub-q type of injections, those needles are tiny and virtually painless, but the intramuscular needles are scary long and thick, a little scary!  Thankfully I will only require one or two of this latter type of injection.  There are also instructions for both procedures.  Both pre and post. 

So all of this starts on 11/15.  I will begin injections with Lupron in the evening, a "baby" aspirin, and doxycycline.  The Lupron is to help time my procedure and the doxycycline is an antibiotic.  I'm not entirely sure why that or the baby aspirin is given but you bet I'll ask on Thursday.

I'm to discontinue the birth control bills on the 20th and have a baseline ultrasound and blood work-up on the 23.  A few days later on the 26th I'll begin injecting Follistim and Menopure, both are used to develop and grow my eggs.  I'll take my last dose of Menopure on the 28th and my last dose of Follistim on the 29th.  

There is some confusion on my calendar about the hCG I will need to use.  I believe I will only use that on the day of my retrieval, but they also have it down a few days earlier.  I will ask for some clarification Thursday.  

On December 7th I will go in for my retrieval.  Because this procedure involves a very large needle I will be given anesthesia.  Tony will also give his "donation" this day.  I have been instructed to stay off my feet for two days, the day of and the day after.  I have already put in for sick time and covered the days.

The day of my retrieval I will start injecting progesterone in oil nightly.  This is responsible for developing my endometrial layer.  I'll also take an oral steroid called Medrol and another round of doxycycline.

I'll go back to the hospital on December 12th for my embryo transfer!  This is the big day.  They will implant two embryos using a thin tube that is inserted into my uterus. 

I'll take some valium to relax me for this but it should only be uncomfortable, not painful.  I am to stay off my feet for two day, the day of and the day after, and have minimal activity for two more days.  I will also need to limit my activity and I will have a weight restriction for a week after that.  I've put in sick time for the first two days and plan to ask at my appointment if I it is advisable to work the next two days.  If it isn't, I will not be working.  This is important and my work will have to understand.

It will be two weeks before I can take a pregnancy test.  That date is right after Christmas.  I should know right before 2012 if a baby is in the future!  

Below is my medication and appointment calendar as far as I know at this point.  I will post more details after my Thursday appointment.

November 2011

Sun	Mon	Tue	Wed	Thu	Fri	Sat
		1	2	3	4	5
		AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal 11am-1pm IVF and injection class	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal
6	7	8	9	10	11	12
AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal
13	14	15	16	17	18	19
AM Microgestin PM Metformin WF Prenatal	AM Microgestin PM Metformin WF Prenatal	AM Doxycycline Microgestin PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline Microgestin PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline Microgestin PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline Microgestin PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline Microgestin PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline
20	21	22	23	24	25	26
AM Doxycycline PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline D/C Microgestin	AM Doxycycline PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline	AM Doxycycline PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline 8:45am Baseline Ultrasound and Bloodwork	AM Doxycycline PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg Doxycyline Last day of Doxy	AM PM Metformin WF Prenatal Lupron 10 Units Aspirin 81 mg	AM Follistim 125 Units PM Metformin WF Prenatal Lupron 5 Units Menopure 1 Vial Aspirin 81 mg Begin Follistim and Menopure. Lupron decreases
27	28	29	30
AM Follistim 125 Units PM Metformin WF Prenatal Lupron 5 Units Menopure 1 Vial Aspirin 81 mg	AM Follistim 100 Units PM Metformin WF Prenatal Lupron 5 Units Menopure 1 Vial Aspirin 81 mg Follistim decreases	AM Follistim 75 Units PM Metformin WF Prenatal Lupron 5 Units Aspirin 81 mg Follistim decreases Ultrasound and Bloodwork after AM meds	AM PM Metformin WF Prenatal Lupron 5 Units D/C Follistim

December 2011

Sun	Mon	Tue	Wed	Thu	Fri	Sat
				1	2	3
				AM PM Metformin WF Prenatal Lupron 5 Units Ultrasound and Bloodwork	AM PM Metformin WF Prenatal Lupron 5 Units	AM PM Metformin WF Prenatal Lupron 5 Units Ultrasound and Bloodwork
4	5	6	7	8	9	10
AM PM Metformin WF Prenatal Lupron 5 Units	AM PM Metformin WF Prenatal hCG (?) Ultrasound and Bloodwork	AM PM Metformin WF Prenatal	AM PM Metformin WF Prenatal Progesterone 50mg hCG @ xx:xx am Egg Retrieval	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM Doxycyline PM Metformin WF Prenatal Progesterone 50mg Doxycyline Medrol Taper
11	12	13	14	15	16	17
AM Doxycyline PM Metformin WF Prenatal Progesterone 50mg Doxycyline Medrol Taper	AM Doxycyline PM Metformin WF Prenatal Progesterone 50mg Doxycyline Medrol Taper Prometrium & Valium to appt Embryo Transfer	AM Doxycyline PM Metformin WF Prenatal Progesterone 50mg Doxycyline Medrol Taper Last day of Doxy and Medrol	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg
18	19	20	21	22	23	24
AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg
25	26	27	28	29	30	31
AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg	AM PM Metformin WF Prenatal Progesterone 50mg Pregnancy Test