Wednesday, August 24, 2011

Wow, all I can say is WOW!

Well, where do I begin.  My stomach was in knots all night last night thinking about where we were headed this morning.  The dreaded injection class!!  So needless to say I didn't sleep very well and the drive to the Dr's office wasn't any better.  Justin and I walked into the office and there, right in front of us was a long table with over 100 needles and syringes on it, oranges, those red needle disposal containers, vials of liquid, and 8 chairs surrounding the table.  I wasn't sure beforehand if this "training" was going to be a group thing, or individual by couple, but we soon realized we were going to be sitting shoulder to shoulder with 7 other couples in our position whom I am sure have similar stories to ours.  It's kinda strange since infertility is such a taboo thing to talk about, and we have noticed through the many doctor's waiting rooms we have sat in that no one wants to make eye contact, let alone smile or even acknowledge you are there.  So this scenario, where we are faced with strangers in similar situations with lots of scary needles in front of us was something completely different and new.  So here we go! 

The coordinator who was leading the training told us that whomever was doing the "injecting" had to sit at the table.  What?  I don't have to belly up and stare at the needles?  Hurray!!  Ok, so I was 2 feet away which was still too close for comfort, but at least they weren't sitting right in front of me. 
So we began by learning where I was going to receive most of my shots.  The abdomen!  Yuck!  She then began to teach the injectors how to use each kind of medication with each kind of needle or injector pen, or vial.  It was honestly like a medical chemistry class.  Load the syringe with a liquid, dial up the dose, inject the area, mix one vial of liquid with a powder, pull it out, put it into another vial, mix that one up, (swirl not shaken please).  I mean this stuff is super complicated!  Each medicine has like 3-6 steps on how to prepare it, what kind of needle to use, etc etc.
And man are some of those needles HUGE!!  Luckily a majority of them are pretty small, but the one big daddy that I will have to take the longest that goes in my hip is SCARY!  I think it even freaked Justin out a little! 
So we sat through about an hour and a half of this injection training (which I was nauseous through most of) and also filled out and signed our IVF/Cryo embryo freezing forms.  These forms specify what you will allow them to do with your eggs, and then your embryos.  Strange, one section asked what would you like to do with the embryos if you get divorced.  Apparently I am assuming they have had legal troubles with this before, so now you must specify in writing who gets the embryos, or they are disposed of pending death or divorce.

Next we had to do our FDA blood work panel which I think I mentioned screens for all infectious diseases.  This is required before you can do IVF.  Well when it was finally my turn, the nurse drawing blood noticed a note on my chart from the doctor that he wanted to do some additional blood work, because he thought I might have previously had some miscarriages.  Oh, I forgot to mention as soon as I sat down in the chair to do the blood work the nurse look at me and asked if I was alright because I was a little pale.  Ha!  And I was the only one who had to have her husband hold her hand.  I mentioned to her that I was very afraid of needles and she responded with, "well these extra tests require several more vials of blood.  Do you want to do them all today or half today and half another day?"  And then the water works started.  I couldn't help it! I responded with, I guess just do it all today and get it over with, and I looked away from her to try and hide my tears. 
And then her next question was, "do you want me to use the small needle that makes it go really slow, or the big needle that makes it go fast?"  Really.......Really?  And what do you think I said....I guess the big one?  So here I am, the only person at the training who is visibly disturbed by the sight of needles, sitting in the blood drawing recliner, crying like a baby, holding my husbands hand, and having to get 15 vials of blood drawn!  Everyone else only had to get 4!  What a crock!  Then I almost passed out because she took so much blood, so I held up the blood drawing process while I drank juice and ate a muffin.  My IVF group probably left thinking oh great, hope I don't have my future appointments for blood work after hers or I'll be here all day, ha ha! 
So here is where we stand with everything moving forward:
I will stop taking my birth control pills next Friday Sept 2nd.  This will then trigger my cycle to start which should be a day or two after I stop taking the birth control pills, Sept 3rd or 4th.  Then from what ever day my cycle starts the dates on my calendar will be filled in according to day 1 of my cycle.  I will take the following medications:
FSH-Follistim/Gonal-F (causes follicles containing potential eggs to develop)-Starts on cycle day 3, injection twice a day 7am & 7pm in my abdomen; I do not know how many days I will take it, but usually around 9-12 days
Menopur/Repronex (stimulates egg follicles to grow)- Starts on cycle day 5, injection once a day at 7pm in my abdomen; 9-12 days of use
Ganirelix (prevents premature ovulation)-Starts around cycle day 8, Injection once a day at 7am in the abdomen
I will be monitored with 4-5 ultrasound and blood work appts starting Sept 5th-Sept 19th to see when my follicles are mature.  I need to have multiple 17-18sz follicles in order to do the retrieval.  If I do not have that, the cycle is canceled.  And you start the process all over again next cycle, Ugh!  Let's hope and pray that doesn't happen.  She said it happens very rarely.
HCG trigger shot will be given when they determine that my eggs are mature and ready to retrieve.


Once the trigger shot is given, exactly 36 hours after that I will have egg retrieval.  The target date for retrieval is Sept 19th, but is based on each individual person, so the window it Sept 14-20.  I will be knocked out for this procedure, but it only takes 20-30 minutes to complete.  Then once they retrieve the eggs Justin will give his sample that day and the embryos will be made.  Then we will wait 3-5 days for the embryos to be at just the right stage and then they will transfer them back in.
Then once the transfer occurs, 2 things happen.  The dreaded HUGE needle injection starts daily in my hip.  And we have the 2 week wait to see if it worked.  They will do a blood test exactly 2 weeks from transfer day.  If it is positive (which I KNOW it will be), we will continue the HUGE needle injections for 4-6 more weeks to ensure the pregnancy.  I am hoping I just get used to the HUGE needle and eventually it will be second nature and not scary, but it is hard to imagine.
I have counted and at the minimum I will have 37 injections leading up to the transfer, and then at least 14 HUGE needles, and 5 more blood draws.  I never thought I would say this, but I hope I have a lot more than 14 huge needles and 5 blood draws, because that would mean we are pregnant! Wow, yes I just wished for more needles.  I think the crazy has set in....

Jenny

Saturday, August 20, 2011

Alex, Twins, and a Beard

I keep wondering why I am the one out of all the people I know who can’t get pregnant.  Why is this my path?  Is it something I did?  Is it something I said?  Is it something I took or drank or ate?  Is it natural selection?   Am I being punished?  Why me?   

Oh yea, I do get down on myself every once in a while.  I cry and have my emotional outbursts and I play the “poor me” game.  Why?  Because I hear about people getting pregnant around me every week.  Does it bother me?  Yea, a little, but I get over it pretty quickly and remember that I should be happy for people and not despise them for having something I don’t.  Because honestly my life is pretty great, and will continue to be great, children or no children.  

I had a dog named Alex that I got when I was 13 years old in 1993, and he was with me until June of this year, which was right after his 18th birthday.  I never in a million years thought he would live that long!  But he just kept chugging along.  About 5 or 6 years ago I was having a conversation with my mom and I said something about Alex being like my child, and that I would never have human children while he was around.  I don’t know why I said it the first time.  But it was so matter of fact, like the time when we brought Alex home and my mom asked what his name was and I said “Alex.”  Really, Alex?  Not really a dog’s name?  And I said well I just know that is his name.   This was just a very strong thought like I had that day and it stuck with me.    I said this statement many times to people over the years, and someone just brought it up to me the other day.  “Well you said you wouldn’t have children while Alex was still here on this Earth.”  Oh yea!  Crap!  So maybe this is why we don’t have human children yet?  (Yes, we have 2 doggie children, Adel and Annie)  So from now on I am watching what I say, because words can be a very powerful thing once they are said out loud and sent out into the universe.

 I was also thinking about the idea of having twins through this process.  Yes, in case you are wondering the risk of having multiples is much higher with IVF, depending on the number of embryos you transfer.  And we will not know how many we are transferring until we see how strong the embryos are, but NO people I am NOT going to be octomom!!

Anyway, when I was 15 I started working at a holistic alternative bookstore called Third Planet Books on Manchester Road.  The couple who owned the place were super quirky, but the nicest people!  Twice a month they would have psychic fairs in the back room and 6 or so different people each time who claimed to have “the gift” would give readings.  Bobbie the owner would always tell me I could have readings done by them for free either before or after the “psychic fair”.  The teenage guinea pig.  Over the 2 year period that I worked there I probably had my fair share of readings, and there was one thing that always stuck out in every reading I had.  Every one of these people told me I was going to have twins!  TWINS?  Are you crazy I am 16 years old!  But this prediction kept reoccurring when my mom and I would visit other holistic fairs in other cities and states!  They all said it!  So needless to say it is something that has stuck with me since.  Twins don’t run in my family, so I didn’t know how this prediction was going to come to fruition.  But maybe this process is how it is supposed to happen.

Please don’t get me wrong, I will be ecstatic just to have one healthy baby.  But I just think like I said earlier, with things being said out loud being very powerful, maybe we are meant to have twins and this is the only way for that to happen?  Coincidence?  Who knows!?  We would love to have 2 children, and if we can do this IVF process ONE time instead of 2 that would be just perfectly ok with me.  Less needles!

Soooo....today is Saturday, and in 4 days, Wednesday, we are heading into the Fertility Clinic to do injection training.  Do I know what this entails?  Needles!  Do I want to go?  NO!  But I will go, because I know there is a bigger picture.  But I can’t promise I won’t cry, or throw up, or pass out.  Justin and I both will also have our FDA blood work screening done on Wednesday, which means several blood draws for both of us.  This screening just makes sure we don't have any major diseases or issues.  Ahhh!  We will also receive our calendar and protocols, so I will update after our Wednesday appointment, if I survive.

As I said before I am currently taking birth control pills for 38 days prior to treatment starting.  But because my body is apparently ornery, I am now taking 2 birth control pills a day, along with a prenatal vitamin, a baby aspirin, a DHA supplement, and something called DHEA.  I guess there was a study performed recently with IVF patients that they gave 75mg daily of DHEA for 30 days prior to IVF and the embryos were stronger, and there were more pregnancies in the group who was given DHEA.  The DHEA is in pill form and I take 25mg 3x a day.  When I received the instructions from my IVF doctor to start taking it about 10 days ago, I went to GNC and picked up a 90 pill container.  I went home and carefully read the label just because I had already been through the steroid prescription fiasco.  The label clearly stated, DO NOT take more than 25mg daily.  Side effects include hair loss, facial hair growth in women, irritability, and aggressiveness.  WONDERFUL!  I was supposed to take 3 times the recommended dose on the label.  So I am going to be the girl who is pregnant, but is bald, has a beard, and it really angry??  LOOK OUT!  Justin is so wonderful and after I told him this he looked at me with this big grin and said, “Baby I will still love you even if you are bald with a beard.”  Wow, now that is love!  Thanks Babe!

On pins and needles (literally)....
Jenny



Monday, August 8, 2011

Thoughts, and a soapbox

I think I think too much.  Or maybe everyone's brain has this many thoughts, ideas, and emotions in it?  After writing my first blog, a flood of things that I have been thinking about for the last year just came rushing back, so maybe this writing therapy will be a good thing.  Just get it out, right? 

First, I am sure that many people are wondering how Justin and I are holding up as a couple.  Well.....  I think we are doing pretty amazing all things considered.  Yes, we both get frustrated, yes every so often we yell and scream and cry, but we always makeup and each time it seems to bring us closer and helps us understand what each other is feeling.  There are moments where we both want to give up and throw in the towel, but then we remember how much love we have to give and that the end result is going to be amazing!  We started this whole baby process right after we got married, and that is one piece of advice I would give to anyone who is just getting married, WAIT a year before you even start trying because it can get super stressful very quick if you don't get the results you want.  But then again, it took us 2 years to finally get to this point, so if we would have waited a year before we started, it would have been 3 years before we would have gotten to this point, so actually I don't know.  That brings me to my next thought and suggestion:

If you are 2 healthy partners and struggling to get pregnant, DO NOT do what I did.  The rigor of tests, procedures and whatever else I went through the first 15 months was unnecessary.  The only 2 simple tests that they need to suggest are an ultrasound (to get an ovarian reserve count), and the swab test to determine if you have the bacteria that can cause miscarriages.  THAT IS IT!  Those 2 super simple tests can be performed in 5 minutes, are totally painless, and can give you 99% of the most important information you need to know about female fertility.  Forget all the surgeries, blood tests, poking, and prodding! This would have saved us over a year of frustration, money, pain, and emotion.  But that isn't how the medical community works and here is why:  (And mind you this is just my experience and opinion)

Obgyn's are taught that patients are supposed to try for 1 year before even having any tests done.  But WHY?  Why not talk to your patients when they decide to start trying and offer these 2 simple painless tests to their patients?  This would at least give couples an idea where they stand.  Hell, even if insurance doesn't cover it I think the tests are like $500.  Hindsight, I would have gladly paid way more than that and saved a ton of heartache, time, and pain.  Needles, Needles, Needles! 

So to answer the question of why don't obgyn's offer these tests to their patients, the answer is simple, outdated teaching methods, no cooperation between obgyn's and infertility specialists, and most of all money.  Obgyn's are taught in school that these rigorous tests, surgeries, and procedures are the first steps if someone has infertility.  But it isn't true!!  Technology has advanced, and these methods are not necessary (in most cases).  So why do they still do them, plain and simple MONEY.  Obgyn's want to exhaust every resource to make the most money, before they throw their hands in the air and say, "Well I am not sure what is wrong.  Every test came back normal, Good Luck!"   

Good luck??  Well what do I do now?  I am the one who had to ask and suggest (after google researching), we try IUI.  And what do I know?  And once we exhausted the IUI route, I once again started asking questions and took it upon myself to suggest IVF to my obgyn and nurse practitioner.  Well, I soon learned that the nurse practioner who was performing our IUI's did not like to hear the letters, I..V..F.  She snapped at me on the phone and said, "Well I guess you have made up your mind, good luck!"  What is with these people and good luck?!? 

So we finally made it to the IVF doctors 1,2,and 3 and this is where we learned that they hate obgyn's and IUI clinics.  So everyone hates everyone!  Perfect!  We are trying to make a harmonious process happen and create a baby and everyone in the industry hates each other?  No wonder it took us 2 years to get to this point.

The point of all of this, is that this industry needs to change!  Women are so misled, because no one wants to work together.  I think it is greed, maybe I am wrong, but the evidence sure points in that direction.  I know from my experience I sure would have rather had the simple tests done first, (which in my case were the only ones that gave us an answer).

Ok, I think I am hopping off my medical soapbox for the day.  Ha! No more ranting!  Happy blogs ahead!

Jenny



Thursday, August 4, 2011

Background...and the beginning

Today is my first time ever writing in a blog. I figured this format was the best way to express how I am feeling and let our friends and family know what is going on with our journey to become parents.  I also thought this might be very therapeutic for me to express how I am feeling and not just keep everything inside.  
Here is a little back story up to this point.

Justin and I met in 2006 at the Lake of the Ozarks. Party cove to be precise.  We had instant chemistry! After coming home from the lake we realized that we had a lot of mutual friends, hung out at the same places, and EVEN lived across the street from each other in the same apartment complex!!  After 2 years of dating, Justin proposed on a romantic gondola ride in Venice Italy in May of 2008, our 2 year anniversary of meeting.  It couldn't have been more romantic.  We set the date for our wedding and kept the Italian theme going by getting married at a winery on Sept 19, 2009.  It was the best day of my life!

Right after the wedding Justin and I decided we wanted to start trying for kids right away.  After a couple months I decided to go visit the doctor and just ask some questions and make sure they thought everything was ok.  The doctor said not to worry and just relax. Well a year went by and still nothing.  So we revisited my Obgyn and she suggested getting a semen analysis and some very generic blood tests for me. Our obgyn also suggested we have an HSG which is where they shoot die through my tubes and then take xrays to make sure my tubes aren't blocked.  Wow, it was super painful and i was awake with no sedative for the whole procedure.   All tests came back normal, so she said to just relax and keep trying.

Two months later we decided to be proactive and start asking questions.  Intuitively I knew something was wrong, but everyone kept insisting we just needed to relax.  After that our Obgyn said if we wanted we could go visit a nurse practioner who had low cost infertility procedures that might help us.  The nurse, Becky did some blood tests to see my hormone levels, and an ultrasound and said we would be great candidates for IUI.  IUI for those who don't know is where they insert sperm with a small catheder tube directly into the uterus, bypassing the cervix which decreases the length that the sperm have to swim to meet an egg.  IUI can be done with or without stimulating drugs.  We were told our best chances were with drugs.  

So October 2010 was our first IUI.  Becky told us clomid which is a pill stimulant would be great for us. We tried clomid with IUI, 2 times before Becky suggested I should have a surgery called a laparoscopy to inspect the outside of my reproductive organs to make sure they were normal.  Once again, not really knowing what to do I asked my ob what she thought and she said I should do it.  

December 2010, I went in and had a laparoscopy performed.  They basically make a small slit in your belly button and a tiny incision by your left hip bone and stick cameras and a probe in there to look at the outside if your uterus, ovaries, intestines, etc.  They are looking for cysts, endometriosis, anything abnormal. My results came back and it was determined that I had mild endometriosis, but none attached to anything important in reproduction, so my ob said I shouldn't worry about it. 
My ob and nurse practioner Becky decided to put me on a low dose steroid called predisone, which they said would lower inflammation in my abdomen from the endometriosis, and hopefully help our chances.  They said I wouldn't have any side effects from the steroid since it was a low dose, so I said I would take it....more on that later.

January 2011 we decided to resume IUI.  We decided to be more aggressive and start doing injectible stimulant drugs along with the clomid.

Oh wait...  I forgot to mention in the beginning of the journey the fact that I am DEATHLY afraid of needles!!! So we are already to January 2011 and I have already had 16 vials of blood drawn over several appts, 2 fsh trigger shots, and 1 IV.

So back to January where I get to add to my needle tally with another round of IUI with 1 injectible drug, 1 fsh shot, and no results.

In February 2010 our nurse practioner Becky decided to do a clomid challenge test.  This meant along with the normal IUI protocol I would be going daily for 1 week to get blood drawn to see how the clomid was affecting me.  Well I ultrasound and blood draw into the challenge Becky said I had been overstimuulated the month prior, so we could not continue with the test or any stimulant medications for this round, but we could still do IUI.  We did with another failed attempt.

At this point Justin and I decided to sit down and have a conversation about what we would do next.  We decided we would do 1 more IUI, and if it didn't work we would take a break and then regroup in a couple months and decide our next plan of attack. 

March 2011, IUI #5, failed.  Ugh, such a disappointment! But honestly I knew in my heart this wasn't going to work. Sometimes I guess I should just listen to my gut feelings.

We took a couple months off and decided to stop thinking about having a baby and just enjoy each other.  But honestly do you know how hard it is to not monitor your ovulation when you have been doing it every month for almost 2 years, because you keep thinking in the back of your head this might be the month!?  If I miss one month of ovulation that might have been our one shot!? It is all consuming.

In the interim I decided to try some wacky herbal vitamin treatment that I found online because a girl I knew said her cousin got pregnant within 1 month of taking it.  The supplements included Norwegian salmon oil pills and wheat germ oil pills.  My 60 day supply came without a pregnancy. So stupid!

In May 2011 I decided to start researching the next step in the infertility journey.  At this point we were categorized as undetermined infertility, which basically means we think you should be able to have a baby, and all your tests have come back basically normal, so we don't know what's wrong. Very frustrating! Sometimes you just want a diagnosis, so you can say exactly what should be done, but then again isn't it better to be healthy and undetermined?? 
Ahhh, the chaos in my head!

I must also note that I am the kind of person to research EVERYTHING! And the Internet gives you access to anything you want to know.  But with the amount of information and conflicting diagnosis' for every test result,  it could send a person to the mental hospital.  There are good outcomes and bad outcomes for every level, age group, syndrome out there.  So I decided to stop trying to solve my problem and diagnose myself from google searches. It is what it is, even if it is undetermined, and I have to live with that.  No amount of google searches are going to get me pregnant.

So Justin and I decided to each choose an IVF doctor and we would choose a doctor from these 2. Doctor #1 was super creepy and we both walked out of the consult confused and feeling like we had just sat in on a medical seminar, not an IVF consult. He said our problem could be the endometriosis, semen quality, or my egg reserve count.  We didn't bother doing any testing with him.

Doctor #2 came very highly recommend, had great results, and had published several books and even been on Oprah.  I thought he would be the one. We did a preliminary ultrasound before our consult which we were told would tell us my ovarian reserve, (how many eggs i have left).  The ultrasound showed that for my age I had a lower than normal egg reserve, and that that was our problem.  He said screw the other possible things that everyone else has guessed about. Eggs and sperm are what you need, and that was that.  He said I should not have had any of the procedures I had had so far including the surgery or the iui's!! He said they were all a waste of time and money. Ok.....really?? I think my jaw fell on the floor. He said all I needed was a simple ultrasound to determine our infertility issue.  He also said I should have never been on that low dose steroid medication for 5 months.  He said it was very dangerous and that I needed to be weaned off of it immediately.  I told him i had stopped taking it a week ago abruptly....more on that again later. Ugh!!  What now??  After waiting in the waiting room for 2.5 hours past our appt time, and having this little man yell at us and his nurse, we decided he probably wasn't for us either, but the information he had provided was infuriating and calming at the same time.  We had wasted a year of time, but we finally had a probable cause for not being pregnant.

Doctor #3 kind fell out of the sky and we were told he was the cowboy in the IVF world and had an amazing personality and bedside manner.  I called and ironically got a cancellation appt for 2 days later. (their next available appt was 2.5 months out) I thought that was a good sign.  We walked in and met the doctor and we both knew instantly he was the one!! It's funny, but it is almost like when you meet your husband you just know and you have that feeling inside.  For us, it was the same with Dr. Simckes, he was it.  We talked to him for over an hour and he was so nice and friendly and agreed with dr #2 about us having too many things done.  He also performed an ultrasound, a blood test, and a swab test to confirm doctor #2's opinion.  His results confirmed that I have a low ovarian reserve and also the swab test confirmed that Justin and I had a bacteria that can cause miscarriages.  So even if we might have gotten pregnant over the last 2 years it wouldn't have stuck because of the bacteria.  OK seriously???  Why the heck weren't these SUPER simple tests performed 2 years ago by my ob??? I was angry!! These tests should be standard before you put someone through surgery and a rigor of needles!!

But the past is the past and you learn from it, so onward and upward.  Dr Simckes said IVF was the best solution for us to get pregnant.  This was the end of June 2011, and we decided that IVF was going to be our path.  We both felt very good about it.  Dr. Simckes said there would be many things we would need to do in preparing for IVF.  He said first things first, go on vacation immediately!

Sooooo, that's what we did.  The end of July 2011 we went to Florida for 5 days to lay on the beach and just relax.  It was nice to just enjoy each other and know that we didn't need to worry any more because we finally had an answer and we were in good hands with someone who was going to get us pregnant.

Oh, I forgot the ending to the low dose steroid story, well about 10 days after I stopped taking the medicine in early July my hair started falling out! Really!?? I called the my doctor and they said that might happen for up to 6 weeks after you stop taking the medicine. Oh, really, just awesome! Someone probably should have told me that!! Lesson learned! And to anyone out there entrusting their well-being to a nurse practitioner practicing medicine like a doctor, don't do it!! Scary stuff! 

Wow, that was a lot of background! It has been quite a roller coaster so far, and the journey is far from over.

We began the IVF journey about 9 days ago now, July 26, 2011.  Our first step was Justin taking an antibiotic to get rid of his bacterial stuff, and I started taking birth control pills. (He and I will both take the antibiotic again in sept). Yea, I know, why birth control if you are trying to get pregnant?  Well I guess it helps the dr regulate my cycle to be on target with the dates he has set for retrieval and transfer, and the birth control kills off old dead eggs stuck in the ovaries.

Then yesterday August 3rd, I had another procedure called a hysteroscopy and d&c.  The procedure only took about 15 minutes and i was knocked out for it.  The hystero scopes your uterus to make sure you don't have any polyps or cysts or anything that would interfere with a fertilized egg from attaching.  The d&c portion just cleans the uterus out. So another procedure under my belt, and another needle IV to add to my list.  It was the least painful of all the procedures I have had, and I am actually feeling pretty normal today, just a little sore.

So for the rest of August I will just continue to take my bc pills for a total of 38 days, until we begin the stimulation injections in September. Can't wait for the needle injection training!! Ahhhh! I just keep telling myself the end result is all that matters, so I just need to get over the needle thing. Ha! Easier said than done. 

Well I just wrote an essay. But that is our story, and I am glad you know it and I hope that you if you are reading this you are sending positive energy, good thoughts, and prayers our way! Love to you all! Until next time..

Jenny