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

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