Wednesday 29 January 2014

Just sharing because....

.....everybody has been so kind about everything else I've shared and I've spent a day simultaneously exhausted and nervy, and I have to let some of it out before I collapse into bed..

We had a new experience today, not of a pleasant kind. The house was broken into.

Yup, arrived home after work and opened the door to a feeling of "notrightnotrightnotright" - I don't leave drawers and closets open, I don't!

Somebody broke a window and made off with everything of value that they could find and easily carry - which didn't encompass everything of material/sentimental value to us, but was a good many things. Among them, most of my jewelry and my 2008 laptop (really, dumdum?)
 
He (I assume?) left all the musical instruments although he removed my euphonium from its soft carry case and took that (to haul away the other items?) And, weirdly, left the euphonium carefully placed upright on a table. Other areas of the house were a mess, drawers pulled apart, boxes empty, stuff thrown everywhere. The thought of my euphonium placed carefully amid the chaos still baffles me.

We're fine, the house is not damaged other than the window; the worst of it for me is the creepiness of feeling violated.

Can I find an IF angle?

Well, hell yeah.

How important are material things to me. Not very, I've discovered.

The only thing on the laptop whose loss I regret was digital photographs. Some are certainly gone for good; luckily I do have quite a few of my photos uploaded or saved elsewhere. And I was seriously considering deleting some of my Facebook albums. Yeah, good thing I didn't.

The jewelry, well that's sad. Most of it was gifts from people, especially Mr. Turtle. I'm not devastated though. After all, the jewelry was not Mr. Turtle, and he is still here (and glaring at the TV, very pissed off, I might add).

I have about 3 complete sets of earrings left, and a brooch my mom gave me at age 11 to commemorate a dance performance. It was in a back drawer.

Yeah, stuff.

Why am I not really cut up about this?

Well. In the past 3 years I've watched my stepmother in law deal with the death of her youngest son in a car accident. Have seen my sister in law lose her mother to cancer 2 months after her wedding. Have faced infertility.

I know my stepmother in law would have given all her jewelry and more if she could have saved her son. I know my sister in law would have done the same if she could have saved her mother. I know what I would give to have a child, if it was a matter of me giving.

None of that makes it OK that somebody violated our home and took our stuff. But, when you get in the habit of thinking about what really matters in life, well, it's not hard to apply that thinking to other situations.

The hardest part for me will be reclaiming the peace and safety of the house - this is where we come to feel safe from the world, not to do battle with its evils. I guess we just have to find that safety in each other.

Sunday 26 January 2014

What happens after (cancelled) IVF?

Now, I don't mean  "What happens after cancelled IVF...DUM DUM DUM..."

...as in, what are the next steps in treatments. We're working on that angle, but it's not something I'm prepared to blog about just yet. Suffice it to say that we are working on Plan B as described in  my entry on Charting Our Course. But I'm not ready to go into it or discuss it right now, if for no other reason that I'm afraid people are going to try to argue me out of it, or in the the case of our non-IF loved ones, bombard us with "their perspective" which, no offense to them, is just not very well informed. Mr. Turtle and I need to focus on each other right now.  I don't feel like explaining/educating/playing counsellor/enduring other people's attempts to play counsellor with me. Eventually I'll be able to deal with that, just not....yet.

What I mean is what actually happens to my body after an IVF cycle cancelled before retrieval?

When we first heard the cycle wasn't working out, this admittedly was the last thing I cared about. After our final scan, the nurse told me "Eventually you'll have a period, but it probably won't be much of  a period" - because my lining was very thin. I can't remember if she said anything after that and I didn't ask any questions.

But after about a week I started to wonder, and I can't find much about it online, other than discussion boards with various people's rambling, which I don't feel like picking through. I don't know if anyone has had a similar experience of a cycle cancelled so early and what happened afterwards.

To be completely clear, scan after 9 days of Gonal-F/Menopur, and 11 days of Suprefact showed a 2.5mm lining, and two very small follicles - I think 1.9 mm was mentioned.  I never grew any follicles, and therefore my body produced no estrogen. Total non-starter. I stopped all drugs immediately.

I paid no attention to anything for several days, but then I started to wonder because around CD 25-27, I started getting what could be interpreted as fertile signs - e.g. slippery/stretchy CM and low readings on my Ovacue monitor. It could well be nothing - but it was also the first slippery CM that I've had since starting the IVF cycle. I was dry when on  the BCP and the fertility drugs.  Right now I'm on CD 27, which should be the end of my cycle if my body was on its natural rhythms (and somewhat within its norm). But...if I count from the day that I stopped Suprefact, I'm on CD 11....which is about the time I'd normally ovulate, give or take.

Is it possible for one's body to just restart a cycle after going of the drugs?  It seems ridiculous...and ironic in an annoying way....but I wonder. If nothing else, it feels somehow reassuring to have familiar responses in my body.  Everything was off when I was on BCP / fertility drugs. Period was very light, nothing was responsive, dryness made sex uncomfortable...which I'll be honest, bothered me quite a bit. The months before IVF had been pretty good sex-wise...whether it was the acupuncture or supplements or whatever, I had an increase in CM and it made all that TTC quite a bit more pleasant. Maybe we can't make a baby the regular way, but I'd still like to have good sex.

Anyway. Add this to the list of things I never dreamed I'd think about. Back to Sunday chores now.

Saturday 18 January 2014

I can't say "I never win anything" anymore

So, obviously, this was NOT my lucky week.

On the other hand, I do feel lucky in a lot of ways.

Mr. Turtle and I both were able to take Tuesday off and spend quality time together. We walked in a nearby park (narrowly avoiding slipping on the ice that is all over the city and its environs) and enjoyed the view of the mountains and  foothills. We went for lunch. We were there for each other. It matters.

Everyone at my school whom I've told about IVF #1 and its sorry conclusion continues to be very supportive. A few  people I work with, but whom I hadn't disclosed  to, asked about my  health as they were wondering about all the medical appointments. So I gave them the Coles Notes version, explaining that while I'm actually quite comfortable with people knowing, it can be a burden to have to always update people, so sometimes it's easier to not be specific. But I did appreciate the concern.

My students had a very good week, and everything I'd planned  for them, including field trips - one of which I missed - went beautifully. This was a big help in that it reduced my stress, and it was also a good lesson that things can go just fine even when I'm not worrying about them. For a lot of my life I've had this notion that if I don't worry, stress, anguish and generally make myself ill and crazy with anxiety, that my plans will fail and bad things will happen. Well, that's just bullshit Turtle, and now is a great time to get over that.

Friday evening Mr. Turtle and I went to my staff party (replacing staff Christmas party.) The organizers did an excellent job. We had a room in the most beautiful hotel in the city, and a delicious  dinner. My co-teacher and two of my other close colleagues where there, and they are definitely people I  can enjoy spending time with outside of work. There were about 50 people there. We are a staff of about 200 but to get everybody together is like herding cats. I also think teachers are peculiarly resistant to being corralled and organized, since we spend so much of our time doing that for other people When it comes time for us to organize and follow instructions, we grumble and snark or just outright refuse to consider it. I'm that way sometimes too, but I'm glad that Mr. Turtle and I came to this evening because it was great.

And....

I won grand door prize!

Now, really, I never win anything. I'm so bad at any game (except Scrabble and Bananagram) that it's laughable.  I don't "get" team sports and never have. I never gamble or enter the lottery because I know I wouldn't win (neither do most people, of course). And door prizes always go to somebody else.

Grand prize was:
-$100 gift certificate to spa at Fairmount hotels
-entry for 2 to Sunday brunch at the hotel
-entry for 2 to "Death By Chocolate" - which is pretty much what it sounds like
-a bottle of wine
-a gift basket of goodies put together by the hotel chefs

Ironically, while they were telling the group what the grand prize was, I said to my table that it really wasn't fair to give all those prizes to one person - they should have split them up so more people would get them. Mr. Turtle said to me "You know now you're going to win, right?"

And, lo and behold, my name was called.

So I got up, feeling very surprised and a bit guilty. I still felt like I should give the presents back. But I didn't. Although I still feel a bit weird about accepting all that stuff. I'm not supposed to be the lucky person. The nice part was, the people who knew about the IVF cycle all told me that after the kind of week I'd had, they were thrilled that I won the big gifts. And I know they meant it.

But it is so weird, isn't it? I think I'll have to share some of the gifts because I can't quite get over it.

Anyway. Mr. Turtle and I will enjoy all of those gifts together in the next few chilly weeks, while we ponder our next steps. Except for the bottle of wine, which I will enjoy on my own or with other wine-inclined people, as Mr. Turtle doesn't drink.

Our appointment with Dr. Cotter on  Thursday went well. I will wait a few days to update, because we are still processing everything and I feel like I need a break from reading and writing constantly about IVF and infertility. Once again, thank you  everyone for reading. I would totally share my treats and wine with you if you could come to my house.

Tuesday 14 January 2014

Aftermath

Today we had the follow-up ultrasound. On Sunday, the ultrasound had shown no response to the Flare IVF  protocol.  The doctor who looked up my lady  parts recommended cancellation two days ago, but we chose to finish the medication and go back for another scan today. I was looking forward to this ultrasound the same way I look forward to a funeral.

The past two days have been tough. We told a few people - my inlaws, my immediate colleagues - mainly because we had arrangements to see and talk to them and it would have been quite impossible to hide the feelings or talk inconsequentially about foolish things.

I went to work on Monday and did OK - but felt tired all the time and had frequent headache/stomachache. And always the feeling of thick sadness and disappointment right at my center. It was like I was wearing a big sticky burr that picked up all kinds of random debris from my daily life till it it formed a giant sadness collage.

For example....When I went to my dance class on Monday, I had to walk past a bunch of children in the hallway. They were all over the benches and floor, getting ready for ballet, highland, or Irish dance class. Girls (sisters?) braiding each other's hair, chattering, the sound of feet coming from the studios. Now, for whatever reason when I imagine my own baby, I almost always picture a boy. But yesterday, seeing all the little girls made me think I would never have a daughter to take to dance class like my mother took me. No getting dressed in tights and leotards, no making costumes for recitals, no tiny pink or black slippers....it was devastating. Of course I realize that even if I had a daughter, she may not want to take dance classes, and then none of that might happen anyway, and I'm completely fine with that....but.......yeah.

And then this morning we drove past a Christian gift store on the way to the clinic. In  the window was a  poster advertising "More selection! - for baptism, first communion, confirmation"...  Neither myself nor Mr. Turtle is Catholic, and we have no plans to participate in any of those rituals. But the list made me think about birth, and growing up, and all the milestones of family and childhood that we have, regardless of religion or lack thereof. And again it was reminder of what we might not have, and certainly won't have as a result of this failed cycle.

The scan at The Fertility Clinic shows no change from Sunday. No response to the protocol. And when I say no response, I mean NO RESPONSE. In fact things looked worse in this scan than in the scan that confirmed the Diminished Ovarian Reserve diagnosis in  May last year. On that scan I had four follicles and a 9mm lining. After doing Flare Protocol, I have two tiny follicles on one ovary, and uterine lining of 2.5mm. Only a giant middle finger on the ultrasound screen could have given a clearer message.

On the good side, everyone at the clinic took good care of us today. This was a great improvement from Sunday, when I felt confused and neglected. First I had to wait in the ultrasound room for 45 minutes because the attending doctor was called to do some other procedure. Then she came in, probed about with the dildo cam for a few minutes - it was very painful for some reason that day - then summarily announced from between my naked legs that there was no response and that usually in these cases the cycle is cancelled. I think I made some intelligent response like "Oh I see." We then went home and got a call an hour later from the nurse that the bloodwork confirmed no response. She asked if I had "discussed" cancellation with Dr. ------? Um, sure. Exactly when were we supposed to have discussed anything? Behind the sadness and disappointment about the cycle, I felt a bit irritated that after paying nearly $9000 to the clinic (not including drugs) we weren't given 20 minutes to sit down with a doctor - fully clothed - and discuss the protocol and the results. I imagine that the doctors see this all the time and it's obvious to them, but it's different when it's your body and your hopes for a family. After a bit of phone tag with the clinic, I  was able to get my questions answered, but I wasn't very impressed.

Things were better today. Mr. Turtle came into the ultrasound room with me, so that he knew everything as soon as I did and I didn't have to leave him in suspense or talk about it in the waiting room. The clinic booked us in for an appointment with the counsellor today, which we hadn't even asked for, but it was a good idea. AND I was able to book a follow-up appointment with Dr. Cotter (who prescribed the Flare Protocol) for this Thursday. I was shocked as we've never been able to get an appointment with her less than four weeks in advance. I've very glad we do not have to wait an eternity to meet with her, ask questions, and discuss options for the future. All of that makes me feel better, despite the cancelled cycle. And yes, we will get most of the money back, not that I am attached to it for its own sake. I would happily have given all that money, twice that much, if this cycle could have succeeded. But it doesn't work that way, and whatever the future holds, we'll find a use for it.

The counsellor was helpful. I cried a little. I'm not a crier, but it had to come out. I think I cried the hardest when she asked what kind of supports we had in our lives. We talked about our family, a few close friends that we've shared with. And then I told her I blog, and that the other women - Dear bloggers, I meant to say that the other women - all of you - were such a big help and support, but I couldn't finish the sentence. I just rained tears and snot. And then croaked out that sometimes talking about kind people made me more sad.  Which is true, but you make things better too. And now there are tears and snot on my keyboard.

I do feel better now that things are finished and we've had a chance to talk and process a little. I'm still very tired but I feel able to engage with the world a little bit.

Thank you to everyone for your compassion and suggestions in  the comments of other blogs to read as well as questions to ask the clinic. It is all very much appreciated and I will look into those things as we move forward.

Sunday 12 January 2014

Not with a bang but a whimper

There are two follicles on one ovary.
Two little ones.
I didn't respond to the drugs.

Sad.

We knew this could happen, that it was in fact the most likely thing to happen. It still really stinks to be here dealing with it.

Based on the lack of ovarian response, and my bloodwork, the doctor recommended cancelling the IVF cycle. But she also said that since I have 2 days worth of drugs left (today and tomorrow) and since they can't be returned, I can give it two more days and see what happens. Nothing is likely to change dramatically, but we opted to do  two more days on the medication and go in for another ultrasound on Tuesday.  If nothing else, I don't feel any desire to hang on to my IVF drugs after a failed cycle.

If one of the follicles can grow bigger, we have the option to convert to an IUI. Of course that may or may not be possible due to sperm quantity/quality after the wash. So many Ifs, and not even likely ones. But, well, I guess I can slog  through the swamps of uncertainty and diminishing returns a  little longer. After all, I did know it could be like this, and I did make the decision to try IVF anyway, so at the very least I can have the courage of my convictions.

I think the worst thing - at least for now - is knowing that nothing I do can  make any difference. I feel tired but unable to really rest either.

It's a fork in the road. Down one path was the possibility that this IVF cycle would work. With my poor response, that hope is fading. If we had at least gotten to the stage of conceiving an embryo, even if we didn't achieve a pregnancy, then maybe it might have been worthwhile to try IVF again. Since we most likely won't......I'm not sure I see the point of doing IVF again with our gametes, unless the doctor recommends it,  which I really doubt she will.

Down the other fork in the road....whatever comes after this. Donor egg IVF is our plan B. It's a long way from feeling real, but everything begins with a first step. It's sad and little scary to start walking down the dark unknown road, knowing that we are most likely leaving the crossroads and the other path behind forever. But, well, I suppose every unknown path is dark and scary at first.  I'm find my optimism again I'm sure. Maybe not today though, and maybe not this week.

For now....I suppose one can always hope for some super miracle eggs to grow in 2 days. I'm not very hopeful, but I can live through another two days.

Here we go round the prickly pear
Prickly pear prickly pear
Here we go round the prickly pear
At five o’clock in the morning.

Monday 6 January 2014

Shoot 'em up

As of today I have started all my drugs.
For anyone just dropping in, this is IVF#1, Flare Protocol.

Down regulation started on Saturday January 4th with Suprefact, 80 IU, subcutaneous injection, twice a  day.

Ovarian stimulation started today January 6th, with Menopur, 150 IU, subcutaneous injection, once in the afternoon.

and Gonal-F, 450 IU, subcutaneous injection, once in the afternoon.

So far, this has all been

......really quite easy. I'm scared to say it, can you tell? I keep waiting for the carnage to start.

I have a system of alarms going to keep me in line. First alarm, on my clock,  rings at 5:45 on weekdays so that I get up and do waking up things. Next alarm, also on clock, rings at 7:10am every day to alert me to get ready for first dose of Suprefact and to take the Gonal-F pen out of the fridge. After that I'm on my own until my watch alarm goes at 3:45 to remind me to get the hell away from work (not always that easy) and home.  On weekends, the alarm goes at 4:10pm. Between 4:15 and 5:00, I do the Gonal-F and Menopur shots. Then I'm free as a bird until 7:10pm, when watch alarm rings every day to remind me to do do the second shot of Suprefact, 12 hours after the morning one.

In between all that I have to remember to take antibiotics, with breakfast and supper (no dairy allowed), and my folic acid, DHEA, CoQ10, and low dose aspirin (no alarms left to remind me of those, I've used up all the ringing devices).

Naturally I am curious about the side effects of the injectable drugs. Here's what I found on information included with the prescriptions, or on the fertility clinic website:

Suprefact:
The Suprefact® injection is used to shut off or turn down your own hormone production in your pituitary gland and prevent you from ovulating too early. This results in a lowered estrogen level and the common side effects of hot flashes, mood swings and headaches.

I haven't had any hot flashes yet, and based on how people describe them, I'd think I'd know if I was having them. Mood swings, maybe. Headaches, yes, although I am not sure if it is the Suprefact or our crazy weather and changing barometric pressure causing it.

Menopur:
Breast tenderness, bloating, flushing, vomiting, nausea and diarrhea. They are temporary and will resolve once treatment is stopped. Other adverse reactions may include allergic sensitivity such as a rash or local swelling near the injection site. The greatest concern is Ovarian Hyperstimulation Syndrome. Ovarian enlargement can be accompanied by abdominal bloating and and pain, and may occur in 20% of women taking gonadotropins.

Gonal-F
Breast tenderness, fatigue, bloating, weight gain, nausea, or diarrhea. Ovarian Hyperstimulation. Same as Menopur, basically.

Since I only started the stimulation today, I don't suppose I'll notice any side effects for a while. Maybe fatigue, but hard to say if the fatigue is caused by drugs or by the emotional intensity of this experience. Although I think I'm doing a pretty good job of being calm, Stoic, and rational, well, it still takes an effort to be that way, and it's tiring. When I go to bed at night, it's with the exhaustion of someone who simply doesn't want to be awake and doing or thinking anything anymore.

I can't connect any of this with actually having a baby one day, and I don't want to. Honestly, I don't think this shit will get real until at least until my next ultrasound (Sunday January 12th) when we get to see if there are actually any follicles growing in there. Scheduling injections is easy, stabbing myself with needles goes against human instinct but is doable.....all the emotions and hopes and dreams....that's hard.

But on that topic, I have to say that I've gotten some amazing support so far. Yesterday I sent an email to three key people at work: my co-teacher, the assistant principal who I report to, and my department head. I had previously told them about the IVF cycle, but in this email I got quite specific about "this is what I am doing and this is how you need to accommodate/support me."

All the responses I received were kind and supportive and made me feel yet more grateful for the people I work with. But the one from my department head went a step beyond.  She said that she was "crossing all her fingers and toes" for me and Mr. Turtle. She knows it can be an "emotional rollercoaster" and to let her know if she can do anything to help out. And, if I need a place to take a break, I can come to such-and-such a room which is never used.

Gulp.

There's two reasons she wrote that email. One, someone near and dear went through IVF, or two, she went through it.

It's awful when people misunderstand infertility and treatments, but it also breaks my heart a little when someone understands so well.

Thursday 2 January 2014

It's January 2014 and I'm.....

.....happy?

I almost can't believe it. But yes. Happy.

January is usually my least favourite month of the year. The fuss and fluff of Christmas is over, but the normal routines of life take two or three weeks to become established again. In the meantime I'm at loose ends.  It's cold and dark a lot of the time. Also, school is extra stressful because the semester is ending, and there is a period of nearly 3 weeks when the students' schedules are completely different, and I have to do extra planning to make the days go by, as well as deal with semester-end details. But this year I'm not worried. I've decided that since we are doing IVF, I don't have the emotional energy to get into a dither of anxiety over school stuff, so I'm not going to.  I'm going to trust my team, and myself and my  plans, and everything is going to be fine.

I was in Michigan with Mr. Turtle for 5 days, which were great for obvious reasons, and difficult for less obvious ones. It was great to spend time with the in-laws, exchange gifts, walk in the snow, play games, and eat MIL's amazing cooking. But at night I kept having the kind of frustrating dreams where I do a task over and over again, because I can never seem  to get it right, or I forget how to finish it at the crucial time. Or I was trying to go on a trip somewhere, but I kept forgetting something. In one dream I couldn't get on  the train because I forgot my shoes. I woke up resolved that if I ever get into such  a situation in real life, I will get on the damn train in my socks!

My BIL and SIL arrived at the house on my birthday, which is December 26th (yah, happy 34th birthday to me). BIL and SIL were married last spring and are adorable. But for quite a few months, I worried that they were going to announce that she was pregnant on my birthday. It's perfectly OK for them to have a baby, of course, but I  really really didn't want to hear about it on my B-I-R-T-H-D-A-Y. SIL fortunately laid my fears to rest by cracking open a beer almost as soon as she walked in the door.

During the quieter times of the day and night I found myself feeling heavy. Not only because of the yummy food.  I felt like I had a hollow empty space right at my center, and every day a drop of something liquid and weighty would fall into it, like a big dollop of cement.  I could dance the heavy thing outside; I could take it to the park; I could laugh and shake it about; but it was mine to carry and it never went away. The other feeling was that the future was a huge empty pit that I was about to fall  into, and it went down and down and  down and the bottom was nowhere in sight.  But then one afternoon, the heavy thing went away. I felt surprised and filled with a kind of grace.

Leaving for Canada was stressful though. Can I say I hate when airlines oversell their seats, especially  around the holidays? Why on earth do they do that when there are so many people travelling? Because my flight was changed only a couple of weeks ago to accommodate my ultrasound appointment, I had  no assigned seat. Leaving Detroit, it seemed like every flight in the terminal was oversold, including mine. So I spent several hours wondering if I would be able to get onto my plane. I decided that if they tried to bump me off the flight, I was going to throw a royal tantrum. I would be loud and crazy and everybody in the terminal would get a full education on IVF. It would have made a hilarious blog entry. But I'm not a natural tantrum-thrower, so it would also stress me out enough to make me physically ill. Luckily all my flights went well, but I was very glad to be safely on the ground in my own city.

Things went great from  that point. Since Mr. Turtle was staying in the States for a few more days, I decided to stay with my parents instead of being on my own. It was an excellent choice. My mom and dad  accompanied me to my appointment at The Fertility Clinic. They haven't really been involved so far, so it gave them a chance to show support for me which made all of us happy. The ultrasound/trial transfer was quick and easy. Maybe I'm just desperate for any kind of hope, but I felt encouraged that the doctor saw follicles on both ovaries. On my last ultrasound the tech only found  follicles on one ovary, which  made me wonder if I only have a single functioning one. But it would appear they both work, kind of.

So, IVF #1 is full speed ahead. I picked up the prescriptions the same day.

I start Suprefact on Saturday January 4th, 80 micrograms subcutaneous injection, twice a day, 12 hours apart.  Continue with that until I'm told to stop.

On Monday January 6th, I start 450 IU of Gonal F, and 150 of Menopur, once a day in the afternoon, also both injections.

I continue taking the DHEA/CoQ10 until it is finished, as well as low dose aspirin and folic acid, of course. Mr. Turtle and I also start on an oral antibiotic on  January 6th.

My next ultrasound and blood test is on Sunday January 12th.

Although I had some anxiety about IVF, now that it's happening I feel relaxed and confident it is the right thing to do. Now that my 3 kinds of lovely needles are in the house with me, I am not afraid of them. It is interesting because the rational  reasons for doing IVF are the same today as they were a  month ago, and so are the statistical chances of success. But my feelings are different. It just feels like we are on the right path, and even though I don't know what the future will bring, and I don't want to speculate about it, I am strangely free of fear.

Of course I may go batshit crazy in the next few days, especially when my body starts vibrating with drugs. But in the meantime I'm going to focus on  being an Subcutaneous Injection Expert. Mr. Turtle is simply delighted to support me as he has knowledge in this area: he takes Humira every week for his Crohn's.

And tomorrow?

It's my last drug-free day! Mr. Turtle and I are going to have a wonderful day together to celebrate.

Happy new year one and all.