Thankful

WhatsApp Image 2017-11-26 at 1.33.57 PM

I did end up hosting Thanksgiving after all (with a requisite picture of the spread). Parent and Hubby took on most of the physical load so I mostly just sat and directed. Though of course, its impossible for me to sit still so I kept getting lectured by everyone to rest more. I also simplified things a lot this year – I made it a potluck and had only two complex dishes. Then again, I compensated by having decorations for the first time.

Typically Thanksgiving is the time I try tons of complex stuff – last year I had made a risotto, nut roast, a souffle, a cake, and a flan. Well, and like 5-6 simpler dishes. This year, the complex dishes were just a tart and a biriyani (I’ve never made one and its quite involved but Mom and I are so proud that it came out perfectly).

And on that note, among the many things I’m thankful for is all of you. Through this whole process, it’s been amazing to get to know you all better, join you on a little part of your life’s journey, give moral support and get it in return. At a time when I’ve felt increasingly isolated, this blog and as a result, all of you have helped made me feel less alone and helped normalize IF. So thank you all for being there for me, for answering my dumb questions and cheering me on.

Advertisements

FET #1: Transfer Day

FET1_embryos

Look at my little baby embryos! I’m calling the left one my ugly little one 🙂 . I was a little horrified when I first saw the image – I mean I don’t know much biology but I figured round is good. But both doctor and embryologist assured me that both look good and that the left one is merely ‘hatching’. So now I feel like a chicken sitting on her eggs, waiting for them to hatch.

The transfer itself went smoothly. It’s never fun to be sitting around with a full bladder but that’s the worst of it. Apparently my lining’s doing really well – the ultrasound tech commented on it several times. Hopefully that actually translate to a good outcome.

Since the transfer I’ve been feeling.. fuller and occasionally crampy. I’m pretty sure that’s just a combination of everything that happened down there today. At any rate, I’m trying my best to ignore everything till the pregnancy test in two weeks.

All you ladies were right – the FET is so much easier than the whole retrieval. It’s been much calmer. But some downsides – Lupron was hard to handle. And oddly enough so are the PIO shots this time. I think it could just be fatigue with the never-ending shots. In this cycle, I’ve been doing daily shots for a month now. I’m bleeding more as well with the PIO which could be (a) it’s taking us a few days to find our footing again (b) all that baby aspirin is making me bleed more easily or (c) my hormones are wonky in a different way. My butt is already sore. The estrogen patches’ residue is so hard to get off. The PIO is causing constipation so I’m making an effort to eat a few dates/prunes each day. Fun times.

Sometimes one of my friends will say something like “I don’t know how you do all this.” In all honesty, I find those comments are really positive – at least it acknowledges that all this is hard. But at the same time – if any of them were in my position, they would be doing the same. Of course daily injections suck. And the side effects are miserable. The uncertainty is stressful and heart-rending. But sometimes you just do what you have to do. It’s not brave or courageous or anything. It’s just recognizing that this is the only way to handle the stuff that life has thrown at you.

FET #1: Last lining check before transfer

Lining is still good – 14 mm. Nothing going on wither ovaries. So I’m all clear for transfer next week. So that’s a relief!

I’ve been having increased discharge (clear) and each time I think that I’m bleeding/my lining is leaking away. I think it’s just a side effect of the estrogen patches but I still get anxious about potential bleeding.

I’m trying not to get my hopes up too much. Things seem to be going well so far (*touch wood*) but the end result is what matters. Anyways, nothing to do but wait and see.

In other things going on:

  • Thanksgiving prep is underway. I’m being fancy this year and getting real serveware (because we finally live in a place which has decent storage)
  • I was reading this article about behavioral interventions to improve medical adherence. It occurred to me that this isn’t really an issue with fertility medications. Though I think there’s an obvious reason why – if you don’t take your meds, well, you get kicked off the cycle. Don’t show up for appointments, you get kicked off the cycle. And there’s a high cost to getting kicked off a treatment cycle (physically, emotionally, financially) so there are huge incentives to be a good patient. Also fertility treatments have short term outcomes (you know pretty soon whether you’re pregnant or not), compared to these diseases where bad things happen after years.
  • Work is crazy. It’s good and distracting and interesting but also starting to feel behind on basically every project. Still, I got a couple of days to step back and think about ideas and brainstorm a bit.

To my little embryos

It’s a little weird talking to you guys. You’re not quite real and yet, you are all too real. You’re my probabilistic children and I desperately hope at least one of you make it through the coming months.

You’re a little like Schrödinger‘s cat. You’re both alive and not and there’s no real way of observing that without a fundamental change in state. You should get used to this sort of language – if we do ever get to hold you, you will definitely have days when you’ll think mama and dada are crazy with all this talk of cats and eigenvalues and neural networks. And we will thoroughly embarrass you with our precious precious pictures of you at 5 days and 100 cells old.

I think of you often. With every shot, pill and patch, I send up prayers that this is one step closer to providing a safe and warm place for you to grow. I already feel my lining thicken as it grows to hopefully become your home for the next several months. I find myself hoping that you’ll like it there and that you find a space for yourself within me.

I think it’s a good omen that you’ll be a part of me at Thanksgiving. It’s a time for gratefulness that you got this far and for family and love. Your brother or sister who didn’t make it would have been due around then. Perhaps this is a sign of renewal and of letting go of the past.

FET #1: lining checks

Lining looks good. It’s at 11mm(!) and shows the requisite triple lining. Honestly, I’m a bit worried that it’ll grow too thick — I have >10 days to go before the transfer. But the clinic doesn’t seem worried so I’m going with that.

It’s funny how I can feel things going on in my system these days. I definitely started feeling heavier in my lower abdomen so I knew that the estrogen patches were doing their job. I think that’s one reason BCP feels so weird to me – suddenly my body’s quiet and not telling me anything.

The Anatomy of an IVF Cycle

IVF_1_sept2017

Of course, I had to plot out this last cycle. Any takeaways? Not as much as the ectopic when there was so much that was unpredictable. This one seemed like a pretty average stimulation cycle.

  • It’s long. But then half that time was on birth control, resetting the body, so to speak. Once we actually started stimming, it went pretty fast. You see that where all the action is crammed in the middle.
  • A  close-up of the stims part of the cycle gives a better sense of how that timeline worked out. IVF_1_stims_sept2017
  • From what I’ve read, it doesn’t seem like IVF cycles are very different between individuals. Meds and doses vary but the time frames are roughly the same. I wish I had this diagram before doing the whole process. It would have helped me wrap my mind around what was going on much more.
  • There’s also a lot going on – the clinic is measuring follicles, measuring estrogen (probably others too but that’s all they told me). You’re on multiple medications, sometimes at once so it can be complex to keep all the moving pieces in one place mentally.
  • Honestly, when I think back about the cycle, really I just feel like it wasn’t that bad. It certainly wasn’t fun but it was perfectly manageable. Mostly I remember my poor little embryo that didn’t make it.

Waiting at the clinic…

Fertility clinics are strange places. Perhaps this is true for any serious illness but (other than IF) I’ve only seen the inside of a doctor’s office for low-level issues.

I find it oddly comforting to see a packed clinic. It makes me feel like I’m not the only one dealing with all this and others struggle too in their own way. And yet, we’re isolated. It’s very rare that patients in my clinic talk to each other. Or even make eye contact.

And it’s such a diverse group of individuals – there’s a wide range of ages and skin colors and all walks of life. That gives me comfort too – there’s nothing special about me that I got stuck with this. Someone has to fall on the bad side of statistics sometimes and apparently I’m one of them.

Some come on their own, some with their husbands (or wives occasionally). I sometimes find myself guessing what their day life would entail (scrubs – doctor/nurse; suit – lawyer?; yoga outfit – umm, freelancer?). They even have different ways of passing time while waiting.. some on their laptops, others on their phones, other just sit there. And no one touches the ever present pile of magazines.

We’re all bound by this strange place in life we’re in. We’re in a limbo – neither carefree newlyweds or young adults, nor parents constantly running after their toddlers. We can’t easily enjoy the freedom of fewer responsibilities. Because we’re tied to responsibilities even before kids come onto the scene. The financial responsibilities of the treatments. The physical and mental load of keeping track of the appointments and medications (plus the aforementioned finances). The physiological strain of all the side effects and hormones. The compromises in so many ways – no caffeine, no wine, careful exercising, planning life around treatment cycles and treatment cycles around life. But we don’t even get to enjoy the positives of the tradeoffs.

I wonder what others think of when they’re here. Do they think they could have done things differently? Do they look at the stats and wonder what this cycle’s chances are? Do they trust the doctor to always know what’s right? Are they worried about the repercussions of another failure? Or maybe they’re just tired because we’re all here early in the morning before we start our actual jobs.

FET #1: Lupron is kicking my butt

For the most part, I think I’ve been optimistic about fertility prospects. Ok, sure this isn’t the clean path that most people have but we’re surviving on this on. And while I’m not able to get over the undercurrent of bitterness, I’m still functioning and for the most part happy. I’m able to take comfort in the rest of my everyday life which is frankly pretty great – I have a job I like, a husband I adore and friends and family who are (for the most part) amazing. So for the most part, I’ve been able to take refuge in all those when IF stuff is not going well. The last couple of days, not so much. And I can’t tell if it’s side effects of Lupron or the general strain from all the IF.

The other day Hubby and I were driving somewhere and he was mentioning that we really should visit some friend of ours who had a baby recently. They invited us over several times to see the baby and for various reasons we couldn’t make it. Hubby was feeling guilty about repeatedly turning them down. At some point, I just broke down and started sobbing about how these friends didn’t give us time of day before having a kid. Why should we bother now just because they happen to be fertile?

I think increasingly (probably since Alison’s post) I’ve been more accepting of how IF is hard. Legitimately hard. Not like everyday-life-stress hard but life-changing hard. At some point I was just sobbing to Hubby that look, our last year was one of the worst ever. We try to keep positive and think of the good things (I graduated! I have a job that I love! Two-body issues worked out and we’re actually living together! He’s getting grants! And publishing! And all our parents are healthy and doing well!). But not one of our friends has dealt with anything remotely this hard (with the exception of two cancer survivors who I admire so much for being so positive and graceful in their outlook towards life). And we don’t owe anyone anything. We don’t owe them new-baby visits when they haven’t been there for us in even the most trivial ways. We don’t owe them time to listen to them talk about how hard life is with a baby when they have 4-6 adults to look after the baby. You know what, I just realized, we don’t even owe them explanations.

Frankly, I’d rather concentrate that energy on friends who actually have been there for us and listened and sympathized and helped. Those who in spite of their newly sleepless nights, still asked us if we were managing and if there was anything they could do. Those who helped with shots and job-hunting random other sundry things along the way.

The weirdest thing – I’m not even sure if all this is the Lupron talking or if it’s me. Or it’s just keeping me close to tears and my mind is filling in the blanks for why. Or it’s just broken down the damn of all these thoughts that I usually try not to think too deeply about.

FET #1: Actually starting things..

Baseline (second baseline? check up? no idea what this round is) looks good. Lining .. exists? Honestly, I have no idea what they were looking for in either the ultrasound or the blood work but whatever it is they found it. So we’re cleared to start Lupron, get off BCP in a couple of days and then go back in for a lining check.

Random incidents from the last several weeks:

  • One of my close friends just announced that she’s expecting kid #2. She was really sweet about it – she didn’t want to tell me earlier in the hope that IVF #1 would have worked and we’d be in sync. But.. life happens. And I was explaining to her that yes I feel sad because things didn’t work out for me but I can also be happy for her and no, that mess of contradictions doesn’t make sense but that’s my life now. Of all things what really astounded me (code for made me envious) is how blase she can be about all of this – when I asked how many weeks, she didn’t know off the top of her head. I’m not blaming her or anything. Just.. it boggles my mind that there exists people who don’t have any issues and thus, don’t need to pay attention to these things.
  • Also women exist who haven’t had a transvaginal US?
  • I’ve increasingly realized just how much IF has changed the way I look at things. Take meds. For a long time, I’ve been one of those people who was pretty anti-medication. For most things I’d treat with hot liquids, herbal remedies and rest. And maybe tylenol. If I couldn’t move from the fever/pain. IF was a pretty big shock for me — there’s so much medication and so much interfering with mother nature’s processes. Now.. well, fundamental parts of me don’t work without medication. No amount of herbal remedies is going to change that. And I’ve had to make peace with the amount of drugs going into my system. I didn’t even realize how much of my attitude had changed until I was talking to one of my labmates about the hives and he said something along the lines of “yeah, I don’t know about that, I never take any medication.” And that’s when I realized — my attitude was all just privilege. I’ve been able to maintain that attitude because, till now, nothing really needed medication. And that’s all luck.
  • On that note my hives has almost gone away after cycling through my body (itchy shoulders -> legs -> arms -> throat -> ear). I’m fairly sure it was the fish oil so at some point in the next several months, I’m going to find an allergist so I know for sure.
  • Family-wise there’s lots of people in and out in the next month. Bro just came for a week. Bro-in-law is coming next week and again next month. I’m no longer subtle about things – I explicitly tell family not to show up it’s during a key time period (ie retrieval/transfer). Unless they’re the type of family who will help with housework.
  • Another change with IF – I’ve lost a lot of inhibitions/modesty. Maybe that’s just age. But it’s been pretty fabulous to threaten people with. Like when I visited Hubby’s family a while ago (we were already in IF hell), I told him that if anyone asks about when we’re having kids, they get responses along the lines of “Why? You wanna know our schedule for sex?”. I have no idea if that threat worked but I never had to carry it out 🙂
  • I no longer have any topic for polite conversation. My home life is all about vaginas and needles and ovulation and failure probabilities at various stages of pregnancy (or non-pregnancy as the case may be). My work life… well, one of the things I study as a postdoc is STDs. So that’s all about how STDs are contracted and anal vs vaginal and condom use probabilities and risk behaviors. A few years ago, I wouldn’t have even been able to say the word condom to my mom. Now, *shrug*, it’s all part of life. She’s still catching up though and I catch her wincing at my language still. But to give her credit, she doesn’t say anything about it.

Annuals

The last couple of years, I’ve been pretty good about getting my annual. Partially because they’re covered by insurance. Partially because I believe it makes sense to be ahead of your health issues. Partially because that’s when I get my flu shot (after getting the flu one year, I never ever want to deal with that again. Plus its mandatory at my job).

So I went, got a bunch of blood tests done. I wanted to give the flu shot myself (after PIO shots, how hard could it be?) but the nurse looked at me weirdly.

The good news – pretty much everything is in great shape *touch wood*. My TSH is at 1.12 (!). Ok, also this makes no sense given my TSH two weeks ago was 2.5 but as I’ve previously established, theres a pretty high intraday fluctuation. But you know what, I’m going to ignore all that because it’s good news 🙂

My weight’s been dropping bit by bit. I think its a couple of factors: (i) low TSH (ii) less dairy and especially less dairy in the evenings (iii) less outside food in general. Personally I think that’s the order of importance but it’s a bit hard to tell.

Glucose is good (especially considering it was random and I haven’t been bothering about my sugar intake for a few months now). Cholesterol/Triglycerides, all normal (my mom’s been struggling a bit with this lately so I wanted to watch out).

The only thing that’s a bit concerning is my AST and ALT levels are a bit high. So I had to look up what these are — they’re apparently a measure of liver function. In general, I think the advice is to wait and see but just to be aware of this. My guess is that this is a result of everything going on in the last year — 2 rounds of clomid, 2 shots of methotrexate, 1 round of stims, 1 of a transfer. Not to mention the sundry medications that now get put into my system without blinking – birth control, aspirin, etc. Anyone know of long term liver functionality issues to be aware of? Or anything to keep in mind for now?