Hello, Goodbye- Part 2

Image: John Via Flickr

Image: John Via Flickr

Phew. Glad I got Part One out of my system. Now that its done, that goodbye has been said, let’s talk about the FUTURE.

Well really, let’s talk about NOW because our next step is already well under way.

Hello Future.

We don’t stay down for long in this family. Before the sun set on us Sunday night I had already emailed the new/old clinic to explain our situation and set up a consultation. It often takes time to switch clinics. Time for diagnostic testing, Time to get on the calendar. I was expecting it to take time this time too. Nope… we are in full swing.

Before we left our new/old clinic we already had a consultation with our Reproductive Endocrinologist (RE) to hear his recommendations for what we should try next after our miscarriage. Those of us in the fertility world call this the “WTH” (What The Heck?) appointment. Some more colorful ladies use another letter besides “H.”

I am more comfortable just calling it a consultation myself. If you think about it, with the odds of IVF being less than 50% the WTH appointment should be reserved for when a patient actually gets pregnant. At least that is how it feels for this unlucky girl.

In preparation for this discussion my new/old RE created a plan. All our lab work and other testing is recent enough that there is no need to repeat. So when I opened my email Monday morning and one of my favorite nurses had already responded, I was pleasantly surprised to find we could pass go and go straight to cycling. All we had to do was call the business office and pay a deposit.

By close of business on Monday, the deposit was paid and we were on the calendar for a May retrieval. We set up consultation appointment on April 10th to review the plan and also make necessary adjustments based on what we learned from Celebrity Miracle Clinic. I was told to call with my “pre-month” menses which I took to mean April.  However when my monthly friend arrived Wednesday I called to be sure and they told me it was close enough that we could get going. Yes!

Drugs have been ordered and are scheduled to arrive. I am back on birth control again and we are taking supplements to improve egg and sperm quality. At the consultation we will pick a date in May and count backwards to select a date when I will go off the pill to begin another antagonist cycle (I will explain what that means in a later post). We will retrieve my eggs in May and create our embryos which will all be frozen.

In June we will thaw several of them for transfer. We are doing this because I have never been pregnant on a fresh cycle. Some women just do better with frozen cycles and I appear to be one of those Ice Queens. More importantly, we know that my embryos are slow starters and a frozen cycle will allow us to better match the time when the lining is receptive to the development of the embryo.

Over the last few days I have already talked to three of my favorite nurses. I am excited. I am nervous. But mostly I am just glad to be ready to go and to be working with my old friends.

Now I just need to give new/old clinic, new/old nurses, and new/old RE a more creative and acceptable name. Something as fitting for them as “Celebrity Miracle Clinic” was for the other one.

I’m thinking about it…

Any ideas?

The End of the Internet

Totally exhausted from three days of travel for work and estrogen overload, I created something a little different for my IVF friends today. Years ago I ran across an “End of the Internet” cartoon and have often thought about it when I go on one of my IVF information binges. These binges are especially common during the two week wait when I scour the Internet to see if I can divine what will happen based on statistics, anecdotes, and real life stories. We have all been there…to the end of our sanity and near the end of the Internet itself.

Enjoy and good luck to you. May you find what you are searching for in life if not on the web.

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The Meaning of Fried Okra

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Every year at this time I ponder the meaning of life and face my own mortality. 19 years ago today this Daddy’s girl lost her real life super hero to an 8 month battle with cancer. I was four days before my 19th birthday and he was only 41. Tragically, I am the oldest of four and my youngest sister was 11 at the time.

This year marks a sad turning point, I am officially crossing the threshold of time where I will now have spent more time without my Dad than with my Dad.

Everyone expects to someday lose their parents, at least parents pray that is how things go. Its how things should go. But when you lose a parent too soon, when that parent dies young, it forever affects your view on the world and your own mortality. Since I hit my thirties, I have been counting down to 41. The number looms around my subconscious daring me to surpass it and taunting me with dark possibility.

Last year, I decided to start making a video for Spork every year on this day. I sing her favorite songs, talk to her about how much I love her, and detail her milestones. I do this so if something happens to me, if I leave her too soon, she has 10 minutes of Mommy tailor made for her age and needs right now.

Between all of this and the imminent birthday, I cannot help but to contemplate the meaning of life and my own mortality. Of course, fertility is a factor. I keep thinking that if we get pregnant this cycle and I only make it to 41, I will leave Bill with a 5 year old and a 3 year old. I wonder if its irresponsible of me to even try. I worry what will happen to my little girl if she goes through her formative years without her Mommy.

Two nights ago, it all came crashing down on me. Lying in bed with Bill asleep beside me I began to question my faith and whether there really was an afterlife. My thoughts on the topic are for a different blog, but in the midst of what was threatening to turn into a panic attack I woke Bill up to discuss it.

Me: “Bill.”

Bill: No response.

Me: “Bill. Are you awake?”

Bill: Some rustling and grumbling.

Me: A little louder and acting surprised “Bill, you are still awake too?”

Bill: “Uh…Yeah.”

Me:  “Oh good. I am freaking out a little bit. Do you ever start thinking about the meaning of life and freak out?”

Bill: “No”

Me: “Do you ever start thinking about what happens to us after we die and panic or get really scared?”

Bill: “No”

Me: “Oh. Okay. Because I am really freaking out.”

Bill: “Don’t freak out.”

I could tell from the grumbling and heavy breathing that followed that he was not awake enough to get me through my mini crisis and I was on my own. I did some deep breathing, a little meditation and eventually fell asleep.

And then I had the most amazing dream.

I won’t go into the somewhat weird and unimportant details, but I dreamed of my Dad. We talked. I don’t remember all the fine points of what we discussed or for how long but it seemed like it was all night. I do remember the sound of his voice. It has been so long since I heard it but it was unmistakably him. At one point I reached up and touched his face and I could actually feel the texture and temperature of his skin. It was so vivid and real. He had unique skin that was tough but soft at the same time, especially after shaving. I rarely dream of my Dad and have never had a dream like this. I didn’t want to wake up, and when I did I was exhausted even though I slept through the night.

Despite all my fertility superstitions, I am generally grounded in reality. I realize there is a limit to how much we understand about the universe but my open-mindedness stops short of believing that dead parents visit their kids in dreams. While I don’t remember the various things we talked about, I do remember the general feeling of the conversation was comforting. It felt like he was trying to put me at ease. He was letting me know he was okay and that I was going to be okay. Maybe this was a sign? Maybe he was visiting me from the great beyond to bring me peace?

And then he said something I do remember very well which totally shattered my illusions about it really being my Dad:

“I really miss fried okra. I wish I could have some fried okra. With bacon.”

Dad did like fried okra. And he liked bacon too. You can’t tell it from the photo in his twenties, but he rarely met a food he didn’t like which is at least part of the reason he is not here today. He could have used more exercise, a healthier diet, and a job that didn’t surround him with second hand smoke. But however much he loved fried food, I have to believe he would not travel through time and space and pierce the vail between two worlds to tell me he had a craving.

I know that what I experienced was probably just my slumbering brain working through its issues. I was unconsciously reconciling the pressure of getting closer to 41 and lamenting the loss of my father and my youthful eggs.

Still, I woke up at peace. Touching his face and hearing his voice gave me the feeling he was still with me, even if he wasn’t visiting me in my dreams. I knew with unshakeable certainty that just like I am okay, my little girl and her (God willing) sibling will be okay. I knew right away that as a parent I needed to accept that I can’t control what happens to them or to me in this life. I can give them life, give them my best, and pray.

I don’t know the meaning of life, but I am pretty sure we should soak it all in and savor every sweet moment. Kind of like the way Dad would have savored fried okra and bacon.

And just as it is with my Dad, I would rather have my family and this life for a short time than not at all. However I have a feeling that someday my kids will be watching decades worth of annual videos of their happy, old, crazy Mom.

His Perspective- Bill’s First Visit to the Gynecologist

I fainted at my first time at the gynecologist… almost….

You can do this:  Hold your breath for 45 seconds and time it..

Breathe…breathe…breathe… Seriously just relax.  Oh my god, it’s 90 degrees in this tiny little room.  Right next to my head on the wall is a poster of the female anatomy.  And on the shelf is the anatomy model that comes apart.  And they want to give her an ultrasound where?

Help.  Help. ……….

I have never fainted in my life but the closest I ever came was my first time to the gynecologist.  Just breathe.

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Most guys first trip to the gynecologist or the OB is with their partner when they are several weeks pregnant.  For us it was to try and figure out what exactly was wrong and hopefully how we were going to solve it.   Was I infertile?  Was my wife?  Was something even worse causing this?

While I wear my heart on my sleeve and can tear up quickly over truly sad stuff, I like to think I am in control and well prepared or at least can adapt quickly.  Well, this was definitely a new experience.  Unless you are in the medical profession, as a guy, this experience and what it involves would probably take you by surprise.  I was sort of taking the whole IVF thing in stride and even a little excited because it was all new and we were moving forward.  Waiting without answers is the worst, or I should say having a sad and stressed out wife waiting without answers is the worst.  If you have ever cared about anyone then you understand that knowing someone you love is hurting about something is usually worse than hurting about it yourself.

Anyway, going to the gynecologist was the wake up call that I needed; I was totally out of my element and this was going to be a “journey”.

First I had to learn how to behave in this kind of setting.  It’s not like I am a 5 year old but I can certainly act like one sometimes when bored, confused, or happy.  In this case, I was reading magazines, playing on my phone, and not paying attention to my wife.  This is the wrong approach at the doctor’s office or for that matter anywhere with your wife.  It took a while but I finally learned that during the whole IVF process I need to engage with my wife and the doctors – talk about feelings, listen, and ask questions.  Sort of mushy but it takes a little work and after all this is my (our) life so I should probably really get involved.  This has led to some silly questions for the doctors, just to participate type questions, that probably got me in as much trouble as just shutting up but, oh well, I tried.   I think at this point, 4 years later, I have gotten pretty good at engaging in the process but my wife still runs the show, knows all the details, calendars, the right questions to ask, etc.

This visit to the gynecologist was the first uncomfortable part of this journey.  It was about to get much more scary, sad, awkward, uncomfortable, expensive, and dangerous.  Don’t worry though because you already know there is joyous success along the way to where we are now.

Our Division of Labor

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I told a great big public lie and its time to come clean. My transgression ocurred  yesterday when I posted the above photo to Facebook with the following caption:

“Thank You winter storm. After eight years of shoveling we finally broke down and bought a snowblower for Valentines’ Day. I would hate to see it go to waste after shoveling our way through the Worst. Winter. Ever.”

I hit submit and immediately felt like a great big fraud. I don’t shovel. I never have and never will. I limit my shoveling to a an 8 foot path to our hot tub and the top of the hot tub on rare occasions. The only reason I even do this minuscule amount of cold, hard, labor is that I am the only one who likes to use the hot tub which means I am sometimes responsible for its upkeep.

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All of the other shoveling? The driveway, the mailbox, the long path to our house and our neighbor’s house? Bill has toiled away for thousands of hours over the last 8 years shoveling us out from under Northern Michigan’s worst wintery white blankets. Saying “shoveling our way though” in that Facebook post was a gigantic fib from a total phony. A poser.

But as much as I have never earned a callous or blister from the handle of a shovel, we are in this together as we are in all things in life.

That is the way it is in our marriage. He shovels. I balance the check book and pay the bills. He cooks and does the dishes. I do all the laundry and straightening. He hangs pictures and puts things away in the attic. I frame the photos and organize the junk that goes into the attic. He takes care of scheduled maintenance on our vehicles. I take care of the license plates and our taxes. We have a division of labor in our house that works like a well oiled machine. We never discussed or planned it this way, we just fell into it based on our natural talents and needs of our family. The invisible hand of marriage created a near perfect process that satisfies both of us most of the time.

This division of labor started me thinking about how shoveling is for Bill like going through IVF is for me. Even though we are both impacted by this process, the heavy lifting is all on me. I take all the shots, undergo surgeries, experience side effects, schedule and attend appointments, cut all fun and taste out of my diet, organize travel plans, and resolve issues that develop. Bill is involved and concerned, but for the most part he just shows up when and where I tell him and does as I say.

Good husband.

Its not as if Bill doesn’t do anything. He does one BIG thing in that tiny little cup to contribute to the cause. He also cut way back on drinking from August until November to get his swimmers in tip top shape. During that time he remembered to take his supplements most days. Yes, I often laid them out for him and had to remind him but that’s okay. That’s what I do. Our beautiful Christmas cards would never  go out if I left it up to Bill, just like he wouldn’t remember to take supplements on his own. It is what our family unit needs to work.

Bill’s real work begins after the transfer when he morphs into the most caring man on the planet. He takes care of me while I am on bed rest for two whole days. He waits on me hand and foot and scolds me if I break the rules. While we are in our 9 day wait he becomes Spork’s primary caregiver since I am not supposed to lift more than 10 pounds. This means he changes all the dirty diapers, plays with her, feeds her, washes her, dresses her, puts her to bed, and takes her to and from daycare. He becomes a single parent of two for those nine days.

But for the most part, during the long months of preparation, its all on me.

Little problems arise every now and again from this arrangement. I haven’t ingested a smidgeon of alcohol, gluten, or caffeine since the beginning of this cycle. So when Friday night comes after a long week at work and I hear him crack open a beer jealousy envelopes me and begins to fester. When I sit for nearly two hours in the parking lot at work because the FedEx truck didn’t make it there with my Lupron before we closed, I become aggravated that I am there alone. When Bill accidentally wakes me up at 5 AM while he is getting ready for CrossFit, I am ready to wallop him because not only do I want to sleep off the effects of the meds I am taking, I also would love to be able to go to CrossFit.

I know I am not alone. This is a common issue among the fertility challenged that threatens marital bliss. And why wouldn’t it be?

Take any woman. Give her nearly all the responsibility for something of great magnitude that will equally benefit her husband. Make sure her husband needs to do almost nothing to support the process. Just for fun, throw in some hormone induced mood swings. What you have are all the ingredients needed to fuel a marital Battle Royale.

Largely, the responsibility of fixing this imbalance rests with me. I am in this alone because as a classic control freak I don’t ask enough of Bill in the process. I worked to begin to change that with our last cycle. It is not that he doesn’t want the responsibility, its that he needs to know how to help and even when he tries I often don’t let him.

I inject my medications myself and always have , even the difficult and painful intramuscular injections in my hips. We started out with good intentions of Bill doing this part, but I travel often enough for work that I had no choice but to learn to do it myself. Once I was comfortable going it alone I stopped asking him to help. Why should I wake him or distract him from what he is doing?

In our last cycle, he gave me all the shots he could. It was a way for both of us to feel like we were actively doing something. It allowed us to feel more connected to each other in our quest to make a baby. I changed other behaviors as well. When we had the little snafu with the Lupron delivery, Bill called the pharmacy for the tracking number and information to help us work through the issue and find the errant driver. In the past I would have taken care of it myself only to become annoyed with Bill later when he didn’t display enough sympathy during my post-problem rant.

This cycle, I am recognizing that while his efforts in the process are less life altering and painful, they are still there and a necessary part of our success. I am consciously asking for more from him when I have a bad day or don’t feel well. He will continue to be my own personal phlebotomist and problem resolution department.

My goal is to change my perspective and bring a little balance into the process. Perhaps by doing this we will avoid our historical estrogen fueled battle and bring about some good luck that will break our current IVF losing streak. In the end, we are in this together and I couldn’t do it without him, even if I almost could. Almost.

The truth is we needed what was in that little cup back in November to make this happen. But even more essential, I need him to grab his shovel and dig me out when infertility dumps its worst on us. He is always there with his calloused hands and his quiet strength to save us from the heavy, cold, worst of it.

Please watch for the debut of “His Perspective” tomorrow. Bill’s will publish his first blog post, yet another way he supports us in our battle with Infertility.

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A Subtle Change of Theme

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Image: Opus Moreschi via Flickr

The self-discovery I experience as a result of IVF never ceases. When I began this blog, I had every intention of posting something humorous about infertility every day. I vowed to readers I wouldn’t complain. I promised to not provide gory details of ultrasounds and other tests. And above all I promised no pity parties or rants. My goal was to bring a little levity to an otherwise heavy topic while also reminding myself to stay positive and laugh.

What was I thinking?

Positivity and humor are still great goals and I am not planning to dive head first off the deep end, but I am only on day two of estrogen and I am already throwing in the towel on trying to be funny every day. I don’t know how I forgot about the effects of that nasty lupron and estrogen cocktail. It’s like having a never-ending hang over. The headaches are constant and pounding. Fatigue has wracked my body. The moodiness is already wickedly bad.

The scary thing is that it is only just beginning. I am wearing only one estrogen patch at this stage in my cycle. By the time I fly out west to reunite with my long lost embryo I will be wearing four patches. Tears will be flowing and fights will be picked. I know myself and my body and its inevitable. Comedy writing on a daily basis is not in the cards.

You can already see the effects of the drugs in my writing. My posts have grown longer and just a wee bit darker as the injections have worn on and the patch was added. What I am learning is that there are just times when I am not a funny person. There are times when I barely feel like a person at all.

Freaking out and worrying are also tell tale signs of successful progression in an IVF cycle that are sure to make humor elusive. Yesterday I was convinced I hadn’t shed my old lining and that I shouldn’t start my patches until I did. I pleaded for an ultrasound to confirm that it was gone and I was getting a fresh start on developing fertile ground for implantation. As expected the ultrasound was fine. Despite the good news, I still dialed up my clinic twice today for no good reason to ask a couple of questions that don’t really need answers until March, if ever.

The questions were about the odds of success of our lone embryo. The doctor already told us the embryo had about a 35% chance of making it to a real life baby. But yesterday I spent some time with Dr. Google, never a good idea, and began wondering what factors went into the creation of that number. Did the doctor take into consideration that the embryo had to be thawed and retested because the first genetic test was inconclusive? What are the impacts of an extra thaw and biopsy on our delicate embryo? What are the odds that we will get all the way to our clinic and the embryo won’t survive the warming process?

I pestered my clinic with these questions even though I laid in bed late into the night last night reminding myself that the answers are irrelevant. The clinic has a 95% survival rate for thawed embryos. And even if the odds were lower, its not as if we aren’t going to go through with the transfer.  What would this information change? Nothing good can come from this knowledge. I have already been meditating on the only statistics that matter, my very own 100% success rate. I visualize a SART data report with my name on it and in every column my results are 100%. Why would I want to mess with that image and its mojo by finding out what some doctor thinks?

One word, hormones. Hormones make the sane insane. They make the intelligent foolish. They make the happy sad. And above all else they make the confident worried. I don’t like worried.

Worry is a meditation on shit.

Worry and hormones aside, there is another reason that I am having troubling channeling my inner comedian.

The real self-discovery has been that its not only that I am not always capable of humor, I have also discovered that I want to try a variety of types of writing. I don’t just want to tell cute stories about IVF, I want to pour my heart and soul out on a page and see what it looks like in black and white. I want to hear my emotions and deepest thoughts roll of the tongue of the voice in my mind. I want the therapeutic jolt of liberation I feel when I hit publish on something I have created. The writing process won’t allow me to limit my life to one genre.

With all this in mind, I made a little change to the Laughter Through Tears subtitle today. Yesterday it read “for those in search of the lighter side of infertility.” Today its simply “In search of the lighter side of infertility.” It’s a subtle change, but its recognition that I can’t promise anyone levity every day, especially not myself. I can’t always be funny and witty. However I will commit to always being in search of the lighter side. For you and for me.

Shoot Em’ Up

Tomorrow is the day. This addict is tired of only popping a measly little birth control pill every morning. Thankfully the waiting for the good stuff is coming to an end. Tomorrow I begin the real work that will take us towards our March 13th transfer date.

Yes, the time has come when I start shooting up.

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I have been waiting with anticipation all weekend for the morning when I start taking Lupron injections. Even though the are small, they are mighty, and the shots are a critical stepping stone that will lead us to the Promised Land.

As I discussed in Addicted to IVF, there is just something about this phase in the cycle that makes the long time IVF gal get excited. Heck, even if it is your first IVF it is thrilling to take that first shot, albeit a little frightening. After all you have so much time, money, hope and energy invested into this part of the process.

And best of all, you finally get to put your Baby in a Box to good use.

What is this Baby in a Box?

When you go through IVF you require a number of different medications for different phases of the cycle. These medications are not your average, every day, run-of-the mill medications. Your local Walgreen’s does not keep them in stock. Therefore they must be ordered through the mail, typically through a specialty pharmacy.

When we start an IVF cycle, all my meds are sent to me in one big box which happens to be about the size of a very large baby. If the meds do what they are supposed to and your body complies you will have a baby in about 10 months or so.

And there you have it, a Baby in a Box.

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There are a lot of drugs that do a lot of fun stuff in the box. What you see above is only a portion of it because we are currently only doing a portion of the IVF cycle.

The first phase of an IVF cycle is the stimulation phase. This is what we did back in November when we amped up my body with hormones to help it develop many eggs instead of the usual one per month. The stimulation phase is without a doubt the most grueling part of IVF. It can be quite uncomfortable and culminates in an invasive surgery to remove the eggs. Stimulation is also the most expensive part of the cycle and I am glad for that reason among many others that it is behind us.

Many clinics go straight from stimulation to transferring a fresh embryo back to Mom anywhere from 2 to 6 days after the eggs are retrieved. This is called a “fresh cycle.”

But that is not what we are doing. Not this time.

We are doing what is called a “frozen cycle.” We had the embryos genetically tested which means we had a great big pause between retrieval of the eggs to the part of the process we are now entering, the frozen embryo transfer.

Our embryo is 6 days old, chomosomaly perfect, and is just chilling out in cryofreeze waiting for us to come and get him (or her). Lupron is the first shot we take that will help us prepare to do just that. Its a small dose with a tiny little needle in my belly. This one I give myself because it is pretty painless and easy to administer. It does eventually make my tummy look like it has freckles all over it from the small scars, but those are battle wounds of which I am deeply proud. They do fade eventually.

Lupron, like most hormones involved in reproduction, is a weird dude. It’s short for Leuprolide or Lutenizing hormone (LH). Male and females both use LH to regulate the pituitary gland and control secretions of other hormones like follicle stimulating hormone (the stuff that makes all those eggs develop in the first IVF phase), testosterone, and estradiol. What makes LH weird and kind of cool in my opinion is that in small doses during certain points in a cycle it will down regulate these hormones. Shuts them right up. Quiets the body and limits the hormones secreted.However mid-cycle a large surge of LH (LH surge) will actually trigger ovulation and the resulting production of hormones. This surge is what will cause a home ovulation kit to have a smiley face or a dark line. I find its dual and seemingly contradictory functions fascinating.

Because LH in regular, small doses will slow the production of hormones that can feed certain types of cancers, it is often used in treatment of those cancers. And here is a super fun fact, high doses are sometimes used to chemically castrate sex offenders. Yep. You read that right.

Isn’t that lovely? As if we need another way for fertility treatments to impact the libido, and this one a scientifically proven one. However its somewhat irrelevant because the birth control pill I am on has already zapped what little libido I have at this stage in the process. Ironic that a birth control pill would do that but it does for me and always has.

For me, the main side effect of lupron is uber bitchiness. I mean, “stay out of her way” bitchiness. The mood altering effect of the drug is my primary side effect , but it also causes weight gain and headaches. Massive, horrible, headaches. The weight gain and headaches of course form a mean pair that further fuel the uber bitchiness. It’s not pretty.

Given all this you would think I would be dreading tomorrow, but in fact I am looking forward to it like a kid at Christmas. The Lupron shots I start tomorrow will shut my reproductive system down. This is so my doctor can take over and manipulate it with still other many other hormones that are to come. Its a little like computer that has been rebooted after new software is installed. When my reproductive system comes back online it will have a new operating system controlled by my RE. One more step toward bringing home baby. When you look at it that way, its pretty damn exciting.