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Archive for February, 2009

Survey

I posted this elsewhere, but I figure it can't hurt to post it here, too.  I saw a one-question poll tonight, which asked, "Who do you think should have the final say in the number of embryos transferred back in an IVF Cycle?" with the possible answers being "Doctor" or "Patient".  I, of course, have a very opinionated, knee-jerk reaction to this one, which I'll enlighten you on later, but I'm curious as to your response to the question.  But while I'm at it, I figured I'd get your thoughts on a broader spectrum of IVF-related questions.  You know, since I was making a poll anyway.  Why not?  It gave me a good excuse to play with google forms. I *heart* google sometimes, even if I *do* think that deep down they *are* a little bit evil.

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Before my first IVF cycle, I took Ortho Cyclen for about 5 weeks (Maybe longer? I’d have to go back and look at my calendar, but whatever, it was a while). My last two weeks on the pill I cried every day. Multiple times a day. I thought that pretty much sucked and I didn’t love it. But you know? I could live with that, especially since I’m only slated to take BCPs for 3 weeks this time. I mean, really, the crying didn’t start until week 4 last time, so maybe I’d miss out on side effects all together this time, right??

Think again, Oh Perky One.

Last time the BCP was prescribed by The Hatchery before I knew I’d be switching to Ye Olde Fertility Clinic. But then I switched clinics while I was already on the BCP. No matter, I just stayed on the BCP while we got all my ducks in a row. No proplem, I had plenty since The Hatchery had planned on me being on the pill for at least 5 weeks anyway.

This time SuperDoc prescribed the BCPs. And he ordered Nortrel. No problem. I mean, seriously, what could possibly be the difference, right? Of course right.

Think again, Oh Perky One.

Since starting to take it my migraines have been out of control. Did I mention that birth control pills are actually contraindicated for hemiplegic migraines? And that I’m actually not supposed to be on BCPs at all? And here’s another lovely side effect for you: I wake up every single morning completly sick to my stomach. I picked up one of my monsters yesterday and almost dropped her because I thought I was going to throw up, it was that bad.

So… what to do? Just switch pills since I happen to have an extra pack of the Ortho Cyclen laying around? Or ask permission first? SuperDoc is out of town right now, but of course my nurse is around and could talk to a different doctor if need be. What to do, what to do…

In other news, my celebrity status has been revived!

J, Marketing Supervisor Extraordinaire, called me yesterday and asked if I would mind being interviewed by a newspaper for a story on eSET. No problem, I said. Anything I can do to help. (But I swear, next time I’m holding out for free cryopreservation for all the good press I’ve been giving them!).

Er, not that I had anything to freeze last time, so not that I can count on anything to freeze next time…

ANYwhozit. The point, as if I ever had one, is that I got interviewed by a reporter yesterday. She wasn’t the crispest cracker in the box, if you catch my drift, and she spent far more time focused on the HOM factor instead of the eSET factor for my tastes, but I think I did a great job bringing her back en pointe, if I do say so myself. She did ask the ever-present question on every reporter’s mind: “So after this one, will you be done??”

You know what? I don’t know. And I don’t have to know that yet. It’s a decision that my husband and I will make when we get there, but right now we know that our family isn’t complete yet.

And she chose that context to bring up the Octo-mom. In any other context, I’d have understood it. But you know? It felt a bit like an unfair and accusatory comparison. I don’t have six kids already. I am not transferring six embryos (au contraire! her story is on eSET! hello?!). My husband and I both have full time jobs. My clinic, the reporter has already acknowledged, has some of the best eSET success rates in the country. How can she possibly compare my choices to those of Ms. Suleman’s?

Argh. I cannot begin to understand Ms. Suleman’s choices. I am not even trying to judge them except inasmuch as they are reflecting so poorly on the choices of every woman who seeks fertility treatment and every mother of higher order multiples out there. But it is so unfair to compare ME to HER.

Anyway, hopefully the story will turn out to be a very balanced and reasonable story on the value and benefits of eSET. I hope that it will. And when it is published, I’ll be sure to let you all know about it, because I’m sure it’s bound to be entertaining at the very least. And the best news is – it was a print interview, not a film interview – so no cheesy shots of me walking down a long halway just for the sake of me walking down a long hallway. 🙂

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Bib-Tacular

So, last evening, I was hanging out with the triplets before Seth and the J-man got home.  The trio was pretty content, and I had a little work to finish up in the kitchen, so I disappeared just for a minute.  And Sam immediately came to the kitchen and frantically started screaming to be let in.  You see, Sam has a new love.  Though he still loves his precious elephant blankets, there is a a new love in his life  and it… is a broom.

I kid you not. 

It's the weirdest thing ever, but this kid is in LOVE with a broom.  He would sleep with the stupid thing if I would let him.  He carries it with him everywhere.  He gets hysterical when I make him put it down to eat or to go to sleep.  He cries at the kitchen to be let in to get to the broom, and when I let him in, he runs in and makes a beeline for it.  He. Loves. That. Broom.  Loves it. 

So there I am in the kitchen with Sam screaming to be let in for his precious broom.  I relented and let him have the broom and he quieted right down.  I finished what I was doing (really, people, it took me less than 2 minutes), and I realized how quietly the girls were. 

Quiet = bad.  Very bad.  So I peaked out of the kitchen and this is what I found:

IMG_3365 

Ellie had dumped out my entire bin of 439,587 bibs.  Yes, I have a lot of bibs.  A lot.  Too many, in fact.  Yes, I have now done some weeding of my bib collection, so that the top to the bib bin will now close.  Because I am smart.  But not smart enough to have done this earlier.  Because apparently, I'm not that smart.  Sigh.

Oh but there's more:

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Abby joined in the fun, too!  Rest assured, Ellie was definitely the one to have dumped out the bin of bibs, but Abby wasn't going to miss out on the fun!

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Sam was SO happy and having such a good time!  (you can't see his beloved broom here in this picture, but trust me, he had it!)

Oh there was so much fun being had!  And they were so cute that I couldn't even really be mad about it.  I mean, they were cute, they were having fun, they weren't making a lot of noise.  I couldn't really clean it up, though, because every time I tried, they just threw more up in the air.  It was clear that this would be an activity that mommy would have to tackle AFTER they went to bed.  Fortunately, bedtime was looming (as you can see by the fact that they were already in PJ's when the bibapalooza began!). 

Here are a few more snapshots of the fun times:

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It's an Abby-in-a-Box!  (Maybe she's a cat!)

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I think Ellie's just wearing that shirt so that I won't get mad about the bibs… 

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Sam and his beloved broom… the least he could do is use it to sweep up the mess!  🙂

Shortly after these pictures were taken, I wrestled the broom away from Sam (with much protest from the little man), and whisked everyone away into the nursery for bed time.  Abby is on a sleep striek these days, so she ended up not so much with the sleeping, SIGH, but I did eventually get the bib situation all sorted out and put away about 40 bibs and put the rest in the box with the lid tightly closed so that I won't have to worry about that happening again anytime soon.  Whew!

And that, ladies and gentlemen, is why Mommy can't turn her back on triplets.  Even for a minute! 

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Shoozapalooza

There are some things you may never have known about me… and I know you're going to find them shocking.  But there are two things in this world I really despise:  shopping malls and shoe shopping in particular.  But yesterday we took all of the kids to synagogue, and they were all cute and adorable, but it was clear that they all need new shoes.  We've never actually bought them shoes, and we do have some hand-me-down shoes but mostly in sizes too small or too large.  So… I made plans to take the kiddeos to the outlet mall  today to purchase some shoes!  And I informed my husband of this plan this morning right before feeding him my traditional Sunday morning pancake breakfast.  (I swear, next week I'm making waffles.  Honest.  I'm so sick of pancakes it's not funny!)

And so, after an aborted morning nap and sending the J-man off with his grandmother, we packed up a lunch, rounded up jackets for all the kiddeos, smooshed a pile of diapers in the diaper bag, looked in vain for my shoes (failed and used a different pair instead), put two strollers in the car, and packed the kiddeos into carseats.  And off we went to the outlet mall.  (Seriously, do you have any idea what kids' shoes cost these days??  Gah!)  We'd never been to the outlet mall near us, but we figured it was worth a shot.  We left about an hour later than my original plan dictated, but having triplets means being flexible, right?  Of course right.

We parked by the food court and arrived just about noon, and went in and sat down for lunch.  We figured if the trio was sated they might not torture us too much in the shoe store.

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Sam was not feeling terrific, as he's got a cold, complete with runny nose (as you can see), so he was content to pick at his bagel and occasionally shove a piece of pasta in his mouth.  But he consistently threw his turkey and other delectables on the floor.

Nevertheless, he was happy to pose for a picture, runny nose and all.  🙂

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Eliana never misses the opportunity to smile.  She was tired from the aborted nap (in fact, she was the only one who DID try to nap, and unfortuantely got woken up a bit prematurely, poor thing).  But she ate so nicely at the mall, and I was so proud of her.  Until her bagels started landing on the floor.  Then I stopped being quite so amused…

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Abby smiling up at me.  She also enjoyed throwing her food on the floor – but she first had a really good time blowing air through the tubes of rigatoni that we brought.  It was fun to watch!  :) 

I had a hard time getting a good picture of her today because she kept trying to grab the camera every time I tried to get a picture… She was so excited to see me taking pictures! 

 

 

After we finished eating lunch, we put everyone back in the strollers and rolled on down to the Stride Rite outlet.  Fun times!  We put fear into the hearts of the Stride Rite Employees as we glided in and asked them to please measure the tiny little feet of our tiny little trio.  Of course, my three couldn't make life easy on me, could they?  Oh no.  They all three wear a different size.  (And Abby's feet are two different sizes!).  They didn't have the shoes I wanted for the girls, but I did get them cute white and pink sneakers (slightly different styles so I wouldn't mix them up, since they are different sizes.  And I got a pair of brown shoes for Sam.  They are all so cute in their new little shoes, but no one wanted to stay still for pictures…

IMG_3356  IMG_3358    IMG_3352 

After the shoe store, which involved us buying the shoes, realizing I'd reversed the sizes (Ellie should have had wide, Abby should have had medium, but I did it backward), returning the shoes, repurchasing the correct sizes, and then finally leaving the store, we braved walking across the hall to the Children's Place to Purchase the J-man some jeans.  He blows through jeans like, um, insert some really witty interesting metaphor here, okay? So even though my mother just purchased some new jeans for him, I knew it couldn't hurt to pick up another couple pairs.  Besides, it gave me an excuse to pick up two stripey sweaters for the girls at $3.99 each.  Not too shabby.  🙂

The kiddeos were EXHAUSTED.  Poor little Abby fell asleep in the stroller and Ellie and Sam were fighting hard against the inevitable.  We whisked them off to the car where Abby promptly woke up and refused to fall back to sleep and Sam immediately fell asleep for the whole ride back.  Ellie didn't sleep but she at least stayed happy and calm.  When we got home, I put everyone in their cribs (Sam barely stirred) and Abby RAGED against the idea of a nap (as per usual), but everyone got a nap.  When they woke up, we took them out to dinner, because we were feeling particularly brave and adventurous. 

And finally, we returned home and the J-man was returned to us – at last:

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And this is the exciting life that we lead. 

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I had someone contact me recently who came across my original infertility blog who has premature ovarian failure. She just found out that she literally has parasites attacking her ovaries. Has anyone else heard of such a thing or had personal experience with it? If so, could you please either comment here, pointing to your blog, or email me directly? (My email address is in the sidebar, as always, but it’s chezperky [at] gmail [dot] com)

I’m also going to ask Mel to post this on the LFCA, but seriously, if any of you have heard anything about this, please do let me know!

Thanks a million!

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And Away We Go

I was talking to a friend today who is about to gear up for an FET in hopes of having her second child. Her first child was born 10 days after our babies were born. I started BCPs today gearing up for IVF#2. So if she and I both have successful cycles again, we could again have kids with similar birthdates. Except there’s no part of me that believes that’s going to happen. In fact even the tiny piece of me that believes it’s possible that I could get pregnant this cycle says, “but what are the odds of you carrying a baby to term?” After all, the only reason my friend and I had babies with similar birth dates last time around is because mine were born 2 months premature (right on time for HOMs, of course, but still a few weeks earlier than I would have liked).

My friend and I were talking about our plans for the future with regard to our current children and she said that a lot of it hinged on when she gets pregnant again. And I said, “Well, yeah, but I guess I’m not really counting on that happening for me.” And I’m not. I never felt this way the first go-around. The first go-around felt like a vast world of opportunity ahead of me with endless possibilities and no end in sight for the chances for me to get pregnant. This time feels like there are so many limitations on my opportunities and I feel like my ability to accomplish my goal within that limitation is… just not likely to come to fruition.

“But don’t you feel like it’s different this time anyway? Since you’ve got kids, there’s only so much you’re willing to put yourself through anyway? Last time I felt like there was no limit to what I’d go through to achieve a pregnancy, but now I feel like there’s only so much I’m willing to commit to to get there,” she said.

Not me. The first time around I definitely felt like there was only so much I could go through. This time? If money were no object, I *know* what the payoff is. I *know* what is waiting for me at the other end of the struggle. I *know* what happens at the end of the story. I’d go through anything to get there again. But obviously, money is an object, and there is a limit. I’ll know when we’ve hit the end, and that’s a tough pill to swallow.

Speaking of pills, I took my first BCP tonight. Thankfully, I won’t be on it as long as I was last time – just one pack this time. 21 days. Last time I was a blubbering mess by week 4. By week 5 I was crying 4 or 5 times a day for no good reason. I am hopeful that only three weeks on the pill will not do this to me.

I picked up all my medications for IVF#2 on Friday. It still feels weird to say that. I know I said a lot that I didn’t have high hopes for IVF#1… but going into it, I kind of did. I told a bunch of people privately, even though I was too scared to actually put that out there into the blogosphere that I had high hopes for George I. I don’t know that I have such high hopes for George II. The fall from hope really was pretty devastating, just as I’d feared.

But onward and upward, right?

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Onward and Upward

Today is Cycle Day 1. So tomorrow I begin BCPs again. Wha-frickin’-hoo! And around and around I go.

I admit that I did have an irrational fear that CD1 wouldn’t rear her ugly head after stopping the PIO and that I’d be waiting weeks and weeks before drawing a progesterone level, starting provera, and all that torture. It does happen to some women, but given how I was feeling, it was a completely irrational fear.

Anywhozit, irrational fears be-damned, CD1 is upon me, BCPs start tomorrow, and onward and upward it is. Which I suppose means I’m in the waiting game for IVF #2. Wow. I guess there’s a piece of me that never really thought I’d get that far. Well then. Gosh.

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Protected: On Being Adequate

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Staying Organized

My kids have reached an age where everything is fun to play with – even things that aren't toys.  They love to open drawers and dump things out of them.  I have drawers and drawers and drawers filled with cloth napkins (I have a "thing" against paper napkins – don't ask me why, but I hate them, so I have dozens, maybe hundreds, of cloth napkins), and one of Ellie's favorite past times is opening the drawers and flinging the napkins (and tablecloths, for that matter) all over the living room. 

They dump their blocks, books, toys, shoes, clothes, food, diapers, everything all over the place.  There is nothing more fun and exciting than taking something that was neatly piled and flinging it across the room and scattering it wildly about.  Especially if Mommy is there to clean it up so they can scatter it about right behind her. 

So imagine my delight when my Programming Co-chair for our Parents of Multiples Club suggested a few months ago that we have a program on Staying Organized with Multiples.  Of Course!  Brilliant!  Our speaker tonight was herself a mother of twin girls, and a Professional Organizer.  She had a lot of great suggestions for organizing both your physical space and your time.  I was delighted to discover that many of the things she suggests are things that I already implement in my daily life.  My downfall, simply, is consistency.  I get caught up with too many things on my to-do list and don't always stay consistent with my ability to always do the things she suggests.  I also, simply, get overwhelmed with the clutter in my house.  Since having kids the sheer amount of *stuff* in my house has increased exponentially. 

Today, the J-man's teacher asked if I'd seen something she'd sent home a few weeks ago.  I hadn't, as J tends to take things out of his backpack before I can get to it.  I came home from tonight's meeting on Staying Organized inspired to sort through some junk in order to find that item.  And sort through the junk, I did!  Why, I was a complete overachiever!  I cleaned off the dining room table, cleaned the sunroom, threw out a dozen magazines that I haven't gotten around to reading and I'll probably never get around to reading, sorted through all the school stuff that's come home in J's backpack that I hadn't gotten a chance to look at, put a bunch of baby clothes away (someone had given us a box of clothes for the girls that had been sitting in our sunroom waiting for me to get to), cleared off two shelves on a bookshelf so that I could use it for easy accessibility for toddler toys instead of my books, cleaned out a cabinet full of old materials from a banquet I'd worked on a couple years ago, put away a couple boxes of toys I'd weeded through a couple weeks ago, but hadn't actually put away yet, cleaned up the living room, cleaned off the dining room table, cleaned up J's bedroom floor, found three missing pacifiers, filed away some papers, and threw out a bunch of junk.  Oh, and I got J's backpack ready for school for tomorrow.   Go me.  (Oh, and I *did* find the thing J's teacher asked me about… eventually)

I.  Was.  Productive.

Seriously!

Seth came home in the midst of this and said, "So, I guess you decided to find out where we had some extra space laying around?" and I said, "I bet you'll never guess what tonight's program was on?"

And you know?  There's more to do (there's always more to do, isn't there?), but it's a great start, and now at least I know one thing is down. 

At least until Ellie pulls all the napkins out of the drawers again…

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Fall from Hope

On December 19th, the first day I started taking BCPs in preparation for my first IVF cycle, I wrote the following:

I know every woman starting an IVF cycle talks about the irony of taking birth control pills in order to get pregnant. I don’t think for me that I find it ironic. I’m struck with a profound sense of – change. This feels like a big step toward my new goal. Toward my new hopes of family building.

I fear that the fall from hope will be devastating.

So today I went in for my beta from that very first IVF cycle, knowing full well that my beta would be negative. I brought with me cookies for J (Marketing Supervisor Extraordinaire, who reports that he has not yet even had a chance to eat my delicious snickerdoodles!), SuperNurse, and yes, even SuperDoc. The receptionist at the front desk was tickled pink when I left the box of cookies for SuperDoc, by the way. It was pretty adorable. I almost felt badly that I didn’t leave any for her, but hopefully the good doctor will share (though rumor has it that he’s quite the cookie monster, so who knows!?).

Two hours later, I got a call from SuperDoc himself.

“I’m sorry to say, I don’t deserve the cookies. It wasn’t the result I was hoping for; unfortunately, your beta was negative.”
“Oh, I know that!”
“Really? How’d you know?”
“Please! You can’t trust your patients not to pee on sticks! Plus I’m mighty certain my period is going to start any second now.”
“Unfortunately, both of those were correct. I already had a cookie and then saw your results and felt guilty about it.”
“Are you kidding me? All the more reason you deserve the cookies!”
“Why’s that?”
“Because now you’re stuck with me! Seriously, you can’t get rid of me now!”
“Wow, when you put it that way, I think I’ll have to have another cookie…”

It shouldn’t bother me, you know? None of this. I’ve been there, done that. Why, it feels practically anticlimactic. After all, I would have probably passed out from shock if he’d given me any news other than a negative today. But there’s something very, very final about the quantitative blood test. There’s no going back from there. It isn’t so much a fall from hope as it is the end of this chapter – knowing that there really are only two more chapters left before the conclusion to this part of the story.

And so… what now? What’s the plan?

In a word, or three? I don’t know.

Originally SuperDoc told me that what he’d do is check my progesterone in three weeks, if I hadn’t ovulated (which he doesn’t anticipate that I would have, he’d put me on provera for 5-7 days to induce a period, start BCPs, and on day 19 start Lupron, etc. etc.

Gah, I said. That gets us into Pesach. No problem, he said, we’ll check your progesterone in 4 weeks, provera, etc, etc, we’ll be a week after Pesach.

I hate the timing. Hate it. I told him so. I hate waiting that extra week I hate waiting that long. I am not a patient person. I don’t want to wait any longer I don’t want to do it. A break isn’t a bad thing, he said. Yes it is! I countered. I was petty, I’m sure. Irrational, no doubt. I gave him no logical reason why waiting was not an option. He said he’d give my nurse a few options on timing and I could work out the dates with her and see what worked best with me on timing, but if I really wanted what I can do is start BCPs as soon as I get my period. Take BCPs for four weeks (rather than the usual 3), then start Lupron, etc. He said from an ovarian perspective, he had no issue with that and I hadn’t hyperstimmed this cycle so he didn’t think it would be problematic in any way. SuperNurse and I can review the calendar together and see what works best for my schedule. [Update: Talked to SuperNurse – I can, in fact, start BCPs on CD2. However, the trick to that is that sometimes it takes a while to get a period, so if it takes a few weeks, we’ll just have to push it off until after Passover anyway. Bah. Hopefully all these cramps are a good sign that this won’t be an issue regardless.]

Which brings me to the protocol issues.

Lupron. Yeah.

He is going to increase my Follistim (not as much as he’d originally planned – my estrogen rise was appropriate for once, once I got to 150IUs… and the accidental 300IUs that one day…). He’s also going to increase my Luveris to 50units (up from 37.5). And… the Lupron. He’s going to keep the Lupron at the same horribly high dose. I told him the headaches were absolutely unbearable and he said that they should have gotten better once my estrogen rose (they got somewhat better around day 9 or 10 of stims, that’s true), and that on higher doses of follistim/luveris, my estrogen rise should happen earlier in the cycle which should mean that the headaches are alleviated sooner in the cycle. I hope he’s right.

His logic is this (or something like this… I was juggling a lot when he was talking, so I wasn’t really taking notes): he feels that the best option is to get more follicles growing early on, while avoiding a dominant follicle. He wants to use the high dose of Lupron to heavily suppress in order to avoid the dominant follicle (and also avoid hyperstimming), but more Follistim to greater stimulate the ovaries into producing a greater number of follicles. I did ask about not using Lupron and using an antagonist protocol instead, but he was against it for a number of logical reasons. While he has had success with that protocol with other patients, with patients with MY profile, he has better success with a Lupron protocol.

There’s a piece of me that wonders if I’m just tying SuperDoc’s hands by forcing the eSET issue. But then I think back to my appointment on Dec. 15th with my perinatologist and his dire warnings about me and a twin pregnancy and I realize that it just isn’t a possibility. I simply cannot take that risk, even if it means I don’t get pregnant again. And it is that reality – the knowledge that it is my own determination to push forward with eSETs that may be my downfall – that humbles me, reminds me that hope is something I may just have to let go of some day.

And at the same time, I know that I am unendingly lucky, for I have smiles and hugs and snuggles every day from the miracles I already have in my life.

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