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What's the Plan?

Anonymous asked, “So, what is the intended schedule for the next few weeks?”

Since I assume “get a lot of blinding headaches, have a retrieval and a transfer in there somewhere, and get devastatingly bad news at some point” isn’t quite the answer you were looking for, I’ll run down the projected protocol my nurse confirmed with me.

3/11 – Lupron starts. Got it.
3/13 – Last BCP. Thank heaven.
3/16 – Expect menses. (I hate that word. I don’t know why.)
3/17 – Lupron Eval. (BW/US). Start Stims (Follistim 166 Units, Luveris 50units). Drop Lupron dose to 10 units (confirmed today)
3/26 – Trigger Injection (projected)
3/28 – Retrieval (projected)
3/31-4/2 – Transfer (projected)

Note the cosmic joke, here… another Saturday retrieval projected. Last time I had a projected Saturday retrieval, I thought, “Yeah, but what are the odds of that actually going as planned?” And I even got my period a day earlier than projected and I thought, “Ha! See? No Saturday retrieval for ME!” And then? I still had the Saturday Retrieval. As planned.

Now seriously. If something simply must go as planned, can’t it be the “getting pregnant” part?*

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*I actually have to give credit to Decemberbaby for that line.

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So the good news is that I confirmed with my doctor that I am doing a 20-10 decrease on the Lupron once I start the stim protocol. My poor nurse. I made her check with him about 6 times. “But you’re sure he knows that last time I did 20-20, right?” “No, I mean, really sure because I think he thinks I did 20-5.” “Okay, but you’re absolutely certain that my record reflects 20-20, right?” “I mean, definitely he knows I did 20-20, and even though he said increase on the phone, he actually meant decrease, right? He *does* know what he’s doing, right? RIGHT?”

Um.

Not like I didn’t think SuperDoc knew what he was doing or anything.

I, um. I mean. Of course SuperDoc knows what he’s doing!

Um.

Ohmygod whatthehelliswrongwithme? When did I turn into *that* patient? I must be stopped. Hopefully they just think it’s the Lupron talking? Maybe they just think I’m a little knackered? A lot? Surely they *must* know these drugs make their patients crazy, we don’t all start out this way. Right?

The bad news is my head hurts. Shocker. Maybe when I decrease to 10units, life will be dandy again. I can dream, right?

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Like a sword

The pain ripping through my head is like a sword stuck into my head. Through my eyeball, perhaps. The pain is palpable.

I forgot this was what it would be like. My head hurt so much and I couldn’t figure out why. Not my normal migraine. And then, then I remembered what I did this morning.


The news I’ve been trying not to say out loud, in case SuperDoc rips it away from me next week, is that it appears I’ll have a reprieve this cycle. Last cycle I took 20 units prior to stims and stayed on 20 units after starting stims. But despite his original statement to me that this cycle we’d increase or stay the same on Lupron… it appears that this cycle I’m decreasing the Lupron dose to 10 units once I start stims.

That…. that would be lovely. If it happens. I hope it happens. I’m afraid it won’t.

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L – 1

Lupron starts tomorrow.

You have been warned.

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Yeah, so enough about politics and ZIFT and whathaveyou. Really, this blog is allaboutme! Duh. Though, really, you wouldn’t know it, because there’s seriously nothing going on here in PerkyLand. Still taking the BCPs. Still getting honkin’ huge headaches. Shocking, I know.

I almost cancelled this cycle. Er, postponed I suppose would be a better word. Anyway, I had an absolutely ridiculous week that involved one child in the hospital, one car getting rear ended (with me and another child in it) and another car breaking down (with my husband stranded). Seriously, you can’t make this crap up. It was a bad week. It didn’t seem particularly prudent to be looking down the barrel of that gun they call Lupron Week.

But hey! Lupron week isn’t until next week! And I just know that if I put this off, I’ll be kicking myself later. There’s nothing I abhor more than a break. Nature abhors a vacuum; Ms. Perky abhors a Treatment Break. God Love Tertia and I loved every single word of her book, but the one piece of advice I didn’t find myself nodding along with in her final words was to take breaks between cycles. Not me. No way. No how. Nuh uh. Nosirree. Maybe I’ll be eating my words later and tweeting her with my tail between my legs, but I doubt it. I just think we’re all different. Me? I need to push forward. I’ll be miserable if I don’t.

I just thank HEAVEN that I was not taking Lupron this week. Because if I had been? All hell would have broken loose.

Meanwhile, I have horrifyingly bad cramps. I can’t help but notice that ever since I started the pill I’ve had pretty sharp pains in my right ovary. I have a tiny (growing) voice in my head that keeps wondering if maybe it’s a tiny (growing) cyst. Can you feel cysts? I hope not. Is this all in my imagination? Golly I hope so. But I do definitely have cramps. My period is imminent. As soon as I stop these BCPs, I’ll be getting it, no question. I start Lupron (whee!!!) on Wednesday. Can you imagine if I’d already been on the Lupron during Hell Week? Dear Heavens!

Given all the stress this week it seems a reasonable time to address Lori’s question (and barren’s followup comment):
Have you ever considered adding some stress reduction techniques to your next cycle? I know how stressed you were last time. My clinic believes so strongly about it they have their own stress reduction program.

It is rarely the cycle itself that stresses me out, just so you understand, but rather that my life is so frickin’ nonstop (I know, I know, like having another kid is going to make that any easier?). The truth is that until this past December I was actually a pretty relaxed, calm(ish) person, and then my life kind of went to hell with the successive disasters of several of my friends. One friend had her house burn down with her triplets inside (the triplets, thank heavens, are fine now, but were in the ICU for several weeks). Another friend lost her infant daughter to SIDS a couple weeks later. Another friend’s father was diagnosed with incurable cancer (he died this week). Auditors showed up at my workplace. Then my kids got the plague. Then a set of quintuplets were born nearby and I started helping them because I’m insane. More auditors. Then I got sick. Then the IVF cycle started. Still more auditors (this is normal in my field of work – not a sign of anything bad happening, but does mean an increased workload). Then the IVF cycle failed. Then my daughter went into the hospital (she’s out now, and fine), I got rear ended, my husband’s car broke down, you know, things just haven’t stopped for us, really. Actually, now things are pretty calm. We’ll see if they stay that way. Here’s hoping.

Now would seem like the perfect time to take a break, now that I think about it, wouldn’t it?

Except that it’s NEVER a good time to plan a pregnancy. It’s never the perfect time. And if I wait until my life calms down? Well, forget about it.

So what about stress reduction in the meantime? Well, funny you should mention it. My birthday present from my mother in law was a 60 minute massage. I loathe massages, actually, but I’m going to give it a go, at a strategically placed point in my cycle (I haven’t figured out when that is – suggestions welcome). As for other stress-reduction thingies… I actually do a lot of directed imagery, breathing exercises, and biofeedback techniques throughout my day, paritcularly when I’m in the middle of a cycle. I went through years of biofeedback training as an adolescent because of my migraines and it worked wonders (less so now, but still does an amazing job if I catch a migraine early enough and can take the time to really focus in on the techniques).

My clinic also does feel very strongly about state of mind/state of being affecting cycles, so they have recently established an afflilation with a center for alternative therapy – accupuncture, yoga, various nutritional voodoo, etc. They are a wonderful center that does a lot of wonderful work. So don’t think I’m knocking the suggestion.

I won’t ever do accupuncture because it makes me feel terrible. I tried accupuncture a few times for migraines and it made me feel like I was going to throw up every time. I did give it a fair go, but I felt awful and it left me with this horrible ICK feeling all over when it was done for HOURS. And Yoga. Don’t get me started on Yoga. Yoga does not relax me. Yoga makes me feel fat and awkward and dumb and I spend the entire time wishing I were somewhere else. But breathing exercises? Focusing inward? Personally working toward an inner zen? I’m all for it. Finding a therapist? Might even be all for that. Listening to music before and after my IVFs? Frankly doesn’t make a difference to me whatsoever and wouldn’t ever make me feel like I was doing anything proactive at all. Stabbing myself in the stomach (or bum, as the case may be) feels far more proactive, personally. But to each his own. I think everyone has those things that work for themselves. Me? I could use some good book recommendations for the waiting room. Got any?

Finally, do remember that part of what happens in the blogosphere is that you hear/read what gets transmitted in writing. I don’t spend my whole day focused on the minutiae of my cycle, but when I sit down to write a post about it, that IS, of course, what I’m focused on. Truthfully, I was pretty zen about the whole thing right up until transfer day when SuperDoc said he was going to transfer 8. (he was joking) That sort of broke my zen.

But it’s all good.

Hey, what’s the worst thing that happens, right? The worst thing that happens is this cycle doesn’t work and I’ve blown some more money, some more time, some emotional collateral, and some more energy baking cookies for SuperDoc, SuperNurse, and J, Marketing Supervisor Extraordinaire.

That’s not so bad, right? After all. That would still leave me with one covered cycle on my insurance before having to switch back to The Hatchery.

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The Good News: I have permission to switch my pill to the OrthoCyclen. I’ll note that I did this without permission anyway, knowing that it would be fine, but it is nice to know that it’s all fine.

The Bad News: My head still hurts like a bitch, which you can tell by the fact that I’m swearing like a sailor (which I rarely do in print, though I usually do in person).

The Good News: Despite my head hurting so much, the nausea is gone. I no longer feel like I have perpetual morning sickness, which is good, because if I have to have morning sickness, I damn well better be getting a baby 9 months later.

The Bad News: I have terrible, awful cramps, which makes no sense, because, hello? That should be over by now. But it’s not and I am not amused. In fact, I am quite ticked off at my effed-up body right now. In fact, the pain I’ve been feeling is quite severe and I am not enjoying it. I’ve been having visions of getting in for my Lupron evaluation (which isn’t for another several weeks, btw, so it’s not like it’s looming, or anything) and having SuperDoc say, “You are benched, Oh Perky One! Look at those Ginormous Cysts on those seriously un-Perky Ovaries of yours!” But I’m sure it’s all in my head, and due largely to the copious amounts of painkillers I’ve been swallowing for the aforementioned throbbing head and now very crampy ovarian region.

The Good News: Only two more weeks of BCPs.

The Bad News: I start Lupron March 11th. More headaches to come.

The Good News: IVF #2 is looming.

The Bad News: IVF #2 is looming. I am petrified of failing a second time. I know this is ridiculous. I can’t not bother starting just because I am petrified of failing. That would be ridiculous. For some reason, though, I was really okay with IVF#1 not working. As hard as any negative cycle is to swallow, I was expecting it and I think I handled it with my characteristic grace and humour. I haven’t even gone out and gotten stinking drunk yet (don’t think I haven’t thought about it). The thought of IVF#2 failing is absolutely petrifying. Please don’t just say, “Oh, but this one will work.” No one knows that. It either will or it won’t, and clearly right now I’m not in my happy, perky place. Maybe I’ll be there tomorrow. But right now? I’m not. Right now I need to work through what I’m going to do if it doesn’t work (aside from the logistical obviousness of – duh! I’ll do IVF #3… my last cycle covered at Ye Olde Fertility Clinic before I return to The Hatchery where I’ll have approximately 2 cycles covered under my husband’s insurance, good heavens, I hope it doesn’t come to that).

The Good News: I’m getting way ahead of myself.

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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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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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