Friday, November 30, 2007

He Shot Me.

Our very first stim shot was last night, and I’m happy to report, it was successful.

There is good news and bad news.

The good news is the scary looking, dart-like needle that I received about a million of, is NOT used to inject the meds into me. It is a mixing needle. While the injection needle is nothing to laugh at, it’s much thinner and less dart like. This was very good news. As you can see, it’s rather intimidating. The bad news is…they hurt like hell! I have a pretty high pain tolerance (ask anyone that knows me that and they’ll say the opposite, but just because I complain a lot doesn’t mean I don’t have a tolerance. I’m just whiny, that’s all) and I winced through the whole thing. Chris did his job just fine, it’s the actual meds that hurt. Sting, to be exact. Sting like a motherfucker to be completely honest.

It appeared to be any other Thursday night. But we knew the injection was looming. You could see it in our eyes, hear it in our nervous laughter. We had a job to do. My window of injections is 6-9pm (since my morning injection window is 7:30-10:30am, I thought I’d mix it up a little. I’m wacky like that) so I decided to just get it over with. Right after Rachel Ray finished her 30 Minute Meal, I was at the kitchen table with my science experiment, the instructions from our clinic and of course, the paper work that came with all the drugs. It’s quite involved. I have felt I deserve my own white lab coat with my name monogrammed on the front for so long, and now I really, truly feel I’ve earned it. We received great instructions from our clinic and it seemed pretty easy. Well, if you consider mixing powder vials with sodium chloride and then adding the FSH medication into that vial, withdrawing all of that out into the mixing syringe (make sure you get it all! There is about $300 of meds in there, it ALL needs to get in your ass!) and changing needles easy, then it was easy. We went step by step, slowly, making sure we didn’t make any mistakes. Did I mention our clinic said, “The first 3 days of stims are the most important, so don’t mess up! No pressure!”? We read each step out loud in that slow, drawn out way you do when you’re concentrating, doing, and reading at the same time. “Noooowww, inject the soodiummmm chloride into the powder viallllll….mmmmkkkkkkkk”. Finally, it was all mixed and ready to go. Chris took the dart needle off the syringe and replaced it with the one that looks like, well, a needle. I took my position, and braced for the shot. He then walked me through each step, “OK, I’m going to start” and did a great job starting the injection, pulling it out a little to make sure there was no blood (“No blood!” “Ok, good!”) and then proceeding with injecting all the meds. Then the stinging began.

Since they are intramuscular, the injection site is sore for a couple days. I clearly remember this from all my trigger shots in the last year. It’s sore. It hurts. And I get to have these shots every day for about 10 days, THEN we move on to the even more atrocious progesterone in oil shots for another two weeks. Basically my ass is getting brutalised for a month.

While I’m open about IVF in my personal life, I’m not in my professional life with the exception of my boss. So while I limp around the office because my ass hurts, I have to lie and say it’s a pulled muscle instead of the truth. They can’t handle the truth. “Oh, it’s nothing, my husband shot nun pee into my ass last night and it’s a little sore now.”

You know, I have to giggle at the moms that only have “I was in labor for 24 hours with you!” to their children. We have so much more to make them feel guilty about. “Your father had to shoot me in the ass for weeks!” is a good start. I’m not sure how or if we’ll even approach the money aspect. Telling them we spent $12,000 (if this one works, otherwise that amount goes disgustingly higher) to even conceive him/her would probably result in some ungrateful, whiny response about that must be why they don’t have the coolest clothes or best toys.

I can’t wait.

Tuesday, November 27, 2007

"OH! Hiiiiiiiii"

Isn't it awkward to run into someone you know at the RE's office?

This morning hubby and I were on the couch in the waiting room when the door opened. Following standard infertility clinic waiting room protocol, I did not look up. For whatever reason, this seems to be how you are supposed to behave, so that's what I do. Well, the person walking in did not follow the rule.

Her: "Katie?"
Me: [frozen] silence. A little too long goes by and I realize I wasn't hearing things. I look up. "OH! Hiiiiiiiiii" - a really awkward, drawn out hi.

It was my old boss, one I had a very volatile personal and professional relationship with and haven't seen or spoken to in over 5 years. Back then she wasn't exactly lucky in love, so I was surprised to see her in an infertility clinic...and automatically thought she was doing IUI's with donor sperm (I'm so bad) until I saw the blinding flash of light from her hand and realized she's now married. She went on to tell me her brother and his wife conceived twins at this clinic via IUI, at which point our names were called and it was time for us to head in to our appointment. She said something else about twins and in my awkwardness I think I crossed my fingers and wagged them in front of my face as I walked through the door. I have no idea what possessed me to do that. I'm hoping for one, not twins! Of course we'd be thrilled, blah blah, but I have no idea why I made that gesture. The last gesture she saw from me.

So on to our regularly scheduled programming. Our baseline ultrasound was good, we're set to start stims on Thursday. Hubby got his lesson on the shots since these are all going to be intramuscular, which was news to me. I assumed they'd be subcutaneous like my easy peasy Lupron, but it's not. Hubs will be fine, I'm sure. I have a pretty big tattoo of a carousel horse on my uh, hip area, that will serve as a great guide for hubs to use for injections. The medical assistant said "Perfect! Just inject it into the horse's head!" Which, when you think about it, it better than her telling him to inject it into the horse's ass. 'Cause that could be taken a couple different ways. Har har har....

Sunday, November 25, 2007

Hit me with your best shot

(I guess I'd be talking to myself by saying "Hit me with your best shot" since I have to give myself these injections).
November 18th marked my very first shot of Lupron. Easy, easy, easy. The Lupron shots are with little insulin syringes, they're like the starter syringe for the whole process. Nothing like the what seem like hundreds of the other syringes I have for the other meds that really do resemble a dart. I shit you not, a dart. Like the ones you throw at a dart board, dart. Anyhow, these little Lupron shots are nothing. I'm quite used to them now. Although I did have a panic moment a few days after I started...things like "Why am I not getting any headaches? Why don't I feel any side effects? Oh my gawd, I'll bet I'm not even getting any liquid in the needle! I'm just injecting air! I've ruined this cycle, I've ruined our lives, I've ruined everything!" IVF can make you a little crazy. So now each time after I give myself a shot, I make sure I squeeze out the tiny little droplet that's left after the injection so that I feel better knowing there definitely was liquid in there. This prevents me from trying to get the old syringes out of my bio-hazard storage container like I did a few days ago. FYI, that top doesn't come off. Easily, anyway.

Why is my RE so big on urine??

I'm just curious. Why does my RE seem so incredibly partial to meds derived from urine? I know there are laboratory created versions of these drugs so I don't understand her preference for the ones she prescribed me.

Are you a confused fertile? There, there, I'll fill you in. There are several different drugs prescribed for an IVF protocol. Some are older, some are newer...and the newer ones are mainly created in laboratories. They are the man-made version of the older drugs. The older drugs, a couple of them, are made from urine. Yes, I'm serious. Urine. Oh, it gets better.
Repronex, one of my drugs, is made from the urine of post menopausal nuns. You heard me. Post-menopausal nuns! The post menopausal part has a good explanation - post menopausal women secrete higher quantities of the particular hormone needed for this drug. I don't understand the nun part, though, as in why their urine is specially used for this drug. Maybe because it's a place where a large group of post menopausal women hang out together - easier to get 'em all at once. Then again, they could go to any Curves gym in the country and end up with the same demographic.

Anyhow, there is another drug that works just like Repronex, called Menopur, except Menopur is not made from urine. And I want to know why I got the urine prescription.

So this was bothering me. Then I realized my trigger shot (Pregnyl) is also the older urine method. Except this time it's the urine of pregnant women. So obviously, not nuns. But the same thing - urine. And again, there is an alternative, newer drug that is not made from urine that would serve the same purpose. But I got the pee.

As if I don't have enough to think about.

Here Come the Drugs

The arrival of the meds is such a weird moment in the first IVF process. There's so much anticipation...this is really starting. It's exciting, it's nerve-wracking, it's a small fortune of liquids, needles and pills...and it's our best chance yet. If you've been on this journey for a while, you've no doubt seen the requisite picture of meds laid out on a table for all to see (see left). It's not a big surprise to us going through this, but it is entertaining to show the pictures to friends and family that have never dealt with infertility and have no clue what we're going through. There's an odd sense of satisfaction in seeing their shocked responses. "WOW! That's a lot of needles! Do you have to inject yourself???" To which we get to nod smugly and say yes, it is a lot of needles and yes, we have to do them ourselves. All the while we continue to nod and smirk as if it's nothing. Just another day.

I could not wait to get to my box of drugs. I tracked the shipment on the web, watching step by step as they arrived safely at my parent's house (no need to leave several thousand dollars of drugs on my unattended door step, and certainly no need for my nosy warehouse person at work to "accidentally" open my box before delivering it to my desk), and finally getting that email from my mom, "They're here, honey." Ooooh, I couldn't wait to see them. "Is it a biiiigggg box??" I asked. "Um, yeah, it's kind of big" (very nonchalant in her reply, I might add).

Now I'm worried. Oddly worried that my box of drugs isn't going to be as big as I thought, thus leaving less of an impact on all involved, including myself. For as much money as I just spent, I really needed that box to be impressive. What if my supply of drugs is unimpressive? Just a handful of vials and some syringes? It would be such a let down.

Annnd, it kind of was. It wasn't a huge box. The pharmacy was quite efficient in their use of space. It wasn't a small box, and obviously to the regular people out there it was a massive box for drugs, but for me, it was a little disappointing. Then I got it home and we took everything out, laid it all out on the table, and I felt a little better. There were more than enough needles there to make an impact on even the most jaded fertile.

Saturday, November 10, 2007

How about a discount?

While sitting in our clinic's office, we came upon a flier for Infertility Counseling. Which, is actually great because counselors and therapists that specialize in infertility are rather rare, and it is something that not many people understand. Like, oh, my grief counselor I saw after our miscarriage. I remember saying, "Well, we've been in treatment for a year" and her immediately saying (this from a woman that did a whole lotta nodding and nothing else, so for her to suddenly pipe up at this moment, with something totally inappropriate, let's just say...pissed me off) "I've heard that's quite normal. That it takes a couple up to a year to conceive." Yes, lady, that can be quite normal. But we've been in treatment for a year, trying for much longer than that. Which I made clear. Then I cried about something else and all my toughness was shot to shit.
Anyhow, hubby and I looked at this pamphlet and the list of things someone dealing with infertility might experience. Shock of all shocks, it was as if it was describing me personally. Hubby even asked "Huh. If you have all of them, do you think you get a discount?" I wish it worked that way. Then it would be free!
But even looking at the "symptoms" now, I still wonder how valid it is. I mean, there are some damn good reasons we feel these things. Like...
Jealousy of people who are pregnant or have children Ok, people, let's be honest. How is that weird or uncommon, or even unexpected? How often do we see people buy things just because someone else has them? Even cars (typically big SUV's, I'm just sayin'...), houses, definitely clothes...we're a society full of gloriously green monsters. So how would infertility be any different? When you're the childless couple at an age when everyone else has children, you're excluded. No one wants the weird childless couple that can sit and drink while everyone else takes (god, hopefully) care of their own kids. Sure, the pregnancy thing is an example of the bitterness the infertiles tend to go through. Until our miscarriage, I didn't have that jealousy towards pregnant women. Thankfully, my instinct to hiss like a cobra as one passes seems to have subsided, and I'm working on my instinct to slap a woman's hand from resting on her pregnant belly. Give me time, people.
Guilt at time and anger at other times Well, how is this different than life in general? I feel guilty that my body is why my hubby and I are spending a small fortune on a chance to have a baby. I also feel guilty when I take that parking spot that I knew someone else was trying to take, but damn, it's raining and I don't want to walk further in the rain! Sure, I'm pissed that we can have what everyone else has or jeez, that no one else we know has to pay to try and have a baby...but I'm also angry in general and that was far, far before I even met hubby, let alone jumped into fertility treatments.
Feelings of intense preoccupation with infertility - Um, yeah. Let's think about this. Let's look at an infertilies calendar. Even without doing IVF, you're spending so much time at the doctor's getting ultrasounds (yay! good follicles! or boo! sorry, not responding, see you next cycle), or blood work (Hi, I'm George, and I'm an intern. Can I take your blood today?), or even taking your temperature every morning, or peeing on an ovulation predictor test, or once you get past that point, analyzing every.single.damn.symptom in hopes that it's not PMS and it is indeed pregnancy symptoms. Or when you do IVF and you're shooting yourself up every morning and every evening, and you can't go to social function that go past 8 o'clock because you have to do your in the fuck does any sane person not have an intense preoccuptation with it?? It would be insane to not be preoccupied by it.
Difficulty Concentrating and Completing Tasks - I attribute most of this to the drugs. The fertility drugs, that is. Sure, the pot in college might be a contributing factor, but I....wait, where was I?
Feelings of resentment towards family because they don't "get it" - In all seriousness, I've struggled with this. Most infertiles have. No one gets it. Nor can we expect them to. We can just hope we have people that support us during this really difficult time.
Feelings out of control. Frustrated at the unanswered questions. Duh. Infertilty/fertility is hardly a perfect science. There is only so much they know, and so much more that really is left to chance. That's frustrating.
Anxiousness and fear of becoming pregnant, especially after a loss. Oh, yes. Oh so very anxious. I mean, who wouldn't be? Losing a baby after trying for so long, taking so many drugs, getting almost through the 1st (and oh so scary) 1st trimester is going to screw up even the most rational and solid person you know. I know, because it happened to me. (Yes, I once was very rational and put together.)
Mood shifts over the slightest things - yes, this is quite possible as well. Infertiles are often on many different drugs that will possibly induce PMS like symptoms with no warning. Hey, YOU take drugs that give you hot flashes during a meeting or night sweats all night or moods that change on a dime and tell me how you feel.
Crying at unexpected times - Again, drugs. Again, depression. Again, anxiety. Again, [sobbing]....

We go through a lot and counseling can help if you find someone that specializes in infertility. But, damn - there really are a lot of reasons why we feel this way. And they really are justified.

Aaaannnd, We're Off!

After 21 months, a year of fertility treatments and a miscarriage, we're finally embarking on our first IVF cycle. Considering we have no insurance coverage, this is a big step. A big, atrociously expensive, step. But unfortunately, necessary. So we're off to our first "interview" with the clinic closest to us.

We've had more than a few disappointments with appointments and our (ok, my) expectations, and since we're now paying completely out of pocket and we're basically paying $200 to interview our RE and clinic, I'm coming out with guns a-blazing. No fucking around. $200 for one hour? Oh, we're gonna talk about what I want to talk about, what I want to know, and nothing else. No need for a biology lesson, here. We've been through the ringer, we know what we need to do to try and have a successful pregnancy, and we don't need the formalities. Period.

Here's hubby's and my conversation driving to the clinic:
Me: We're paying $200 bucks for this appointment and we will discuss what I want to talk about.
Hubby: Uh-huh.
Me: No biology lesson, no detailed explanation of IVF - I know what it's all about.
Hubby: MmmmmmK.
Me: Yeah - I have no problem telling her that we aren't going to sit there and listen to her whole shpeel. We're not her average patient. We're not new. Right?
Hubby: Right...

This is the gist of what happened:

Dr. R: - OK, so here is a diagram of the female reproductive system, and here are your ovaries...
Me: [silence and some head nods]

Yeah, I talk a pretty good game. But this woman was intimidating, even for me! I went in with my guard up - big time - and even crossed my arms across my chest and smirked a few times, until I realized, uh...I think she really knows what she's talking about. Aside from her comment that I should lose weight (I am ONE good stomach flu away from an ideal weight - I'm not a skinny minny, but c'mon - a couple days of intense diarrhea and vomiting and I would so be at an ideal weight) to which I again smirked and thought "You are so fired before you were even hired", but eventually, she did get my attention in a good way. I also started to relent that maybe, just maybe, my Google MD might be no competition for her actual MD, or PhD, or certification in Reproductive Endocrinology. That maybe, just maybe, her competence and great statistics and overall computer mind when it comes to infertility, might finally be our answer. So after a little over an hour (score! we totally got free minutes), we both decided this would be our home for our very first IVF cycle. And so the journey begins.