Friday, July 31, 2009

ROLLING RIGHT ALONG

I'm back on the Lupron. I really don't think I mind it too much. I've heard a lot of women complain of headaches while on it, not me. The first night I injected it, the medicine hurt going in. It didn't sting or burn and the needle obviously doesn't hurt much (it's tiny), but when I slowly pushed the plunger, that medicine wanted to hurt me. The second night's shot left a golf ball-sized bruise on my tummy. I can handle the bruising, and I can even handle the burning when I'm short on patience and don't wait for the alcohol to dry before injecting the needle, but I don't like the pain. I don't think that's supposed to happen. Have any of you experienced a dull pain when injecting Lupron before?

I stop BCP in a couple of days and begin loads and loads of progesterone very soon. I will be wearing progesterone patches, inserting vaginal progesterone suppositories, and getting shots of progesterone in oil in my rump. I let Kev give me those shots for a few reasons:

1. the needle is enormously thick and I would never be able to jam it in
2. I would laugh hysterically with the needle poised inches over my skin, thinking about how unpleasant it will be and never actually do it
3. the solution is so thick it takes a very long time fully inject all the medicine
4. I hold my breath while the meds are going in, and because it takes so long I would undoubtedly pass out with the needle hanging on to my muscle at a ninety degree angle


I know, call me a wuss. I have a very high tolerance for pain, but a weak resolve to inflict it upon myself.

I'll also be taking a few other things to help prepare my uterus for the frozen embryo transfer. I hope they like it in there and want to stay a full nine months!

Tuesday, July 21, 2009

FET COMING UP

We had our frozen embryo transfer planning meeting yesterday. I think we both felt a little disappointed by how we were treated. We weren't treated badly, but we weren't made to feel as important as when we were planning and going through the entire IVF process. We waited over an hour before we were seen, then the consult only lasted twenty minutes. We were informed that although we were told we had a substantial credit to use toward this transfer, we actually did not and would be paying full price instead. We were also told that the transfer would be September 1st. It's really not that different from the original "end of August" date, but just to hear that it is in yet a different month broke my heart.

It seems our infertility battle just keeps going and going and going. We've had such a long journey, and after six years of heartache, I'm ready for some good news.

I couldn't help but cry at the appointment. I've been doing that a lot lately. Honestly, I've cried (hard) every day for the past nine days. Maybe it's my body trying to regulate from the massive amounts of hormones I pumped into it for two months to prepare for IVF. Whatever it is, it's driving me and Kev nutso.

Thursday, July 9, 2009

STABBED

I've been putting this off long enough. I just need to get it out. Here's the last installment of the story of how our IVF cycle turned into a nightmare. If you missed the beginning of this story, you'll want to read this post first, then read this one.

Deep breath. I can do this.

Once admitted to my hospital room, I had a team of nurses buzzing frantically around my room. Though they worked quickly and seriously, they did a nice job of keeping everyone thinking that this problem was, in fact, fixable. It was now after 5:00 AM and I had been violently ill for over two hours. The nausea and vomiting was getting worse; I gasped for air between painful retches. As I continued to be sick into my trusty hospital-issued mauve bucket, Kev stayed by my side, dabbing my face with a cool rag. Meanwhile, Nurse #1 attempted for fifteen minutes to find a vein in my left arm for an IV. She stuck me several times, but found no usable vein and no blood - I was too dehydrated. Nurse #2 took over and began sticking my other arm. She tried for another fifteen minutes and was about to give up when she finally was able to find a vein on the back side of my forearm near my elbow. As soon as the IV fluid hit my bloodstream, I suddenly felt life again coursing into my fingers. I hadn't realized until that moment how dead I had felt. Although I was still vomiting, I raised my hand to my face, in an attempt to see color return. I couldn't see anything but the bottom of that ugly mauve bucket.

I was given the first of six shots of Hep.arin in my stomach and a shot of nausea medication in my IV. In addition, I was given an initial round of nine bottles of Alb.umin in my IV. Over the next two days, I would be given somewhere around 20 bottles of this medication (I lost count). I was very hopeful that the vomiting would immediately stop as the nurses had promised, but I was so far gone that the vomiting lasted another eight hours for a total of eleven grueling hours of the most extreme nausea I didn't know existed. Once the vomiting finally stopped around 2:00 PM, I felt I had returned from the dead.

My fertility specialist came to my room around 3:00 and told me how much better I looked. I don't remember seeing him prior to this; apparently, I had my head in the mauve bucket the first time he came to check on me. He ordered that my abdomen be tapped to drain the excess fluid that had built up over the previous four days.

Oh God, give me strength. This is where it gets ugly. The squeamish may want to skip the next paragraph.

I was wheeled down to the radiology department where the nurse sonogramed my abdomen to find the best place to make the incision. He X'ed me with a magic marker and left me there for over an hour as I waited for the doctor to perform the procedure. The doctor finally showed up and shot the local anesthetic into my abdomen. It stung a little at first, but I gritted my teeth and the pain quickly subsided as the anesthetic began to work. Then it was time to make the incision. He began cutting. At first, I only felt pressure. But as his scalpel reached beyond the superficial layer of my abdomen, I felt the blade of the scalpel stabbing, cutting, tearing deeper and deeper. I screamed in pain. I screamed and screamed and begged him to stop. I screamed and stretched and waved my arms out in an attempt to find something to hold on to. There was nothing there to hold. There was no one there to help me. He screamed for the nurse to turn on the light. I screamed for a break so I could catch my breath. I don't know what he did with the light, but he soon asked for it to be turned out again so he could watch the sonogram and finish the incision. And so he did. And so I continued crying and screaming as the scalpel stabbed deeper and deeper. Several minutes later, he was finally through. He inserted the drainage tube and attached the collection bag to my leg. As I lie there trying to stop crying and to catch my breath, the nurse brought me a form and a pen and told me to sign. I was shaking so hard and had tears clouding my vision, so I asked him what it was he needed me to sign. He did not tell me. He just repeated that I needed to sign it. I asked again and got the same response. All I wanted to do was get the hell out of there and away from the man who just stabbed me. I signed it. The nurse helped me into a wheelchair and took me back up to my room. When my mother-in-law saw me white as a ghost and shaking, she went limp, obviously worried, and asked me what had happened. I couldn't speak. All I could do was shake my head and quiver.

I don't know what went wrong. I don't know why I could feel the scalpel slicing my flesh open. The doctor who performed the procedure came up to my hospital room and gave some lame excuse that his needle wasn't long enough to reach all the layers of my abdomen. I know that has to be bullshit. I'm not that big. He fucked up and was trying to cover his ass. I will be filing a formal complaint with the hospital. I don't want anyone else to have to endure that terrifying pain. Imagine a small child in that man's poor care. He needs his cutting license removed. I'd like to cut him. I digress.

Over the next 30 hours, over two gallons of fluid was removed from my abdomen. As disgusting as that sounds, it was definitely sweet relief to no longer have that fluid crushing my organs. I was given more Hep.arin, several shots of Dem.erol, and loads of Darv.ocet. Neither of the pain medications did anything to alleviate the torture of the drainage tube lodging itself into my enlarged and extremely tender ovaries. Once the tube was removed, I was pain-free for the first time in five long days.

I was sent home Wednesday evening around 9:00. I had an appointment for embryo transfer the next morning. At the appointment, I told my doctor that I had been extremely dizzy since 4:00 PM the previous night and that I still was not urinating. The embryo transfer was cancelled. I was still too sick with OHSS too transfer. He said it would have been inevitable that I would have ended up in the hospital again if the embryos implanted. The OHSS would be worse and would last much longer. Weeks or months. I was crushed.

Writing this post has been difficult. I had to stop and cry a couple of times, but I think it has helped me. Maybe now that I've gotten it out, the insomnia and nightmares will stop.

Now on to our frozen embryo transfer in August. We have ten embryos frozen and waiting for us. I can't wait to meet them. I love them already.

Wednesday, July 8, 2009

SHOW & TELL - BROKEN UP

Is it possible to Show and Tell about two completely different things? I'll try. Let's see how it works out.

First, the show:

Our new puppy Polly. She's about ten days old and I can't wait for her to come home.

Next, the tell:
I'd like to continue the story of my recent hospitalization, but honestly, I'm getting to the traumatic part that I keep reliving over and over and I don't think I'm quite ready to write about it. If you missed the beginning of the story, read this first, then read this one. You'll have to check back soon to get the most intense part of the story. I promise I'll write about it. I just need a minute to catch my breath.

Tuesday, July 7, 2009

MISERY



If you missed the beginning of this story, read this first.

To follow up on the story from yesterday...

After the egg-retrieval I spent two hours in the recovery room because my nurse's computer crashed. This made me VERY uncomfortable and unhappy. I just wanted to see my husband and get the report from the retrieval and go home. They finally released me, escorting me in a wheelchair to my car. And so the super fun-time OHSS party begins.

I began feeling very ill in the car. We only had a fifteen minute drive from the hospital to our house, but somewhere on the highway, I informed Kev that I was going to faint. And so I did. As he maneuvered the highway, he held my unconscious head in his hand, in an attempt to keep me sitting upright even though I had gone completely limp and fallen between the two front seats of our little SUV. As he later recalled the story to my sister, he said that people probably thought he was some kind of creep riding around I-35 holding on to a cadaver. I regained consciousness at some point, but don't remember the rest of the ride or our arrival at home. Somehow, Kev got me into my PJ's and brought me downstairs to lay on the couch - my new home for the next four days.

If I remember correctly, my sister and sister-in-law came to visit later that afternoon. I was already incredibly bloated by the evening, and walking from the couch to the bathroom was excruciating. As I walked, I was a slow, hunched-over, crying mess of a woman. The Darvocet prescription I was given did nothing to alleviate the pain. I was not in pain from the procedure - I was in pain because the excess fluid on my abdomen was crushing my organs.

Maybe now would be a good time to explain Ovarian Hyperstimulation Syndrome for those of you who are fortunate enough to not have experience with it. OHSS may occur during or after a controlled ovarian stimulation for an IUI or IVF cycle. I have experienced OHSS twice - once during an IUI cycle which we were forced to cancel, and this time, which also caused us to cancel the fresh embryo transfer and postpone two months for a frozen embryo transfer. Symptoms can vary from mild to severe. Mild symptoms cause discomfort, while severe require hospitalization and have, in rare cases, caused death. Symptoms include collection of fluid in the abdominal cavity which causes bloating, shortness of breath, organ pain, possible organ failure, ovarian torsion, decreased urine, dehydration, dizziness, fainting, and vomiting. Here's a good article on the subject written by a woman who has experienced OHSS.

By Friday evening, I was bloated, dizzy, fainting, short of breath, had very little urine which was tea-colored, and in moderate pain. Saturday, my symptoms worsened and I was in so much pain from severe bloating that I could barely breathe, while movement was excruciating. I fainted every time I tried to walk somewhere. That evening, my symptoms were worrying me and I decided to phone the doctor on call. I described my symptoms and she said that as long as I was still urinating and not vomiting I would be okay. She told me to stay on the couch and only move to the bathroom with assistance. She called in another prescription for Darvocet and some nausea medication. Sunday, the pain subsided a bit and only hurt when I moved, as opposed to constant pain, even when at rest. I did, however, faint about six times.

Urination was painful and infrequent, but because I was urinating a little bit, I didn't think I was dehydrated. I was wrong. Very wrong. I wish someone would have described the symptoms better to either me or my husband. I would have gotten help by Saturday when I really needed it. Perhaps the hospitalization could have been avoided.

Monday morning, I woke up and took two bites of an English muffin with jelly and promptly vomited - violently. I took some nausea medication and slept for a few hours. When I awoke, I called the fertility clinic and told them about my morning, but also told them that I was feeling better. Once again, I was told that I would be okay. My embryo transfer was scheduled for Wednesday.

Kev brought me a delicious portabello sandwich for lunch at about 1:00. I was starving. I ate the whole thing. I took more nausea medication and went to sleep. Four hours later, I woke up and began vomiting violently. This time, it didn't stop. Thirty minutes into this frightening episode, I reached for the cordless phone and managed to dial Kev's office. Between retches, I begged him to come home and help me. He promptly left, but got stuck in traffic. Wonderful. When he finally got home, he called the doctor on call and she said that if the nausea subsided then I would need to take more of the nausea medicine. She said that I even needed to be woken up during the night to take it. She scheduled a visit to the clinic for the next morning, so Kev called my parents and asked them to come in to town to take me to my appointment since he had to work.

I woke up to vomit at 3:00 AM. I didn't stop. Kevin woke up at about 4:00 and asked me what the hell I was doing in the corner of the dark basement with my head in a trashcan. I told him I didn't want to wake anyone up, but that I had now been vomiting for over an hour. He called the doctor on call again and told her that I needed to go to the emergency room. Escorted by my mother and father, I carried my giant white trashcan to the car as I continued to vomit violently. I have never experienced such extreme nausea and pain. I wondered if it would ever end.

We got to the hospital at around 4:45. Thanks to the doctor on call, I was able to bypass emergency and be directly admitted - still puking into a mauve-colored plastic bucket - to the last room in the entire hospital. It was a double room, and my poor roommate had to listen to me vomit for hours. That's not to mention the poor man with whom I shared an elevator. I can only imagine what he must have been thinking when he heard my wailing and retching. At one point, I actually cried out to God to help me.

There's more. Lots more. I'll finish up this story tomorrow. Stay tuned.

Monday, July 6, 2009

DANCE FOR ME

I guess I should at least start to record my awesome fun-time carnival of IVF with ICSI.... Wait a minute. I mean egg retrieval and severe OHSS. So...

Kev and I awoke bright and early to go to the hospital for egg retrieval on Friday. We had a very short wait - in fact, they called me in even before I sat down in the waiting room. I went potty like a good girl, then changed into the lovely blue open-back dress and was escorted to the staging area for surgery. I signed papers stating that I understood that I could die under the anesthesia, blah blah blah. They stuck me for the IV and blood shot all over the nurse, onto the floor, and covered my hand. I didn't see this as a good sign. I'm never nervous before a surgery, but I was now nervous for this one. Kev was allowed to come in, and he kept me entertained by spelling words on a calculator. "Boobs," "boobless," "shells." Then he kissed me goodbye.

The nurses came to get me and told me that they would first give me something in my IV to relax. They said it has an amnesiac effect, so that I wouldn't remember anything afterwards. They assured me it was "the best margarita you'll never drink." The male nurse by my head squirted half of a syringeful of this magic cocktail into my IV. I shot the guy an inquisitive and worried look, and he assured me that he would give me the other half of the cocktail once we reached the surgery room.

He didn't lie.

Once we were in there, I was definitely feeling the effects of that "margarita." Feeling no inhibitions, I informed everyone in surgery that the room was pretty boring with all those lights and instruments, so I suggested that they dance for me to liven things up a bit. That's the last thing I remember....

...Until I woke up and asked them if they danced while I slept. The very last thing I remember from that room is hearing the anesthesiologist say, "Holy shit. She remembers!"

The best (er, worst) part is yet to come.

 
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