Blood test this morning with ultrasound following. I’m going in to the fertility doctor’s office two out of three days now. At the ultrasound, the 3rd doctor (as opposed the the 1st male one I worked with and am assigned to, and the 2nd female who’s been taking ultrasounds in the interim who discovered the [disappearing] polyps, now this 3rd is the same guy I had at my last appointment with on Tuesday) measured my now larger follicles. It looks similar to the ultrasound photo I posted in the prior post, but now there’s less white space in between the black circles. Follicles measured up to 12mm. “That’s big!” I exclaimed.
“Not really,” he said. So what’s big? “They get up to 18 to 20mm.” Eep! “You’ll definitely feel them.” I already feel them now. I had a hard time falling asleep last night because I was very aware of my ovaries. It kinda feels like mild bloating with gas. Not painful, just an awareness that it’s there, especially in certain positions.
I also asked about the sushi/sashimi ban. My mom and aunt have been on my case about stopping raw fish consumption, saying it’s bad for me. I just sort of “yeah yeah yeah” wave them off, but I wanted to know what the risks are. The doctor said the argument against sushi is mercury consumption, and he wasn’t concerned about bacteria or parasites. (The sushi joints we eat at are pretty clean and careful about quality control.) So that means I should also watch my cooked fish consumption for mercury, and it’s not raw-fish-based. Which makes sense, cuz what do the women in Japan eat when they’re pregnant? Just ramen and yakitori? (Yes, I know there are more Japanese foods than that but I’m making a point.)
The doctor said the office will call me later today to let me know whether to adjust the evening’s Follistim dose based on the bloodwork from this morning. “We’re being very careful because if the estrogen level gets too high, she goes into a state called [some word] and she’ll get very sick,” the doctor explained to Mr. W. I was told to still take my Menopur dose this morning, so we (Mr. W mostly, I just sat there and went “Ow.”) administered that in a free patient room in the office. That hurt, especially when all that liquid got squeezed into my abdominal fat. The morning’s little dose of Lupron that I administered myself at home was fine, great. Again, I sigh: Why can’t all injections be like you, Lupron?

Sperm retrieval still set tentatively for February 28 (next Monday), egg retrieval tentatively March 1 (next Tuesday). At the appointment desk (where they booked me for yet another blood test/ultrasound tomorrow, cuz they’re monitoring THAT closely so I don’t get sick on being over-estrogenized), I asked her about exercise I’m allowed to do. She said, “No exercise.”
I think I stared at her for a few seconds trying to process that. “NO exercise?”
“None.”
“Um, when was I supposed to have stopped exercising?”
“Well…now. What kind of exercise do you do?”
“Weight-lifting, yoga, pilates, cardio…I did pilates yesterday.”
“Yeah, stop doing all that. You can walk, though.”
=P
The nurse handed me two pieces of paper, saying, “You’re also going to have to follow a special diet now, because if the hormones go on [hyper-something, she said], we don’t want you to get sick.” I read through the patient information on those papers as Mr. W drove us to work. Neither paper really addressed diet, but they FREAKED ME OUT. One explained that because I’m overstimulating the ovaries, my ovaries will be tender and delicate so to not do anything strenuous. It recommended “complete bed rest,” which is described as laying down or in a reclining position most of the day, getting up to use the restroom or sitting up to eat. Are they KIDDING? Starting when, NOW? But the nurse said I can take walks. It also said because bloating and water retention is “normal” thanks to the extra dosages of hormones, to cut out the salt. No biggie, I’m pretty lean on sodium intake anyway. There’s something in there about possibly having to monitor the quantity of urine at some point to make sure I’m urinating enough. The second paper talks about what to expect in symptoms coming up. The symptoms range from mild to moderate to extreme. Mild symptoms, like bloating and some water rention, is expected now, due to the enlargement of the ovaries. Moderate and extreme symptoms are apparently experienced by women 6-8 days after this course of hormone treatment is over, things such as decreased urination (you’re supposed to drink some allowable fluids on a list, things like Gatoraid, V8 [both of which seem weird to me cuz I thought they wanted to cut sodium out], carrot juice I think, and some other stuff), dark urine, weight gain of 2-3 pounds a day due to water retention, more bloating and measurement increase due to bloating. Call the doctor if weight gain is more than 5 lbs a day. (EEK!) Extreme symptoms that something’s wrong would be thirst but no urination (cuz the water is sucked into the abdomen thanks to the hormones, so there’s nothing to spare to urinate out), more extreme weight gain (10lbs), nausea, vomiting, sharp pains in the abdomen. 1% of women are hospitalized due to the hormones getting too heavy like that, and they have to have the fluid drained surgically from their abdomen (WAAH!).
While I whimpered and freaked out in the front seat, Mr. W took the papers out of my hands and put them in the back seat. He said that all pharmaceutical drugs list a ton of really adverse side-effects but how many people actually experience those? I drooped over sideways and said weakly that the paper didn’t say only a small percentage of women MAY experience these side effects; it said that the mild symptoms are expected during the course of treatment and the moderate and severe 6-8 days after treatment. Sounded pretty definite to me. He didn’t believe it.

So when the nurse calls me later to tell me my hormone level and how much Follistim to administer tonight, I’m going to ask her: WHEN am I supposed to be on this complete bed rest? Are those symptoms on the sheet a guaranteed thing? And WHAT diet am I supposed to follow?

*** UPDATE ***
Just got the doctor’s office call. So last Friday, my estrogen level tested at less than 20. Tuesday, it was something like 271 when they started decreasing my evening Follistim dose from 225 iu to 200 and then 175. Today, my estrogen measured at 1,456. I don’t konw what all this means, but I’m thinking it’s a pretty damn steep climb in a very short time. The nurse told me to decrease my evening Follistim to 100 iu (woohoo! less pain!) and tomorrow morning, before I go in for my blood test and ultrasound, to take the usual tiny dose of Lupron but to skip the Menopur, but bring it with me in case they tell me to administer it in the office like they did today.
I asked about the “complete bed rest.” She said I’m definitely not at that point, and hopefully with careful monitoring I won’t get to that point until after the retrieval/implant. She said I need to have bed rest for 48 hours after the implant, which makes sense. We don’t want to bounce the embryo out after everything we went through to get it in there. So as to the crazy symptoms needing hospital visits and abdominal fluid extraction? She said that’s worst-case scenario and hopefully I won’t be anywhere near that point, either. Whew. I asked about the restricted diet which wasn’t specified. Is it just cutting sodium? She said not just that, but also carbs and sugars. I asked if this includes the natural carbs such as from fruit and juices and yogurt, and she said yes, all the good stuff. Sounds like bloat control. Okay, I can do that. Except that I had a Subway sandwich on 9-grain bread for lunch and a pomegranate cherry yogurt for brunch before they called me. =P