cindy's world

Email from me to my dad, mom’s work, and mom’s home email at 9:30 this morning (since she has very limited access at work):
Subject: First baby picture
Here is your first photo of your grandchild.

Reply email from mom’s work to me:
We can see the baby already? I can’t open it!

Reply email from me to my mom’s work:
awwww, I guess you’ll have to wait until you get home!

Reply email from my dad to me and my mom:
Dear Cindy :
Wow ! look’s just like you ha ha ha

Reply email from me to my dad and mom:
I know! That’s what I look like at night after I take off all my makeup! Mom says she can’t view the picture.

IM from Flip Flop Girl (whom I showed this string to):
hahahahahaha
you and your dad are so mean!!!
but SO funny

IM from me to Flip Flop Girl:
hee hee!
she’s probably called my dad by now and has wailed, “I can’t see it! What does it look like? Can you print it out and fax it to me?”

A coworker recently lost her elderly mother after the mom broke her hip in a fall, then suffered a heart attack after her surgery in the hospital. I wasn’t aware that her mother’s funeral was yesterday after work because I had taken Monday off for bedrest, so it was a surprise to discover we had after-work plans of such a nature. On the drive to the church funeral, Mr. W and I called his mother for her birthday. They (mom- and dad-in-law) were on speaker, and we were on speaker, so it was a 4-way conversation. We exchanged pleasantries, they asked about my shots and pregnancy, we joked around, and they said they were on the way to a steak dinner to celebrate MIL’s birthday. They asked where we were going; we told them to a funeral. =( I said they were the bright spot to the day before we went into something more solemn. In the church, the way the children, grandchildren, a neighbor and friend spoke about the coworker’s mom made me wish I’d known her. Even without ever knowing her, I aspired to be like her, but I’m a long shot off. I thought about how my kid(s) would see me as a person and a mother when I passed, how I wanted them to be able to say honestly, like this woman’s daughter did, “she always tried to do the right thing.” How they trusted her heart and her advice, her nurturing and open arms, and how this was the way she treated everyone from family to friends to strangers. And I thought about being irritated at my mom over an email she’d written me earlier last week, how I’d resolved to not respond because I was so offended, and then having Flip Flop Girl invest solid time over IM in the middle of the day to talk some sense into me. Everything Flip Flop Girl said made sense but I was too mad to budge, until her most effective line: “…but our parents are the only parents we have, and they mean well, you KNOW they do.” It suddenly struck me how hard it had been (somewhat recently) for Flip Flop Girl when she lost her own mother. And I finally took her advice and wrote my mom back a very detailed, patient, explanatory email about what’s going on. She still wrote me back something I found condescending, but maybe she thought the words in Chinese and it just didn’t translate well or something. Like Flip Flop Girl was trying to tell me, take into account the intent and not the delivery.
Toward the end of the coworker’s mother’s service, I had an odd sense of an elderly white-haired woman, face creased with the lines of over eight decades of smiles, coming to each person where we were sitting facing the pulpit. She walked down each aisle, back to the preacher and paying him very little attention, but focusing instead on the friends, family, and strangers, leaning down just a little (because she was small) to be almost level with our faces, her hands over ours, acknowledging each of us, welcoming all of us with complete joy and acceptance. As if she were hosting her own funeral and greeting guests. And then it struck me… “Mabell,” I asked her in my mind, “Would you like to connect with your daughter again?” Her daughter, my coworker, had made an attempt a couple of months ago to set up a private reading with Rebecca, but unexpected expenses came up and she had to defer to a later time. I think it would be a wonderful thing to buy her an hour with Rebecca when Rebecca’s next in town at the end of this month. My coworker was having a very hard time with the thought that her mother, her roommate, her best friend, was no longer physically in the next room. “Would you like that?” I asked the busy image of the older woman in a light-colored cotton nightgown-looking garment. But she had moved on to other guests. I think this will be just for my coworker.

I’m pretty lucky. I told college roommie Diana the other day that I lead a pretty charmed life, and I think I do. After gymming on Monday, Mr. W came home with an armful of two dozen yellow-orange roses (the petals were yellow, my fave, but had swirls and touches of orange, very pretty). “For my future baby’s mama,” he explained. Diana and I had chatted before about her seeing a far-along pregnant woman in a bikini, and how her then-boyfriend had seen nothing wrong with it, and she asked me for Mr. W’s opinion. He saw nothing wrong with it, either, although Diana and I couldn’t imagine ourselves pregnant and strutting in a bikini in public. Mr. W had been talking for months about taking artistic silhouette-y pregnancy photos of me, which I’d always stuck my tongue out about, but he was always starry-eyed about the whole deal, saying how “cute” it would be when my belly got that big and my belly button got pushed out (ew?). I get the sense that Diana’s Eric is of the same mind. I know a lot of women who have been weight-conscious most of their lives don’t see the body changes that come with pregnancy as beautiful; it’s a cliche that women feel “fat” and “ugly” and many are fearful that their husbands would wander toward a, um, less curvy idea of beauty when we are at our “largest.” But I have none of those fears with Mr. W; is he quite irrationally excited about what’s to come. I, of course, am not sure what to expect, and am considering getting a baby book so I can stay on top of doing the right exercises, eating the right things, looking for the right signs of baby’s health.

So far, pregnancy feels similar to any other time of PMS. I’m not overly bloated (I finally weighed myself, 121 lbs, so my maximum weight will be 145, which is still below my lifetime heaviest by a pound) and I’m not as cranky nor do I crave chocolate, but my breasts are tender and I have a few mild cramps a day. Mr. W says this may be the hormone drugs and not pregnancy at all. That’s true… last night’s Progesterone injection didn’t go so well. After he put the shot in, he drew back on the syringe a little to check for blood, as he’d done before. It’s to make sure he didn’t poke into a vein cuz the med is supposed to sit in my muscle, not my bloodstream. I heard him say, “Uh-oh, there’s blood!” I told him matter-of-factly the next steps that the nurse had explained and that I’d read multiple times on the injection instructions.
“Okay, pull it out, and we’ll just find a different spot. Change out the injection needle and screw on a new one. Put a cotton ball on the spot you just came out of, and you’re gonna have to re-swipe the area with alcohol before you inject again.” He couldn’t get a cotton ball on the site before blood was running down, exactly as it had the first day with the Pregnyl shot. The bleeding didn’t stop for awhile, which made me concerned that the first Pregnyl shot, when he’d forgotten to draw back on the plunger to check for blood return, had indeed been an intravenous injection. I hope nothing was affected from that. 🙁
Mr. W removed the needle, but asked what he ought to do with the blood filling up the top of the syringe. “It’s my own blood, just leave it, it’s fine,” I figured.
“But how will I know if I hit blood again? When I pull back I won’t be able to tell if it’s old blood or new blood.” Oh. Good point. While I was still pondering this quandary and trying to call a nurse friend while watching people injure themselves on “America’s Funniest Home Videos,” Mr. W said, “Okay, I got it.” I guess he’d managed to squeeze out most of the blood. He found a new spot and this spot hurt worse than the former spot and I jerked involuntarily. But he reported, “Okay, no blood,” and completed the shot. The first hole was still bleeding, but the second was fine. And today, I feel like there’s a golf ball buried in my right butt muscle. But that was the worst thing that happened in my personal life all day, so yeah, I’m still pretty charmed.

I had no idea what to wear that Saturday morning. What does one wear when one meets his/her child for the first time? I suppose the impression you want to give of your identity would play a factor. If I dressed business-casual, does that make people think I’m professional and responsible? Maybe a little cold and unmotherly. If I dressed athletically, do I appear sloppy? I didn’t think I wanted to wear anything trendy, or anything remotely uncomfortable or restrictive. So I opted for a loose red hooded tunic (sort of my signature color now) and black cotton drawstring yoga pants. It’s sort of a homemaker, casual look. Maybe something that says “I’m ready to roll up my sleeves, jump into the midst of the action with both feet, and be mom.” Plus it’s roomy for optimal comfort.

The lobby at the Redondo Beach branch, the place my kids have called home for the past 5 days, was empty when we walked in before 11am. I was eventually called into the back into the same room I was in the last time I saw my doctor. He had agreed to come back for this procedure, but was coming from his office in Beverly Hills. A nurse walked me through some consent forms, then handed me a Valium pill. “I didn’t take this when I did the trial transfer,” I said. I don’t like being drugged up.
“No, you wouldn’t have. This is to relax you, and it also relaxes your muscles. Since your uterus is a large muscle, this will keep it from cramping while we’re doing the transfer.” Oh, it’s for the kid. Okay, then. I popped the pill and swigged the water. Then I changed into the provided gown and when I reopened the door to let the nurse know I was changed, I felt the panning delay of my eyes, like I was getting a little loopy.
“I can feel it working already,” I said. She looked surprised, as it had only been about 5 minutes. I explained it’d been hours since breakfast (I probably slept 2 hours the night before, and it was an odd insomnia as I was not nervous, I just wasn’t sleepy) so the medication hit me fast. She told me to climb into bed and that she’d check on my doctor to see where he was. Turned out he was just leaving the other office. He arrived only 15 minutes later than the planned time (although the nurses and embryologists jokingly gave him a hard time about it), which meant it had been about half an hour since I took Valium, but it had worn off. I wasn’t dizzy or spacy or anything anymore. That’s some powerful liver I’ve got there. I tried my best to relax my muscles on my own as the doctor played classical music, inserted the cold speculum (“Just a warning, this is going to feel cold,” he said. The nurses all said, “Well, it was WARM when we set her up but it’s cold NOW by the time you got here,” haha) and cleaned what he needed to inside with some cotton swabs. Meanwhile, the embryologist came in from another door wheeling a big clear box that looked about the size of a large treasure chest on legs. I knew what was inside was more valuable to me than any pirate’s booty.
“Is that the embryo?” I asked.
“Yup,” she said. She looked inside the box through a microscope attached to the side wall of the clear box. “Wanna see it?” she asked Mr. W. Of course he wanted to see it!
“That’s a really good-looking embryo we’re putting in you,” the doctor said as Mr. W looked.
I joked, “Oh, I’m sure you say that about all your blastocysts.” Mr. W later told me it looks much like the photo they had taken for us, but less clear. Here’s the photo attached to a report that the nice embryologist had shown me before the doctor got there:

Oh, speaking of this report, the embryologist had also told me that they would be freezing 3 embryos that day; 2 top-notch quality blastocysts (“A”s), 1 mediocre blastocyst (“C”). The C blastocyst has rather thin walls, so it’s likely it would not survive the freezing and thawing process. There are 2 more embryos they’re watching that are growing slowly, and the embryologist is going to give them more time to see if they grow into blastocysts. If they do, they will be frozen with the other ones. So with 1 embryo going in, 3 frozen, 2 being watched, that leaves 5 more that are not accounted for. I assumed those 5 did not survive the 5-day waiting period.
The doctor very, very carefully, using a surface ultrasound on my stomach controlled by a nurse to guide his movements (all my ultrasounds had been vaginal before this point) threaded a thin tube called a catheter through my cervix into my uterus. I didn’t feel a thing, but only knew what he was doing because he explained every step to me as he was performing it. He looked at the ultrasound screen and referenced a white line in the middle of a tight C-shaped dark mass, saying “That’s me.” The catheter. I could SORT OF make out what he called “the white line” but only because he insisted it was there; if I were looking at the screen without direction, it would’ve all just been various shades of gray fading into other shades of gray to me. Mr. W seemed to see better, since he was sitting closer to the screen. The doctor described his actions, how he was going to bring the catheter in a little farther, and said that there was a little polyp he had to go around to get in.
That dropped my jaw. “But they said there were no more polyps, that they were all gone!” He didn’t seem concerned and said it was fine, he just went around it, that’s all. So I guess my body just makes and then gets rid of polyps between cycles? At least the polyps had disappeared in time for me to catch this cycle, even if one came back later. =/ The embryologist then brought the embryo to the doctor. I didn’t see how it was administered, but the doctor told me to expect to see a small white flash at the end of the line, and that would be the embryo in some fluid going into my uterus. I COMPLETELY missed it. I was looking, I just didn’t see anything. But somewhere in there, it hit me the magnitude of what we’re doing and emotions suddenly rose to the surface and choked me. I didn’t make a sound, but I saw the convulsion on my uterus in the ultrasound. I forced myself to calm down and it did not happen again. After the doctor withdrew something, he kept the speculum in me, backed off a bit, and the embryologist quickly rushed back to the big clear box and looked through the microscope again.
“She’s checking to make sure that the embryo’s not still in there,” he explained. In a few percentage of cases, the embryo for whatever reason did not get released with the fluid, and is still stuck in the instrument. Soon, she gave the all-clear. “Okay, the embryo’s not there, which means it’s in YOU,” the doctor said with a smile. He carefully pulled out the speculum and lowered the bed.

They wheeled me to the recovery area where less than a week ago I listened to another patient throw up. The nurse told me to prop my knees up, and tucked me in under the warmed-up blankets. I was directed to lay there for half an hour before they released me. I was kind of surprised they just squirt the embryo in there and it somehow magically sticks. Too bad no one’s come up with some sort of dissolving tape. They can put the embryo up against my uterine wall, slap some tape over it, and let the tape melt away in a week. I guess nature’s more efficient. So as the embryo presumably burrowed itself into all its surrounding nourishment, Mr. W leaned against the railing of the hospital bed I was laying on and looked at me adoringly. We just chatted until the nurse came by and asked me if I had to use the restroom yet. I sure did; in order for the abdominal ultrasound to work well, I had to drink 16oz of water an hour before the procedure and hold it. That fluid was ready to come out now. After I returned to the bed and my doctor popped his head and the arm in the curtain to squeeze my toes “for luck” and to tell me to rest up for the next 48 hours while forbidding me to exercise until they see a heartbeat, I was soon discharged.

I started my bedrest downstairs in front of the TV in the living room. That soon hurt my back. In the evening, I was shooed upstairs for my nighttime Progesterone shot. Luckily, it was a relatively uneventful shot, unlike the night before when Mr. W said “Hmm” after he withdrew the needle. “What?” I’d asked. He said there was blood in the syringe, but he hadn’t noticed blood when he drew back after first stabbing me to check for blood. “Maybe it’s too dark in here, and I’m not wearing my glasses,” he’d said. I demanded to see the syringe. Soon I took a picture of of it and sent it to Bat for a nurse’s opinion.

Bat seemed initially confused that there was blood in the syringe AFTER the injection, but then said if Mr. W truly hit a vein and accidentally gave the shot intravenously, first of all it’d be a miracle, and second, we’d see a lot more blood than that. So I felt a teeny bit better. He said likely we just went through a couple of little capillaries on the way in and out. =P

I bed-rested for a FULL 48 hours. I was bored, I watched way too much wedding-related shows on TLC, and texted photos of my constant companion, Dodo, to people who probably had better things to do, like work.

Mr. W had planned to work out for 4-5 hours on Sunday, the day after the embryo transfer, but after seeing that I’m literally put on “strict bedrest,” meaning NO getting up at all except to use the restroom, he decided to stay home. He stayed downstairs and played computer games, played on his iPad, read outside while sunning in the backyard, but popped in anytime I texted him. I tried to keep the requests to a minimum. I felt guilty being waited on. I texted for water and an orange, asked for vitamins once, and he brought me my meals on trays and ate next to me on the bed before he brought everything back down and disappeared to his own devices again. He’d reappear for shots, and when I texted about how I watched the entire day start, peak, and wane right outside my window and I felt like I’d never even started my day. He slept in the spare room the last 3 nights to allow me to sleep sideways on the bed with the TV on. I guess when I laid like that, there was only room for me and this guy:

If you’re over 6 feet tall, you’re outa luck on this bed. I also joked about wanting a bell.
Somewhere in there, the lab called. An embryologist I was speaking with for the first time explained the following:
18 eggs extracted
12 were mature and fertilized
11 became embryos
4 embryos became blastocysts
3 were “A” quality, 1 was “C” quality
1 “A” was implanted, 2 remaining “A”s and the remaining “C” was frozen on Saturday
The remaining embryos had stopped growing and the cells had stopped dividing, despite the extra day in the lab they gave them to see what would happen. She asked for my permission to dispose of those non-blast embryos; I said of course. And then I asked her: If out of 18 eggs, and 11 embryos, only 4 survived to become blastocysts, that’s only a 22% survival rate. Does this ratio apply/transfer to my eggs if I were going through natural pregnancy? If I released 18 eggs, would only 4 get to this point, meaning chances are it’d take me up to 4-5 months of “trying” before I get pregnant? She said this was not a clear ‘yes’ or ‘no’ answer, because there are so many factors that went into this; there was all the artificial meddling I’d done to my hormone levels, there’s the fact that ICSI was performed and not natural sperm selection (I guess ICSI is a delicate operation), and, as Mr. W pointed out, the quality of his sperm may have had a lot to do with the fact that some of my embryos met with early cessation. And maybe if these embryos were conceived inside my body, the conditions would’ve been more conducive to their continued growth. There are too many variables to know for sure. “But we put a really pretty blastocyst in you yesterday, so hopefully everything will turn out great,” she said comfortingly. “Good luck!” That’s the second medical professional who has praised the attractiveness of this embryo. Hope it doesn’t get to Riley’s head.

I moved so gingerly after the transfer. Although “bedrest” means I can lay on my side, front, back, however I want as long as I’m horizontal (thank goodness or I would’ve lost my mind), I was paranoid every time I moved and got up to use the restroom. I’d check the toilet immediately after using it to make sure there’s not a little round embryo bobbing on the water surface. I know, I know, I wouldn’t be able to see it. But I didn’t want to see blood, either. About 26 or so hours after the embryo transfer, I suddenly felt like the insecurity was gone. Things sort of just fit into place, not in a tangible physical way, but more as a “feeling” I have that things are right now. Like the kid has burrowed itself into my uterine wall now. Things happen fast, from what I understand; when the embryologist showed me the photo of the blastocyst they were going to transfer, she explained that the actual thing measures bigger than that now. I asked when the photo was taken. She said 9:30. “This morning?!” “Yeah, they grow fast.”

Mr. W came up and curled up behind me at around 11:45 a.m. this morning. “Harro!” I said.
“I came up to join you for the countdown,” he said. “Fifteen minutes!” Finally?! The first thing I did off bedrest was take a shower. Then I carefully peeled and stuck my first two estrogen patches on my lower abdomen (thank goodness SOME of these meds are in the form of pills and patches; one shot in the heiny a day is quite enough). And then, the three of us (including my girlie stepkidlet) went to The Counter and had a burger. Yum.

It’s been a tough 48 hours without being able to reach a computer. =P

Mr. W and I took advantage of Orange County Restaurant Week this year. The first day of this promotional week on Sunday, we hit up one of our favorite healthy eating spots, True Food Kitchen and ordered off their prix fixe menu for half the cost. Heavenly, indulgent flavors for no guilt. Tuesday, the day after my eggs retrieval, we took the day off so I could rest, but did skip off for a lunch treat to Andrei’s Conscious Cuisine. I’d never been there but did hear about it from Ann, who’d gone there soon after it had opened last year. The place was SO chic. We also ordered off their 3-course prix fixe menu and Mr W had a spicy blood orange vodka martini (this place makes their own vodka) since he’s now able to drink after his swimmers were extracted.

The food is WONDERFUL. Like True Food Kitchen, Andrei’s takes its ingredients from wholesome, locally-grown sources, organic when possible, but it’s a notch or two fancier than True Food. Mr. W read some reviews online before we left so he ordered a popular, often-raved-about item: boneless beef spare ribs. I had trout, which was also excellent and certainly better than other trout I’ve had, but I was jealous about his savory, melt-apart beef.

I felt bloated and swollen after that meal and was uncomfortable walking, like I had gas trapped in my stomach cavity all the way up to my diaphragm. (Turned out that it’s not uncommon for gas bubbles to get trapped in your body post-surgery and your body works the bubbles out, or absorbs and diffuses it, which is what happened as the week wore on.)
Wednesday after work, Mr. W arbitrarily drove us to The Counter, a customize-it-yourself burger joint with quality ingredients, again organic is available, and their meat is humanely treated, hormone- and antibiotic-free. I also learned about this place from Ann. Hubby got the Wednesday slider special where they pre-selected the toppings for four distinct flavors of burgers, and it came with a beer pairing. I think his flavors were something like Greek (with feta, olives, cucumbers, tzatziki sauce), Asian (carrot strings, scallions, ginger soy glaze), Italian fresco (fresh mozzarella, cilantro, basil, basil pesto sauce), and Buffalo (blue cheese, fried shoestring onions, some spicy peppers, celery, hot wing sauce). He said all the flavor blends were incredible and delicious.

I just custom-picked a burger on whole-grain bun, with Gruyere cheese, grilled onions, black olives, organic mixed greens, sprouts, and basil pesto sauce. OMG, it was SO GOOD. If I were to ever give a burger a standing ovation, it would be at this place. (We went back today with Daughter for lunch, actually.)
Thursday at lunchtime, Mr. W and I looked for a restaurant commutable for lunch that was participating in OC Restaurant Week with a lunch menu. (Some restaurants only participate for dinner.) We went with Cedar Creek Inn, which is near an old residence of mine and I’d driven past it before but never stopped in. I’d always been curious. It’s not a “healthy” restaurant like the first two, but it seemed to have good quality food so I was sure we could find something healthy. The place looked SO cool inside, like a classy lodge with river rocks, high wood ceilings, giant fireplaces. “This is exactly what I’d expect from a place called ‘Cedar Creek Inn,’ ” Mr. W remarked. We had a little snafu going in; we were seated immediately despite not having reservations (the place was crowded with dressed-up business people on their lunchbreaks as well as some older geriatric-age patrons), but as the menus were placed in front of us, we realized we were not given the OC Restaurant Week Prix Fixe menu. Mr. W watched the same older hostess seat another couple and said that they got some long cards that appeared to be the prix fixe menus. He got up and inquired at the hostess table, and returned with the cards. Apparently she rather snappishly told Mr. W he should’ve asked for those special menus when we checked in at the hostess table. What?! Since when did we have to BEG for featured menus? But everything was great after that. The wait staff was attentive and efficient and food came very quickly, each course following the last as quickly as we were done. They obviously were used to people having limited lunchtimes. Mr. W had cedar plank salmon in a misoyake sauce that was VERY good; I had the beef shortribs. HA! Also amazing, melt-apart. We were unfortunately still a little late back to work. I’d totally forgotten I had a meeting and walked in 5 mins late. I was embarrassed, but others walked in later than I did, so I felt better.
Friday, we wanted something special knowing I’d be on bedrest after Saturday late morning for the next 2 days. He also wanted this to be a place to celebrate our last step in the in vitro process. We chose Splashes Restaurant in the Surf & Sand Resort in Laguna Beach. Grace was supposed to be married at that resort, and her reception was to be catered by the restaurant on-site, so I’m pretty sure it’s Splashes Restaurant. I remember it being shockingly expensive when Grace told me about some of her wedding planning details back in ’03. I had no idea that, just because the reservation had the word “wedding” in it, a restaurant would charge PER PIECE of stuffed mushroom appetizer. She did say the food was amazing, though. “Wait till you try it!” she’d said excitedly about their wedding selections. Of course, I never did eat there for her wedding; a year later when she passed, we (her family and closest friends, us bridesmaids) stopped by the resort and scattered some of her ashes off-shore around a little secluded rocky cliff area. Her wishes. So it means something to eat there now. We got there before the normal dinner crowd (the restaurant was booked solid on reservations already between 5:45p and 8:15p, so I reserved for 5:45) and we selected patio seating under two cozy heat lamps. We were right up against the glass overlooking the beach, and were alone on that patio section our entire dinner. Other diners all chose to eat inside or on the lower level patios.

It was so romantic, watching the sun slowly deepen from golden to rose as it set into its liquid bed.

For almost a full hour as we enjoyed our fancy dinner, a family of dolphins played, jumped, torpedoed right in front of us. I think there must’ve been 7 or 8 of them. In our private enjoyment and conversations, Mr. W called this the perfect date, and kept talking appreciatively about how great his life is, has been. About time he realized it! haha
I told him it feels to me like this perfect evening before my embryo transplant the next day had a little tag underneath it that reads, “Love, Riley.” Just a little gift, a greeting while he can still pull strings as energy from the Other Side. And the dolphin show? Could be Grace saying hello, thanks for thinking of her, and she’s with me. I feel like she kinda knows Riley. That’d be cool.

…I’m just not pregnant yet.

The lab called. Out of the 18 eggs they retrieved from me yesterday, 12 were mature and able to be ICSI‘ed. So they fertilized those 12, and 11 “took” and became embryos. That’s a 91.7% success rate right there! I thought statistically it was more like 50%, but the female embryologist who called from the lab said, “Not for us, we’re more like 80% success rate.” Then she looked over the numbers from everyone they retrieved from and fertilized yesterday. There were two 100%s, and everyone else was in the 90%s (of course I don’t know how many eggs those women had). Given that there are so many viable embryos, the embryologist said she’s going to put me on the lineup for a blastocyst transfer on Saturday. In these 5 days, genetics and the quality of sperm and egg will determine which of the 11 potential kidlets will survive to Saturday, and they’ll take the hardiest of the remaining and implant that one. The implant procedure itself will take 5 mins, altho I’ll have to be on bedrest for 48 hours afterwards.

The pain from yesterday’s procedure has subsided at least 90%, the sun is shining, we just got good news, Mr. W has already started drinking (yesterday), so we’re gonna take advantage of OC Restaurant Week and find a cool new place to have lunch! Yay!

Right now, somewhere in a lab in Redondo Beach, my EIGHTEEN eggs are being introduced to hubby’s sperm in a petri dish. With a needle. “What do you think my eggs will think of your swimmers?” I asked him. “Would they be like, ‘So THIS is what she married? YOU guys?!’ ”
“I think it’ll be love at first sight,” he said confidently.

I got kicked out of bed this morning at 4:30am. Getting ready wasn’t hard, since I wasn’t allowed to wear contacts, makeup, or scented lotions. I just put on a comfy tee, sweatshirt, loose workout pants, socks, glasses, and I was on my way. Of course we got to the facility half an hour early for the 6:15am check-in time. My procedure was scheduled for 7am. I filled out some consent forms and Mr. W and I went to the back into a prep/recovery area with three hospital beds. I was told I could leave socks and my t-shirt on, but to change to the hospital gown. So here’s my fashionista self in that state:

The anesthesiologist came by and chatted with me about what to expect. Apparently I wasn’t going to go totally under; just enough to be buzzed. She said she’d watch me and keep me at just above a local anethesia so we don’t need breathing tubes and stuff. I told her I’m pretty cerebral so if I could feel something and recognize what’s going on, my brain goes into hyperdrive and I freak myself out. She said that won’t happen. Okay, if you say so. While we were waiting for my turn to go into OR, another patient came out and was put next to me, a curtain between us, to recover. A nurse asked how she was doing. She croaked some weak response. The nurse offered to get her anti-nausea medication, but only seconds later, I heard the patient throwing up. Oh, CRAP. Was that going to be me in a half hour? But the anesthesiologist had said that looking at me, it doesn’t appear I’d have any problems.
When they got ready to take me into the OR (just a room off the prep/recovery area where I was laying on a bed), Mr. W kissed me goodbye and off he went for his own procedure, 20 minutes away. The OR was FREEZING. I couldn’t get my legs to stop shaking. The anesthesiologist, a nice Asian woman, said I’m her little Asian girl patient so she felt like she knew how to take care of me. She swung out a little footstool so I could climb into the higher operating bed. I definitely needed that, and thanked her gratefully. As a surprise, my regular fertility doctor was assigned to do my procedure that day, even though we were told it would be a different doctor. I was happy to see him and he squeezed my toes through the blanket playfully. The anesthesiologist went to work trying to get an IV into my right forearm, but after a poke, couldn’t find my vein. She slapped around on my arm for awhile and said, “You are NOT the veiniest girl I’ve seen.” I did warn her nurses often had problems finding my veins. My fertility doctor came in and said, “I think you can’t find her veins because it’s too cold in here.” He brought me a HOT blanket to put over my chest, and another one to wrap my right arm in. A few minutes later, the anesthesiologist was able to find a good vein on the back of my hand, and she agreed the heat must’ve helped. And then she said she was going to administer something to get me buzzed. “If you’re the typical Asian girl, it wouldn’t take much,” she said. I said something about high tolerance, and she said, “No, Asians have low tolerance!” Some time went by when I gave some identifying information to another nurse, and my doctor told me to place my calves into stirrup type contraptions. I didn’t feel anything yet. Then, as I was looking up at the lights, suddenly it felt like the lights were trailing behind where my eyes went, exactly my first symptom of being buzzed. Like my vision was slower to follow my head turning. I told them, “OH, I’m feeling it now.” The nurse said something else and I answered her, and then hearing myself, I said, “I think I’m slurring.” I decided then to stop talking.
I was aware of the people in the room the entire time, I don’t think I fell asleep, although I did close my eyes a couple of times toward the end. There were two times when I knew the doctor was pushing something into my vagina that felt rough and uncomfortable, almost like how fabric would feel. I was an observer, but I had no cognitive activity. I had no opinions about it, no fears, I really didn’t care. Because I didn’t care, I didn’t even pay that much attention to them or what they were doing or saying, even though I was aware of them and their talking. I remember I was rather comfortable in that position, surrounded and covered by fresh hot blankets. At one point, when I thought they were still doing the preparation (I knew a nurse had to wash, then the doctor had to rinse), I realized the drapes were being taken off my legs. “That’s it? We’re done?” I slurred. My doctor came by and tucked something hard and square but nice and warm underneath my right forearm, saying that’s for me to warm up. I thanked him.
By the time I got from the OR into the recovery room where the beds were, I was clear-headed and my speech was normal. “How do you feel?” the nurse asked.
“Fine,” I said honestly. I felt the same twinges on both of my ovaries I’d been feeling the past couple of days, but it wasn’t unbearable in the least. I was mostly grateful I didn’t feel or sound like the woman in the next bed, who was still there, moaning and nauseated. I heard another nurse explain to that woman they were giving her more nausea medication.
I laid there for maybe 20 minutes while they kept the IV in me, and meanwhile I read a book I brought, and the nurse gave me 2 extra-strength Tylenol, a couple of saltine crackers, and a cup of apple juice. She encouraged me to get up and use the restroom. I said I didn’t feel like I had to go. She pointed to the nearly empty IV bag and said they dumped a lot of fluid in me, and it was important to them that I’m ABLE to pee. So she helped me put the IV on a wheeled pole and off I went with it to the restroom. “Just sit there until you’re able to go,” she instructed. Okay…a tablespoon later, I came out. She said it was fine.
They don’t think it’s necessary that I stay on a stringent diet, but because of how many follicles I have, my estrogen level will be high, which means I’m at risk for hyperstimulation. They said to stay off the refined white carbs, like white rice. I can’t even remember the last time I had white rice. They said wheat or grain bread, fruit carbs, that stuff was fine. So basically my normal diet makes them happy. Since I was clearly doing well and could walk and pee, the nurse took my vitals one last time, took the IV out, and discharged me a few minutes later. Oh, while she was removing the IV, she looked at the bed and said, “What’s this? How’d you get THIS over here?” and pulled out a small square plastic container filled with hot liquid. I didn’t know what it was, but I know my fertility doctor put it there to warm me up. She chuckled at his inventiveness. I waited for Mr. W in the now-full waiting room in the lobby. He called me soon after and said he was on his way, 8 minutes away.
He came in holding this:

The receptionist said they’ve never had someone deliver their own vial before, and let us into the back and led us to the lab area. Hubby handed his stuff to another nurse, who looked at me in surprise and said, “OH, you look GREAT!” She was one who was with me in the OR. Realizing who Mr. W was, she said, “And YOU look great for someone who’d JUST had a procedure!” He laughed.
“So how many eggs did you guy get from her?” hubby wanted to know.
“Eighteen,” she said.
He let out the most hickish cowboy “Whoo-hee!” I’d heard. But clearly he was happy cuz the more eggs, the better our selection.
“They’re not all mature,” she explained. “We’ll fertilize the best eggs and you’ll get a call tomorrow to let you know how many embryos we have. What would you like me to do with the leftover sperm? Would you like it frozen so you don’t have to go through that again?”
I looked at Mr. W and we both thought the same thing: extra expense. And since they were going to freeze the unused viable fertilized embryos, what use did we have for sperm? So he told her to go ahead and discard what’s left.
As we turned to leave, I asked the nurse, “Did she have to give me an extra dose of the drug?”
“Yeah,” she said, smiling. “You weren’t a cheap date.” I knew I had high tolerance. Ha.

In the car, Mr. W described to me his procedure. He didn’t have the buzzy drug like I did; he just laid back and the urologist picked up one out of 10 needles the nurse had lined up on a tray, and he stuck it into the right scrotum. After aspirating (hubby said there was very little pain, but did feel a prick), the doctor said he’d be right back and went to an adjoining room with the syringe, to check for sperm under the microscope. He came back and said, “Nope. Nothing there.” Mr. W started getting nervous. The doctor tried again with the same scrotum. Ran off to the lab again. Returned, said, “Nope. Nothing.”
“Is that bad?” Mr. W asked, now imagining the worst: that he has no swimmers.
“No, it just means I didn’t get it in the right place.” The doctor changed needles again, and poked into the left scrotum. Repeated the procedure, ran off, came back and said, “I got it out of the left. The right one is blocked, I thought it might be.” The doctor dug into the left again for more swimmers, now that he knows where they are. Apparently he went in a couple of more times, each time making sure he had sufficient samples under the microscope. Mr. W thought there should’ve been hundreds pulled out. After Mr. W was done, the urologist let him look into the microscope, too. Mr. W saw one sperm “propelling” forward, another swimming in circles, another laying there kinda twitching, others looking curled and broken. He asked about those last ones, and the doctor said those may “wake up” later. The sample in the syringe got deposited into a test tube of pink fluid which is supposed to nourish and sustain the guys. Mr. W asked if there were any special way he had to carry the sperm in his transport. “No, just keep them close to your heart,” the urologist said, so Mr. W tucked the package into his front chest pocket. Apparently these little guys will live up to 7 days in this fluid.

Since we were so close to the beach, Mr. W drove us to brunch oceanside. This was our view at our table:

My only discharge instructions were to take it easy, to take extra strength Tylenol every 6 hours (the 6th hour just passed and I didn’t take a second dose, and the twinges have deepened to something less comfortable, but still not unbearable), not to eat refined carbs, not to do any twisting motions, to call the doctor if the pain were more severe than menstrual cramps and if I bled more than I would on a normal period, and to get up every so often and move around. I haven’t laid back down since I’d gotten up from that hospital bed 7 hours ago, but after the hospital was the beach, and we walked a little bit there, and when we got home, my stepkidlet had to catch me up on all the stuff that’s happened recently with her social life (so entertaining I didn’t need painkillers). Mr. W took a nap as he wasn’t as interested in girl talk, and he woke up in pain. I checked out his boo-boos…the left side had small purple bruises under the skin.

By the way, Rebecca called it on one side of his scrotum not working…LAST SUMMER before we started all this. Looking back, I think she even did say the right side, the way it’s shown to her, was the one that wouldn’t “take” because of some problem with the duct not connecting properly. Just like she called it yesterday saying my procedure today would be smooth and problem-free.

Because my follicles look like this, this morning…

…we now have hard dates so that my gametes can meet my hubby’s gametes for the first time. My blood test must’ve been okay, cuz the doctor cleared me for egg retrieval on Monday, Feb. 28. (The blood retrieval process this morning, btw, sucked. The regular phlebotomist wasn’t there, the nurse who took my blood yesterday wasn’t there, and there was some very rough looking large woman who wasn’t particularly warm. Think “Berta” on Two and a Half Men. She pricked me FOUR TIMES, frowning and, according to Mr. W, pretty carelessly, before she poked the right spot. OW.) So at the ultrasound, Doctor #3 measured a bunch of follicles between 18-20mm. They’re the right size! They’re SO right, I could feel the ultrasound wand poking at my ovaries, making me squirm. The doctor told me to take my last dose of Menopur in their office (yeowch!) and the nurse gave us an orientation on what to do next and how to administer the next shots, over 2 weeks’ worth of daily intramuscular injections (*whimper*). The urologist also called us and worked his schedule in with my surgery schedule. So here’s the beginning of the scary stuff happening in the next couple of weeks:
Tonight, at 8pm (the were very specific about the time), I am to take my first intramuscular injection, a hormone called Pregnyl, to start the ovulation process. It’s a two-vial med like Menopur, and Mr. W has to draw 1 cc of the fluid from the liquid vial, squirt it into the powder vial, mix it, draw it into the syringe, change the needle to a thinner one, then inject it to my upper outer buttock area, just around the corner from my hip. I’m glad I don’t have to do it; it’s so counter-intuitive to stab oneself, even after having done it daily for the past few weeks. I actually sat on the bed with the teeny Lupron syringe aimed at my abdomen this morning, my brain went into hyperdrive, and I could not get myself to do it. Mr. W was there and he just took the syringe and did it for me. It felt like being 7 again, standing at the edge of the highrise diving board, and being absolutely unable to make myself step off the board to fall 20 feet into the water. (Swimming class.) It’s a good thing the doctor announced I’m done with all other previous injections now. YAY! After this scary Pregnyl thing, I have NO SHOTS tomorrow, the first shot-free day I’ve had in almost 3 weeks. (Great timing, cuz tomorrow’s Rebecca At The Beach day and it would suck to have to rush back by 6pm for my evening shot.)
The Monday morning at 6:15a, I’m to check into a different medical office that has operating rooms and labs on-site. My surgery is scheduled for 7am; I’m the first patient. They make a little incision in the back of my vagina, use that hole to reach the couple of centimeters to each of my ovaries, suction out the fluid in the follicles, collect the egg in each follicle they suction. (They do approx. 550 of these a year.) I’m going to be put completely under for this, which is scary to me because I’ve never been totally under anesthesia before. I hope I won’t be paralyzed but conscious, THAT is a horrific thought. Bubble of light, bubble of light!
Meanwhile, because they moved my surgery up a day to Monday, it means Mr. W’s sperm retrieval is not possible the day before as it would be Sunday. So the urologist worked out something with Mr. W: hubby will drop me off in the morning of my procedure, then go to the urologist’s nearby other office. Sperm collection will take place then, then the goods will be packaged and handed to Mr. W so that he could drive his own boys back to the OR where I am. Then at that lab, my eggs will be fertilized that day. And then he drives me home. I thought he would need his own driver after his procedure, but the urologist and Mr. W aren’t concerned. I definitely will not be allowed to drive; I’m told to be on bedrest and be cared for in the 24 hours following retrieval.
The following night, I start the first of what the nurse called “the monster of all these injections,” Progesterone. It’s only 1 cc in the same butt muscle area (switching back and forth between sides), but because the hormone’s in sesame oil, it’s thick and requires a thicker needle to draw into the syringe. Once in the syringe, the needle is unscrewed and replaced with a thinner one for injection. And supposedly it’s very uncomfortable once in; the oil makes it harder for the body to absorb, so they recommend massaging the injection site immediately after administering the shot to help the liquid disperse and absorb, then to use a hot compress on the area 3-4 times a day. Apparently what’s not absorbed may harden and stay in there, so they want heat to help keep the stuff liquified. UGH! I’ve heard about how painful Progesterone could be. Although, I wonder if it could be as bad as that same area felt after I climbed the Great Wall of China; I couldn’t even straighten my legs or walk upright the next couple of days. “I’ve been through MUCH worse, this is nothing,” I keep telling myself.
So the day of retrieval, the eggs are fertilized and doctors monitor the embryo growth. They’ll let me know same-day how many eggs they’ve collected. Then a day or two later, the lab will tell me how many embryos have successfully been created. If the embryos look like they’re not doing well, they’ll pick the best and implant it on Day 3 after the collection. If the embryos look like they’re doing well, or there are enough good embryos to wait, they’ll wait till Day 5 to implant, so they have more time to pick the best one. In those couple of extra days, the eggs would’ve evolved into “blastocysts,” which I guess just means they’ve got more cells than the Day 3 embryos would have. I’ve prepaid up to the blastocyst transfer; if they have to do an embyro transfer (day 3), they simply refund the difference since we’ll be using less lab time.
After the implant I’m on bedrest for 48 hours. Then on March 16, they have me go in to the fertility doctor’s office for the last time for a pregnancy test. Meanwhile, through all this, the progesterone injections continue, one a day. And starting the day of the retrieval, I take two drugs orally, Doxycycline and Medrol for about a week to fight off infection and stuff. After the implant, in addition to the Progesterone, they add the hormone Estrogen. LUCKILY, this is in the form of a Vivelle sticker dot; I just stick 2 to my lower abdomen, and change them with new ones every 3 days.

Mr. W is at the gym right now, since he can work out and I’m not allowed to. I do feel my lower abdomen in the sense of twinges when I walk or when I’m in certain positions, but nothing more severe than the twinges I feel in my left ovary when I’m ovulating from that side naturally. However, I’ve felt sick in the evenings for the past 2 days in a row. A tad nauseated, just a general feeling of “ick.” I blame that on the hormone overload. I expect to feel better from now on because I’m off the 3 hormone injections. Eating has been tough on this high-protein, low-carb, low-salt, low-sugar, no-caffeine restriction. I’ve gotten used to the no-caffeine and removed coffees, teas and chocolate from my diet, no biggie. But the past couple of days of the other stuff, I started running out of things to eat. I had an eggwhite omelette with cut pieces of tri-tip steak for two mornings, steamed tilapia over kale salad for dinner, half a butterflied prime rib with steamed veggies for lunch, and last nite I made cream of asparagus soup for dinner, processing firm tofu in place of cream with my boiled asparagus and shitake mushrooms for extra protein. The thought of meat makes me nauseated. I’m craving fresh fruits and veggies. Today for breakfast I had an avocado, and for lunch, a smoked salmon, capers and tomato omelette. I’d meant to ask how long I have to keep these dietary restrictions up, but forgot. Mr. W ate a small basket of mini muffins, Thin Mints Girl Scout Cookies, and other cookies in front of me, but I didn’t cave. In fact, maybe due to these restrictions (plus it’s amazing how much junk food you don’t eat when you eliminate chocolate from your diet), or maybe due to the workouts I’d had since joining the ultra gym, I think I’ve dropped a couple of pounds at a time when a common symptom is to bloat and gain a couple of pounds a day. That’s good, cuz I figure, if I’m not going to gain more than 24 lb through my pregnancy, I want to start a little on the low side so I can reuse my adolescent stretch marks (wishful thinking). Starting right about now brings my maximum weight to what I weighed at my heaviest.

Less than 2 hours to my first intramuscular thought. I feel a little sick thinking about it. But it’s coming to the last stages!

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

(hee hee, it sounds like “whore money.” Okay, I’m my age again.)

Whatever the doctor saw in my blood in yesterday morning’s blood test made them call me and move my next appointment, previously scheduled for tomorrow morning, to this morning. They didn’t scare me, they said “Your hormone levels are fine, but we want to see you tomorrow instead of Wednesday.” Today, I met the third doctor in the clinic (also very nice, like my male doctor I’d originally started with, and the female doctor who took most of my ultrasounds after that), and he performed my ultrasound. I clearly saw large round black circles in my ovaries. Yup, the follicles are expanding. He measured only the large ones, 8mm-10mm. There were medium and small ones he wasn’t interested in, but there were probably 5 or so large ones per ovary he measured. Mr. W gaped at the monitor and said, “Wow, they’re big! Do you feel that?”
I said, “I don’t feel anything.” (Really. Not even psychologically.)
The doctor said, “Not yet, but you will.” I guess I’m gonna expect bloating soon. We asked if we could take a photo of the monitor screen, and he said he’ll just print us out an image:

See that upside-down skull-looking thing on the upper right of that image? That’s my ovary with the giant follicles (sac of fluid with an egg inside). You can see 3 large follicles and one medium, and one small. Freaky, huh?
The doctor also explained that the reason they brought me in early for ultrasound is because my estrogen levels measured a little high in Monday’s blood test, so they want to check on the eggs. He likens what we’re doing to cooking; you’ve got a pot boiling on the stove, and the heat is turned on by the medication, but you don’t want to overcook the pot, so if it starts to boil too hard or fast, you turn down the heat to adjust. If it’s not boiling, you turn up the heat. He said they’d let me know after this morning’s blood test how the hormone levels look to determine whether my doses need adjustment. I hoped they would adjust down cuz this morning’s pricks hurt! My little Lupron prick felt like two jabs going in, and Mr. W’s large Menopur dose hurt with the stab and hurt a lot with the administration of the meds, and even hurt with the removal of the needle. I thought maybe it was because I worked out so much the last 2 days that my ab muscles are swollen and sore so maybe that affected the injection site, but he later confessed that he had the needle held at an angle where it was manipulating my skin a little.

I got the call just now. My estrogen level when I was just on ovulation-suppressing Lupron was less than 20 (“Okay, your estrogen IS properly suppressed, so we can start the other medication now.”). They didn’t tell me what the estrogen level was from Monday’s blood draw, but this morning’s blood draw, they said it was something like 271. So that’s high, as I knew it would be, cuz the evening Follistim dose of 225 iu just seemed high to me. Their new instructions: Drop this evening’s Follistim dose to 200 iu, then drop tomorrow (Wednesday) evening’s Follistim dose to 175 iu. They’ll see me Thursday morning for another blood test to see how that’s going. Also for Thursday, they tell me to NOT take Menopur in the morning and to bring it to the appointment. If they determine I need it, they’ll administer it for me then. Good, the painful stuff is being reduced. They’re keeping my morning Lupron the same, but I’ve never minded Lupron.

The doctor’s office has been really good about booking my appointments (now becoming almost an every day thing as they monitor closely) at 7:30a in the morning, so we can get to work by about 8:40ish. That means for me, as court doesn’t start until around 9a, that they really don’t miss me and don’t have to find a relief clerk to fill in until I got to my desk. Other clerks come in regularly at 9a anyway. My supervisor has been very understanding and cooperative, just asking for a heads-up on days when I MIGHT be a little later than usual.

TAXES: We visited the tax guy Thursday evening. It’s someone Mr. W has used in the past and I’m happy he found his way back and took me along. We were hoping we wouldn’t have to pay (much) given that our expenses are at an all-time high right now. Imagine our relief when we got a refund, and our tax refund came out to, not as much as last year’s, but about 1/3 as much. We’ll just say that if applied 100% to my “fertility credit card,” will pay off more than half of it. It’s like getting 20% off on fertility treatments. But now I’m thinking, we’re letting the government withhold way too much of our money for taxes. I should increase my exemptions for this year. (Mr. W has himself plus 8, I have just myself plus 1.) So, that went well. 🙂 The tax guy’s modest office lobby is well-stocked with hospitality, too, but I couldn’t indulge in the red wine, chilled white wine, Cokes and diet Cokes, coffee (which they had run out of anyway), so I chewed on a lemon Tootsie Roll (I didn’t know these existed!), flipped through a celeb mag, and played a form of Scrabble on my cell phone with Jordan and Mr. W. (They both cheat. What kind of word is “vim,” anyway? They both played it against me. Hmmph.)

FERTILITY DOCTOR VISIT: Friday morning, we went in to our fertility appointment. First, they did another ultrasound to count my follicles again. I don’t know what these drugs have been doing, but I’ve never seen my follicles (egg sacs in the ovaries) look so clear on ultrasound. I could finally tell what my doctor was counting. He pointed to various large dark circles and said these are the good follicles that will mature and he will take the egg from them. He pointed to various medium and smaller sized dark circles and said these probably won’t mature much, given how young and small they are, so he’ll just ignore them when he’s doing the egg extractions. He counted the viable (large) follicles. SEVEN on each side. Woohoo! (And, ouch.) I’m definitely at the right stage to change over my Lupron drug (halt ovulation) to Menopur and Follistim (start egg ripening). Since we were on the subject, I noted to him, “I didn’t feel anything on Lupron.”
“You’re not supposed to,” he said. “One out of six or so women get menopausal type symptoms, but most don’t feel anything at all.” Mr. W said he would’ve thought I’d be one of the six since I’m “sensitive to medication.” Lucky for him I’m not, although it’d be interesting to get a glimpse into what I’d be like at menopause.
After the ultrasound, I went to the phlebotomist station for a blood draw to test my hormone levels. We discussed what happened last time they drew blood early morning. (Before we left for the airport on our Europe vacation, we went to the fertility doctor’s for multiple blood draws. I stood up when I was done, waited for Mr. W to be done, then when I was at the payment desk, I started feeling nauseated. It got worse until I had to tell the receptionist to stop talking because I needed somewhere to sit down. Then ringing in my ears set in and I started getting a “static” thing going on the outside edges of my vision, which closed in until my vision went black. I told them I couldn’t see anything and felt really sick. A nurse and Mr. W led me into an empty room to a chair and the nurse fanned me (I had broken out in cold sweat) while feeding me a box of juice. Soon the ringing gave way to a water rushing sound and I could hear better and I started seeing shadows moving around in black and white. My vision then came back and they instructed me to sit there while Mr. W kept fanning. Apparently juice in the morning before a blood draw was not enough for my little body.) The nurse said losing vision without losing consciousness was “weird,” cuz usually people that start to black out on their vision faint. This gives me a little concern about “going under” during the egg retrieval; what if I’m paralyzed and blind but I’m conscious and can FEEL and hear? *vomit*

After the blood draw, we went into a separate nurse’s office and the nurse who was with me at the ultrasound came in to explain my next course of medication for the next 8 days. Apparently I’m not done with Lupron. I’m just going to halve the dose to the “5” line (.05ml?) on the tiny skinny subcutaneous syringe (the ones with the orange caps in the photo), and administer that in the mornings as I have been doing the last 10 days. I guess that explains why I got an entire separate pack of insulin syringes in addition to the ones that came in the Lupron box, and why I still have half the vial of Lupron left over. “We still don’t want you to ovulate,” the nurse explained. I’m adding Menopur to the morning Lupron poke, though. I found out Menopur can also be administered subcutaneously, so I was greatly relieved. That means I can still do it myself. But this one’s trickier to set up. Apparently the syringes for Menopur comes with a “mixing needle” attached to the syringe. She said I don’t have to use that because it’s more difficult, so to just twist that needle off and throw it away into the Sharps container (provided). That was a relief, because the “mixing needle” is thick, long, and scary. I then screw on a “Q-Cap,” which is shaped like those ointment tube caps that have an inset puncture point on the other side that you have to turn around and push into the foil seal of the ointment tube opening to puncture it. So you screw the Q-Cap onto the syringe and use it to puncture a small vial of clear fluid. The way the cap is shaped also snaps onto the vial. You then use the syringe to draw up the liquid through the hole at the tip of the puncture point into the syringe. Then you pull off the vial and insert the Q-Cap with syringe onto a second vial of white powder. Squeeze the liquid from the syringe into the vial, shake the vial, mix the two. Then draw up that bottle of mixed meds into the syringe. Remove the Q-cap and vial, screw on the thin half-inch subcutaneous needle head, squeeze the air out, tap out the air bubbles, and you’re all set.
In addition to those 2 morning shots, I have to do a Follistim shot, also subcutaneous, at night. This injection “pen” is the stupidest invention in my kit. The concept is cool; you load a vial of the liquid into the middle of the pen. You screw on a new needle tip. You turn the back of the pen until your directed dosage (225 iu for me) shows up in the window. You inject the half-inch needle into your skin and push the button at the back of the pen with your thumb. You pull out the pen, toss the needle, and you’re done until the next dose. Here’s the impracticality of it: The vial is preloaded with 300 iu of medication. My second dose, I use up the remainder of the vial (75 iu) and have to open the pen, pop in a new vial, screw in a new needle head after tossing the old one, turn the dial to administer the rest of my dose (150 iu), and re-poke and re-inject. That’s TWO POKES for one dose! And then the next day, I’m going to have 150 iu left, so I use it all up, then put in a new vial, turn it to dispense the remainder of my dose (75 iu), repoke AGAIN, and I’ll have 225 iu left in there, the full correct dose, for the next night. To make keeping track of all this easier, the Follistim pen kit has an instructional booklet with a chart in the back pages you write your doses and remaining iu’s in, like a checkbook register. WHAT THE HELL! The preloaded vial is 2/3 empty. Why can’t they fill the damn thing up so I get more uses out of one vial, or better yet, dump all that liquid into one big vial and let me draw up my own dose like I do with Lupron? Argh. It’s such a ridiculously fancy zippered kit, too. See the right side of the first photo. At least it’s in the proper colors of blue and yellow, altho it’s more of a Cal navy blue than the UCLA royal blue. =P

So this morning, I tried the new meds. Mr. W has always been eager to help and so far I hadn’t needed him to. He asks often, though, if I’d like him to do the shots for me. This morning, he woke up before 6am and laid there, fidgeting, keeping me awake. Then 45 minutes later, he prodded me and said, “Want me to set up the shots for you?” I said no, I could do it. He said he paid good attention to the nurse and can do the mixing. I said I can handle it. He offered to do one while I do the other. I still declined, and he said then I’d have to get up now and start setting up the shots to keep to my time regimen of adminstering the shots 12 hours apart each time. I got up and while I was in the restroom, I heard him opening up packaging, heard the clink of vials and the snapping of the Q-cap. I just let him do it while I set up the Lupron. It must’ve been fun for him. After he drew all the Menopur fluid into the larger syringe, I balked. There is SO MUCH FLUID in there, almost 2.5 ml. I’ve been used to .10 ml on the Lupron.
“How is all that liquid going to fit with a little half-inch needle under my skin?!” I wailed. He handed me the syringe. I stared at it, freezing up. I thought of what commenter Bat said (in my Pincushion post) about the discomfort in shots coming from the volume of liquid going in, and not from the prick itself.
“Want me to do it?” he asked again.
“Okay,” I said in a small voice.
I swabbed my problematic right side (which was next up in order of stabbings), sat on the bed, and administered my little .05 ml of Lupron. I felt nothing, which was great, except when the needle came out, a larger drop of blood appeared. Stupid right side. I was still gripping my abdomenal fat roll with my left hand per protocol for injection, and turned my head. “Don’t put it right where I put the other one,” I said in paranoia.
“I won’t, I’ll put it right here,” he pointed to a spot about a third of an inch away from the blood drop.
As I looked away, he went for it. “Hey, that’s good, I didn’t feel it,” I said. A second or two passed. Then I felt the fluid. “Ow. Well, it doesn’t hurt exactly, just sort of sore. Ow. Okay, I’m going to start letting go of my fat now so there’s more room for the fluid to go. Ow. That’s uncomfortable, it feels like pressure inside…” When I fully released my fat roll (I know, this sounds gross), the pressure was relieved significantly.
“Okay, and I’m done,” he said.
“Leave it in there for 5 seconds before you pull it out to let the drug settle,” I said. I had read that somewhere, altho it was probably the instructions for the Follistim pen that I’d be using later that night. My mind was a whirlwind. I figure it couldn’t hurt to prevent liquid from squirting back out like the stream from a clown’s lapel flower. I didn’t feel the needle come out, and he certainly didn’t leave a big mark on my skin the way I did with my dinky little injection, which was already bruising purple under the skin. So he did good, despite the fact that he dropped the Q-Cap when he took it out of the packaging and he stabbed himself with the needle before he administered my shot.
I laid back on the bed, afraid that movement would squeeze the fluid out. How does that much fluid fit in there?! I could feel the pressure as my fat cells were being pushed aside to make room. A minute later I got up and went about my morning and the pressure feeling went away after a few minutes. Now, almost 3 hours later, I still feel normal, not that there’s anything to cause mood swings anyhow. We’ll see how the evening’s Follistim goes.

NEW ANTICIPATION: The fertility doctor’s office called me a few hours after our morning visit yesterday. They said the blood test results show that my estrogen is indeed suppressed, so everything’s on schedule and going as expected. They said to go ahead and start the new drug treatment the next day (today). I go in on Monday for a blood test just so they can make sure the hormone levels of the new injections don’t need to be adjusted (I hope they adjust DOWN!). I go in again on Wednesday morning for another ultrasound and blood test to check the status of my eggs now that they’re being told to ripen, and to recheck hormone levels. At that point, they should be able to tell when the eggs will be ready for collection. (Like a hen.) Presently they expect tentative extraction dates sometime in the week after, so they’re going to call Mr. W’s urologist to clear Monday through Wednesday of the week after next for sperm retrieval. Whenever I’m set for egg harvesting, Mr. W will get the sperm retrieval done the day before so that it will be prepared and ready to fertilize my eggs the day my eggs come out. After that, I will get the best embryo implanted in 3 days or 5 days, depending how well the embryos are developing in their little petri dish beds. Throughout all this, I will be undergoing various shots and I’d still be shooting up, intramuscularly, a couple of weeks after the implantation.

I woke up in the middle of the night last night and stayed awake a bit. I thought of how I’m not going to have sex for a year (cuz right now I’m in menses and after that we’ll both be going through surgery for sperm/egg retrieval and after that I’ll be pregnant and that just seems wrong to give the kid a visitor before he’s truly met his dad). And I thought of how starting now, our lives (well, mine mostly) will never be the same again and it will be completely new territory. I felt a little pensive, and I wondered if this was fear, or maybe cold feet. But then Mr. W snuggled up to me in his sleep and I remembered that one of his traits, which has sometimes annoyed me, is his overeagerness to help and take over on things that I’m doing, which has made me feel like he thinks I’m inept, but maybe when it comes to a baby, I’d really, truly BE inept. I’d certainly be inexperienced. I thought of how a couple of days ago, he was sitting on my La-Z-Boy recliner reading his iPad and I sat perpendicularly curled up on his lap, and he’d patted an empty spot between his stomach and my lap, and said, “In a year, there’s going to be a baby laying right here on us.” And I thought of how I’d been afraid that marriage would be a goodbye to all the things I loved about my life — the freedom to wander around the house nekkid or sloppy, the luxury of falling asleep downstairs in front of the TV for naps, the availability to hang out with friends and take trips — and how none of those things really changed. And then, with my husband curled up behind me and with my cat luxuriously balled in front of me and the rain beating outside, I fell asleep again.