AF arrived.

First off I just have to say that we got our start date! Apparently we can start with whatever cycle we want, even my current one! But I decided for various reasons (three reasons: one, I’m not emotionally prepared yet, two I’m not physically recovered yet, and three starting now would mean an early January baby, not my ideal), so we’re starting next cycle. She said it doesn’t matter if we use birth control pills or not, this month or the suppression cycle… because I ovulate so regularily they can start lupron in my luteal phase if I so desire. I might just do the pills anyways, but it depends how I feel next month.

Okay, so my day was super long today, I had so much to do, I’m just totally wiped out. The whole reason I was rushing around was because I had a million things to do and we had our protocol class at 2pm… I had to pick Den up at work at 1:30, which meant leaving my work at noon so I could get home, shower, do the things I needed to do here, and take off.

We got to the class just on time, mere seconds before the nurse walked in. We were one of four couples. The class was mostly about what exactly our cycles will look like, what medications we’ll be taking when and why, and also how to take the medications… how to mix them in the vials and inject them.

A lot of what I wrote down is specific to me. Here’s what it’s looking like for me. (I apologise in advance to any of my readers who aren’t familiar with IVF protocols. This is likely going to sound very confusing.)

Next cycle when I get my period I will call and let them know. I will either start the birth control pill then, or go with a natural cycle. They’ll start the insurance process and call in my prescriptions. She said that the overseas pharmacies, while cheaper, will not accept any insurance so we’d have to pay entirely out of pocket. So we’ll have to go with either Freedom Pharmacy or IVP Care. I’ll be using either Gonal-F or Follistim, she said for me it doesn’t matter which I use (some of the other ladies need to use one particular one), so she’ll just ask which one’s cheaper at the time they call it in and do that. They both come in “pens”, even.

If I do the natural cycle I’ll go in for a blood test on day 21 to see if I’ve ovulated yet. If so and everything looks good to go then I start lupron. (I think that’s what she said, but I’m not sure now.) If I do the birth control (which is likely, I think) I will start lupron on day 18 of the pills (last pill at day 21).

I continue taking the lupron until I get my period one way or the other.

On day three of that next cycle I’ll have a baseline ultrasound to make sure everything is quiet and ready. If it is that night I’ll start stims – the follistim or the gonal-f, with menopur… and of course the lupron, all mixed together. She said we could do them seperately if we want, but that most women prefer one shot to three. I fall into that group. ;) Once I start stims I am not to take any advil/ibprofen – tylenol only for any headaches, etc.

On about the third day of stims I go in for a bloodtest to make sure my estradiol is behaving accordingly. If it isn’t they’ll adjust my dose. After that I go in for frequent (every other day, I think) ultrasound and bloodtests to check the development of my follicles. She said most women stim for 7-10 days.

At some point in there both Den and I will take antibiotics (doxycycline) to clear out any infections, etc. You have to take it with food or you will get a very upset stomach… and apparently it makes you more succeptible to sunburn, which in my case is pretty hard to believe. Sunscreen is important.

Also in there somewhere (I forgot when I start it) I will start taking baby asprin (81mg) daily. She admitted there’s no real conclusive proof that it helps, but it does no harm by taking it and it could increase chances of a success, so they do it.

They’re looking for the follicles to get to be 17-19mm. When that’s the case they’ll tell me to stop the follistim/gonal-f, menopur and lupron and to take my hcg trigger. They will give me a precise time that I need to take it, and she said it needs to be done within 10 minutes of that time given. The day after the trigger I do nothing at all, and then the morning after that I go in for retrieval. The retrieval will be exactly 36 hours after my trigger shot… so if I trigger at 8:30pm tuesday my retrieval will be at 8:30am thursday.

When I go in for retrieval I’ll get there an hour ahead of time. It is a surgery proceedure, with anesthesia… which means – oh yes – an IV. Fucking hell. If it takes four times again I’m going to cry. (Did I mention the back of my right hand is STILL covered in a bruise?) I don’t remember if they put me right out or if they just make me completely loopy and don’t remember anything. Either way. I will meet with the embriologist and andrologist(?) before the proceedure, so I’m told. Den will go give his sample at that time, and then wait for me to be done. She said it will take about half an hour. Afterwards he’ll drive me home and I’ll probably sleep the rest of the day due to the anesthesia. Oh yes, I remember that well.

The next morning they will call with our fertilization report. Very important. Very exciting. Then we sit and wait in anticipation. Oh, and take the prometrium (vaginal suppliment… apparently NOT very fun – however it sure beats an intramuscular butt shot, IMO) 3 times a day and estrogen patches, two patches changed every other day.

3 days past transfer they will either want to do a transfer, or let them go to blast stage. So we won’t really know which day we’ll be going in for the transfer.

The transfer is the exciting day, she said – the day you’ve been aiming for. It can be uncomfortable, though… worse than an IUI, but the same sort of thing, just more uncomfortable. She said you need a 3/4 full bladder, and my ovaries will still be tender from the torture of the many follicles they just removed. They go in with a catheter, guided by abdominal ultrasound. After they’ve put the little embryos where they need to be I’ll stay laying down for 20 – 30 minutes. Then they tell you to go home and take it easy… desk jobs are okay, but anything more than that (like my job) they want you to take the day off. So I will. I can go back to work the next day though.

Then we wait. Oh the waiting is hard, she said. I can only imagine.

I forget how many DPR they want you in for the blood test. She said it’s so early that a lot of times it’s too early for anything to show up on a urine pregnancy test… they advice you don’t waste your money. (I probably will.) You go in the morning for the blood test, and they call you that afternoon with the big results.

If it’s positive, we celebrate! ;) I’ll go back a few days later for a repeat blood test to confirm doubling beta numbers. I’ll continue the estrogen patches until 6 weeks pregnant and the prometrium suppliments until 8 weeks. They give an ultrasound at 6 weeks (generally that’s to confirm good placement of the sac and to count how many there are!). At 8 weeks they release you to your ob/midwife.

If it’s negative, I stop the estrogen and prometrium and wait for my period. Which, she said, will be a really heavy one, unfortunately. She told us it’s totally up to us when to try again… some couples start another cycle right away, some take a month or two off, some take 6 months off. “We’re not going anywhere,” was her comment. At that point Den and I will have to figure out what the hell to do next – if a FET is an option, then to decide whether or not to use our last IVF cycle coverage on it and when to do it. I doubt I’ll be ready to start another cycle right away – but she did say that it’s something you won’t know until you’re in that position. She also told us that once a week the entire time – nurses, doctors, embryologist, etc – get together and review failed cycles. They look at what went wrong, what could be changed to improve chances next time, if it was just plain bad luck that caused the cycle to not end in a pregnancy. Then they mail you a letter with their recommendations.

So there it is, the summation of the upcoming cycle(s). It’s a different set of nurses from the “other stuff”, and at very least the one who gave us our class today was super nice. And knowledgeable… not just about what she’s talking about – as I’d expect her to understand that ;) – but she knew each of our protocols and what we were doing. After class when she talked to each one of us personally, when I said I’d just started my period a few days ago she said she thought I’d have started already. That impressed me. She also told us that the three nurses are constantly in contact and updating each other on each patient’s status so they all know where each patient stands and are able to help them with any questions or problems they have.

And now I am so friggin’ exhausted I think I’m going to fall asleep.

This afternoon is our IVF protocol class with the IVF nurses… where they teach us how to do injections and hopefully figure out dates and exactly when our cycle will be happening. I’m really excited to know when we’re starting.

Next week I have my post-op appointment with my doctor. I need to start thinking about what I want/need to ask her about the endo. We’ll also sign those IVF consent forms at that time.

Seeing a lot of failed IVF cycles lately. It’s really bringing home with me how chancy all this is… sometimes it works, sometimes it doesn’t. It’s not a miracle cure. I’m just so scared. What if it doesn’t work? What the hell do we do then? We don’t know if we an afford even a FET until next year. Next year! I just can’t dwell on it. Den just told me by email to just take it as it comes, if it doesn’t work we’ll find some way to do another try… but for now to just worry about this cycle. And he’s right. I know he’s right. I’m just so tired this morning it’s hard to stay positive. :(

My belly button incision is really bugging me today! Mostly itching… really really bad itching, bordering on little sharp pains. It’s more irritating and distracting than anything. Also, while inspecting it (to make sure it all looked good – it does) I think that the new shallowness of my bellybutton might be because it’s stuck together as it heals… not because it was stitched that way. Wouldn’t that be nice. ;) Stupid belly buttons.

Den is having some trouble understanding the “alternative” way I want to do things. Now just in case you’re not aware, I’m leaning towards more of a “crunchy” side of things. I think a lot about labor and birthing because honestly when I started TTC I was absolutely terrified about it. So I immediately started researching and reassuring myself. Here are some of the conversations we’ve had recently:

About me wanting a medication-free birth Den says he’s being supportive, but I see the barely-suppressed eyeroll and his, “We’ll see how it goes dear.” Which pisses me off. I’ve tried explaining to him that there’s no room for doubt, I WILL DO IT and I need him to fully believe that and not let me down. IF I do get in a situation where I need medication I can and will make that decision… but I need him to be onboard so when I say “I don’t think I can do this!” he will respond with, “YES YOU CAN!!” So we’re still working on that.

I mentioned that I hope to labor in a position other than flat on my back. I want mobility, I want to be able to choose whatever position feels right at the time. He seriously stared at mel ike I grew a second head. His response was, “What?? How else would you do it??” I mean I don’t blame him for not knowing much – he’s never dealt with a woman in labor before! – but just the fact that he was STUNNED that there was any other way to give birth than laying on your back in a hospital bed… I had to explain other ways, such as squatting, or a birth stool. He freaked out! He thinks it’s “weird” and kind of gross. So again, something to work on later. (And I know at the time of labor he will do whatever I need him to do or I will probably take his head off… and he does not want that. I can get somewhat, umm, cranky.)

Another thing I mentioned is my desire to be intermittently monitored and not hooked up to a machine (unless of course there is a need for it). That freaked him out too. :sigh: He got a little angry with me, saying how I want what I want without regard for the baby’s health… he wants me hooked up to every monitor to make sure everything is going 100% well. I tried explaining that studies and recommendations state that intermittent monitoring is JUST as safe. You do “check in” with the baby to make sure they’re doing well, but you don’t have to twitch at every little blip on the screen. He didn’t really believe me. So I’m going to have to show him the research to get him on board with that.

Still absolutely no consensus or compromise on the circumcision issue. His only real argument is that “it’s gross” (not circ’ing). Which is completely rediculous to my mind. Den thinks a lot of things are “gross”, such as breastfeeding and squatting in labor. I think he needs to get over his own “issues” of grossness and think about the bigger picture. I do feel bad I mean I am kind of running rufshod over him with these things, and with anything else I’d probably give him the circ decision to placate him, but I feel really very strongly about it, and it’s not really something I feel I would be okay with giving up. I really do think I would strongly regret that the rest of my child’s life, and I don’t want to put myself in that position. I think the whole idea of circumcision is outdated and somewhat barbaric. I really try not to judge other people’s decisions for theirselves and their own families, even though I don’t necessarily agree with it… but when it come to my OWN child, that’s a whole ‘nother issue.

Anyhow. We are obviously far apart on many issues. One saving grace is that the hospital he wants me to give birth at – the same one I have all my infertility stuff at – also has a woman’s birthing center located in one of the buildings. I haven’t checked it out yet, but I would LOVE to give birth in a birthing center. And it’s basically attached to the big hospital that Den wants, in case of an emergency.

My first day back to work was today. I did take it easy with the lifting, lifting no more than about 15 to 20 lbs… but even so by the end of my day I was feeling the strain in my stomach muscles and my incisions were starting to irritate me. I took lots of breaks. And I got people to do the few heavy lifting things that needed to get done, I was a good girl.

The little white strips they put on my lower incisions are starting to come off. I trimmed the ends off so there’s less chance of them catching on something and getting ripped off… just want to let it all heal as gently as possible.

An aquaintance on a forum just got a BFN from her first IVF cycle. GREAT response, great fertilization, two blasts… no pregnancy. Just bad luck, the doctor said. Started to make me worry. What if we don’t get pregnant our first IVF? What the hell are we going to do? I really don’t want to think about that until I have to.

I took off my bandaids.

Ow motherfucking OW.

See I can get through surgery just fine, even four IVs, but taking off a bandaid? Give me some friggin pain medication. (Note to anyone going into a lap? Might want to consider shaving your belly of all the little fuzz and those stray little belly hairs. Just a thought.)

But anyways, I survived, and everything is healing up nicely. My lower incisions aren’t as minor as I had hoped, I guess they bled a bit afterwards and so they have some scabbing on them. Ick. My belly button incision, the one I thought would be the worst, is pretty tiny. However – they sewed up my belly button! I always had a pretty deep belly button… a little annoying, but it was me. Now it’s pretty shallow. They sewed it closed. Aacckkkk. Mustn’t dwell on it too much or I’ll freak out a little. (Yeah, of all the things to freak out about… )

So if anyone is really interested in seeing a photo of my belly 4 days past lap, I’ll post it in the more section. I need to lay off the chocolate cake. Badly.

More…

I woke up feeling physically quite good today. Not 100%, obviously, but better than I have for a while. My incisions are itching though! Guess that’s a good thing. I still haven’t peeked under the band-aids though. I’m afraid of messing it up somehow. I figure the longer I leave them alone, the quicker they’re heal.

I’ve been struggling a lot the last few days to deal with the emotional aspects of my surgery and diagnosis. I think it was the day of the surgery, perhaps the day after, when I typing something on a forum about endometriosis and I just froze as it really hit me – I have endometriosis. It’s “only Stage I”… but I have this disease inside me that I didn’t know I had. It’s funny because I went into the surgery knowing it was a possibility. I suspected there was “something wrong” inside me, but mainly I just went into it with the determination that I wanted to get everything checked out and crossed off my list if need be. I never really sat down and really thought about the outcome.

The infertility diagnosis was this big, looming, inevitable thing. I knew it was coming, I was counting down. It was like a giant weight on my shoulders, yes – and a sad thing to have to accept – but I knew it was coming. The endo was much more of a shot in the dark, not something I really expected to happen.

I’ve been reading up on endo – because I hadn’t really before – and learning what I can. I’ve been wondering about the stage that it’s at. I know it can grow back over time, which makes me wonder if it will get worse over time. I read an article about how endo used to really only be diagnosed in 30+ patients with very severe symptoms because laparoscopy wasn’t an option, it required full surgery. Now that the surgery is pretty minor more younger patients such as me are having it done and being diagnosed with minimal or mild stages of it. Which just makes me wonder… those of us who are now getting diagnosed early when it’s minimal, would we be some of the ones with really advanced cases in our 30’s? I’m only 23 now – how bad will it get in 10 years?

So it’s been a bit of an adjustment for me.

After the surgery the anesthesia must still have been floating around in my system because I was sooo happppy. Not like deliriously so, just very very content. I was so pleased that they found something, so pleased that I decided to do the surgery. I was very happy with my surgery experience (I still am, in fact – they took very good care of me there). I had endo, it was removed, we were doing IVF, I’d be pregnant soon. Life was really good! And then I fell back asleep again for the tenth time. ;)

Unfortunately over the past few days that glowy contentment has kind of faded. I’m back to being my worried-about-everything, grouchy-as-heck, semi-depressed self. And that makes me sad. It’s too bad I can’t just stay happy all the time, that was a really nice feeling.

Guess who showed today, despite me still taking my birth control pills? Yeah, I just now figured out why my abdomen was getting more roiled up today instead of less. Guh.

Guess I get my chance to see what the lap has done for my pain. I’m totally afraid it’ll be just as bad. :(

It feels like I’m doing much better in some ways and worse in others. The shoulder pain has all but gone away entirely, I’m able to stand and sit and not worry about laying down soon after. The incision “pain” has stayed the same – which is to say, I don’t have any. Or very, very little. Once in a while I’ll move in such a way that I go, “Oh yeah… that,” but it’s more my own worries of hurting myself than any kind of pain. It’s more of a “tickle”.

It’s the general stomach discomfort that’s getting me still. I still feel bloated as a blimp, though Den says my stomach is looking much better than it was. The gurgling is still going on in spades, sometimes to the point of pain. We ate a real dinner tonight, and that was a mistake on my part… my body was not ready to share stomach space with food…. and I think the gas and the food got into it. Or at least that’s what it feels like. It’s unpleasant.

I’m pleased I’m still able to sleep on my stomach though (or at least mostly). I have a heck of a time sleeping any other way.

Just as an aside – my dog keeps really good care of me. This afternoon I look over and there she is on the bed along with five of her toys. She brought them all up on the bed so she could play with them and keep herself occupied while keeping me company. That’s just the kind of dog she is. :) She’s spent the greater part of the last two days either napping or playing quietly by herself on the bed beside me. Such a sweetie.

My shoulder pain has subsided significantly – during the night I was up and about for over an hour without any pain. This is good! Unfortunately my stomach isn’t doing so well. The entire time I’m laying down I’m hearing the most aweful rumbles and gurgles from inside there. I really wish I could stick a pin in me and “deflate” myself!

I almost feel like I’m getting a precursor to pregnancy. I can hardly bend over to pull on my socks, and levering myself up out of bed requires a lot of forethought and arm strength. However I’m willing to bet pregnancy will feel much more like a heavy weight and less like sharp little stabs of pain. Course I could be wrong on that one.

I hate to say it, but I’m getting a little bit bored staying in bed. TV, unfortunately, is pretty crappy most of the time – and the DVR is in the living room. Message boards are not active enough for someone who has nothing better to do than refresh each and every one of them. I’m getting desperate for some virtual “company”! I find myself hanging around on IM a lot, hoping my dad comes online so we can chat. I was even excited when my young cousin signed on (she’s a teenager, and tends to talk a lot about girlie teenager issues, lol).

Last night when I tried going to sleep I felt a bit of pain in my incisions for the first time. I hadn’t had any problems sleeping in my usual position before then, not sure why it’s bugging me now? I just felt the need to be very very careful about where I put any pressure on my belly. And sometimes I think it’s the big bandaids that are annoying me worse, but I’m afraid to take them off.

Oh, does anyone know how to get that aweful yellowish stain off my skin?? So far soap and water has done absolutely nothing. It makes me feel so gross!Gur