My ultrasound is tomorrow morning and I feel a lot calmer than I expected to. I’m resigned to What Is, but not in a negative way. I think I’m learning how to let go a little – to just let the possibilities be until life shows you what path it’s on. Tomorrow isn’t THE answer, but the first of many. I have hope – but it’s a very reserved hope.

::

Today I was describing to my therapist what my new mondays consist of, since I am not working at a client’s office like I had been for months. I set my alarm so I won’t sleep all day, I get dressed, I eat, I shower, then I set my laptop up in my light, bright living room and get caught up on emails, phone calls, friends. Then I go to work for a couple of hours to get caught up and set my to-do list for the next day. And then I have my acupuncture appointment before going home and relaxing. I told her how much I love it, how I start my week with a deep breath, start on the right foot.

“Natalie,” she said to me, “I think you’ve learned how to relax!”

My next thing to think about is how to extend my routine and feeling of peace through the darker months, when I have weeks of no sunshine to bask in. This is my first step, and an important one, but now I need to figure out how to achieve it when the conditions aren’t perfectly ideal. And that has always been the hard part.

::

I am so damn happy to be off the pill. Everyone says how horrible lupron is – I don’t notice the lupron! But the birth control… oh my. I have felt like a veil was lifted from my head since I stopped those pills. I felt so angry, so frustrated for no reason. Now I feel so much less burdened. I feel like myself again.

::

I called my acupuncturist’s new office and booked a massage with the [male] massage therapist for Saturday. So Saturday I have work, then an hour of acupuncture, than an hour massage. Awesome. I hope this massage therapist works well for me.

I do love going to my grief group, but at the same time I need to take a deep breath when I leave. It is comforting to my grieving self, but a little terrifying to my trying-to-conceive-again self. When the time comes that I am pregnant again I am going to need to find a way to compartmentalize, so as not to let paranoia completely take me over. I will need to return to the land of “normal” – well, as normal as I can ever be, now. Unfortunately I can’t join that world of eager pregnant chit-chat until I am actually pregnant (and even then, maybe not). So I straddle the world of grief, edging my way to keeping one foot in, one foot out. The problem is, right now I don’t have anywhere to stand.

::

I talked with my SIL a little today. She saw my update on facebook and was asking me questions about my cycle. “As much as you’ve been through,” she said, “It’s still a little exciting. It’s… hope.”

Hope indeed.

::

I got there early this morning, time to get blood drawn before they were calling anyone back for ultrasounds. It wasn’t long before I was in an ultrasound room, waiting to be seen. I was eager to see what was going on inside, but not very tense about it. She immediately reassured me that everything looked good. I was distracted by relief so my notes are kind of spotty, but I had 9 follicles on my right ovary and 8 on the left. The biggest ones measured 10/11mm in size, and there were no tiny ones hanging around – they were all of a pretty consistent size. Lining looks fine.

This may be one of my smallest stims yet – I really appreciate that they’re all the same size and not one side more than the other, but I admit I’m a tiny bit disappointed I have under 20 follicles. Even with this menopur-only protocol I can still expect only around a 30% maturity rate, and less total eggs means that I’ll more than likely end up with less embryos than last time. All we can hope for is that a smaller stim and the acupuncture will make better quality, more mature embryos. I know, all I need is one good one – I got pregnant with Devin after a devastating cycle with only one embryo, I should know. But there still feels like there’s a buffer with more embryos – more to freeze, more chances to take. I have to constantly remind myself that my goal right now is 2 great embryos to transfer. Frozen embryos are extra.

I go back in on Saturday for another check-in with the ovaries. Judging by their size today and my past performances I’m leaning towards it being a Sunday trigger/Tuesday retrieval, but it could just as easily end up being a Wednesday retrieval. Saturday will tell the tale. It is also the ultrasound I am most worried about – my major overstimming was not apparent until my second scan when all the little ones popped up. So if I can get through Saturday safely then I’ll… start worrying about retrieval and number of eggs. Yeah, this worrying thing just never stops.

In less than a week I’ll be done with retrieval. Which both seems soon when I look at a calendar, and very far away when I feel my ovaries. The ultrasound tech did mention to me that having surgeries can result in being more sensitive to the pressure and other physical sensations during stims. I realized this is indeed my first stims cycle since my laparoscopy and tube removal.

I meditate to the image of my ovaries being strong and carrying the burden. I am thankful for my body and what it can do, even under such physical and emotional pressure.

Somewhere today I abruptly turned the corner from “feeling fine and hopeful and happy to be where I am” to somewhere close to “angry, bitter, and wanting to throw things at the happy pregnant woman walking down the street”. Just like that, flip is switched.

I’ve been trying to isolate myself lately – staying off the baby topics, away from the pregnant chit-chat, away from the happy happy. I’m doing it because, first, it hurts and I don’t like hurting. Second, because it either gets me thinking about what I don’t have, or about what I will have; it gets me imagining scenarios and either getting really hopeful or really depressed, and honestly neither one of them is what I want right now. I cannot be that person right now. I don’t want to be angry and bitter, that is not what I want to carry around with me.

I know – or at least I hope very much – that one day this burden will lift from my shoulders and I will be able to open the floodgates and let all the joy in without the overwhelming bitterness. I had a brief taste of it in April, what it felt like to walk the world as a pregnant person again, as a happy, joyful person. It helps knowing that is waiting for me.

::

I remarked to myself and to my therapist that this IVF feels so very much different from #3, the first one I did after Devin. The desperation is missing. The desire and longing are still there, always, but I don’t have that needy, urgent desperation digging fingernails into my back. For IVF #3 I was 9 months out from Devin’s birth. I think it was long enough that I felt so driven, so needy, but not long enough to gain any patience. Now I’m 18 months out. I just feel so much calmer, about everything. Calmer about my situation, calmer about the grief, calmer about the IVF. Even the lead-up for IVF #4 felt desperate, with Devin’s first birthday coming up. I had set an invisible, arbitrary goal. And I was failing.

Sometime after his first birthday I felt the grief and raging frustration settle down. It was spring. I remember looking around at spring arriving and feeling like something lifted from me.

All of 2008 is a cloud to me, a blur. I can tell you that I got my job that year, I can remember training and starting. I can remember meeting my boss for the first time. I can remember Christmas at BIL’s with BabyH. I remember March very clearly; some moments that month stand out in perfect relief in my memory. I remember laying awake at night staring at the ceiling, tears falling silently. I remember cleaning the entire house to the point of perfection. I remember helping Den paint, because we had lots of time, but our hearts and minds were shattered and all we could manage was to paint walls. I remember the memorial service, how I fidgeted and arranged and bought a new table just for that day to display his things. But ask me what I did between April and August and I honestly can’t remember a damn thing. I know I started working again at the non-profit in that time. I think I went there a few days a week. But what did I do the rest of my time? Where did I go? Who did I see? I remember nothing. Summer 2008 simply did not exist to me. It has been wiped out of my memory in a fog of grief and simply coping.

So spring 2009 felt like my new beginning. It felt like the sun had been gone for a long, long time, and I had finally opened my eyes and stepped back out into the world. I am sad to see the summer coming to an end; it hasn’t been long enough for me.

Next year I will probably have a totally different view of 2009, depending on how things turn out. But right now it feels so much better than last year, and as long as things continue in this general direction I will be okay.

My dad says I am weird. (And for my dad to say that makes it a little scary.) He thinks it is weird that I enjoy having surgery. Seeing how he has never had surgery himself I am not quite sure how he would know if he would like it or not, he’s just assuming. But me? I’ve been there. Many times. Not that I mean surgery like “cutting into my foot” or “drilling holes in my brain”. I am pretty sure neither of those would be fun, though of course, like my dad, I’ve never had either of those things happen. But egg retrievals? Oh yeah… been there, done that.

First of all, the “starting to feel it” has evolved into “definitely feeling it.” The ovaries are starting to ache just a little bit. It’s not pain, just bloating. Pressure. A little tenderness. I am not fond of pants right now. Standing up is a-okay…. sitting down causes the waistline to cut in right there and it rather feels like someone gently squeezing a bruise. I am feeling the right more than the left, which makes sense when you consider that the right is the side that was operated on, pieces removed and all. I don’t want to be all whiny, because honestly it’s not that bad. Actually in a way it makes me slightly giddy. Things are rolling right along, and that makes me happy. But anyways, I feel them, it’s getting a little worse each day, and I’m really looking forward to having all those eggs sucked out so that things can get back to normal in there. And so I can wear my jeans again.

Back to the giddy. The giddy is definitely part of the reason I like this surgery. I want to know how many is really in there, I want to find out what fertilizes. I’m always anxious when waking up from retrieval, but I like getting info. I like waking up knowing that now they can finally give me some concrete numbers. I’m all about the numbers.

But for me retrieval has another aspect to it. They go out of their way to make you feel well taken care of. I like getting tucked into bed and covered with heated blankets. People ask me if they can get me anything, and I get wheeled around in a bed. Getting the IV put in sucks, but the medication is pretty awesome, off to dream as the world fades away, like nothing is of any importance at all. I’m lucky, waking up from retrieval doesn’t involve pain or sickness, just a heavy sleepiness. And then of course I get to go home and sleep for the rest of the day.

All of that combined equals Hell yeah, retrieval, woo woo! I happily skip-hop along through the back room at work, knowing that retrieval is tuesday…. or wednesday. Either way it’s soon.

::

I have done two of my stims injections myself. Just wanted to say that, so I have record of it. Den has been working hellish 14-hour days at work the past few nights, so I sucked it up and jabbed myself. Which I have never done before – not the full needle of stims, 1cc of fluid. And you know… it pretty much felt the same. It stung. It always stings. But I just breathe through it and it’s over.

The only one he cannot miss is trigger. We’re doing it intramuscular again. This time at least I’m not worried about it, since I survived it once just fine. I’m figuring out that most things in life sound a lot worse in your head than they really are in real life.

::

Appointment in the morning. Holding my breath.

Then I go to work, and from there go to my acupuncture and massage appointments. I have permission to sack out and do nothing the rest of the afternoon…. just be limp noodly. Sounds perfect to me.

I got there really early in the morning for a Saturday, walking in the building before 8am (when they start doing scans). I had my blood drawn first – did I mention how I hate getting my blood drawn on weekends? Sigh. But I survived and she did actually get it on her first try, though I nearly yelped. Then quickly I was in an ultrasound room, chatting with the nurse and u/s tech.

Things look great. She counted 18 follicles this time total – 10 on right, 8 on left – which is only one off from Wednesday’s scan. And, other than a couple that were a little smaller, all of those were measuring the same size: 14-15.5mm. I was/am positively giddy about how my follicles are looking… you can’t get much better than that. Maybe I’d have asked for a couple more in there, but even though there’s less follicles total this time I really think these might be better quality than last. There are less small ones, and I am getting acupuncture treatments. Who knows if that will do anything, but maybe. I got 6 embryos last time and I’m really really hoping I get 6 again this time… though I know for me that is a high goal, especially with less follicles.

The nurse said she is thinking 2 more days of stims for me, which means trigger on Monday evening and retrieval on Wednesday. With my follicles the size they are today I highly doubt they’re going to be ready to trigger by tomorrow, and neither does she, but they’re having me come back in tomorrow just to check on their growth. Later in the day I got a voicemail today from the Dr himself. It cracked me up a little, because normally its the nurses who pass on boring information like “come again tomorrow.” The nurse said that I’m a “special case” and that they were sending my ultrasound and lab results to him so he could look them over and call me… but I didn’t think he would actually call me himself.

He said my E2 is 1500 today. Sheesh, that sounds so low! I know it’s not, but my previous cycles have almost all had much higher E2 (which is why they’re always so concerned about me!).

Then I did have my acupuncture appointment. My acupuncturist moved to a different office, which felt a little weird (because it’s a new place, unfamiliar). She was very pleased with my progress in the cycle. One belly point really made me jump when she put it in… like an electric shock. I don’t think I quite fell asleep this time, but I almost got there. Then she left me and the massage therapist came in. Right away there was definitely a clear difference between this and the spa massage. I could feel him finding all the muscle knots and trying to work them out. He spent a long time on my back, which I liked. But yeow, did some of them hurt. It wasn’t just that he was doing deep tissue, but there were many spots where he just touched them with his fingertips with light pressure and my muscles spiked. Pretty sure I had some huge knots. I do think they felt looser by the end, but it was not what I would call a relaxing massage where you fall asleep or anything! A few times I really had to work at breathing steady. I do think it’s what my back needed, it’s been a mess lately, and I hope it all relaxes and stops aching soon. Or I’m going to need another massage. LOL (A gentler one!)

And now it is nap time.

I made the mistake of asking the blood tech to try my right arm. Wrong wrong wrong – always tell them, “Whatever works best!” No blood on first try. Switched to left arm, same vein as yesterday… got it.

At the ultrasound today the first measurement was a 19.5mm follicle. I blinked in surprize. 19.5 means trigger time. She measured the rest on the right: 19.5, 19.5, 16, 18, 15, 19, 17. And my left: 17.5, 18, 19, 18, 17. Definitely triggering tonight. I’m a little bit annoyed with the 15 and 16 – hello, stay with the others please!! – but all in all this looks like a very nice batch. Total on the right was 11 with 8 being of a mature kind of size, total on the left was 8 with 6 of them big and fat. I’m still guessing 17 or 18 retrieved. I hope. Come on, eggs. I have done everything I could possibly do for you this time, please please be mature and ready to fertilize.

Since I’m an ICSI patient I will probably be the first retrieval of the day at 7:30 on Tuesday.

Suddenly today I’ve started getting really, really anxious. I did meditate for an hour at noon, which helped me settle down for a little bit. I didn’t want to just sleep the day away so afterwards I made myself get up, go out, and get some work done.

I triggered at 5:30. Yes, that’s 2 hours earlier than scheduled. Den and I decided to do another 38 hour interval instead of the typical 36. It’s my last-ditch effort to help my eggs mature that last little bit. (We’ve done a 38 hour interval before, with no ill effects, but it’s always a little nerve-wracking.) As I was preparing the shot I was getting a little flushed and sweaty, just from nerves about the IM shot. I went over with Den again how to do it, gave him the needle, leaned forward. I felt a poke and he said, “Shit! It wouldn’t go in!” and I was like damnit, do you have to do it again?! But no, it was already in and I didn’t feel anything beyond the poke. Awesome. That buttcheek was a tiny tiny bit sore for the next hour or two, but nothing like what I was fearing. (I didn’t use an ice pack or anything this time. I’m done with the stupid ice. I think the freezing hurts more than the needle pokes.)

So that being done I just sit here and fret. About everything. The trigger, the follicle count, how fast they grew in the last day, my general proclivity towards immature eggs, the possibility that even the mature ones won’t fertilize, and so on and so forth. I am just sitting here, rubbing my belly, hoping beyond hope that everything is growing properly in there. I wish I could check on them, I wish I had some kind of little ball that told me how many of them were going to be any good. I have all my data plugged into my spreadsheet, but there comes a point at around IVF #5 that you realize that data is great for review but sucks at predicting anything at all. I could sit here for years comparing cycles and E2 levels and follicle counts and I would still have no better clue what’s going to happen on tuesday than taking a wild guess.

Pretty much just pacing the house today. Watched a movie. Went to the bank. Meditated. It was a whole lot of “nothing to do” with a lot of “stressing” to fill it with. Ugh. I might try another massage therapist this week, if I can… I still don’t feel like I’ve found the right person, and I really think some de-stressing would be great right about now. Any other suggestions for short-notice stress relief?

It’s so weird to have an entire day between trigger and retrieval. At least I have a lot of work to do in that time to make up for the day I’ll be missing, but agh. I want to be in retrieval now!