BrooklynGirl

Waiting by the Phone

I had another monitoring appointment this morning, and I'm waiting for the call but I think tonight is trigger night. My regular doctor was on monitoring duty this morning so it was nice to see him--although some people have described him as looking a little like a young Elliott Gould, an image I just can't get out of my head. Since I've recently seen the remake of Ocean's Eleven, in which Gould is a fabulous crooked casino magnate, and the episode of Friends in which Gould, as Monica's dad, gives Monica and Chandler some advice on getting pregnant it was all I could do not to giggle throughout the appointment. But I digress.

The bad news is that there's only one really mature looking follicle in there and it's hanging out on the right ovary and measuring at over 19 mm. There's another medium-sized one also on the right at 16 mm. Everything else is less than 15 mm. Now, this is my first injectable cycle so all this sounded reasonably good to me, but as he was leaving, Dr. Gould (hee hee) said we'd probably play with the meds next month to get a better response. And since I didn't know until that moment that my response had been at all disappointing, I was sad.

Oh, but there was good news, and it comes in the form of a nice little drug called Ovidrel--it's a sub-q HcG trigger. Woo hoo! I'm not nearly as much of a badass as getupgrrl so I was dreading the IM Novadel shot. So, phew.

Anyway, my sweet husband woke up and drove to the appointment with me, and it's much faster by car--1/2 hour by car versus 1 1/2 hours by subway (I can't drive during the week because I work in midtown and there's no street parking and garage parking is outrageously expensive). I was done by 7:30 and we had the morning spread out before us so we headed over to the Doughnut Plant, which was nowhere near the doctor' s office or our apartment, but which I'd heard makes wonderfully delicious fried bits of dough and hence was worth a detour. We got sugar doughnuts that were still warm and so very tasty. The counterman said that you feel like you're eight years old again when you eat food like this, and as we gobbled them down and covered ourselves in sugar, I had to agree: two eight years old on the loose in lower Manhattan, waiting for a call from their reproductive endocrinologist. What could be better?

Afternoon Update

We are going to trigger tonight with the IUI on Monday. I'm supposed to call tomorrow to make an appointment tomorrow for the semen wash and insemination. Of course Monday morning's not great for me: I have a Spanish test. There's really nothing on earth that meshes less well than an undergraduate classroom and fertility treatments, which my husband and I were chuckling about this morning. Trying to convince these kids that it's hard to get pregnant goes against all cultural programming. I mean when I was an undergraduate (in the age of "No glove, no love") we were all so damn sure you could get pregnant just by *thinking* about sex. Somehow we'll muddle through. Anyone know how to say intrauterine insemination in Spanish?

2+1=Ow!!!

So, after Julie, Julia S., and Heidi talked me down from the ledge regarding my anxieties about being bumped from two amps of meds to three, I was feeling pretty much okay with it.

Also, my latest effort to reduce stress is to take swimming lessons (this is also part of the Maximize Your Obscene Tuition plan, in which I avail myself of every possibly benefit Needlessly Yucky University has to offer), and last night was my first class. Though I swam quite a bit in high school, I haven't been in a pool for the express purpose of exercise in over a decade so by the time I got home I was heavily chlorinated and exhausted and couldn't really summon the energy to do anything more than prepare the shot.

I mixed my amps, swabbed my belly, and called my husband over for the jabbing. He has perfected his dart-like stabbing motion so that was not a problem, but he depressed the plunger, YOWZA! That bad boy hurt like a motherf*cker. Until this point, I was getting ready to publish the definitive study that Bravelle was the answer for those ladies who were suffering with the burning Follistim, but I know see the folly of my ways. Follistim sufferers everywhere I now quite literally feel your pain.

Update: Sending for Reinforcements

So, this is my first injectable cycle and my first IUI cycle to boot, and even though I read just about everything I can get my hands on about both topics and then attempt to affect a laissez faire attitude, I really don't have any idea what I'm doing.

Today, for example, was cycle day 8 blood work and ultrasound. I hauled myself up to the clinic, where once again the phlebotomist ever so politely insulted my "small and deep" veins and then I had the ultrasound. At my clinic, the doctors all take turns doing the ultrasounds during the morning monitoring so the doctor I saw today was not my regular doctor, nor the doctor I saw on cycle day 3. But he was perfectly lovely. Or, as lovely as any man wielding a vaginal ultrasound probe can be.

Anyway, he very kindly angled the screen so I could see what was going on (so efff off ultrasound techs who find this behavior inappropriate) and explained what I was seeing because even though I've had a dozen or so ultrasounds by now, I can't tell my follicles from my.....well, from anything. He said I had 2 follicles on my left ovary, both under 10 mm and 3 on my right, 1 at 10.5 mm and the other 2 smaller than that. He said this was a good number of follicles, said we'd probably trigger early next week, wished me luck, and was off.

So, "5 follicles," I was thinking as I wandered out into the brisk morning air (the sun having fully risen while I was inside), "5 seems like a nice, solid number." And I clung to my 5 follicles like this was the very best of news, but the doctor's office just called--as they do every day of monitoring between 3 and 5 pm--to say they're upping my dose to 225 units of Bravelle for tonight and tomorrow. Being told to up your dose feels a little like being told you need extra help in trigonometry...in front of all your friends who just aced their trig exams. And I don't know: 225 seems like an awfully big number. Unless we trigger on Friday (which seems unlikely), I'm going to have to go buy more drugs. UGH.

Monday, Monday

I am not a morning person. This is not news. If you knew me and were trying to describe me to a complete stranger among the first things you would say is "Oh yeah, and she’s really not good in the mornings." I’m not psychotic or anything—it just takes me awhile to become fully conscious, and I need plenty of time and space to wake up on my own along with a long, hot shower and Bob Edwards yammering away on Morning Edition.

And so the freshest torture of infertility is early morning monitoring. When you're cycling at my clinic, you dutifully report on your assigned days between 7 and 8:30 in the morning for jabbing and scanning. In and of itself, this is not so early, but I live 3 subway lines away from the clinic and given the vagaries of the transportation system, I give myself 1 1/2 hours to make it there. On the mornings that I have class, I need to leave the clinic by 8:30, so I like to be there by 7:45 or so, all of which means leaving the house at 6:15 am. A tall order for someone who is not a morning person.

Add to this: yesterday's phlebotomist could not draw blood from me to save her soul. Like Monica, I am a tough stick with uncooperative veins. It is not uncommon for medical professionals to look at my arms and run screaming from the room without even trying. When I had my lap a few weeks back, the teenaged-looking anesthesiologist poked around for a little while unsuccessfully while my doctor and his staff paced impatiently around the operating room, and I made jokes about how the state of my veins was really the best insurance I had against becoming an intravenous drug user. No one laughed. Yesterday's vampire suggested that I should plump everything up by drinking a lot of fluids before coming to the office, which I'm eagerly adding to my routine. As long as it means I don't have to get up any earlier.

P.S. Yesterday's bloodwork was fine. I'm staying the course on 150 units of Bravelle and going back for more monitoring tomorrow morning.

Two Strikes

Well, I couldn't inject myself last night either so my husband stepped up to bat yet again. He's really good at it, and it doesn't hurt, but I'm really frustrated that I can't do it myself. Tonight I'm going to try jabbing my thigh--there's plenty of subcutaneous fat there (God knows) and somehow that seems less scary than my poor belly. I think I'm going to send DH off to a Super Bowl party so I'll have no choice but to do my own jabbing. We'll see how it goes.

My husband, by the way, has been amazing. Yesterday I had a mini meltdown (I can't imagine it's already the hormones in action, but maybe), and he cleared out of the apartment--I assumed he just needed some alone time. I had to go see a friend in the suburbs which meant digging the car out from the enormous snow drift (possibly the most annoying thing about winter in the city), and I was hoping he'd return from his alone time so he could help me when he showed up, and what do you know, not only had he dug out the car, but he also took it to a car wash to get all the salt and city muck off it. Then, while I was out, he cooked up this amazing dinner--including a yummy chocolaty dessert, and he cleaned up as I fretted about and prepared my injection, and then, after all that, he shot me up.

How did I deserve this man?

Who's The Wimp?

That would be me. I couldn't do my injection last night.

The whole night was sort of comical. We went to our favorite Thai place for dinner, and there was a wait for a table as there often is. This is a restaurant cum lounge sort of place so there's a DJ, an active bar scene, etc. Ordinarily, I would order a beer and happily (well, mostly happily) stand around, but since I've embraced the credo of better living for this new cycle, the idea of standing around without a beer was less appealing. Still, they sat us pretty quickly, and it seemed like all the tables around us were filled either with hipsters drinking yummy looking cocktails or perfect little families doting over their brood ("Come on, junior--just one bit of Kang Gai and then you can have another soda.") And then there was us.

Anyway, we got home, and I lined up all my supplies: alcohol swabs; syringe with big, scary mixing needle; less scary but still fairly intimidating smaller subcutaneous needle; 2 amps of Bravelle; and one amp of dilutant. I had chosen 10 pm as injection time so we attempted to relax by watching a rerun of Sex and the City--the one where Miranda meets Steve for the first time. Being my early cycle optimistic self, I couldn't help but see this as a good sign: I mean, Miranda winds up getting pregnant with Steve when she's not even trying so what better omen could there be for my first injection, right?

Then, the time came to start getting ready: the mixing of the meds and the dilutant went okay. I switched needles; I got rid of the air bubbles; I swabbed my skin; I pinched my inch; and then....I freaked out. My husband suggested I get another needle out and do some practice injections, which seemed like a good idea (though at that point I think I was happy to just stall for time), and I wandered around the apartment stabbing potatoes and bananas, which was not a problem. But then again, I am neither potato nor banana. So, I settled down to start again and still couldn't do it.

I kept staring at my white, quivering flesh, trying to focus on puncturing quickly like a dart, but the ideas of darts and my poor belly (maligned, ignored, and totally unlike Julia's fabulous belly) seemed so incompatible. So, my husband did it. And it was fine. I couldn't even feel the needle go in: I felt it when he depressed the plunger, but that was it.

I'll try again tonight and hope for the best, but I have to say that all I've been thinking for the last 10 hours or so is this: all you ladies out there who have done this injectables thing, my hat's off to you. I hope to join your badass ranks sometime soon.

Survey Says: Bravelle

So, it’s been a busy few days in the life of this infertile woman. Yesterday was injectables class, which was actually kind of hilarious. I mean the whole process overwhelms me—the drugs, the money, or the fact that I’m going to have to stick a freaking NEEDLE in my own body—so you can bet I was paying attention. I’m nerdy this way: I take notes, ask questions, and so forth. I’m the kid in the front row no one wants to be friends with. Anyway, this one other woman, we’ll call her Muffy, in the class kept jumping up to talk on her cell phone, and when she reappeared at the end of the class she announced that she wasn’t interested in injectable drugs: she wanted to take the pill. The nurse asked if she meant Clomid, and Muffy said, no, that she had already taken that. She wanted to take the pill that makes you ovulate the next day. I scowled. The other people in the class scowled. Even the nurse scowled and said they would speak later. I mean, come on Muffy! Get with the program!

Anyway, my protocol is 150 units of Bravelle, starting tonight. There were two pieces of good news. The first—and it’s not insignificant—is that my insurance covered my meds so I paid $122 for drugs that otherwise would have cost me about $700. Since my insurance is unlikely to pay for anything else, this is really, really a wonderful thing. The second is that my phlebotomist was actually able to get blood from me on the first try and that never happens. I’m choosing to see the confluence of these two events as a good sign. The kind of sign that—brace yourself—this might work.

I know, this early cycle optimism is annoying, but please bear with me. After a few days of jabbing myself with needles and hauling my butt out of bed at 5 am only to have strangers poke me with more needles, and I'm sure to be back to my surly old self. Just you wait.

The Gift of Apathy

Well, it’s a busy week for me. Classes have started so I have homework, papers, and even my first multiple choice/fill-in-the-blank test in more than a decade (!) tomorrow. I’m also busy at work and—what with the incessant snow shoveling required these days—busy at home.¹ But at the moment I have to say I don’t really care about any of this. Not even a little.

This week is all about Friday’s RE appointment and whether or not I start injectables as I hope to. When not blogging, I tend to be pretty private about my fertility issues so the people I meet in my daily life have no idea what dominates my thoughts so I think of myself as exuding a false laissez-faire: so what that I don’t have time to study for the test, or finish that project or work, or clean out the mysterious brown gunk under the burners of the oven? Will any of that help me get pregnant? No? Then I don’t really care. I’ll go through the motions of pretending to care because that seems the socially responsible thing to do, but don’t expect me to get riled up.²

I like to think that I'm not exclusively self-involved: when not obsessing about my own baby making prospects, I whole-heartedly obsess over those of my friends and acquaintances. Julie's in the 2WW, for example, so I'm thinking about her. Also my friend Michelle who's on her first round of injectables, and Amy who's on her second, and Julie who's waiting to trigger. So that's where my mind's at these days. Just counting down to Friday....

¹And by busy here I mean that I occasionally remind my husband that he should go out and shovel the stoop of our apartment building or grouse about the fact that none of our neighbors are doing their fair share of the shoveling, but my actual contribution vis-a-vis shoveling is fairly minimal.

²Unless it involves George W. Bush. Then I can riled up.