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Today I Ate a Burger

Of the veggie variety, of course.  No one panic.

This may seem like no small deal, but I can’t tell you how ecstatic I am about it.  Last Tuesday was the last day I ate somewhat normally, and that evening I started feeling very uncomfortable in the abdomen.  It’s been one rough week since & I wanted to offer an update here which I will try to keep brief.  It is quite detail-y, so no hard feelings if you want to skip this one.

I chalked it up to GI issues related to the meds.  Our transfer was Wednesday but by Thursday afternoon I was really struggling, with severe upper abdominal pain in addition to extreme bloating and was even having some shortness of breath.  I checked in with my doctor about these symptoms and she wanted me to go to urgent care, where they were concerned about my high heart rate and could not rule out a blood clot (which one is at a higher risk of on these hormones), and so they sent me to the emergency department.

After blood work and some concerning results there (i.e. high white and red blood cell counts), an EKG, and CT scan the blood clot was ruled out but they discovered fluid in my abdomen.  They gave me some good IV fluids and meds and chalked the heart rate and breathing issues up to related dehydration and the fluid in my abdomen pushing up on my heart and lungs.  We left around 1:30 a.m. & had an appointment at 7 that morning with Dr. C.  Three hours of sleep for us!  Hubs was a trooper through it all.

I’d also like to give myself a little tip of the hat…have you had a CT before?  They inject one substance in you that gives you a rush of heat throughout your body, then you have to concentrate on breathing normally which is harder than it sounds, then they inject you with another substance that makes you feel like you peed in your pants (but you didn’t) and then you have to hold your breath for ten seconds.  After signing a consent saying they will do their best to not harm a potential fetus with some hardy shields, if s/he has stuck around since Wednesday.  And of course all the while they are calling me pregnant which I’m both thrilled and terrified by.  In the IF community there is a slang term, PUPO, Pregnant Until Proven Otherwise.  I suppose they were following this line of thinking, but I couldn’t help but correct them in my mind each time, They may just be all wrong.

Although my hormone levels and other tests were within the normal range and I didn’t have many of the symptoms for it (some lower abdominal pain but not severe, normal estrogen and albium levels, no problems urinating), the next morning Dr. C diagnosed me with OHSS (ovarian hyper-stimulation syndrome).

Some of my numbers had improved and I was able to force myself to eat and drink despite feeling so full that I didn’t want to, so we thought I was on an upswing and left it up to me whether they would “tap” me or not.  Tap = insert long needle into fluid pocket and drain it.  Because she thought I was improving and because it involved a rather long needle and the word “paracentesis,” I gladly declined.  She put me on a strict diet of high sodium and high protein foods and I ate my approximate body weight in dill pickle chips and guacamole (not together) in the subsequent days.  It was fun at first.

My abdomen expanded increasingly, however, and by last night it/I was gigantic, I really did not want to eat or drink, and it was very difficult to get comfortable.  Basically what happens is the hormones cause your blood vessels to become leaky, directing the fluid into your abdomen and around the uterus instead of to the kidneys.  This leads to the bloating but also to dehydration.  I broke down and googled OHSS and allowed myself one professional site (Mayo Clinic) and one lay site (some IF forum).  I learned on there that the full, pressured feeling can last 2-4 weeks, more if you’re pregnant, and that many people feel instantaneous relief from the tap.  Tap, it is.  There is just no way I could take this for much longer.

We went in today and — lo and behold — they drained almost 2 liters of fluid!   My apologies for the gross detail (I will tell you what it looked like upon request).  Also, because of the proteins in it, the fluid apparently is amazing for your garden but we politely declined the offer although we’d just gotten ours going this weekend.  The procedure was a bit painful, but not terrible and compared to all the IF involves and relative to the ongoing pain of the last five days, it was totally 100% worth it.  I highly recommend it for anyone with OHSS.  They also threw in some IV fluids, my first and third IV all in a week.  And I had room to eat a burger tonight!  High salt high protein, yippee!

Dr. C and the nurses urged me to take advantage of the window of feeling hungry because — get this — often the fluid comes back and additional tap(s) may be necessary.  They also urged me to wait as long as possible between taps.  The fluid can return in women who are not pregnant, but is even more common in women who are.  How will I not overanalyze this in the coming days?  One of the wild things about OHSS is that it is triggered by the hormone HCG.  This is the hormone contained in the Ovidrel shot that triggers ovulation pre-retrieval and also the pregnancy hormone, what the Beta test will detect to determine pregnancy on Friday.  Last Friday my HCG/Beta level was 7, so the Ovidrel was almost out of my system but not completely.  So there is a possibility that my OHSS symptoms weren’t resolving because I could in fact be pregnant — a possibility Hubs found assuring.  I was more skeptical.  However, I am a total freak and secretly hoping that the fluid madness returns.  Oh, the things IF does to you.

Lastly, neither of our two final embryos made it.  It still is so hard to believe, and hard to accept that we only got two viable embryos out of this process — especially after how awful the past week has been.  We are pressing on, though, and actually feeling fairly accepting at this point, although I fear that will all come crashing down if it is negative on Friday.  Of course we are praying like crazy for Friday and I’m hoping to have more energy to devote to that now that I’m feeling more normal.

Here’s something I got in the mail last weekend from my beautiful sis.  One of my mantras through IF and she made it into a canvas.  In our bedroom for now, but one day a nursery.

My sister is brilliant.

My sister is brilliant.

In honor of feeling a bit spunkier today, return of visual hilarity for you…

Reading for my Psychoanalytic Development class last Tuesday, the night before our embryo transfer.  What are the odds?!  Needless to say, I did not participate very much in discussion that night.

Reading for my Psychoanalytic Development class last Tuesday, the night before our embryo transfer. What are the odds?! Needless to say, I did not participate very much in discussion that night.

And Dozer the Dog — a fitter version of our little meatball, a YouTube video my sweet in-laws sent for entertainment over the weekend.

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For Today I am Pregnant

However short-lived, this we do know today.

We got a text from our doctor this morning letting us know that of the four embryos, two were healthy blastocysts, the other two were at earlier stages.  At the appointment I first had an acupuncture treatment (yum), then Dr. C and the embryologist came back and showed us a picture of the to blasts.  They were beautiful (in my humble opinion).  I asked why they were oblong — more like a figure 8 than a circle — and the embryologist said it is because they already have begun to hatch, even better!

The other two are still hanging on, but one seemed to be stalled in its growth and would not result in a baby, and the other they are going to let grow through tomorrow morning and then check in.  If it has reached blastocyst stage (they estimate about a 50/50 chance) we will be able to freeze it for a later transfer.  You know what I’m praying for.

So, in the end, having two healthy blasts, we decided to transfer one and freeze one for a later transfer.  Both Dr. C and the embryologist were fine with whatever we wanted to do but felt more comfortable transferring one.  The likelihood of either of them becoming a baby is the same whether they’re transferred at the same time or separately.  So transferring one does a couple things for us: it reduces our likelihood of multiples, it gives us more than one transfer (praise God!!), and the second transfer may even be slightly more optimal than this one because the uterine lining tends to be healthier when your body has not just undergone stimming and retrieval.  This second transfer could always even be for our second child down the road, if all goes well this go round!

All in all, the disappointment from the low fertilization rate has been quelled a bit and we are very grateful to likely get to have one other transfer from this IVF/retrieval process.  I have to admit, physically I feel pretty cruddy right now.  No one warned me how rough it can be post-retrieval!!  This is the worst part by far!  My ovaries will continue to be enlarged for another couple weeks, my digestion is whack thanks to the anesthesia and progesterone (which was so high it didn’t register on the clinic’s machine — just what they want to see), I’ve been sleeping terribly thanks to those symptoms and the side effect of the steroid, eating isn’t sounding so great but I’m guessing is kind of important for staying pregnant, and I overall feel like I just might pop.  Of course it is all worth it to give the little pearl babies a fighting chance but I will say I am glad I’m taking off the remainder of the week from work to rest and recuperate.

So tonight I am more pregnant than I ever have been (or known I have been) before.  Our embryo is with us, the beginning of a baby.  I’m imagining it continue to hatch and slowly make its way to a comfy spot in my uterus to hang out for nine months.  (We will know a week from Friday.)  I’m connecting with it and praying for him or her.  Trying to be at peace and in the moment in this emerging relationship.

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Today I Am a Mother

I have learned a lot about myself in the past 48 hours.

1.  I have tough skin.

No, unfortunately not metaphorically, quite literally.  The nurse anesthetist had quite a time getting my IV going on Friday and, after telling me the first one “burst” and I told her that the word burst made me anxious, declared that despite my being a dainty lady (fairly certain that will be the only time in my life that I hear that), that I have tough skin.  After several tissues worth of palm sweat my husband wiped off my hands, providing much-needed comic relief, laying me back to prevent a further vagal response, and a couple tries later, we were in.  I, as usual, was a high maintenance patient as my anxiety got the best of me.  I wish it were figurative, too.

2.  I am a curious anesthetic drunk.

My friend Laura warned me that she was a sobby and sappy anesthetic drunk, that all the emotion of IVF buried deep emerged as she came out of the anesthesia post-retrieval.  Me?  I was that before it even started.  As the nurse walked me back to get changed and Hubs left to provide his sample, I broke down crying.  It all rushed in.  I gathered myself, read Scripture on my phone (coincidentally the passage of the day was II Corinthians 1 on “The God of All Comfort), and again resumed crying when Hubs returned.  And then when the nurse came back, and the anesthetist, and my RE.  It was all a bit overwhelming.  For some reason I chose to wear a ring Hubs gave me for my 20th birthday that I hadn’t pulled out in a while.  As I looking at the thing, I couldn’t help but think back to those two innocent kiddos and how they had no idea what the future had in store.  Certainly infertility is not the only thing — most of it has been great  — but we had no idea we’d be in that room, doing this wild thing 11 years later.  They somehow managed to get me back to the operating room and my RE and the nurses wished me well on my trip to the beach and requested I bring a drink back for them.  Have I mentioned how great they are at my clinic?  They were all so understanding and comforting with me and all my emotion and wispiness.  I was awakened when they brought my husband back and quickly began asking him questions about when had I woken up, how did they wake me up, how many eggs (of course), etc..  Not a single tear, I was fairly clear-minded, super relieved that part was over, and wondering why the heck I still felt so full in the ovaries (apparently they pop the follicles to retrieve the eggs, and the follicles become cysts — great).

3.  I like dried prunes (and I cannot lie).

No need for a lot of details, but did you know they taste like those Whole Foods fruit leathers?  Yum!  I can be so close-minded with my produce selections.  I still lament all the years I spent without avocado in my life.

4.  My friends are amazing cooks.

They (you all) have brought us the most delicious meals, it is no wonder we live in the foodiest small town in America.  Quinoa and roasted vegetables, lentil and rice soup, extra-ginger carrot soup, vegetarian ziti, spinach enchiladas, southwestern grits, Dahl and brown rice, sun-dried tomato artichoke quiche (dairy-free!)…and lots and lots of chocolate and cupcakes which I have been eating indiscriminately but don’t tell Julie the acupuncturist.  Biggest thanks for all of this love.  And I am proud of you, my community, for your incredible cooking skills and being the hands and feet of Jesus.  You people have even taken our terror of a puppy on hikes — that is love.

5.  I am a mother.

Lastly and most importantly.  It feels weird to have been chipper in this post so far, because I’m actually very very worried and sad and scared.  The low-down on the retrieval: the procedure itself all went very well, they harvested 13 eggs as we had hoped, the sperm report was perfect.  We got a call Saturday, though, that only four had fertilized normally.  Of the 13, three weren’t mature (in line with the 80% we predicted), and of the ten remaining, five had signs of maturity but did not fertilize, one fertilized but abnormally and so would not result in a baby, leaving our four embryos.  That is a low fertilization rate of 40% when you’re usually looking at 70%.  Our RE said that we should realistically hope for just the one fresh transfer.

The blastocyst conversion rate — how many day-1 embryos make it to a day-5 blastocyst — is 50%, meaning statistically speaking, we are hoping for one to two embryos by Wednesday to transfer, likely none to freeze for later.  What a blow after all of that work and pain and time and hope.  It is bad enough if we are not pregnant this cycle but have frozen embryos to thaw for a later attempt, but so much worse if we are not pregnant and that was our only shot after this long and grueling process.

As many have reminded me lately, it only takes one.  I am praying for this and was encouraged today to hear a story of a friend’s friend having one embryo and now having a rambunctious five-year-old girl.  But, more than that, I am incessantly praying for our four babies.

This morning I couldn’t help but realize that I am, in fact, now officially a mother.  I just felt different in my love and concern for them.  I feel desperate for them, want to fight for them, be with them, do anything I can for them.  Of course at this point that is next to nothing except for prayer.

I realize that it is highly unlikely statistically, but I am praying and asking others to pray that all four would fight and make it and be strong and healthy on Wednesday.  That the Lord would do that fighting for them.  “He is able to do immeasurably more than all we ask or imagine” (Ephesians 3:20).  This verse hung in my sister’s twin’s nursery who were conceived with the help of fertility meds and sustained after being born 8 weeks early.  Today in church we sang “He is Able.”  This is true and I believe it.  All four may not make it, but it will not be for me not having asked.  And, on the other hand, they just may.  I am that persistent woman before the judge this weekend, asking this of the Lord over and over and over again.

We’ll get a report on them midday tomorrow.  It has driven me crazy today to think of them, 20 minutes down the road, not knowing how many are still there, how they’re doing, if they’re growing.  But I am believing in my babies and my Father who is with them, hoping they have tough skin like their mama.  Praying that the Lord would see them through.  I’m very aware that they are ours, that we are their parents and love them already.

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Today I Found Seven More Gray Hairs

Well it’s been forever since I’ve blogged.  Like most posts I’ve read the past week, it’s been a wild month with all of the holiday rush and unfortunately this outlet of writing has neared the bottom of the list.  I now find myself on vacation at the coast, but with only a day left before returning to work.  And pre-mourning of course.

I’m learning more about what this pattern of pre-mourning and complete dread of returning to real life are: my life feels completely in limbo.

Besides all the cooking, hosting, partying, wrapping, and attempted-but-failed-reflecting-on-Advent of the past several weeks, there’s also been some serious decision-making.  And subsequent swings.  We decided a few weeks ago that we just weren’t quite ready to start IVF yet.  It was a week before we’d begin birth control and we were pretty sure, but just not positive.  I couldn’t imagine feeling okay with being this unsure just a week before beginning such an intense process, so we canceled the appointments and the trainings and settled on giving ourselves the three months for acupuncture and dietary changes and aiming for end of February.  I’m realizing now that said holiday bustle served as a convenient buffer from feelings about waiting.

I was feeling good, enjoying the idea of a break, brainstorming how we could make it feel restful and not just like killing time, dreaming about how to finance a little getaway to somewhere tropical.  Now that things have slowed down a bit the ache has returned.  We’re on vacation, where the past two years we were certain we would have a baby by the next.  I walked these same shores dreaming of having an infant with us next year, bringing a pack ‘n play in tow, our child getting great time with her grandparents and aunt.  This third year I’m finding myself more realistic, more guarded with my fantasies.  I begin to imagine it happening by next year, having a little one with us, but if we don’t start IVF until February, those chances are really slim and I quickly reel myself in.  If we don’t start the adoption process until then, count on two to three more Christmases without a baby.

As New Year’s Eve is here — also what would have been Day 1 of stims — I need to just call it, this year has sucked.  I’ve had some rough ones: my parents divorcing, moving 500 miles away from my dad, dealing with my crazy mother, breaking up with the love of my life (which I eventually ended up getting to marry!).  But this one goes down as the worst.  And as I look in the mirror this week I see it on my face.  Literally seven new gray hairs in the past three weeks.  (Shouldn’t the opposite be true now that we’re on a “break?”)  I’m vainly worrying that any physical beauty I did have is now behind me and that I’ll be an old, gray woman when I’m a new mother, not the perky, energetic kind wearing a yellow frilly apron that I’d imagined.  I feel like my body sucks and is failing me in this most important, female way.  Infertility has taken it’s toll in so many ways.  Not the least of which is that I’m tired of not knowing in the slightest what the next year is going to hold.

In each of the moments of returning to real life that have come at the end of a vacation the past two+ years, I thought it would all be changing soon.  I’m getting tired of that hoping, though, and realizing that, too, shouldn’t be assumed, because it hasn’t changed.  Still no baby in these arms, still hanging in at a job I’m lukewarm about, still going to appointments all the time, still seemingly zero control over our family building.  Will my life be any different this time next year, or will it still be hanging in the balance of uncertainty?  Still waiting.

Tonight I’ll drink my champagne — heck yes, thankyouverymuchbreak — and toast to 2012 being over, ushering it out gladly.  I’ll also try to breathe in and breathe out and try to welcome 2013 with whatever it does or does not bring.  While many things externally are exactly the same as last year, I do know for sure that on the inside I am a different person.  Hurt and wounded in some ways, absolutely, but also better, stronger, more grateful, aware of what I can take, learning I’m a fighter, and wanting it all even more.  Cheers to that, too.

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Today I’m Drinking Dandelion Tea

Sounds good, doesn’t it?  Like it would be yellow and pretty and smell yummy.  Wrong.  It’s kind of nutty and very bitter and resembles coffee in color more than chamomile tea.  But it is one of many things I’m changing lately to try to have only healthy things flowing through my body.

We have all but decided to go forward with IVF and have a tentative start date of December 31st.  (Yay, shots, happy new year!)  We would begin initial meds (birth control, which is so odd for any infertile woman to take) mid-December and stimulation would start the last day of 2012.  I hear the stimulation phase is the most intensive of the IVF process from a time and attention perspective, including shots a few times a day to stimulate your body to grow lots of follicles and every other day ultrasounds to monitor their progress.  This growing and watching leads up to a shot triggering the ovaries to release the eggs, retrieval surgery to get those puppies out, fertilizing them, letting them grow in the incubators, and transferring back in 3-5 days.  That’s IVF in a nutshell.  Oh, and the two week wait before finding out if it all worked.

It feels exciting to be moving toward beginning but also scary.  Obviously we’re wanting to do all we can to create a baby-friendly environment, hence the dandelion root.  I have to admit that it can feel very depriving and borderline masochistic to do all of these things.  But as my co-worker recently reminded me about scaling back with work hours, all mothers have to make sacrifices for their children and I’m just getting an early start.  This angle actually does help me a good bit, legitimizing and encouraging me forward in these decisions.

So, what I’m doing lately:

  • Eliminating processed foods, including diet coke (gasp)
  • Cutting way back (if not out) dairy, sugar, and soy to prevent inflammation and hormonal spikes/imbalances
  • Dandelion root tea and/or drops 3x/day and warm lemon water every morning for liver cleansing
  • Udo’s Omega-3 oil blend, vegetarian source of DHA (also ick)
  • Being a good girl with drinking lots of water
  • Acupuncture

As a vegetarian I’m used to having a limited diet, but adding these changes on top of that was beginning to feel overly restrictive and, enter feeling sorry for myself.  But I’m beginning to, instead, focus on being creative with all that remains — which, in reality, is most really good things.  If I were doing that Thanksgiving gratitude-a-day thing on Facebook I would say: Whole Foods iPhone App.  I’ve gotten some inspiring recipes on there and it’s helpful to view my market trips as time to stock up on good things to build up and nurture my body.  Mmmm, seltzer water.  Who needs diet coke?  Okay, fake it ’til you make it.

So as we’re looking to jump on the IVF track here in a couple weeks I’m yet again struggling a bit with the balance between doing my part in it all and yet acknowledging that I can’t control this process.  I’ve even wondered if we should postpone IVF until threeish months after I’ve consistently implemented all of these changes because what goes in my body now affects eggs that will be ovulated in three months.  But then I step back and wonder about all of the people out there who make terrible health decisions, abuse substances, live on doritos and are still pregnant.  These things help but are they enough on their own?  No.  Dandelion root can’t create life.  Omega-3s can’t create life.  I’m praying for an accurate perspective right now.

I also don’t want to get in a position of blaming myself or putting all of the pressure on me to perform just right in order to become pregnant.  As I’ve said many times before, a baby is not something I can earn or make happen for myself.  I would have done it by now.  The parallels with God’s grace really can’t be overlooked here.  I couldn’t make Him love me or earn my way into a relationship with Him.  It’s just a gift.  I don’t know how all of that works and applies in this situation with a failing body, but I do want to remind myself that He gave me that best gift already and that He is the same God I’m crying out to hundreds of times a day now.  He is a God who hears and I have seen that before.

In the meantime, in all the waiting and the hard work, I’m taking pleasure in the small things, like the holiday with family, the Christmas tree being up, a fire in the fireplace, and my amazing new fuzzy slippers.

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