6

Doing this…

Ignoring the half-dozen incomplete posts glowing in my drafts folder, I am going to jump straight to the present (with the promise of catching up on the older stuff very soon!).

Cue scratchy, ‘audiotape getting fast forwarded’ type of sound.

Today is day 7 of stims and my first day in Colorado. Broadly, things have been progressing reasonably well and it looks like my retrieval will happen on either Monday or latest on Tuesday. I had two local monitoring ultrasounds back home in SF and one in the morning today at CCRM. The follies are ripening and the estrogen is climbing and I’m keeping my fingers tightly crossed.

This cycle has been very different from the last one. There is the obvious difference of a new protocol; I took estrace for almost two weeks this time (the effects are quite like teasing yourself with a gun against your temple everyday!) and along with the jazzed-up hormonal cocktail that CCRM dished out to me last time, there’s also clomid (hello nausea and headaches!) making a special, 5-day appearance! Also, unlike last time this time I did not take cetrotide in the priming phase; it was only added to the mix mid-way into stimming.

Mentally, I’m in a very different place this time around. Riding the truckload of dread accompanying the realization that this was our last cycle at CCRM (unless of course I win the HGTV sweepstakes) and quite possibly the last one with my own eggs, fear terror & sadness (with a reluctant anger trailing behind) have come sailing in, entirely uninvited. The 2 months between my two cycles were days spent working hard on my teetering state of mind (more on that in a separate post). I went round in crazy circles, sinking to fathomless depths of despair & struggling to break the surface and then riding the buoyancy of self-administered hope and squeezing the future of its ability to provide the scantest reassurance. I would wake up crying in the middle of the night as an icy panic would creep up over me. Breathe, B-R-E-A-T-H-E my mind would urge my heart to pay heed. I forced myself to remember what is true today. I am well today, my life is full of love. Older (angrily discarded) platitudes would come rushing to my head —I’m a good person, I deserve to be a mother; God does well by his children…

I have battled with a crippling doubt, the kind of doubt that rips away every shred of innocence from your soul. I look back to the person I was and I marvel at how old I feel. I am proud of who I have become yet my heart aches with sadness at my inability to remember what ‘pure, unadulterated’ everyday living felt like. The joy of untainted expectation, the beauty of just living without the feeling that all of your life, everything that you believe in, everything you hold dear is being held ransom to this one event.

So what changed? Honestly? Nothing, really. I didn’t turn zen overnight and the panic attacks did not disappear. But I did not stop trying. Trying to live in the moment, trying to strengthen my faith (and this wonderful blog constantly inspires me to do so!), trying to be there for others… trying to be a better person (my only NY resolution this time!). Because it is only in this trying that I find solace.

And this is where I am today, sitting in my room in Littleton, Colorado typing out this blog post. In the next few days life could go in strangely unexpected places. I have no idea what will happen or how I will cope with whatever happens. All I am going to concentrate on is today and this moment, right now, when things are just fine.

0

Searching for answers…

In the past few days I have witnessed some of the most saddening events on a few of the blogs that I frequent. I have no desire to make public anyone’s anguish so I will certainly not be using names or url’s but suffice to say there is a whole lot of suffering going on out there that really has me wondering ‘why, God, why’?

Isn’t it already terrible enough that so many women have to bear the cross of being infertile and endure year after year of invasive testing, countless painful procedures and staggeringly expensive treatments only to have their hopes dashed again and again, that they also have to go through the heartbreaking ordeal of going through miscarriages and of losing their babies before term? How is their right to hold their beautiful, healthy babies in their arms any less than those of countless other women who get to do this effortlessly day after day without a thought to the magnitude of the dream it represents to scores undergoing the IF torture-fest?

I, of course, do not have any answers to the above. My heart aches for these women, all the more so because each one of them is so strong, resilient and so full of faith that even in these trying times they stay steadfast in their belief that God is with them and that he will carry them through. I feel humbled by their fortitude and deeply frustrated as to why this has to happen; what reason can exist behind such colossal suffering?

All I can do is pray for each and every one of them with every fiber of my being.

0

Oh, the follies!

We are finally in Denver! It’s been a dramatic couple days and I have a lot of updating to do so there will be a flurry of posts over the next day or two. Bear with me!

Tuesday was a hellish day. It was my first monitoring appointment at my OB’s office and it just did not go the way I wanted it to. K drove me over to the clinic and promised to join me after he got some coffee to jumpstart his day. However, before he got there I was undressed and ready for the scan. The doc came in, liberally pumped lubricant on that vile ultrasound wand and started off. He was looking at my right ovary first and he nodded his head as he measured what I assumed (and hoped!) was a follicle.

How many, I asked nervously. I don’t think he heard me for he remained quiet for what seemed like an eternity. 12, he said, looking at me and smiling. Oh really, 12?? That’s simply wonderful, that’s possibly the best– … I cut the sentence off right here as I realized he did not mean the number of follicles but the size instead. Wait, there’s more there right?, I asked. Not really, he replied. There’s got to be some small ones you can’t measure right now, I insisted. He shook his head grimly saying that there was just the one and moved the wand over to point at the left ovary.

My stomach did that uncomfortable sinking thing it does whenever disappointment hits me. It’s a mixture of despair and deep, paralyzing fear I think that makes me head swim and makes me want to run, flee to the comfort of my bed so I can safely hide within the covers and keep all the demons at bay.

This is much better, he said as he scanned leftie. Better, to him, was 4 follies sized at 16, 14, 11 and 10 mm. This made me feel even worse for I knew that the 16mm one seemed too big for this early into the stimming process and I instantly started worrying that I would ovulate before time and my cycle would get canceled. The rest of the scan was a blur as I tried hard to control my lurching stomach and my woozy head. Doc looked back at me as he walked out urging me to have faith and to remember that it only takes one (if only I had a penny for every time someone says that to me!). I could barely look at him for I knew another sympathetic word would have me sobbing my heart out. I hurriedly scrambled into my clothes and walked out the clinic downstairs to get my blood drawn at the lab.

The lab assistant seemed to be having a good week as I found her once again in a rather cheerful mood. She whisked me in and had me out in under two minutes, promising me that she would send the bloods out soonest. I walked out to find K sitting in the lobby waiting for me. One look at my wan face and he knew something was wrong. I told him about my 5 follies, about my worry that I was responding too fast and yet, not enough and then I told him I did not want to talk about it at all. I felt sick to my heart, I wanted to crawl into a black hole and never come out, I wanted K to hold me and tuck me away in some corner of his shirt pocket. I was angry, I was sad, I was frustrated but most of all I was scared. Petrified, really.

The drive back home was a somber affair. I walked inside, ignoring my parents questioning looks. Shook my feet free of their shoe-d confines, drew the drapes tightly shut and crawled into my bed, covering my face with the blanket. I knew everyone was worried. I wanted to tell them I was okay even though I was far from okay. I did not know how to do it. Again and again my mind insisted, how could there be just 5 follies. From an AFC of 13, I get only 5 stinking follies? Even my first IVF I had 9 follies.

What made everything worse was that it was a special day for us–an Indian festival that celebrates marriage and married life. I really like celebrating this day with all its attendant rituals, especially dressing up in traditional clothes. Yet, here I was in my sweatpants and a ratty old sweatshirt, feeling numb and ignoring my rumbling stomach. K called many times to try soothe my fears but with each passing minute I grew more and more anguished. I cried for hours on end, my poor parents trying their best to get me to calm down. At one point I was so exhausted from all the crying and not eating that I dozed off. I woke up to realize it was late afternoon. CCRM still hadn’t called which meant they did not have the results with them yet.

The next couple hours were crazy stressful. CCRM was about to shut for the day and the nurse had called me to let me know she had neither the u/s report nor the labs. I called the doc’s office and had them re-fax the report. The labs seemed to take an eternity but a call to quest revealed they had been faxed early afternoon. I was at the edge of my patience. I was worried that I might ovulate too soon and wanted to start the cetrotide sooner but of course needed the nurse to confirm that with me. Furthermore, I wanted to know if the cycle was at risk of being canceled. Finally at 4.58 pm mountain time, my nurse called and told me they had everything but that Dr S had left so she would have Dr. Schoolcraft look over my reports and advise me on next steps. I waited by the phone and in about 20 minutes she called back to let me know that I had to start the cetrotide the next morning, keep all other doses the same and travel to Denver as planned. To my concern that things were looking bleak, she said it did seem that I was responding fast but then my follicles were of similar size and my estrogen level (at 209) was where they like to see it at this time.

It wasn’t quite the thumping vote of assurance but then, under the circumstances, this was the best that could have happened. At least there was no mention of canceling cycles. Moreover, she told me they preferred doing their own measurements and bloodwork as they did not trust results from other labs. With that in mind, I finally ate and tried to salvage what was left of the day. My adorable husband had already given me a wonderful gift–a beautiful down jacket to keep me warm in Denver–and he now helped me pack and get things in order for out trip the next day.

As I wrestled a nagging headache in bed at night, I prayed hard to God to carry me over this one.

2

Seductive dalliances with the perennial what-ifs… plus, a calendar!

Last week was emotionally draining. After the consult with Dr S, the realization that we’re about to cycle again hit me and it was all I could do not to get overwhelmed. Distraction intervened in the form of a trip to LA to meet with the dissertation committee. I flew out early morning and got back in around 10. Perhaps it was the physical exhaustion (flight was delayed on the way back), perhaps it the sudden influx of pregnancies in my department or perhaps it was the reinvigorated tussle between dissertation related inertia and enthusiasm -I came back home feeling subdued unlike my characteristic chattery self.

Also weighing on my mind was the big, white elephant in my inbox -CCRM had finally sent the calendar (it looks like the study schedule for a ridiculously competitive exam!) and I have been largely ignoring it, watching it burn a slow hole on my laptop screen. Going with an altered protocol this time means there’s a lot of stuff I’ll be doing which was missing in my previous IVF attempt–adding in estrace, cetrotide, dexamethasone, saizen etc. I swear each time I look at the calendar I can feel my blood pressure escalating at the thought of what lies ahead. I know I should be excited but I’m mostly apprehensive.

Friday, however, brightened my spirits. I went for an early acupuncture session and as always Y managed to relax my frayed nerves. I drove back home feeling significantly better. The rest of the day was a busy blur as I worked on my stuff and K micro managed a Dish TV installation (goodybye pricey Comcast!). I was aghast to walk in on him and the installation guy happily routing a thick, black wire right in the middle of my beautiful living room, smugly announcing that by making sure half of it was submerged under the rug, aesthetics were all taken care of! Men! Friday evening was spent on the couch, watching movies (free HBO for three months!) and guzzling herbal tea.

Saturday, I got to know that my brother (who recently moved to the US and lucky for me, found a place just down the street!) was moving back to the other side of the planet with his family. I am happy for him; this is something he’s wanted for a long time. But it’s hit me hard. Having them here was just so wonderful. They came at a time when we were at our most vulnerable and it felt good having someone to talk to when our first cycle failed. Sis-in-law and I often went out for errands and shopping trips and my nephew is such a delight to be with. It’s going to be tough seeing them go. For the first time ever, we’ve had family here in the US and, that too, living so close to us. It brings me back to the feeling that were my own family complete today, perhaps I would not feel as rudderless and raw all the time. What makes the situation worse is that I work from home and afternoons are really the loneliest times. As I went for my afternoon walk today I passed by my nephew’s school and felt a jab of sadness that soon he won’t be studying in there anymore.

I’m trying hard to stay even-keeled both for the cycle ahead and for the love of my life, my darling husband who patiently supports me through everything even as his eyes tear up often at seeing me sad. One hug from him and the world doesn’t seem such a threatening place anymore. The what-ifs, though, are always around, hanging out in the dark recesses of my mind, waiting to pounce upon me and smother me with their what-if-ness! Just do, don’t think, I keep repeating in my head like a mantra. It’s hard though. I can feel depression creeping in as the fear of another potential failure paralyses my senses. I find it hard to move on yet I only find solace in movement -in walking, in doing the most basic tasks –cleaning, scrubbing, washing dishes, sorting laundry. Sleep teases me, promising a lingering embrace one moment and the very other, deserting me without warning.

I sit on my bedroom floor typing this post. As I look up skywards, I will the clouds to ebb away and for sunshine to become a part of me.

0

Yellow, not green!

We finally had our much anticipated regroup with Dr S today. It went by pretty quick and was sort of anti-climactical. I mean I obviously knew, basis the test results, what he was likely to say but somewhere our last failure has left me so wary I was prepared for the worst.

He started by discussing our test results and I believe he mentioned the word ‘good’ when describing my ovarian reserve even though my FSH is borderline high (10.3) and my AMH is below what they consider normal for my age at about 1.4-1.5 (mine’s 1.3). APA testing revealed only one slight elevation on the IgM (mine was 13, normal’s <11) so he said I did not need any blood thinners (interestingly this is something he told us on our first phone consult itself without any testing!)… phew! Uterine x-ray showed an AFC of 13 and normal blood flow to ovaries all of which is good. DH’s numbers also look good with his motility at 55% even though morphology is low at 2% (he did remind us that they use very strict criteria so, with 4% being the normal, this wasn’t too shabby). His sperm DNA fragmentation results will still take another week or so to come in.

So, he is sticking with his earlier prognosis and his recommended protocol for me is

****drumroll****

EPP–Estrogen Priming Protocol

He also wants to add in a growth hormone (saizen??) and probably an antagonist to prevent premature ovulation. He thinks we should wait on taking a call whether to do embryo banking or not depending on how the ER goes. Anything above 6 eggs and we should not need to bank, according to him.

We asked him a few questions which he patiently answered. He will be using a double trigger for me (HCG/ Lupron) and closely monitoring estrogen levels even though I am unlikely to hyperstimulate. When I asked him how I can improve egg quality he asked me if I was taking the supplements prescribed by them and I said no, I am taking then of my own accord. He told me to ask my nurse for a list and then hung up with the promise that a nurse would contact us soon to discuss scheduling.

So, from the above, it would seem that this went pretty well, right? Well, perhaps its the exhaustion from last evening’s yoga class but truth is, I don’t feel too spirited somehow. Perhaps because I am still, somewhere in the back of my mind, coming from a DE perspective whereas he was pretty clear right from the get go that I should try again with my own eggs. Perhaps because I was anticipating getting rejected by them basis my AMH (which had been much lower at 0.48) and my FSH (which I had never tested before). Or perhaps because I just don’t trust my luck anymore! I kept asking K whether he thought we’re in and he said of course silly girl, this is it; we will be cycling at CCRM.

Really?

All I could think about was one strange comment Dr S made–something about this being a yellow light, as opposed to a red one. Why not green, my mind asked? I categorically asked him if there was any further testing to be done or any issues to resolve before we could start and he said no, it all looks good. Then why yellow? K reasoned with me saying that he is probably meant that about the whole process, especially since we made no chromosomally normal embryos last time. He’s probably right. Perhaps I am just being silly and over-thinking things (surprise surprise!).

The nurse is yet to call. I hope she gets in touch with us soon. I need to see my calendar to believe this is real!

0

Tick tock…

It’s been a good weekend. Yesterday was shopping at the farmers market followed by BBQ at my brother’s place in the evening and today was seafood lunch with friends, grocery shopping and a saunter through the mall. Tried my hand at making some Thai gai pad krapow but it didn’t quite tickle the taste-buds as much as the restaurant version usually does! Oh well, next time maybe.

We’re both feeling a bit on edge, though, with our regroup appointment with Dr S coming up on Tuesday. I am anxious to know what he has to say (there should be absolutely no reason why they would not let us try with our own eggs but I want to hear it from him) and also when we can start. There’s a part of me that is undeniably excited and hopeful that things will work out this time and yet there’s another part that is quite simply terrified. This whole IVF process is so fraught with the fragility that hope instills in us -hanging on to every day all the time hoping, hoping, hoping that things will turn out right. The hope that there will be enough follicles, that they will mature at the right pace, that  they will result in mature eggs which will all hopefully fertilize and that finally they will create perfect day 5 blasts that will be chromosomally normal. It’s a crazy roller coaster and the cocktail of hormones just makes the ride that much more precipitous.

Plus, this time there will also be the additional stress of travel which I am quite nervous about. It was another thing to get injected in the secure confines of my home while sticking to my daily routine and it will be quite a different matter, altogether, to do the same thing in a hotel room in Colorado with nothing really to distract us! Anyhow, fact is I am grateful to have a chance to cycle at CCRM and I’m going to keep that in mind anytime I feel the stress levels begin to rise.

Fingers crossed for Tuesday!

0

Moody tears with a mind of their own

Another month, another breakdown.

July was exhausting with DH and I barely stepping out from the haunting shadows of our first failed IVF. We tried naturally but our heart was just not in it. Every day we put our energies in healing, in moving on, in planning for the future. Slowly, agonizingly painfully, we started recovering what had so brutally been snatched from us–hope.

On July 30th I turned 36. Every year my birthday reminds me cruelly of my lack. This year was particularly tough. I had hoped so much to have my baby in my tummy on this day but, sadly, it was not to be. Once the day was over, though, I felt so much better. Strangely reinvigorated. And August was thumping proof! A happy, busy month with lots of social engagements, a ton of pre-IVF testing, DH’s birthday and in general a lot of stuff that kept me as sane & content as is possible to be in the circumstances. Some days I even laughed out loud and the sound was so harshly unfamiliar I almost winced!

Which brings us to September. September, that month when the leaves change color and the air whispers secret promises. This is an important month. We get to know the way forward with CCRM. An exciting month. Then why did I, now almost blase to the omnipresent spectacle of heavily pregnant women beaming beatifically in public places, break down last night at yet another Facebook sighting? Hadn’t DH already told me that our neighbor is knocked up?! What was so shocking at seeing her swollen tummy against a lush Hawaiian background that reduced me to a pathetic, slobbery mess? This is why I no longer have a FB account, my mind screamed. Why do I have to torture myself with visiting DH’s FB? It’s not like his friends are immune to pregnancy?!!

I raged at the unfairness of it all. Not why she is pregnant and why not me but more like everyone gets pregnant when will it be my time? Haven’t I suffered enough? What is ‘enough’? How many more tests, painful procedures, disappointments and heartbreaks do I have to endure before it is deemed that I am ready to don the maternal mantle? I silently yelled out at the universe. I let myself feel the primitive want that was crowding my senses. I sobbed hot, angry tears into my patiently accepting pillowcase. DH came to me so many times, hugging me, consoling me, loving me, soothing me in the way only he can. His concern, his love it broke me further. Why can I not make him a daddy? And then, even more sadness, as I see his face fall when he is unable to stop my crying.

I want to be happy, so happy. I want to shop for onesies and choose the best stroller out there. I want to get a pristine white crib from Pottery Barn. I want to smell baby powder and snuggle against oh-so-soft baby blankets. I want to select cute little shoes and take endless pictures. But most of all I want my arms to feel the blissful weight of my child. And for that, I will persevere.