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CCRM days 1 & 2 (contd.)

… which brings us to today i.e. day 2 @ CCRM (CD 7)

I woke up feeling somewhat refreshed and hopeful. Our only appointment today was a regroup with Dr S. K and I had already been through the questions we wanted to ask him, of topmost priority being his opinion of how I was responding and how he sees this cycle shaping up. We also wanted to discuss embryo banking with him. If you remember, we had brought up this question in our initial consult and in our post OWDU regroup and both times he had suggested we wait on the day of ER for if we make anything above 6 he would not think we need to bank. We wanted to know if his opinion had changed since then.

Owing to a time crunch, lunch today also was at the food court. I had a plate of falafel, tabouli and chicken shawarma from the mediterranean grill while K had some chinese. We checked into CCRM for our appointment and prepared to wait in the lobby. We were called in soon after and seated in a consulting room. That’s when I started feeling really nervous. We had not spoken with the doctor ever since we started this cycle which, if you count the pre-priming and the priming part was over a month long already. I was anxious to hear what he had to say about my chances. I didn’t have to wait for long though; he walked in soon enough and after exchanging some pleasantries it was down to business.

Well, he said, there is good news and bad news. My stomach lurched uncomfortably as my mind got stuck on the ‘bad news’ bit. He said he was happy that the follicles were all a similar size but yes, he was surprised by how little he saw. He did not hold out major hopes for the 9 and the 7 to catch up so, in his estimation, we would be looking at 5 eggs at retrieval. My heart clenched at those words. 5 eggs retrieved would mean at best, if we were ridiculously lucky, 5 mature and 5 fertilized. This was worse than my first cycle where we had 7 retrieved.

We discussed embryo banking which now he was wholeheartedly recommending. He emphasized the financial implications of banking but even though K & I had already discussed it before, all I could think in my heart was I would not be pregnant this year either. Another effin’ year gone by and I am still not pregnant. I tried hard to ignore my mounting frustration and pay attention to what Dr S was saying. He suggested a regroup after retrieval to discuss our next steps esp. what protocol I should be following for the next round. He said we could add in clomid to the cocktail I am taking right now to try kickstart my recalcitrant ovaries into action. If all went well, I would be back here in early January for my second retrieval. Wonderful.

It all seems so damn ambiguous, even this IVF thing. We thought we were covering our bases by going to the best -CCRM. But there is no guarantee ever, is there? Even with some really good test results and a consistent AFC of 13, I seem to be a poor responder and that makes me very angry. I am trying hard not to resent my body for all this but its tough. I see pregnant women everywhere and its hard not to let my bitchy self get the better of me and think ‘oh all you probably needed was some red wine and some mood lighting’. I want so badly to have my own bump, to feel my belly swelling, to hold a tiny little person in my aching arms and to complain of sleepless nights…

Ever since we got back from the appointment I have been quiet as my mind churns in anguish. My darling love, my husband, my best friend is doing such a great job taking care of me yet letting me be. We had planned to go somewhere today, a short trip somewhere close by. But after the meeting, I felt so glum I did not feel like appreciating the natural beauty that surrounds me (and there is SO much of that here in Colorado!). I hate feeling like this. I hate this sadness, this uncertainty getting the better of me to an extent that I am unable to function normally and all I can do is stare into space, trying to calm the noisy chatter in my mind and quell the rising despair in my heart.

I want so badly to believe that there is a happy ending after all this. I want to have faith and I want to feel happy and light with the knowledge that my baby is on its way to me. But I feel immensely tired and sad and just plain bleak. Let’s see what tomorrow’s monitoring brings.

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CCRM days 1 & 2

I write this post with a heavy heart. I wish I had good news to report. I wish things were going as well I as I have been hoping, wishing, praying that they would. But, for some reason, luck does not seem to favor me lately.

Day 1 (CD 6)

We got into Denver late Wednesday evening and after grabbing a quick dinner en route to the hotel, we checked in and almost immediately started the whole injecting process. Hampton Inn & Suites where we spent the first night does not have refrigerators in all rooms so it was quite the complex process getting them to put the medications in the fridge, the coolers and ice packs in the freezer and retrieve them one at a time as needed. Anyhow, once done, I read for a while in bed and by midnight fell asleep. I had a strange, restless night waking up many times to use the bathroom. My nose felt blocked and my throat was uncomfortable congested no doubt from the change in weather. It’s not crazy cold yet but there’s a distinct difference from the NorCal winter we are used to. Early next morning I noticed a significant amount of white discharge and immediately panicked worrying that I might have ovulated too soon. There was nothing I could do, however, till I made it to the clinic for my 9 am monitoring appointment.

We reached CCRM early and were taken in quicky enough. The woman who did my ultrasound was extremely nice and super apologetic that she was causing me a considerable amount of pain. She was just measuring everything twice since the numbers were vastly different from my first appointment back home. Here is the final tally for day 6:

LO: 14.7, 12.4, 10. 7.3, 2

RO: 14, 10, 9, 1

Two very kind nurses sat down with K & me in a small, private chamber and gave us these numbers, explaining that they do not rely on local monitoring too much for precisely this reason–measurements are often under or over estimated and it they all too often miss out on some of the smaller follies. They were both confident that I was doing pretty well and the two smallest follies had every chance of catching up. Our hopes renewed, K & I completed our morning set of injections in the same place and soon after I went in for blood-work. Once done, we stepped out of the clinic feeling lighthearted and madly optimistic about the future. From a dismal forecast of 5 follies we now had 7 measurable and 2 small ones. Things could well still turn out in our favor. K still was of the opinion that we should bank but I was hopeful we might be able to hit a home run with this very cycle itself.

We drove over to Townplace Suites where we had reservations for the next 4 nights or so. It was too early to check in though so we spent the next hour at Target, K sitting at Starbucks and working and me just aimlessly wondering the aisles, feeling cautiously happy. We went back to the hotel only to discover that the room we had checked in to was still a mess and had not been cleaned. A sharp reprimand to the front desk had us moved into a freshly cleaned room with the assurance that we would be charged half the room rate for that night! K worked through the evening, he had conference calls to attend and I slacked of as usual, absorbing myself in a historical romance and spending an inane amount of time googling follicle numbers for poor responders.

In the evening I got a call from the clinic. Dr S had reviewed my reports and wanted me to continue on the same dose of meds. He also did not require me to come in the next day for monitoring but just for the regroup appointment we had scheduled with him. My estrogen level was looking good at 767 and the nurse said things seemed to be tracking on target.

With that reassuring news, we stepped out in the evening to grab a quick meal at the food court in the Park Meadows mall after which we rushed back to our room for injections. Since we’re done with saizen, the nightly regime has become way simpler with only Gonal F which is a pen and therefore does not require any mixing. That done, I settled into bed with my book and fell asleep soon after. I slept well for the most part but had an extremely disturbing dream in which K and I were in a car hurtling down a freeway. I was urging him to drive slowly but just as he was about to slow down a large truck came in front of us and he slammed on the brakes. We crashed into a black wall of space and the last thing I remember before being jolted awake was thinking this is how it feels like to die! How truly morbid, right? I get scary dreams very often and once I wake up I am so frozen in fear that I cannot move for the next few minutes. This time though I nudged K awake and he instantly pulled me close to him. I felt relief flooding my senses and soon enough dozed off again.

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Never a dull moment!!

The past few days have been crazy. I’ve constantly felt like updating you all out here but been busy and somewhat reluctant to take a dip in the virtual world. Which, I suppose, is a positive sign! My parents are visiting (did I mention that?) so the days are a happy blur of taking them out, cooking yummy Indian meals with my mom, catching up on school work and just generally basking in their affection!

On the IVF front, though, there’s been a fair bit of action. The meds are all here including the saizen and are chilling in the fridge. Freedom did a great job as always and Braun pharmacy (they sent the saizen) were sweet enough to send me a nice big box of alcohol swabs which I had requested for. This past Monday I started off with 2mg estrace twice daily and then three Cetrotide 0.25 injections beginning Tuesday. As always, my super husband does a great job with the needles; I have barely felt a thing and even though I’m bleeding more at the puncture sites than last time, it all goes by in a flash. I think the most painful part for me is slapping the ice pack on my tummy to numb it.

I was extremely apprehensive about the estrace since I’ve heard horror stories of side-effects while on it, especially for women who have endo. So far, though, I haven’t had much trouble barring some headache and fatigue. I decided to stop yoga until I’m done with the stims so exercise has been mostly restricted to my nightly, after-dinner walk with K which I relish and look forward to.

So where’s the action, you might ask? Well, a couple nights back as I was about to doze off it suddenly struck me that my suppression check was scheduled on a Saturday. My OB’s office had assured me they would take me in (the doc on emergency duty that day would perform the u/s) so that wasn’t an issue but what about the blood-work? I know that the Quest I go to does not do stat testing for hormone levels on Saturday and that is the only Quest around here open on a Saturday. Before long I was hyperventilating wondering how I would get the results to CCRM on time and mentally going through a list of possible places I could go for same day testing in the area. Another option, of course, was to skip the OB’s office altogether and head to a local IF center which would be okay with monitoring me locally. I spent the entire night restlessly anguishing over things and first thing next morning called my OB’s office to find out if they could help me. The staff was very nice but unable to confirm whether or not Quest would do it. I emailed my doctor in the meantime hoping he would reply soon with possible alternatives. At the same time, I called CCRM wanting to confirm that they would have someone in their office to receive the results and advise me on next steps on a Saturday. Turns out, that was the most important call I made! My nurse (who has a remarkable ability to be frightfully dense!) let it out that in case my period (scheduled to arrive a day after my last dose of cetrotide) was late and came over the weekend, the suppression check would be moved to next Wednesday and stimming would begin next Thursday! Apparently CCRM lets patients stim only in a Thursday-Sunday period. Fantastic! I wasn’t as irritated by the obvious repurcussions this would have on our travel plans (we’ve already booked the tickets) as I was by the fact that it took my calling for her to inform me of this rather critical point!!

Of course the rest of the evening was spent stressing over whether or not now period would arrive on time. I spent the day pretty much on the road driving from one place to another, completing long-due errands. By the time we finally made it back home after picking K up from work, I was beat. I was feeling feverish, achy and just massively lousy. After dinner, I just about managed to crawl into bed, grateful the day was over. Each muscle in my body was screaming in protest and sleep came as soon as my head touched the pillow. At about 3am I woke up feeling craptastic. My period had started bringing with it a fresh round of anxieties. What did this imply for my suppression check? Would things get significantly postponed or, worse still, canceled? Another night spent trying to coax sleep into my weary eyes, to no avail.

Anyhow, today after what seemed like an eternity, I managed to get through CCRM and was told to continue estrace but move up my suppression check by one day. This is actually better for us because it means we don’t have to run around town like headless chickens trying to find a lab that will process same day results for us on Saturday. So that’s where things are at. Tomorrow first thing in the morning I go to my OB’s office for the scan and blood-work, and then cross my fingers (and everything else that’s crossable) that things go well and I get the green signal to start stimming this Saturday!

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OWDU @ CCRM

This should’ve been posted about a month ago but I’ve been in a different mind-space altogether and I suppose ignoring this blog was my way of ignoring everything TTC-related! 

(Aug 7, 2013)

Soooo… we had our initial phone consult with CCRM’s Dr. Surrey (who, btw, is super nice to talk to); he seemed pretty positive about things and asked us to schedule a One Day Work Up, which is their standard procedure. This was on Friday, the 2nd and as luck would have it, I was at the right time in my cycle and a cancellation came through so before we could say ‘Baby’, we were on a plane from California to Colorado!

We took the clinic’s advice to fly out a day before (the appointments began at 645am the next day!) and stayed at the Townplace Suites, a few miles away from CCRM (thanks to them, got a great discounted rate as well!). I’ve been to CO before (accompanied the spouse on a work trip to Vail last year) and I find it breathtakingly pretty. Lonetree, where CCRM is located, is a lovely place with some seriously huge houses, wide roads and lots of sky! While we didn’t have time to saunter about and explore, we managed to squeeze in a trip to the nearby mall (the whole place had wooden floors!!)

Next day, bright and early, we walked over to the reception, checked in and picked up a copy of our schedule. It was quite like the first day of grad school, complete with multiple back to back sessions, orientations and power-points and lots of sizing up strangers! Overall, I would say that the entire affair was extremely well organized, we never waited for longer than ten minutes and everyone was nice and courteous. The only minor complaint I have is about the food; they have a little kiosk that sells sandwiches and stuff as well as some basic beverages (they even provide ten dollar coupons for the same) but it opened late and there was nothing gluten or dairy free that they offered (actually, come to think of it, CCRM doesn’t seem to be a big believer in altering diet–no mention of gluten, dairy whatsoever!). Anyhow, we did get a lunch break of sorts which we used to hop over to a nearby strip mall and chomp on some delish Vietnamese food.

So, back to the OWDU. Basically, it takes you through every possible aspect of the IVF journey at CCRM and provides you with a LOT of information regarding IVF itself as a process. For folks new to the IVF world, there was a great presentation that explained the female biological makeup and how IVF works by controlling hormonal response etc. We found it a little painful to sit through mostly because we were well acquainted with all the info and well–we were starving! But we both agreed that this was probably one of the more comprehensive explanations we had come across and perhaps we would have appreciated it more earlier in our IVF journey.

The rest of the day was a blur of testing, nurse consultation, business office and lab consults etc. An ultrasound for me revealed a normal uterine cavity, an AFC of 13 and good blood flow to the uterus. I was especially happy about the latter because I routinely suffer from cold feet (literally, I mean!) and my acupuncturist has been concerned about uterine blood flow. A hysteroscopy conducted by Dr S himself revealed no abnormalities or inflammation. He was great to meet with, just the right combination of professionalism and a laid-back, friendly demeanor. He told us he was optimistic about our chances and while we had a plethora of more testing to do, he hoped things would work out well.

Another few consultations and 11 vials of blood later (6 for the spouse), we were free to go. We walked out, exhausted and just about managed to make it back to the hotel and crashed! Two hours of a much needed nap later, we were both feeling half-human again. Over a nice sushi dinner, we discussed the day and concluded, cautiously, that it had been a reasonable success and that hopefully CCRM would give us the green flag to try with our own eggs!

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The long weekend that became a week long!

How was everyone’s Labor Day weekend? Well you’re about to find out how mine was! As I mentioned in the last post, non-medicated IUI was what we had decided for this month and that’s what we did. The u/s on CD 11 showed 3 strong follies at 17, 17 and 18mm with the doc refusing to believe I wasn’t on injectables (go acupuncture!!) and we were asked to BD that night and trigger the night of CF 12. On a side note, it will never cease to be amusing for me to get instructions on when the spouse and I should be getting naughty!

The trigger shot was causing me a huge amount of anxiety… I am dead scared of needles and the only way I survive getting so many pricks (I’ve got a record number this year) is simply by squeezing my eyes shut and refusing to open them till the band-aid has been applied. The pain I can handle; the sight of needle penetrating skin-NOT! Hence it was left to the husband to do the deed. We got some pretty rad instructions from the pharmacist and looked up videos but preparing the medicine was the most nerve wracking thing ever. I have no clue how doctors trust their patients to do this stuff! I managed to inject the diluant into the powder but then the damn mixture refused to get re-injected into the needle. I went into panic overdrive but the spouse totally played the winner as he not only managed to do what I couldn’t but also injected me so smooth I couldn’t feel a thing! The IUI itself went very well; doc was certain I was ovulating and said she got a clear shot at my cervix (yayy!). We went back home happy and took a nap to celebrate (it had been an early morning!).

Trouble came knocking in the evening. First it was just this sore feeling in the tummy that became progressively worse and turned into a raging stomach ache that had my curled up fetal style and screaming for my mommy! I couldn’t move, I couldn’t breathe it was like someone had bashed up my insides with a baseball bat and, for added effect, taken a few shots at my back too. To make things prettier I puked up all my dinner. DH called doc and was told I likely have mild OHSS which will take a few days to go away. Wonderful! I drank tons of Gatorade as told and rested (couldn’t move if I’d tried!). The next few days the pain did get better (that was without doubt the worst pain of my life! Worst!) and I got an u/s to make sure things were okay. Doc said ovaries were slightly swollen but nothing to worry about.

The days after the checkup, the abdominal cramping went away and so did the terrible back ache. However I had a recurrent fever and this crazy bitch of a pain in the back of my head which felt like someone had taken pincers and was pulling at my nerve and releasing it. It would go away for a while but then come back. Tylenol would help bring the fever down but it drew the line at the pain (Tylenol to me: “sorry buddy this bitch ain’t my thing!”).

So today is day 6piui and I feel better without a doubt. Temp was normal in the morning and so far the bitch ache has stayed away. Fingers crossed!

One thing the docs did warn me about is that in case I get pregnant this cycle the OHSS type symptoms are likely to reappear. Sweet.

It’s been painful, it’s been lonely and it’s been miserable. My husband has, as always rallied around me but this time we both anew felt the ache of not having any family (or good friends) around us. That’s why I had started this blog. So I could vent here and be brave for him. But sometimes I wonder if anyone even reads it. If the reading stats are actual people or just some digital bots who clearly wouldn’t give a damn about babies!

So… if you’re reading this and you’re human… say hello! It would mean the world to me.