Follistim lives up to it's name

Nurse V called around 3pm yesterday with my instructions.  I had three measurable follicles on each ovary, five being between 10-12mm and one 16mm.  Dr. S was very happy with my E2 and I was told to add the 75iu Follistim back in that night.  I would come back in for monitoring the following morning.  At this point it was obvious that we were in for daily monitoring until trigger day.

We've been extremely lazy around the house lately.  Confession: the Christmas tree was still up in the living room.  We made a pact to pack the tree and ornaments away and start organizing the guest room.  After dinner I took care of the tree and Dave started on the guest room.  He made a lot of progress and our next big project for that room is to go through all of the books.  Injects went smoothly, though the Menopur continues to burn like hell.  Icing beforehand has really helped and the bleeding/bruising has been minimal.

Early wake up again this morning.  Nurse V seems to think I love having the first appointment of the day.  It's fine really, it guarantees we get to work on time at least.  MJ, my favorite blood drawing nurse, asked if I wanted her to try drawing from the left arm today.  If I actually had competent veins there, yes.  Unfortunately my left arm is like a dead zone and no one has successfully drawn blood from it.  So into the right arm the needle went and it really hurt.  The next few days of this will not be good.

Next up was u/s time.  Despite peeing right before we left the house my bladder was apparently full again.  It was pushing against the u/s wand and the tech couldn't see anything.  There are few things more annoying than having to get dressed again, pee, then come back in to try again.  Discomfort was still the name of the game today and I had to push down on my abdomen to move righty over.  She took a ton of pictures and measurements before finishing up.

At 1:30 Nurse V called with my instructions for the night.  I now had 11 follicles, 4 on the right and 7 on the left, all between 12-16mm.  Tonight will be the same protocol of Follistim, Menopur, and Lupron with monitoring in the morning.  She originally only had a 7:50 appointment, but was able to get me in early with a 6:20 appointment.  Nurse V predicted that my ER will likely be Monday which will be perfect since I have plans with some lovely ladies on Sunday.

It's crazy to think we only decided to move on to IVF a little less than 8 weeks ago.  Things have moved so fast and so many good things have fallen into place for us.  I only hope we continue to get good news.        

Take it slow

On Monday afternoon I got the call from Nurse V.  Everything was looking good and I had lots of small follies.  Dr. S was concerned with my E2 level so I was instructed to not take the Follitstim that night and Tuesday night, just the Menopur and Lupron.  Of course they cut out one of the easier meds.

We had friends over for our weekly Monday Game Night.  They know about our IVF and played a quick game of Cthulu Dice while I was shooting up in the kitchen.  Nothing to see here boys, pay no attention to the crazy needle lady.  It makes me so happy to have such supportive friends during this time.  I know I'm not acting like myself, the meds are really taking a toll and making me tired, irritable, and sluggish.  Having our friends over for a fun night of gaming and bad movies is a very welcome distraction.

Unfortunately after everyone went home things took a turn for the worse.  I was up most of the night in the bathroom.  Not sure if it's the Menopur or Metformin, but something has been wreaking havoc on my stomach.  When Dave woke me up the next morning I was a mess.  We ended up staying home from work and I slept on the couch all day while he worked from home on the bedroom computer.  Things were a little better by evening, but then came the next dose of meds.  Luckily it wasn't as bad as the previous night, but the early morning wake up for my monitoring appointment came very quickly.

I was the first one there this morning for monitoring.  My stomach had been gurgling, I was honestly afraid something bad would happen on the u/s table.  Thankfully my body behaved and there was no incident.  The u/s was very uncomfortable, usually a sign that my ovaries are getting big.  The tech took a ton of measurements and pictures, hopefully of lots (but not too many) of little growing cocoons.  Now I'm just waiting on the call from Nurse V with my instructions.  It's my mission to get all the information from her on my E2 levels and follie sizes.  They don't seem to give them out freely, but I am a freak and need to know everything.  

Butterflies and bruises

On Saturday I met up with a lovely NJ Dreamer.  We had lunch and headed down to a cute little art studio for their 'Paint and Pour' event.  Basically, they have a painting picked out and teach you step by step how to do it.  Bringing wine is encouraged and the other ladies had multiple bottles.  As we were both in our IVF cycles, no drinking for us.  The painting for that day was butterflies and we had a blast.  We've always referred to my embryos as butterflies and hers as ninjas so her butterfly got a sweet ninja mask.  We definitely want to go back with the other NJ Dreamers!    

Dave headed up north to spend time with his best friend and would likely be spending the night.  I got home from painting and relaxed for bit, snuggling with the kitties on the couch.  A little after 8 it was go time.  The Follistim pen was very easy to put together and the needle attached with no problem.  Lupron was a piece of cake by now, just lowered to half the dose.  Menopur was the one I was most apprehensive about.  Each dose involves two small bottles.  One is filled with the powder and the other contains the solvent.  Using a special needle attachment you transfer the solvent into the powder bottle and swirl, allowing the powder to dissolve.  Then you suck the mixed Menopur back into the syringe, change the needle for injection, and clear the air bubbles.

I had to ice the injection area this time.  For some reason, be it nerves or sensitivity from previous injections, it hurt like hell when I tried to inject the Follistim.  After numbing the area the shot was much easier, but bled like hell.  The Lupron was easy as usual.  With the Menopur I knew there was a chance it would burn so it was recommended to inject slowly.  My hands were shaking as I removed the needle, it was done.  After a quick clean up with an alcohol swab I placed a gauze pad on the area and applied pressure.  It burned like crazy!  The Follistim injection site bruised up immediately and the area stayed red for a while.  I celebrated the successful stimming with chocolate chip cookies and went to bed early.

Sunday night's stims were much easier.  I had confidence on my side and preparing the meds went much faster.  I iced again before doing the injects and didn't bleed as much.  The Follistim site didn't bruise this time, but Menopur burned on the way in.  Before bed I had a terrible headache and had a hard time falling asleep.  Tylenol helped a bit and I was finally able to drift off to sleep.

We had a very early morning today, my monitoring appointment was set for 6:30am.  I was the first one there, but things were already running behind.  Remember the sad u/s machine from last week?  It was doing much worse.  The tech was able to input my information, but as soon as she went to the next screen the computer flashed an internal error and shut down.  Luckily they have two machines in the office so she swapped them out and had no other problems.  As usual I have to wait for the nurse to call this afternoon with the results.  My ovaries feel heavy and there was definite activity in there this weekend.  Hopefully things are looking good.  

Buckle in, it's go time

It was hard waking up early on Thursday morning.  I've been going to bed between 9:30 and 10:30 every night and just can't seem to get enough sleep.  I'm really looking forward to sleeping in a bit this weekend.  Anyway, we headed to the RE's office for my baseline monitoring.  The purpose of this appointment was to make sure my ovaries were sufficiently suppressed prior to starting stims.  Blood work was easy and I was called back for ultrasound right after.  Tech didn't have any problems finding righty, but just as she printed the last picture the u/s machine shut itself off.  Luckily all the pictures came out and she had all the needed measurements.

Later that day I got a call from Nurse V.  Everything looked good and I am to start stims on Saturday night.  My protocol is 75iu Follistim, 75iu Menopur, 5iu Lupron, and baby aspirin for two nights.  Monday morning will be my first monitoring appointment and meds may be adjusted depending on response.  I will also be continuing the 1000mg Metformin.  

Tonight is going to be my last night of drinking, hopefully for a long time.  I want us to have the best possible chance with this IVF, but tonight we're going to live it up.

Loopy Lupron

It's been a while since I last updated.  Things are still moving along and my suppression check is only two sleeps away!

On Friday the nurse called and confirmed that Dr. S wants me to start taking metformin.  She had already called it into the pharmacy and we could pick it up on the way home.  I would start by taking one 500mg tablet a day for three days, then bump up to one 500mg tablet twice a day.  Work was incredibly crappy on Friday and it looked like we would have to work all weekend.  We hadn't made any Valentine's Day plans so I was expecting to go home, open a bottle of wine, eat chicken curry, and relax a bit.  Dave said he needed to pick up some spices on the way home and plugged the address into the GPS.  It was a crappy drive and I didn't really notice where we were going.  We parked and Dave held my hand as we navigated the icy sidewalks.  With a devilish smile he guided me towards a familiar awning, the Melting Pot restaurant.  He had made a reservation two weeks ago and kept it a secret.  We had an amazing dinner, it was very much needed after such a crappy day.

We then worked all weekend and it was terrible.  I hate relying on other people to do parts of a project because they always let you down.  Most of the work we did was fixing other people's mistakes.  This was supposed to be a relaxing weekend before starting stims.  Not so much.  I did take my last birth control pill on Saturday night so that was exciting.

Yesterday I drove Dave into work since we couldn't get his car out as it was encased in ice.  I worked from home for a few hours then headed to my OB appointment.  It is a large practice and I was seeing a different OB than usual, Dr. A.  After doing the usual intake blood pressure, weight, and signing consent for not having a nurse in the room during the exam I waited for the doctor.  I was nervous after last week's speculum horror show.  Dr. A came in, introduced himself, and asked if I had any questions or concerns.  I asked about their ability to take care of high risk cases and he was very confident they could.  He started the exam and I barely felt the speculum at all.  There was a bit of pain during the scraping, but overall it was the most gentle pelvic exam ever.  He took some extra cultures just to be thorough since we are doing IVF.  It was a great appointment and I will be requesting Dr. A from now on.

Lupron has been doing a number on me.  About an hour after the injection, which I take at 8:30, I've been ready to pass out.  Last night we had friends over for our weekly Game Night and I managed to stay up until 11:30.  I've also had some food aversions, achy back and shoulders, and loss of appetite.  Hopefully when I drop down to a 5iu dose the side effects will lessen.  Suppression check is on Thursday and that will determine if I'm able to start stims on Saturday!  It seems like the past few weeks have gone by so fast, hopefully that trend continues.
      

Achievement Unlocked: Successful Self Injection

Our IVF class started right at noon with Nurse V.  We went into her office and she started to go over the cycle calendar.  I would start 10 units of Lupron the evening of 2/11.  Dave immediately looked at his watch, looked at me, and it hit me that I would be starting Lupron that night.  My last birth control pill will be Saturday.  Thursday 2/20 will be baseline testing to make sure everything is suppressed and ready to go.  If things look good I will start stimulation Saturday 2/22.  I will drop down to 5 units of Lupron a day and add in 75iu Follistim and 75iu Menopur.  My first monitoring appointment will be Monday 2/24 and will likely go in every morning.  My dose of Follistim could change depending how I respond, we're starting at a very low dose.  Egg retrieval will likely be the first week of March.  They do the procedure in office and I will be under anesthesia for the collection while Dave is giving his sample.  We are doing the CCS (also known as CGH) testing so any embryos that make it to blasts on Day 5 or 6 will be biopsied and frozen.  The biopsied cells are sent to a special lab and will undergo full chromosome testing.  We'll get the results in a few days and if my body is ready we'll start prepping for FET right away.

Nurse V went through each medication showing how to assemble the needles, load cartridges, where to inject in the belly, etc.  Everything is pretty straightforward.  The Follistim comes with a cool pen that the medication cartridges are loaded into, you set the dosage on a click wheel, and inject.  The Menopur comes as a powder so it needs to be mixed with saline before injecting.  The Lupron is very simple, just fill the syringe and inject.  Funny enough the thing I am dreading is the Crinone.  Crinone is a messy progesterone gel that is inserted into the vagina through an applicator after ER (egg retrieval).  Guess I shouldn't be too worked up about it though, for the FET I will be using PIO (progesterone in oil) which is administered via a big needle in the butt cheeks.

We both had to get some blood drawn as our infectious disease panels were over 6 months old.  After finishing that up we met with the IVF coordinator K to sign lots of forms.  He went through the ER procedure, embryologist's process, CCS procedure, and subsequent FET.  He felt our chances were very high and expects lots of good quality embryos.  While looking through my chart he noticed that Dr. S had circled that I should start metformin, but further down the page had crossed it off.  Apparently I have PCOS.

After signing and initialing more forms than we could count it was back to the waiting room.  My trial transfer was to be done by another of the REs, Dr. C.  Dave ran out to get us lunch since it was going to be at least a 30 minute wait for the procedure.  I was called back and had to change into a paper robe so Dr. C could check my vitals and abdomen.  We talked a bit about my concerns for ER, mostly due to my wandering right ovary.  He was confident that the ovary would be heavy from all the follicles and sink down.  I would be knocked out anyway so they could try and push it down like I have to do during some ultrasounds.  I asked him about the PCOS and he looked at my previous ultrasounds and commented that my ovaries are textbook PCOS.  Looking back on it, I do have a lot of the symptoms of PCOS so it really isn't that shocking.  I just don't know why Dr. S has never brought it up before.  The nurse was going to talk to him today to see if I should start the metformin.  Dr. C said it would help prevent hyperstimulation which we already know I am at high risk for.

After taking my blood pressure, listening to heart and lungs, and checking my abdomen it was time for the "fun" part.  I'm pretty sure the speculum he used was meant for use on elephants and was spring loaded.  There was so much pressure and pain.  If I had not used the restroom beforehand I probably would have peed on him.  The catheter went in very easily and he didn't suspect there would be any trouble with the embryo transfer.  The timing was perfect as Dave was just getting back from picking up lunch from a nearby Indian restaurant.

That night it was time for the first injection of Lupron.  I was so nervous, afraid of messing it up like I had done with the Ovidrel.  It took a few seconds to psyche myself up to push the needle in, but it surprisingly did not hurt at all.  There was some discomfort after injecting the Lupron and I had to keep the needle in for five seconds.  There was no bleeding, but it felt a bit sore for a few minutes afterwards.  My confidence levels have definitely gone up and should have no problem with the remaining Lupron.
      

Party in a box

On Friday Dave let it slip that he had bought me a Valentine's Day present.  The man is terrible at pulling off surprises, but he always tries really hard.  He was determined to not tell me what it was until the 14th.  We had to run out during lunch to run some errands.  While getting back in the car with a few bags I felt something on the seat.  Dave had managed to toss a small jewelry box onto the seat before I sat down.  It contained a beautiful sapphire claddagh ring.

                                             

Dave had stalked my Pinterest boards and found a similar ring I had pinned a while ago.  I nearly started crying, it is so beautiful.  So this year Dave wins Valentine's Day.  For his present I am going to take him on a used game/comic book store adventure.

On Saturday morning I woke up early and headed to the pharmacy to pick up my party pack.  The pharmacist came out with a huge bag with lots of little prescription stickers on it.  I hurried home and immediately unpacked everything.  I have never seen so many needles in my entire life.

Meds with bonus cat

Our IVF class is tomorrow afternoon and I should be getting my calendar.  Judging by the Lupron kit we are probably looking at a March ER.  On Sunday I ordered a bridesmaid dress for a friend's October wedding.  I ordered it two sizes up since best case scenario has me ~6 months pregnant.  Hopefully I will be getting it altered around a baby bump.

That was fast

I unexpectedly received a phone call from the pharmacy saying that my order was ready for pick up.  The pre-authorization went through and insurance covered a surprising amount of the cost.  So tomorrow morning I will pick up my party box!

Picking up speed

Hope everyone is staying safe and warm in this frozen winter "wonderland".  While leaving for work yesterday morning we discovered that my car was completely encased in ice.  It would have been really pretty had it not been such a huge annoyance.

We worked from home on Tuesday as our town was still digging out from Monday's 10" of snow.  I really love working from home.  No bothersome co-workers interrupting me with stupid questions and not having to listen to the incessant whining is amazing.  I get so much work done while sitting on the couch, movie on in the background, with snuggly kitties curled up next me.  It is especially helpful when I am on the phone with our ERP company most of the morning and do not have to compete for volume with the harpies.

After lunch, which was delicious taco salads, I got a call from one of the nurses from the RE office.  It was time to schedule our IVF class!  The earliest she could schedule for was next Tuesday at noon.  We'll be meeting with the nurse to learn how to do the meds, possibly doing a trial transfer, and signing lots of paperwork.

Today I got another call from the nurse saying that she was calling in my meds to the pharmacy.  They would be calling me to confirm insurance details.  It seems I will definitely be doing injects.  About an hour later the nice pharmacy lady called.  She took down the insurance info and said she would put my order in right away.  Someone will be calling within the next 48 hours to go over details, but we will likely be picking up the meds this weekend!