To Add a Little Excitement and Drama

I was picking up clothes from the bathroom floor (we are such neat freaks!) in order to start laundry this morning and made a not so great discovery. 

On Thursday when I started my stims I asked W to grab what we needed from the fridge (Gonal-F). We have some old pens in there as well and he brought those up along with the new box which was in an opaque bag. We talked about the old ones (3 pens) and decided it was best to throw them out since it had definitely been more than 30 days since they had been opened. I started to mix the Luveris, measured my Lupron, and took the Gonal-F pen that was on the vanity and used it. 

I continued to take all of my meds for the past 3 days without thinking anything of it. I had seen the old pens in the garbage and ignored the opaque bag on the floor since I assumed it only had needle tips in it. 

That brings us back to this morning. I was picking up the clothes and I found the opaque red bag. Don't get me wrong, it's not that our laundry pile was so large it was buried, but it had ignored it, assuming what was in there wasn't an absolute necessity to deal with immediately. I opened the bag to get the extra tips out, and what do I find? I completely unopened box of Gonal-F! I immediately called W upstairs and we realized that instead of throwing out the pen that was so full, I had accidently been using it. We did the math and figured out this pen was first opened during IVF #1 in July!! Oh Shit! 

When we were talking about throwing them away, W didn't throw them all away, only 2 of the 3. He tossed the bag with the new one aside and put the old one up on the counter. Distraction set it when I started to measure out my meds and I grabbed the old one assuming it was the new one he took out. Man, is his support in this process a mixed blessing. Last IVF I got upset because he wasn't involved enough. This time I realize his company in the room is enough and that the meds need to be all my responsibility. That way I have no one or nothing to blame if things don't go as planned. 

So I spent a bit of time this morning googling expired and opened Gonal-F and am not sure what to think. If it hadn't been opened I wouldn't be freaking out. But, it's likely not as potent as it should be, if potent at all. I emailed the NP at the clinic and am waiting to hear back. I really hope this doesn't mess things up. There's never a dull moment with IVF, huh? I guess I just assumed by the 3rd time around I would have it all figured out. Well, not so much. 

It's safe to say the first tears have been shed this cycle. Maybe that means the FSH is working after all?

IVF #1 CD 10 (trigger tonight)

After going to bed at midnight last night, getting up a little before 6 was not the most fun this morning. W was able to come to my appointment since it was the weekend so that was nice. We got to hospital #1 and they were directed towards the laboratory. Once we got there they weren't exactly sure why we were there, but then eventually figured it out and took my blood. We then headed to hospital #2. 

As soon as we arrived in the lobby the ultrasound tech was waiting for us. She brought us over to the office and let us in with her key. My ovaries were frickin' HUGE under ultrasound, no wonder I am so uncomfortable. She did all of her measurements and then called my RE while we waited. She reported that I have 17 follicles, all good in size and that my lining was great and tri-layered. She then put me on the phone with my RE. He told me most likely I would trigger tonight, but he needed my estradiol levels to be sure it wasn't too high. I once again got the OHSS talk, but I think it is just because he is super cautious. He also said depending on how many eggs we get, we could be looking at a 5 day transfer like we talked about last week. He seemed really optimistic and said I had a great response. 

We went and got breakfast and then killed a little time before my acupuncture appointment. While I was in for my appointment, my RE called with the results. My estradiol level is up to 2,773 and I will trigger tonight! I will take 150 units of Gonal-F and the HCG trigger this evening at 9:30. No more Lupron! I can't believe how fast it actually went by once the stims started. 

I have been really uncomfortable, and full feeling as well as pretty anxious. I feel like I can't do anything too fast. I am hoping that subsides once the retrieval is over, since that is the part I am most nervous about. I'm not sure if it is the meds, being so bloated, or being so anxious, but I have been feeling a bit nauseous and my appetite is off. I can't believe we trigger tonight!! 

Egg retrieval here we come. I just have to get through work tomorrow. I am also planning on treating myself to a pedicure tomorrow so at least my toes will look nice in those stirrups. 

IVF #1 CD 8 (What a day!)

I am a day late on this post, so it is about Friday. I woke up early and made it on time for my blood work and sono. During the sono she was clicking and measuring away, so I immediately felt reassured that everything was progressing well. The left side had definitely picked up the slack a little bit so that was good. I left in a good mood and headed off to work.

I first saw a little boy at our play group and it went well. I then went to another house and they weren't home (what else is new?), so I called the next family and asked if I could come a little earlier. This little guy I have only seen one other time and he is an adorable little peanut. He just turned 2 in April and stays with his grandparents during the day while his parents work. His grandfather has had a few strokes and is not very with it, so grandma is the one I deal with primarily.

 When I got there the grandmother told me she wasn't sure how he was going to be since he had gotten into some of his grandpa's pills (WHAT?!!). She said she was trying to get ahold of the doctor and his parents. Well, he sat down with me for about 5 minutes before I started to notice he was acting really strange. He wasn't interested in what I took out so kept getting up to try to get to my bag to get something else. When he stood up he was really unstable adn he was staggering, and then when he sat back down his legs started shaking really badly. This moved on to his whole body so I told the grandma and she called 911.

She gets on the phone and is practically hysterical so I ask her if she wants me to talk to them. I get on the phone and try to help figure out which pills he took. He took 2 anti-seizure meds, one Metformin, and one other pill I can't remember what it was. The ambulance arrived quickly and put him onto gurney and brought him out to the truck. I spoke to the police office who also arrived and then went out to check on the little guy. At this point he was super out of it and trying to doze off. I hung out in the back of the ambulance shaking him and trying to keep him awake. They were directing most of the questions to me because the grandma was too upset and the grandpa didn't really know what was going on. They got ahold of the parents and they were going to meet them at the hospital.

At first they asked me to ride in the ambulance with him, but I would then be stuck without a car or ride about 40 minutes away. They took the grandpa with them in the ambulance an I followed behind. When I arrived at the hospital his parents were there and they were trying to get an IV in him. He was SREAMING and wasn't so sleepy anymore. I answered a few questions for the doctor's and told the parents I hoped he felt better.

The grandma called me later in the day and said that he was doing fine and that they had a given him a catheter and EKG and were just going to monitor him for a at least 8 hours to make sure there wasn't any permanent damage. She also thanked me for being there and helping.

So, by 12:30 I had been to Syracuse twice (about 45 minutes each way), and was headed back to work. It was crazy and so scary. I can't even imagine if it were my own child, but seeing how little he was in that ambulance and at the hospital was awful. He only weighs 23 pounds!

That afternoon I got the call from the nurse at the office. My estradiol was up to 1287 and I have 9 follicles one the right and 7 on the left. Some were too small to be able to catch up, but the idea is to get the ones that are 13 and 14 cm to catch up. I will stay on the same dose of Gonal-F and go back Sunday. Since my clinic isn't open on Sunday I will be going to the hospital for the blood work and sono. Two hospitals actually. Luckily, they are right next to each other. My RE called later that day but I didn't get the call and he ended up leaving a message. He said the only risk of continuing me on the Gonal-F is OHSS. He doesn't think this will happen, but he said each person is different. I am hoping to avoid OHSS, especially since my sister's wedding is in exactly 2 weeks!!

They are planning to have me take the same dose Friday, Saturday, and Sunday and then trigger late Sunday night and come in early Tuesday for retrieval. I am getting so nervous for retrieval and have to say I am super uncomfortable. We joked this morning that I have the 4 B's of IVF: bloated, bitchy, broke, and bruised. Doesn't that sound like fun?

IVF #1 CD 6 (PIO vs endometrin, and 3 vs 5 day transfer)

So this morning I got up bright and early and headed out to my appointment. I realize I need to shoot to leave at 6:45 rather than 7, because I got there a little late. The office was quite busy and it took longer than I had expected. 

The ultrasound went fine and the tech actually said to me "We've seen a lot of each other over the past year." Yeah, that's an understatement! I've completely lost count of how many dates with "wandy" I have had at this point. I watched as she measured away. She didn't seem to measure many follicles on the left side, but there were a bunch on the right. I left sure that my dosage of Gonal-F would be upped. 

Since the regular nurse was out today I got a personal phone call from my RE this afternoon with the updates. Our conversation lasted 35 minutes and allowed me to ask a bunch of questions. He said I had "at least 8 good follicles." They were all around the same size and he said I am responding well. My estradiol level was 249, up from around 20 on Friday. He wants to keep me on the same dosage (150 units of Gonal-F) and to come back Friday for a repeat sono and blood work. 

I got the opportunity to ask about 3 vs 5 day transfers. I wasn't sure if the clinic even did 5 day transfers and my RE said it all depends on the number of embryos. The pro is that the embryos are heartier for 5 day transfers. It also gives a better opportunity to minimize the number of embryos. The con is that if we wait too long the embryos could arrest and we could be left with nothing to transfer on day 5. Dr. S said the literature states that the take home baby rates of both 3 and 5 day transfers are about the same. So, unless we have a large number of embryos we would be better off with a 3 day transfer. 

We also spoke about the number of embryos to transfer. He said the biggest factors were the age of the recipient and the quality of the embryos. Before the transfer we will have a better opportunity to discuss our odds given our specific embryos. 

I asked about progesterone. Last cycle my legs broke out in hives from the endometrin. I'm not sure why this happened since when I was pregnant I was on endometrin and didn't have any problems. As soon as I stopped it last cycle the hives disappeared. He said it is possible I developed an allergy to something in the tablet and that in rare cases people develop allergies to progesterone. He didn't seem to think this was the case, but said I may be better off with the PIO instead. I have also read that a lot of RE's prefer PIO for IVF cycles. Dr. S said it all depends on personal preference. For those of you who have done both, what is your preference???

IVF #1 CD 2 (suppression check)

So everything went well. I was cleared to start stims yesterday and the ultrasound was uneventful. I am currently on 150 IU's on Gonal-F and my Lupron was reduced to 10 units/day.

Speaking of Lupron, we had some issues yesterday. I had the nurse call in a script on Monday to my pharmacy and went Wednesday to see the status. They told me they were waiting for pre-authorization from my insurance company form the doctor's office. I asked yesterday and the nurse said she never heard from them. Well, the kit I had was almost gone so the nurse had to do some scrambling to find some. Due to the shortage, the closest she could find it was a pharmacy in NYC. I had to pay the full price since I didn't have time to get the pre-auth from insurance, and pay to have it delivered next day. The price wasn't too bad and my insurance company will reimburse me if it is something they cover. I just received the package and have a new Lupron kit in my possession.

The worst part about my appointment yesterday was the nurse. She is the main nurse at this clinic because it is small. She is the one I talk to with my questions, she did my IUI's, and is basically my go-to person. Well, I walked in yesterday to see she was bald. I finally asked her if everything was OK and she shook her head and didn't really say much. She then talked about how her voice has been bothering her and she thinks it is from the new round of chemo she started. I knew she had surgery a few months back but thought it was just back surgery. I felt really sad for her the rest of the day.

We had dinner on the boat with my in-laws yesterday. The weather was amazing and the wine was delicious. Going to the lake reminds me of when W and I first met and would hang out. We were both working at a restaurant and I would often go to his parent's lake house to hang out after work with him. We have so many great memories there, and just being there reminds me of how lucky I am to have him and everything great in my life. I am so thankful we are even able to have the opportunity to do IVF. Maybe I will be brave enough to go swimming today, we will see.

Something horrible happened a little while ago. I checked on the robin eggs to see whether they had hatched or not and then went back inside. About 5 minutes later I heard a loud boom and looked out to see the hanging basket fell and the eggs were broken on my front porch. I felt horrible (and still do). I'm sorry momma robin : (