Tag Archives: drugs

It’s the %@*$# drugs

Drugs, Infertility Feelings, , , , , ,
We're done with the injectables, but these two seem to pack a more emotional punch. The Mr. finds it funny; he's allowed. Everyone else, look out.

It’s the drugs. It’s the drugs. It’s the drugs.

At least, that’s what I’ve been telling myself as a result of reaching the highest levels of pissivity. (That’s an original derivative of a word I hate to use and wouldn’t, well, if not for the drugs.) I was warned of the side effects of estradiol and progesterone, but I wasn’t expecting the same work-related poop storm from a few weeks ago to keep spinning. I don’t have the time, the patience nor the willingness to address it, but here it is, and here I am, nine kinds of ticked off.

Soooo, maybe it’s not the drugs.

However, the fear and resulting paranoia that pressure from this clusterfox will hurt my chances of housing the Wonder Twins long term might be drug manufactured. It would make sense to think that every significant upset would have a negative effect, but honestly, it doesn’t. Medically anyway, no one thinks so.

In addition to preparing me for mood swings, fatigue, and general haziness, the RE-mandated psychologist addressed stress and how I’d deal with it. Her focus was specifically now, the time between the transfer and the first blood test determing whether the in-vitro cycle was successful. Even though she encouraged a coping strategy — because, obviously alcohol is out of the question — she insisted that everyday wanna-throw-a-shoe, to-Hades-with-everybody, dare-you-to-walk-in-front-of my-car varieties wouldn’t be enough to derail pregnancy. What would have an effect is stress related to fear for my life, of being evicted and otherwise homeless or of not having food. Anything less than that would be implantation gravy.

I was relieved to leave aside the pressure of always trying to relax. In trying for so long to conceive, I’ve heard “Just relax” enough times to consider the phrase profane. And telling me that never works anyway. So rather than “Keep Calm and Carry On” like the book says, I’m doing just fine aligning myself with its companion piece, “Screw Calm and Get Angry.”

And if you don’t like me when I’m angry, well, let’s go with that idea that it’s the blankety-blank drugs.

Fentanyl is your friend

Drugs, Egg retrieval, , , , , , , , ,
This is a 2-cell embryo on Day 2.
So much for “conscious sedation.” I was out almost as soon as the nurse injected it into my IV. (We won’t talk about the collateral damage done to both arms to get the IV going in the first place.) Right before then, I’m told I started singing “Nowadays” from the musical “Chicago.”

“… You can live the life you like. You can even marry Harry but mess around with Ike. Good, isn’t it grand …” I vaguely remember that. And I can recall turning on my side for the rump shot of progesterone. Sade’s greatest hits played in the recovery room. I remember hearing it, but I don’t remember singing along. A nurse said she wanted my autograph, so I must’ve done a decent job. I was hazy but soon awake enough to walk. At home, I slept the rest of the day — the whole day.

I think I’m done with the abrupt sleepiness from the fentanyl, but the Mr. keeps reminding me that it hasn’t been 24 hours since the procedure (it’s 8 a.m.). That’s the recommended time before I can operate heavy machinery. I didn’t think of it like that, but I guess it is a good idea that I’m working from home today editing printouts from last week. Even with uncomfortable bloating and a literal pain in the behind, I find it hard not to be celebratory.

My doctor extracted 15 eggs. Based on today’s call from the embryologist (how do you even become one of those?), seven of the 15 were mature and all seven were fertilized. Now, it’s a matter of days before the transfer of two embryos and yet another dreaded two-week wait. I’m done with injectable medications. Instead, I’m taking antibiotics twice a day, estradiol twice a day and progesterone inserts three times a day. One is to ward off infection from the procedure and the other two held prepare my body for implantation, the next hurdle.  

Countdown …

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One innocent victim of my hormone-induced emotional outburst hours before the egg retrieval

So, just like a magwai, I can’t eat after midnight up until after the procedure Monday. It’s amazing how much you want something when someone says you can’t have it. I think the frustration is really just masked anxiety about whether everything will go as planned. I signed the waiver, but I’m still not worried about the more severe risks like excessive fluid buildup, stroke or death. I’m not sure about many things, but I’m most certain that God wouldn’t allow my last “meal” before meeting Him to be pineapple jelly crescent rolls, doxycycline and candied gummy pre-natal vitamins.

Speaking of God, I imagined laying out on the altar Hannah-style in church today after all because I just didn’t have the words to pray for what I want. We sang a song, “God is sovereign, holy and just and on His word we’ve got to trust. For the at the sound of His voice, the Earth became. When God speaks in your life, you won’t be the same.” Between the singing, ministering and worshiping, I felt my heart praying and the tears fell. It wasn’t a shining moment because I haven’t figured out how to cry and sing at the same time. Nevertheless, it was a moment that I felt like God and I were on the same page on this babies thing. It made worship at the next service that much easier. Even then, the tears kept flowing though. I’m sure it’s the estrogen.

According to the Mr., I’ve also been a little more aggressive in a way more characteristic of me PMS’ing. I never take it out on people — or at least not at people who can hear me — but it definitely comes out at the television, traffic, talking heads on TV. The victim on the way home from church was a squirrel pausing in the middle of the street. A squirrel! Yep, it’s got to be the drugs. And it’s expected to get way worse.

After the retrieval … (I should describe that. Using a transvaginal ultrasound to find the follicles, a doctor will guide a needle to where it’s supposed to go and extract fluid that should include an egg. If it does, the egg goes into an incubator. He or she will repeat that process until all the follicles are aspirated. The eggs will then pair with a fresh sample from the Mr., and then we wait.), I’ll start oral estrogen and, uh, non-oral progesterone. That’s supposed to not only make me sleepy but also edgy. Doesn’t that sound like fun for everybody?

I’ll keep taking the antibiotic to ward off any cooties from the procedure and wait again to hear about the number of eggs and the likely transfer date. In the meantime, at least immediately after the procedure, I’ll do nothing but feel the lovely haziness of good hospital drugs. As always, we’ll see what happens.

Mindless update

Drugs, Infertility Feelings, , , , , , , , ,

I’d been concentrating so hard on that joyous news of follicles and a continued cycle that I nearly ignored the most profound display of unprofessionalism seen in my entire working career, and it was directed at me. There’s a lesson in everything, and perhaps mine was that life goes on despite all the interruptions of my infertility battles. So, in the midst of the ultrasound-blood work revolving door and phone gazing in hopes of a nurse’s call, I’m pretty sure I have to actually deal with a petty workplace problem before it becomes something else. I don’t have the patience for this, though, I’m not sure whether that’s a real reaction or whether it’s the drugs. They’re supposed to make me crazy at some point; I’m sure they’re already making me sleepy at odd times.

I’m currently on three medications, all administered via injection — Gonal F, Menopur and that evil Ganirelix acetate. The first two essentially create an ovarian Superman, and the latter is like the Kryptonite to keep the hero from winning and thereby ending the tale too soon. The idea is to develop follicles but to keep them, keep me from ovulating before doctors can go in and get the eggs. It’s for this reason that the Mr. and I have to keep our hands off of one another. Apparently, sex naturally triggers ovulation. How that for another counterintuitive fertility measure? Remember, this cycle started with me on birth control pills. So far, though, everything is working.

My estrogen level doubled from Tuesday to 1424. I do know that’s a positive sign, particularly now that, per a nurse’s message, I’m walking around with 10 measurable follicles. With Clomid, a drug given orally that I took for all three intrauterine inseminations, I only produced two follicles. Each time, they came from my right ovary. My left has been on vacation until recently. It’s now holding five at 11, 12, 13, 14 and 15 mm. The right has the remainder at 11, 12, 13, 16 and 16.

At this rate, the retrieval could happen in a few days. I’ll find out more — including how I feel about everything — at my next appointment in a few hours.

P.S. It was actually almost an hour and a half ago. This just didn’t post when it should have. I’m still pondering everything while trying to focus on work. Here we go …

Ganirelix is the Devil

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This Ganirelix acetate shot might as well be a small taste of hell in injection form.

Not that anyone’s grading me, but in my on mind at least, I passed an inital hurdle in the in-vitro fertilization race. Based on results from Tuesday’s ultrasound, I have seven measurable follicles at decent sizes (three at 12 mm, two at 11, two at 10 and a lot of small ones) to keep the cycle going. It’s been my biggest fear that the $350 in prescription drugs and the past five days of shots to the gut would suddenly end in a canceled cycle. But today is cycle day seven, and we’re still on.

About those follicles: Everyone who ovulates does so because of an egg that matures inside a follicle before popping out in anticipation of a sperm hookup. My injectable medications have given me super-powered ovaries that have produced more than the typical one or two follicles that would ordinarily lead to one or two eggs. Mature follicles tend to measure about 18 mm. When I did the intrauterine inseminations, 18 mm meant it was time for a “trigger shot” of Ovidrel, an injection that encourages ovulation. I’ll still get the Ovidrel with in-vitro fertilization; it’ll just be exactly 36 hours before the retrieval.

That would be shot No. 4. But that one, I can handle. It’s that doggone Ganirelix that is most certainly from the devil. It burned after the Mr. injected me and left a bruise that is painful to the touch. I walked around work with my pants down, covered by my jacket. So far, it’s the worst thing that has happened in the process, and it’ll happen again — every morning until … Crap, I don’t know when it’ll stop.

All I can do is follow the advice of a diabetic friend with 15 years of needle experience and consider the pain an offering commemorating Christ’s ultimate sacrifice. It sounded trite when she first said it, but given the hell of this Ganirelix shot, it’s gon’ take Jesus, the 12 disciples and Rufus to take this devil down.

Next ultrasound and blood draw: Thursday.

It’s Only a Test …

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Bag lady, you gon' miss your bus dragging all dem drugs like that. That's just for the holiday weekend.

I got the go-ahead Wednesday to start my plethora of potions in the build-a-baby kit.

You’ll have to pardon my irreverence. In addition to my normal last-minute packing, I also had to prepare and pack all my drugs for the next several days to get me through Thanksgiving weekend. Making sure I had the right amount of needles, vials, ice packs for the refrigerated stuff and necessary alcohol wipes and gauzes added an hour to my ritual. I’m exhausted, but sitting under this hooded hair dryer is the first time I’ve sat still since I left work. And I have to stop my mind from reeling; it’s been on 90 mph since my ultrasound and blood work this morning.

The point was to make sure my reproductive system responded well to the birth control pills by essentially taking a nap. I didn’t know I was worried about the possibility of the cycle being canceled until worry came up during our workplace Bible study. Boo, hiss. I hate when God calls me out like that. I relaxed a bit after that, but my relief was only temporary even after the nurse called to say the meds were a go. It was like I was suddenly eligible to take a test I hadn’t studied for. I really did mean to brush up on the shot and medicine-mixing lessons from the first in-vitro appointment last week. Just like college, there was so much information that I’d resigned myself to figuring it out on my own time. Tick, tock, tick, tock — lo and behold, the test is tomorrow!

Instead of worrying, though, I’ll sing this song until my iPod changes to Thanksgiving songs:

“It’s only a test you’re going through.
It’s gonna be over real soon.
Keep the faith; don’t give up
For it’s only a test!”

Let’s play 20 questions (Part 1)

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They arrived. That’s a month of in-vitro fertilization drugs.

It occurred to me once I decided to go public with my infertility struggles that people would have a lot of questions. I’ve found that when I open up in a quest for comfort, I instead do more educating than emoting. To remedy that and to avoid repeating myself, I present the most common questions I encounter and answers as they stand right now. That’s my disclaimer for if or when my answers change.

1) Why can’t you have kids?

I don’t actually know that I can’t. I just know that I haven’t. I have a diagnosis of diminished ovarian reserve, meaning I don’t have as many eggs as expected for my age. (I’m in my early to mid-thirties.) Therein lies the challenge and why we – the Mr. and I – are trying everything available to make it happen.

2) What’s that like?

Well, in short, it sucks. It’s annoying. It feels unfair. And I wish it wasn’t so. I get down about it sometimes, and maybe I wanna complain. It just doesn’t make me feel any better. So, I refocus. I write. I pray. I take my prenatal vitamins as an act of faith.

3) Did you pray about it?

Yes, for Christ’s sake, AND in His name with fasting. Intercessors welcome.

I get very tempted on Sundays to throw myself on the altar at church Hannah-style, but I’m pretty sure security would take me down and carry me out before I can say, “Amen.”

4) Are you having enough sex to get pregnant?

(People do ask.) Yep.

5) How long have you been trying?

I’d say not long enough for infertility street cred. Things have moved really quickly, but when I count back, the path to this point feels like a long road. I ditched the Nuvaring the last week of January 2010. I can’t believe it’s almost 2012.

6) What’s the effect on your marriage?

There’s been no negative effect. It was already the two of us against the world. Now, it’s the two of us against infertility. Beyond that, my husband amazes me every day just by being his funny, supportive and thoughtful self.

7) How many kids do you want?

For most of my life, I wanted five. Before we got married, we decided on three. There’s a song from my hometown that’s now my song: “Any way you bless me, Lord, I’ll be satisfied.”

8 ) Why not just adopt?

Oh, why not get a bike instead buying a car? It’s transportation, right? Sorry, that darn humanity. Um, adoption could be considered a “fix” for childlessness perhaps, but not infertility.

9) So you’ll be doing that artificial insemination stuff?

Kinda. Nobody calls it that anymore. For one, there’s not much artificial about it – sperm and eggs are still required. What used to be called “artificial insemination” is modernly known as intrauterine insemination, or IUI. Sperm cells, which usually “walk” to meet a single egg, instead get a bath before taking an express train via a thin catheter guided in most cases by a nurse. The actual procedure takes about a half hour, including time just laying there. I’ve done that three times. No dice. That’s why I’m at the in-vitro fertilization stage. The fur is similar, but it’s an entirely different animal. We’ll be experiencing it together.

10) What do they have to do?

Essentially, with drugs, they’ll suppress my reproductive system, jump-start it with more drugs to make my body produce multiple follicles, which house eggs. Doctors will then go get the eggs, pair them with sperm from the Mr. in a lab, offer them wine and hope they hit it off. Once matches are made in heaven, the doctor will let me hold one or two of them for safe keeping, and I’ll eventually look like I ate a watermelon seed. I’m oversimplifying to explain the procedure without the gory details that – again – I’ll experience when it all happens with you along for the ride.

Apologies to Nancy Reagan

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I followed Nancy Reagan's advice. Alas, my answer has changed.

Even though I was born before that, I’m a child of the ’80s who took the “Just Say No to Drugs” campaign very seriously. I wouldn’t even eat cough drops as candy. I made it through adolescence as a “clean teen,” and as an adult, I avoid pain medicine as much as possible.

Now, I’m awaiting a call from my drug dealer. The drugs are legal, depending on how you use them, but they’re drugs nonetheless — a whole lot of drugs. That’s one side of in-vitro fertilization I forgot to think about. I was prepared for the injections; I just didn’t realize I’d have my own pharmacy of tablets, powders, vials, inserts and syringes. In the next 30 days, I will have taken multiple doses of eight medications through multiple methods, rooter to tooter. That doesn’t include a prenatal vitamin and the hazily wonderful hospital drugs to come.

Like any fiend, I’m anxious to talk to my pusher to work out the drop and how much these high-end, high-copay pharmaceuticals will cost me.

So even as I struggle to wrap my mind around it all, Nancy will just have to understand.