Tag Archives: shots

Reflections of the Way Things Used to Be

Last year this time, I was in New York with a fresh needle wound from the first shot of my in-vitro fertilization cycle. I was trying to be thankful for a wonderful husband, a promising job that fit my talents and general happiness with life despite the ache of not yet being pregnant and having to endure IVF at all. That was a difficult balance. It was even worse to battle such inner turmoil while wearing the permanent smile-face of holidays with in-laws who didn’t know or necessarily understand anything about me or anything I might be feeling. Empathy from outside of the infertility circle is hard to come by even after the explanations of why and how.

But. I. Survived.

And I came out with a story to tell happily ending with a real live Rufus and Reefus, born exactly three months, two weeks and three days ago. Even as I listen to them sleep in their cribs (for only the third freaking day ever FINALLY), it’s unbelievable that they actually exist way beyond a couple groups of dividing cells, a collection of heartbeats captured in a whirlwind doctor’s visit or even the invisible sources of discomfort in the late hours of labor. Ready or not (with emphasis on the NOT), they’re here.

Their presence means:

– I’m up at 5:43 a.m., having just nursed the boy for the third time this hour with him now wanting to play. (Grrr, boy, go to sleep!)

– I contemplate daily cutting my hair to a low fade to avoid looking a hot mess. (My stylist’s feelings will be so hurt.)

– I haven’t slept more than four hours at a time since a week before I delivered. (I’m done with the “I’m tired” complaints of my childless friends, BTW.)

– I ate Thanksgiving dinner with a baby on my lap, having cooked a minimal spread with another on my hip.

– I’m incredibly isolated from the civilized world most days and evenings and often lonely because of my husband’s work hours.

– This is life as I now know it with no end in sight.

Yet this year, even with all of that, I’m not superficially thankful with a veneer over the potentially heavy burdens of new motherhood. Instead, I’m overwhelmingly humble for the greatest gifts since salvation and welcoming of the collective discomforts that my babies bring. I can’t say I don’t complain — I do because, well, this crap is hard — but the comfort of this new family is greater than the discomfort of feeling it would never happen. This is true every day all day with baby giggles, smiles and developmental skills that put icing on the cake (which I can eat worry-free with the calorie burning of nursing). And I’m nothing but thankful for that. I’m also thankful for the smallest hope that led me to this point, the prayers of the people around me, those who remain to share in our children’s lives and to God, who made it all possible.

Recognizing that things didn’t have to work out in my favor has made every day with the twins a day of thanksgiving, regardless of what the calendar says. To those whose struggle continues, try to know that my heart is with you. Happy Thanksgiving (give or take four or five days. Sue me; I’ve got twins).

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Fentanyl is your friend

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.  

“Write this down and repeat it back to me.”

Monday is egg retrieval day, but hold the sparkling cider. I've had too many BFNs to get excited just yet.

“What? Huh? Wait. OK. Um, hold on. OK, I’m ready now. Go.”

That was the beginning of my conversation with the nurse today confirming that Monday will be my retrieval day, also known as the great Christmas Egg Hunt. I worried about the shots, and now I’m the subcutaneous injection queen. I worried about the drugs having no effect, and now I have 12 measurable follicles (right — 19, 17, 16, 14, 12, 12; left — 17, 15, 14, 13, 13 and 11). FYI, follicles grow 2 mm per day and are mature, meaning more likely to have mature eggs, around 18. The number of follicles does not necessarily correlate to viable eggs, and not all eggs retrieved will necessarily be fertilized. My awareness of the fact that there’s no guarantee that they’ll find enough quality eggs for fertilization basically gives me another reason to keep the sparkling cider on ice for now.

It’s not that I’m trying to be Debbie Downer; it’s just that at this point of trying to have children, I know all too well how it feels to get my hopes up and then let down with a BFN (big fat negative). After peeing on stick or two every month, you learn to take everything as it comes. I used to search for pregnancy T-shirts with funny sayings in anticipation of a positive test amid imaginary symptoms. I’d always feel dumb afterward for thinking too far ahead. Although by God, I’ve managed to accomplish many things and overcome situations that haunt people for life, my inability to get pregnant up to this point has always made me feel like something of a failure and occasionally like God wasn’t listening on this one. I kept praying but then encouraged other people to pray; though, I didn’t tell them about the struggle.

As for being a childless failure, cognitively, I know otherwise. Emotionally, though, it takes some convincing. Being happily married and struggling to have children feels like being the smart girl who isn’t considered pretty. You do a good job pretending it doesn’t matter, but then something happens as a reminder that you do. Some of my Facebook friends are fertile Myrtles; they’ve had two kids in the time I’ve been trying to have one. Stuff like that can get to you if you let it. I’ve tried not to let it, but I’m human. And maybe that was behind my annoyance with having to endure the entire in-vitro fertilization process to have the children I’ve been psychologically preparing for since 2005.

Now, here I am at the critical point — less than 36 hours from the egg retrieval but beyond the hard part — and I’m only thinking as far ahead as drug No. 6, a pre-emptive antibiotic that I’ll take orally starting in the morning.

Mindless update

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

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.

Apologies to Nancy Reagan

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.