Thursday, April 30, 2009

Panic in Needle Park

Well, it's been an exciting six days. Last Saturday, I began injecting a veritable cocktail of stimulation meds.

Possible cocktail names: A Stimulator? A Feisty Follicle? A Purple Bruise? A Hormone-tini?


1. Gonal-F pen. This one seemed a tad complex in the instructional videos, but is actually quite user-friendly. It's chunky and pen-shaped, and lives in the fridge. Each day, I pop a small needle tip on the end, turn the dial at the bottom of the pen so that a black arrow points to my required dosage, pull out the stopper and inject. The needles are pretty small and comfortable enough - the only odd bit comes when you've got one hand holding up a chunk of your skin and the other holding the pen; then you realize that you need to slide your hand up the pen (whatever the opposite of 'choking up' would be), to give yourself enough leverage to push the little stopper back in with a finger. It doesn't glide as smoothly as a syringe would, but all in all, no major complaints. 

2. Lupron, still, but now half as much. Same old.

3. Menopur. Jeepers. This one involves mixing, which introduces all kinds of chances for human error. First, you draw up a clear liquid diluent into a syringe, then you shoot that into a vial of white powder. You swirl the vial around a bit until the powder is totally dissolved into the clear liquid. Then, you put that in a spoon and heat it over a flame in your dark, seedy den of iniquity... MWAHAHA. Okay, no. Not really. 

When the powder is completely dissolved, you pull the solution back up into the syringe, switch to a smaller needle, and inject. The awkward part of it all is that they gave me a Q-cap, which pops over the tops of the vials and on the ends of the syringes, and which is meant to facilitate all the mixing and blending, without the use of a long mix-y needle. Somehow, though, I didn't get that from the instructions, so I popped a Q-cap over one vial, then stuck a needle into the Q-cap, and couldn't figure out why I couldn't use the needle to pull liquid through the plastic cap. As I said: USER ERROR. I have now, fortunately, mastered the use of the Q-cap, but still struggle a bit with these syringes, which seem specifically designed to collect giant air bubbles, then wiggle free from my fingers and shoot expensive liquid on my kitchen counter. 

Sidebar: this stuff is apparently made from the urine of post-menopausal women. I'm quite sure I could have obtained some of that on my own. Sadly, I bet I wouldn't have been able to save any money that way. 

So now: three injections, and one bad-ass hematoma to show for it. It's about the length and width of my pinky, oval-shaped, a rainbow of purple and pink, with some interesting circular shapes underneath. I don't know which needle to blame for that one. 

I have 19 follicles, which I saw on my ultrasound today, none of them up to 10mm yet. When I think about follicles, I imagine they look like tentacles, or like sea anemone fingers waving underwater. They're not nearly that cool. Seriously, they're just black spots on the ultrasound screen.
I got a small boost in my dosage amount two days ago, since my estrogen level was only at 89, instead of the desired 150. Today, though, it's at 300, so we're holding steady at current doses and seeing if those follicles get bigger by Saturday. I'm waiting for the steadily rising estrogen levels to make me suddenly freak the freak out and want to watch Hallmark commercials or "The Hills." Fortunately, I've felt pretty good so far. On the night I started these meds, I had a migraine and a bit of nausea, but that condition hasn't been repeated since then. 

One small complaint - I don't really know if my number of follicles is "normal" or something that I should feel good or hopeful about. As it was explained to me, they still needed time to fully mature before anything more could be done. They didn't really say how many they were hoping to see, or how many the average patient had, or how big they should be. The doctor implied that things looked promising, and the nurse told me "let's stay positive and see how things look on Saturday." What I wanted to say was that I was positive I wanted to know what was happening inside me. But I didn't. 

Sunday, April 26, 2009

The Ectopiad, part II

Let it be known that Sunday is pretty much the worst day for any sort of medical problem to occur. I've been doing my OBGYN appointments at the big state/teaching hospital where my husband works, for the sake of convenience, so the on-call doctor for that Sunday was some 20-something resident who told me only to come in if I began bleeding enough to soak through a pad an hour. This was not the mental picture I wanted to have - in fact, I went ahead and decided for myself that I might go in to the ER if I were only soaking through, say, a pad every two hours. 

So I spent my day on the couch, reliving middle school and replacing my giant maxi pads as needed. I kept thinking the shedding of significant amounts of bright red blood was probably not the best way to begin a pregnancy, and watching "The Tudors" on Showtime On-Demand was probably not helping. Or maybe it was. I watched Natalie Dormer's Anne Boleyn writhe in a puddle of blood, clutching her sheets between her legs as if in a futile effort to keep it all in, and thought:

A. She's doing a pretty decent acting job here.
B. Well, at least no one's coming along to decapitate me after all this. 

Around 6 p.m. I became tired of not knowing what was happening to me. I was also tired of the increasingly anxious phone calls I was getting from my mother. So, despite the husband's moaning and groaning that the ER was a new, special ring of Hades, we went. We spent 6 or 7 delightful hours in the ER - an exam showed that my cervix was still closed, an ultrasound revealed nothing, as is the case when one is only 3-4 weeks pregnant (despite this test being almost guaranteed to be inconclusive, it was given to me anyway, probably because ultrasounds are so cheap). They took blood to check my HcG levels, and told me those levels would need to be checked again in two days for comparison. By the time we finally convinced someone to send us home, I was delirious, tired, hungry, and out of sanitary items. I was almost zombie-esque, standing in the doorway of our room, blood on my skimpy hospital gown, slowly kicking a stool back and forth for entertainment. 

Yes, I know - it's my fault for going to the ER instead of waiting for the clinic to open. By showing up in the evening, all my subsequent blood tests had to be done in the evening, guaranteeing me more needless and pricey ER trips for simple blood draws. But somehow, just being in the hospital, even when I was being driven nutrageous by the slowly grinding gears of the hospital machinery, (I waited 30-45 minutes for someone to come push me back to my room from the ultrasound room in a wheelchair, despite the fact that my own legs worked perfectly well. Also, the person being asked to push me had not shown up for their shift. So that went well.) made me feel as though as least someone was listening to me and would figure out what was going on. 

That bubble, eventually, was burst. 

Sunday, April 19, 2009

The Ectopiad, part I

I should first invoke a muse, no? Which one covers oligomenorrhea? 

Sing to me of the woman, Muse, the woman whose fallopian twists and turns
have driven her time and time again off course. And the people and things that have plundered the hallowed depths of her womb-iness.

We'll begin, as you're s'posed to, in medias res. 

Last July, I stood at my washing machine with the remnants of an old bar of soap, trying to scrub blood stains from the crotch of ten to twelve pairs of cotton underpants, thinking "Is this as bad as it's going to get?" 

I began 2008 free of birth control and ready to spawn. I had just turned 28 and I wanted three children. I soon discovered that periods could be unpredictable and that cycle day counting is harder than calculus. After years of being told that any missed birth control pill could immediately land me pregnant, suddenly I felt that the rules had changed. The same people impressing upon me that no method of birth control was 100% effective were now cautioning that it could take some time to become pregnant. Bizarre.

In May, after two negative pregnancy tests, I got the two blue lines. And I was happy. My husband, on the other hand, is basically Your Superstitious Grandma from the Old County. He has an evil eye charm, for reals. He expressed very few opinions on the subject, didn't want to tell his parents, the whole bit. I thought, as we all do at first, and as I never will be able to again, that I had no reason to be afraid. I had no reason to think that I wouldn't have one of those perfect, uneventful pregnancies. I felt like a healthy hoss of a girl - exercised four or five times a week, drank tons of milk, popped a prenatal vitamin every morning. 

So I got to feel that way for about three weeks. And honestly, I never will again. I feel like that might be the worst part of this whole experience - that I'll never be able to look down on a pee stick, see two blue lines, and feel secure or optimistic, because now I know that two lines don't equal baby.

One night, I showed the husband something that I'd bought at Target - a three-pack of receiving blankets with little ducks on them. And not just ducks - ducks wearing snorkels.

Me: "Look at this! How adorable are the ducks with the snorkels?"
Him: "Put that away!"

I dismissed his worries - why shouldn't we be fine, like so many of our friends? Like every other person we knew, in fact? Why shouldn't we be lucky? 

The next morning, I woke up early, needing to pee. I stumbled into the bathroom and screamed for my husband when I saw the bright red blood stains in my underwear. It was Father's Day.

Burnin', Doin' the Lupron Dance...

(How much you do love that song? The original, I mean. Take a moment if you need to have a brief impromptu dance party. I'll be here.)

Lupron injections are proceeding without much ado. Oddly, I have no trouble injecting myself on the left side of my abdomen, needle sliding right in and everything. The right side, though, feels much more like...oh, I dunno...jabbing at myself with a needle. It must have something to do with being right-handed and the angle I'm using.

So, since things on the pharmaceutical front are uneventful, I was thinking about How I Got Here. It's been fifteen months since I chucked the NuvaRing - and I distinctly remember primal screaming my ass off last July or August, because I thought I was going to be derailed from TTC-ing (T'ing-TC? must ponder the conjugation) for two months. Am I Zen or massively repressed? Hard to say. For the benefit of anyone who cares, though, or anyone who can identify or be comforted, I give epic.

- The Ectopiad?
- Tubeowulf?
- Le Chanson de Zygote?
- One Thousand and One Nights in a Maxi Pad?   


Wednesday, April 15, 2009

The Best Part of Waking Up...

Is a trans-vaginal ultrasound at 8:05 a.m. Goooood morning!

On Monday, I found myself in a familiar place - on a table with a Wii controller poking around in my goodies, while a doctor looks for The Amazing Disappearing Follicyst/Cysticle. This time, she's accompanied by a young woman, who is introduced to me as a resident. 

However, this supposed "resident" (and yes, I'm making air quote fingers) was not wearing a white lab coat, or a clip-on ID badge, as one would expect a hospital staff member to wear. She was a semi-bashful young woman in a skirt and sweater set, and the more I think about it, the more I feel that I should have asked for some ID. For all I know, this was Take Your Grown Daughter to Work to Vaginally Probe a Stranger Day. I suppose I'll never know. 

So, the impostor gingerly bumps the wand around and of course, the attending doctor then helpfully shows her that she was not PUSHING DOWN (oof)  with enough FORCE (grunt). 

"I feel like I'm going to pee now. Like, forcefully."

This did not perturb either of them in the least. After a few more deeply awkward moments, I was told my ovaries were Follicyst/Cysticle free and given the go-ahead to commence sub-cutaneous injections. 

That started yesterday. far, it's been fairly easy. The needle is small and thin, and slides quite smoothly into my nice, convenient ripple o'abdominal fat. It's almost strange how quickly one becomes accustomed to sticking teeny needles into oneself. I could have been doing this all along! Back in high school, when I'd go out for the evening with friends, my mother would always say, "Be home by 11:30 and don't shoot any heroin into your eyeballs." A grotesque image, to be sure, but had I only known, I could have been shooting things into my belly instead! Oh, for opportunities lost. 

Until next time...

Sunday, April 12, 2009


Is on hold for another week. Last week's ultrasound showed a follicle on one of my ovaries; in the IVF-verse, this is an obstacle. Perhaps because they want complete control of when I make eggs? The nurse who called to remind me to come in for the ultrasound told me that another week of BCP would treat my "cyst." 

Me: "What cyst? The doctor said it was a follicle."

Nurse: "Cyst, follicle...they look the same."

My interior monologue: " opt for the word with the negative health connotations? Awesome."

Another day, another diagnosis, another mysterious set of events unfolding in the unknowable vortex that is my uterus.

Saturday, April 4, 2009

Book of Uteronomy, Chapter 1

Terms I Cannot Bring Myself to Use

1. "Baby Dance."

Seriously, y'all, this is just awful. I've seen this expression on way too many TTC message boards. It's not "baby dancing," it's procreative sex - intercourse between two consenting adults for the purpose of achieving conception. Call it sex, doing it, getting it on, screwing...anything but "baby dancing." That term is a set of Lee Press-On fingernails down the blackboard of my soul.

And then there are people who abbreviate the term and make it "BD," which makes the whole thing far too close to both "BM" and "VD" - two things I don't want associated with the action in my boudoir.

"Baby dancing" is what happened in the early years of "Ally McBeal," (ooga-chaka, ooga-chaka) and despite my love for Ally, "Hooked on a Feeling" and Nick and Nora jammies, this expression has got to go.

Thursday, April 2, 2009

First blog post. 

It's kind of like singing along to the radio in your car. You're jamming, all by yourself, not sure if your voice sounds good, or if it's just your own ego. Eventually, some of the people driving by you notice that you're singing. They might think you're completely lame, or they might think "she seems to be having fun."

And why now? Because two days ago I received a large box in the mail, full of vials and needles and pre-loaded pens and my very own wee biohazard container. And for some reason, I thought - I need to chronicle this. Trying to conceive can be lonely (sexytime notwithstanding), and we often find ourselves on the internet, looking for answers to the questions we're afraid to ask our doctors, or the encouragement we need to get on our feet (or on our backs...) and try again after months of negative pee tests. 

My intent is for this blog to be about:  life as a not-so-fertile person, bouncing back from an ectopic pregnancy, the absurd side of trying to conceive, and a realistic look at ART for the curious and wary. I'm not overly sentimental, and I don't do sparkly animated fairies; my goal is to be humorous and helpful, but honest. There are certain phrases I will never use. I'll tell you what they are later. Maybe it's a diary that nobody reads, I dunno. 

Anyhoodle - T-minus five days until I give myself the first injection, hopefully without spearing my own spleen like a cocktail weenie.