Thursday, August 28, 2014

A Respite

My mother came and swept me away to the lake for the last three days...All I had to do was chill and perform my rehabilitative exercises.  I've come back rested, a lot more healed, and able to walk a lot better sans crutches.  HAPPY DAY!

On the fertility side...I've finished my z-pack, sticking to my baby-aspirin regimen, and also up to 3 estrogen patches. I stay on 3 for the next set of three days and will bump up to 4 next Monday.  So far, I really don't feel too differently.  If anything, a little happier.  Honestly, I think my ovaries are kaput on estrogen production.  So it's been a nice change of pace to feel like a younger woman again.  No hot flashes, no bleeding at random times, and actually having a libido again...Yeah...I just confessed that...Getting old ladies, is not fun.  So enjoy your ovaries while they're still functioning.

Honestly, though, this is easier than a ovarian stimulation cycle.  No stress, no every other day appointments, and no worrying about the quality of my embryos.  I already know!  It won't be until I start the progesterone that my craziness will come in.  Unfortunately, progesterone is the hormone that gives you all your pre-menstrual AND early pregnancy symptoms.  In other words mega-confusion...So we shall see how I handle that...and two huge IM injections in my ass everyday...

So, tomorrow, I have more rehab, an appointment with my regular GYN, and then next Thursday I'll have my lining check to make sure I have a fluffy, happy place for a tiny human to live for the next 9.5 months.  Hopefully, I can talk Dr. B into drawing my estrogen level tomorrow, just for a sneak peak to see how things are going...

BJ and I are actually kind of excited about this cycle.  Honestly, I could stay guarded and negative that this will not work, either, but it would not change the amount of devastation I would face when we got our negative results.  So why make myself worried and miserable now?  I'm hopeful, I'm excited, and I'm scared as any newly, about to be pregnant, person might be.  BJ and I joke that we aren't ready for children.

So for now, it seems like the turmoil in my life has come to a pleasant halt.  For now, all I have to do is swallow a couple of pills, stick on a few patches and be merry.

Peace, Love, and be Merry,
Mary Katherine

Friday, August 22, 2014

Cramps, broken knees, coughs and fevers, OH MY!

Oh yes...all of the above.  I'm at that breaking point where I would cry if it would help, but it just hurts my throat and ears worse.  I can't sit still without having menstrual cramps, and I can't move because of my knee.  But who really cares because this is  temporary and tomorrow I start estrogen priming!

I had my baseline today.  My uterus looked fine, but my ovaries were all follicular-like with about 10 follicles on each... They are supposed to be quiet.  They may stay where they are, or I may need to get any cysts that form drained, but for now they are acceptable.  They will have nothing to do with this pregnancy, if I achieve it...that is kind of weird. I will depend on estrogen patches and oral and injectable progesterone until *gulp* the placenta takes over and my obstetrician decides I do not need them anymore.  

I started on my baby aspirin yesterday because of my knee surgery, but tomorrow I'll add Minivelle estrogen patches, and a z-pack to my repertoire.  The priming stage should last about 2 weeks, and I will titrate to 4 patches over the next 2 weeks.  It's been a long time since I've had that much estrogen, so I'm not really sure what to expect. 

The last 5.5 days of my estrogen priming will include 2 IM shots of progesterone a day.  Luckily for me, I know a lot of nurses that are really good at giving shots.  And I'm sure some of them will jump at the task of shooting me in the ass. :)

I'm scared and stoked at the same time.  I have moments where I feel like this is hopeless, and I might as well be known as the Knoxville Embryo Killer, but then I also have moments where I feel like this is actually it, and we might become parents after all!  I've felt like this before...I was so excited for our first IVF cycle because I thought fertilization was our major hurdle.  It was a soul-crushing experience to go through the failure of that not once, but twice.  

I told my mom I was scared of killing this baby, and she reminded me that I was giving this baby a chance.  That's all this is...a chance.  

Peace, Love, and It's Time...
Mary Katherine

Thursday, August 21, 2014

Biopsy, surgery, Go time!

So after a discussion with Dr. D, we decided that even if I couldn't do the transfer this month, I would just be out a little endometrial tissue.  So we did it.  Only took 4 tries this time to thread the catheter. OUCH!

I had also scheduled surgery for Wednesday...hoping for a meniscus repair, but  My meniscus was shredded. So, Dr. H had to cut it out.  I was super-bummed because I thought I would be out too much to do my transfer, because the turn-around is pretty quick, but not quick enough for me to not drain the remaining time off I had.

I know it seems silly, but when you've been trying 4.5 years to get pregnant and you get this close only to have a stupid knee injury potentially derail your chance at parenthood, it's hard.  I mean how long do we have to wait?  I guess you can't really know until you've been there, but it's like having the rug pulled out from under you, again, and for something stupid.

I love my husband, I really do, but my heart beats for this family we are supposed to be. I've given up a lot and had to adapt this dream to my reality.  It's quite possible that this will not work, and I will have to adapt more, but for now the thought of carrying a pregnancy gives me a reason to get out of bed and go to work.  Much like your dream car, dream house, dream partner, my family dream, which my husband is a very significant part of, keeps me going when everything else is crumbling around me. For someone with infertility, waking up every morning to an emptiness you, alone, are incapable of filling is a grueling task.

So on day 2 post-op, I'm going to go to work tomorrow after rehab and salvage as many hours for this week as I can.  I still have a couple weeks I can work the desk, which should be perfect for my recovery, and still have days off if I need them to do my transfer.  I'm super lucky to have a manager that has let me do this.  

As general anesthesia tends to do, my period started. It's not enough to just have surgical pain, I have to have full-on endometriosis cramps which some-how seem to be able to trump muscle relaxers, narcotics, and phenergan coma.  I swear, my next surgery will be a hysterectomy!

On the upside, I'll possibly be starting my estrogen patches as early as Saturday!  Crazy!  This is happening.  I could actually be moving forward. Of course we have to make sure my ovaries are behaving and aren't going to throw anything off. So tomorrow I have my baseline ultrasound and lab work.

The nice thing about frozen embryo transfers, is there is quite a bit more wiggle room.  The babies are fine.  They are just chillin' out, so we have time to adjust.  Dr. D can drain my cysts if that becomes an issue, we can prime more or less with the estrogen, and because my ovaries are feral, I would predict more.

I just can't believe we've made it this far, in spite of my knee hiccup.  Oh, my knee hiccup was pretty nasty as I'm missing quite a bit of my meniscus now...supposedly no running/squatting/high impact activity...looks like I need a gym with an indoor pool and water aerobics.  That is, honestly, quite a blow for me.  The alternative is wearing the rest of my meniscus out and being the first of my peers to have a knee replacement...honestly, I'm not old enough for water aerobics!

Peace, Love, and Phenergan is my friend,

Sunday, August 17, 2014

Biopsy 2...POSTPONED!!!

Yeah...So apparently I hate endometrial biopsies so much, I will indeed tear my meniscus to get out of it.  Oh, well crap...I don't "officially" know that...the medical center I work at just happens to allow me to look at my lab/imaging results, so I did.  According to the radiologist, I have a torn hamstring, a calf-muscle strain, something about my patellar tendon, and a bucket-handle tear of my meniscus that is displaced in the joint, hence my inability to straighten my leg...So that buys my ticket to the OR.  On the upside, my ACL graft is intact!!! NO RECON FOR ME!!!

So anyway, I was all half-naked, self-medicated, and covered in the opaque tissue paper blanket that was all I had left of my dignity when I told my nurse practitioner, "I don't know what to do."

She is amazing. We had a long discussion on our options. Anesthesia while I'm doing the first part, estrogen priming, is not a problem.  According to one of my expert maternal-fetal medicine acquaintances, I just need to tell the anesthesiologist because all the estrogen could cause me to potentially have a hypotensive episode, and I'll have a little bit bigger chance of developing a blood clot. [Cue "Nothing's Gonna Stop Us Now"!]

They were fine with me potentially doing rehabilitation while pregnant, but they have nixed foreseeably for a while, as in the duration of my pregnancy...Like shut the front door, WHAT? *Sigh* I guess I was fooling myself into thinking as soon as I got pregnant it would be a "normal" pregnancy, but that is not really the case.  For one thing, I am gently reminded, that this embryo is not genetically mine.  So while in a normal pregnancy, a lady's immune system recognizes that, "Yo, at least some of this is my own genetic material."  I will not inherently have that layer of protection, and I don't want to be doing something that could potentially complicate the level of hormones in my system.  Dr. D does not want me participating any activity where I have to tighten my abdominal muscles for more than a few brief seconds...their example was, "It's fine to lean over and lift a bag of groceries." I know...My husband, who keeps me on an extremely long leash, and I decided some things are just not worth the risk.  So as much as I wanted my pregnancy story to include WODs, it's just not gonna happen for me. It's looking more like water aerobics for the elderly and walking with the Emma Grace. But considering where I come from, what I've been through up to this point, the limits to what I'd do for a chance to carry a pregnancy are few and far between.  So as much as I've loved CrossFit, it's just going to have to be placed on the back burner.

So anyway, after all this half-naked but biopsy free discussion, we decided to wait until after I had my follow up with Dr. H (ortho) and potentially had a surgical date before we moved forward.

So tomorrow we move forward one way or the other.  I'm too nervous to be excited at this point. I'm afraid I'm going to kill my baby.  BJ on the other hand said he's ready...which is better than a personal serenade from Jason Mraz.  SERIOUSLY! BJ is the most comforting thing ever.  It's why he's my lobster.  He's my strength when I'm running out, and he's my confidence when I have none.  That's an amazing thing to have.

Peace, Love, and Meniscus for the win (cuz endometrial biopsies suck),

Thursday, August 14, 2014

Biopsy/Torture Session 1

Ok, so it was not as awful as I remembered...

It did take 3 attempts to make it into my uterus...but whatevs...It ended fast...Oh, and I did load up on all the drugs they gave me for my knee...I mean...being in stirrups with a knee injury is not if it's ever fun...but somehow I've found away to make it even less fun!!!

So I'm still in a bit of a conundrum...As soon as I finished my steroid pack, my knee blew up to the size it was after I tore my ACL...bugger.  I have no idea what I've done, but my ortho's nurse is guessing meniscus. I'm thinking that it's probably going to be surgical...On top of that my meds came today for my transfer...It's a holy mess.  Clearly I don't want to have surgery after my transfer, but I can't walk with my knee stuck at a 20 degree bend, either, and therefore cannot work as a nurse. I'm ready to stop taking birth control and start sticking Estrogen patches all over my body according to Dr. Donesky, but I have no idea if Dr. Holt can squeeze me in, in the next 2 weeks.

Gah...Why?!  Why do I complicate everything????

Sometimes you just gotta role with the knee injuries, I guess...What can you do?

I have to get ready for biopsy numero dos...which means my knee is suddenly hurting again, and I must take that pain pill...oh darn...

Peace, Love, and Crutches suck!

Sunday, August 3, 2014

Well, here's a wrench

Well...this could slightly complicate the embryo transfer.  I was trying to move on, forget about the nagging pelvic pain from last Thursday's little aggravation, and enjoy my happy place...being on the lake.  At first I was like, 'don't wakeboard, your lower tummy is too sore'...but then I couldn't stand being on our new boat and not trying, plus the pain lessened with I rode for a good little while.  It was my third ride, and I hit the wake wrong, tipped the toe-side of my board in too far and was falling face-plant style...I tried to turn to avoid landing on my abdomen in case my ovaries exploded and my foot stayed in the bindings....Unfortunately, my wakeboard flipped in one direction, and I in the other with my foot still strapped in. I heard and felt a nice pop...

What-evs, I'm a two-timer on the ACL recon front, so I was like, "no big deal", I'll be able to walk and can get it fixed maybe in the middle of my "maternity leave" if we are so lucky.  However, when I wanted to get back in the boat, my knee wouldn't straighten... if fact that's my extension in that picture...I couldn't get it in the immobilizer @ ED visit one on Friday evening.  ED visit number 2 on Saturday morning because I was up all night with spasming and feeling like my lower leg was falling off at whatever angle I put it in...I called to ask if there was a weekend ortho clinic anywhere in Knoxville, and they said..."You're gonna have to come back to the Emergency Department." I've never been to the ED twice for the same problem...So embarrassing...anyway, after 2 doses of Dilaudid, zofran, and an IV muscle relaxant they got it "straight enough" to barely fit in the immobilizer. My knee is probably 3 inches from the back of the immobilizer.  I went home on more pain meds, muscle relaxers, and steroids.  I slept in the immobilizer but my knee was cramping up more and more and now I'm stuck at 20 degrees again...

So I was supposed to work this weekend...It's hard to be a nurse with 2 hands...much less no hands because of the crutches...oh, and it hurts quite a bit, so I'm wasting my time-off away, and I'll need days sooner rather than later for an embryo transfer.  This is just, well, typical "Shull" luck for me.  I have enough time off to make it through 2 shifts and then I'm tapped out.  I can't go back to work until I'm cleared by an ortho. That sounds well and good, but I don't hear too many people getting in to see an ortho the day they call.  I'm feeling pretty screwed...I mean I can probably get my short-term disability, but I doubt they will let me have that for an embryo transfer...and I'm in a little deep to stop now...

This just bites...on the upside I have pain killers for my endometrial biopsy!

Peace, Love, and Gimps,
Mary Katherine