Cluck, Cluck

This morning at 6:00am with four different alarms buzzing (it's a time-sensitive thing, and I was not taking any chances!!!) my amazing husband and I headed to the Chat-town facility of the fertility clinic we are using.  We had to do this because this is where the embryology lab is.  I slept like a baby the night before and woke up feeling rather que sera sera about the whole ordeal.  I knew I had taken my medicince exactly as instructed and refrained from any activities (such as running) that would possibly have had a negative impact on my ovaries.  However many eggs I had was what I had, and there was nothing more I could do about it. 

They took us back to prep for my "surgery".  They started an IV and all those shenanigans.  They use propofol, which is a short-acting anesthetic that is partially to blame for Micheal Jackson's demise.  It's good stuff.  I also found out that as of today I have gained 15 lbs in the last couple of weeks which was extremely depressing.  Most of it is water-weight from the fluids in my follicles, but it's still miserable.  What's worse, is that my body thinks it needs to refill  that fluid so it's going to hang on to water for a while still.  I'm on a diet of gatorade and have to weigh myself everyday for the next few days and until my weight get's back under control.  No one told me about  this part...but it sure explains why I've been so miserable the last few days.

I walked myself back to the operating room and once again was strapped into stirrups while being put under...sigh...It was not awful though.  I had an amazing staff of nurses working with me and they were super-comforting and encouraging.  They knew this was a big deal and treated me with a lot of deference which I really didn't expect.  Dr. D came in and helped get me ready.  They have to wait until the last possible minute to give the propofol because it can damage the eggs.  As soon as I was out they used an internal ultra-sound wand fitted with a 12" needle bayonet, with pipettes.  Dr. D individually inserted the needle into each follicle on my ovaries and removed all the fluid.

This is what was happening to me. How was your morning? (image from babydust.eponym.com)





It only took Dr. D about a half hour and I was rolled back into the recovery area to get an iv antibiotic and be monitored for a bit.  I had no pain what-so-ever when I woke up which is amazing for getting stabbed at least 24 times.  The embryologist, Susan, came back and told me they were able to retrieve 24 eggs, and after yesterday's freak-out, I broke down.  I was truly overwhelmed with emotion because I was so relieved to find out I actually had eggs.  The nurses hugged me and told me they were very proud.  Susan reassured me that she was an excellent baby-sitter.  After some more discharge instructions, they sent us on our way.  I thought I'd made it home without any funny anesthesia stories, but not so...

I hate to be mean, but the other couple getting their retrieval today was super-annoying.  They had a monitoring appointment around the same time as us Sunday, and we were laughing at them then, because they brought the maternal grandmother-to-be.  Well she came to the retrieval, too.  I was embarassed for the couple in their upper-thirties from that alone...(I'm Miss Independent, remember) but then we had to listen to them, too.  The husband opened up the conversation with, "How many times have your dropped the test tube with the eggs?"  HOLY HELL!  WHAT AN ASSHOLE! I asked BJ to go punch him (this was before my procedure so I wasn't drunk yet and asked it quietly.)  Then I had to listen to the potential mother-to-be refuse to drink gatorade.  "Can I drink water with miso, intead?"  OMG lady...you've gone through all this and you are refusing to drink Gatorade because of the sugar-content.  GET REAL!  The nurse more nicely than I can type implied she could do whatever she wanted, but that they've had to cancel transfers because of OHSS when people did not follow the protocol. 

After the procedure (when I was a little drunk), I had to listen to the granny-to-be argue with the nurse about the appropriate needles to use for the progesterone-in-oil injections.  REALLY??? Just do what they tell you for God's sakes, people!  Is it really worth 2 months of your time and $15,000 grand down the tubes for not doing what the experts who do this everyday say?  So then they mentioned that they were able to retrieve 17 eggs from "dip-shit" couple, and that is when I loudly said, "Yes, we beat them! We got 24!"  What!? I can't help my competitive nature!

So now, I'm supposed to keep drinking gatorade, heal up, and get ready to have my babies put back where they belong on Sunday.  Susan performed the ICSI this afternoon, but it will still take until tomorrow to find out how many fertilize correctly.  Each day some may quit progressing, so I intellectually understand that I'm not going to have 2 embryos to implant and 22 to freeze.  Emotionally, however, it's still sad to think that a little life (how-so-ever small) did not make it. I'm going to get a call tomorrow with the results of the ICSI.  Pray for my babies! 

As for now, it's time to go face a 1.5" needle with a large bore.  Hopefully, only five days of this!

Peace, Love, and Fertilization!
MK

How I Got Here Part 2: The Lap

No, not the clap, the lap...As in laparoscopy...

I had a really low-key Valentine's Day without any chocolate-covered strawberries. I figured it would not be in my best interest to be throwing up what would look like blood clots. I worked out for an hour and a half thinking it would be a while before I could do that again. Took shower #1 as directed by my pre-op instructions...I found it rather disturbing that I needed to be told to take two showers before going to the hospital. Do people really show up dirty for this kinda thing? Eww...Anyway, I laid out my clothes which included a new pink sweater from Victoria's Secret that I bought for myself as a pity gift, skinny jeans and my Uggs. (My dorky-ness even confounds me at times.) I set my alarm for 4:15 am and laid there until it went off.

Showered (#2), hair straightened and ready to go, BJ and I hit the road by 5:00 am to make the 6:00 am show time. On the way down "Brick" by Ben Folds Five played on my iPod which made us giggle...(we're kinda sick like that...)

I get taken back to the pre-op area and my blood pressure is something ridiculous for me like 150/100. (My normal is 90/70.) I kept asking the nurses when I would get my Rufy (yes, I'm talking about the date-rape drug), and they just kept saying soon. They started an IV, during which BJ cringed and cowered in the corner because he hates all things related to doctors. (He can watch Saw, but not his wife getting stuck!?) The anesthesiologist met with me and told me they did not use Ruhypnol, which was disappointing because the cocktail I did get, really didn't do it for me. My doctor came by and told me what to expect when I got rolled into the operating room, lots of people running around and the like. He told me he would be there before they put me under.

(Ok, so maybe the drugs were working a little bit)

I find the waiting before the surgery to be some of the least fun times...so not soon enough I was kissing my still green husband, giving up my pink fuzzy blanket (it's generally really cold in hospitals), and putting on a super sexy hair cap. The operating room was even colder. They had me scoot myself over to the operating table, and then scoot my head up, and then scoot down to the other end of the table while they tried to figure out what to do with my 5-foot frame. Just as my doctor said, people we're running around and sticking things on me including these nifty little air massage things to keep me from getting blood clots in my lower legs. Dr. B was there rubbing my arm until I went out. The last thing I remember was seeing one of the nurses attaching the stirrup to the table, and looking at my doctor and either mouthing or saying (I hope mouthing) "oh, shit."

So while I was completely out they inserted a breathing tube and then placed a port with a camera and a few other devices in my belly button. They inflated my torso with air so they could get a better picture. My insides were inspected for any deformities, lesions from endometriosis, or anything else that could be an obstacle to our quest for spawning.

A couple of hours later that could have been 30 seconds for all I knew, I was waking up in recovery. The nurse came over and asked me how I was, and I kept saying, "My beav hurts." The nurse asked, "What hurts?" Emphatically I responded, "My beav." The word beav, while once used frequently, has not been in my vernacular since I graduated from college. It is amazing how messed up anesthesia can make you. My mind felt completely coherent, but I was too sleepy to put the effort into sounding coherent...at least that is how I felt. Anyway, the nurse smiled and nodded and dosed me up with something probably with more interest in shutting me up than pain relief. I was not in extreme pain at all. It kinda just felt like I had lost my virginity again...less fun, and with more drugs...

The second time I woke up, I saw BJ, and all was right with the world again. I didn't care if anything hurt. I was just like, "He loves me," then back to sleep. I was starting to stir for good and was really thirsty. I tried to drink, but I immediately started hurling. Anesthesia and I have never gotten along. So then I got dosed up with all kinds of anti-nausea meds and remember the nurse saying this is a good time to take her home hoping that I'd sleep the entire way back and not puke on anything. I got dressed mostly by myself and decided I needed to use the bathroom again without being babysat. So I took off leaving BJ confused and the nurse asking where "Miss Independent" went. Apparently, I had a catheter placed (another eww, gross, sorry), and it kinda messes with your bladder's sensibilities for a bit. I thought I had to go, but 10 minutes later, I gave up. I opened the bathroom door to find that the nurse was standing there with one of those "wide load" wheel chairs. I was humiliated. "Which side do you want me to sit on?" I asked her. She was just told me to get in, and I was getting more drowsy, so I did. I can imagine the nurses were all relieved...

Upon, returning home I whisked myself to bed. I slept most of the rest of the day, and when I woke up, I was in no pain. Peeing was still a little weird and seemed to take forever. I was a little sore, and my incisions stung, but no real pain. I've only had orthopedic stuff done that involved bones, so this by comparison, was a breeze. Food didn't seem too appealing to me, still, but other than that I felt downright plucky. To my surprise, because I was expecting it, I didn't have any bleeding. I was however unthrilled to see that there was a 3rd incision just over my left hip bone. BJ swears my doctor told me this would happen if I needed any lesions or adhesions removed, but I apparently had selective hearing...Anyway, I was immediately in less pain after my surgery than I had been in for almost three months. My husband let me drunk-dial my boss (thanks, baby) and tell him I felt fine and could come in to work. He told me to go back to bed, and I did.

I was still pretty nauseous the next day and had some dry heaving. That was probably the worst thing. My ab muscles were really sore, so the heaving motion wasn't making me feel too good. My mother, who had come down to stay with me when BJ went to work, became obsessed with getting me to eat. Every time I tried, I started heaving so it really wasn't worth the effort. To control the pain from heaving my mom gave me a percocet, which in turn, also makes me sick. In hind-sight, I should have had my husband ask my doc for a prescription for phenergan...oh, well...next time. Which is the unfortunate thing about endometriosis, there quite often is a next time as it comes back...especially if you don't get pregnant. Anyway, the final torture came when my mother tried to make me drink warm Jell-O. I've always thought my mom had a touch of Munchausen by proxy (crazy parents that get off on making their children sick), but the warm gelatin really sealed the deal. It didn't take 15 seconds to be up-chucking that heinous concoction.

The next day my doctor's partner called in some Phenergan for me. I immediately felt better after I woke up and was able to keep down some soup. I think I did have some weird discharge, but a super-thin panty-liner was more than enough to take care of it. My abs were still pretty sore, so I thought I was going to kill my husband when he wanted me to watch The Wild & Wonderful Whites of Boone County. Laughing was still not a pleasant situation at this point. Besides eliminating comedies from your routine and having anti-nausea meds on-hand, my other suggestion is to keep some cranberry juice on hand to help with any bladder weirdness, which I also had, but it wasn't bad.

By Friday, 4 days post-op I was ready to get out of my house. BJ had gotten a new job and we were in the middle of house-hunting during all this craziness.  I was then chauffered around several different neighborhoods and went furniture shopping. By late afternoon, I was getting pretty sore so back to bed I went. Saturday morning I felt great. I felt like a brand new person, and like an idiot decided to go for a run. I made it about 50 yards out of pure spite, but I was comfortable enough to walk a couple of miles.

I went back to work full-time on Monday and was able to really run by that Wednesday. We were even able to resume our procreation efforts after a week. Again, I can't say enough good things about my doctor. I never had the shoulder pain that people almost always get from the leftover gas used to inflate their bellies. I had immediate relief from my endo pain. He did a great job making me feel as comfortable as I could be. Thanks, Dr. B!

Tootles,
MK

How I Got Here: Part 1, "You need surgery"

So, BJ and I had been trying to spawn, unsuccessfully for 6 months. During that time, my menstrual cycles continued to get more wonky. I had been on depo provera (the shot that lasts three months) for birth control for just over three years. My last shot was in August 2009, and my periods restarted March 1, 2010. From March to June, my cycles were 31 days apart. 'Perfect,' or so I thought...

June 2010, I noticed that I started having mid-cycle pain, known as mittelschmerz (leave it to the Germans). It wasn't terrible, just uncomfortable. Over the next few months this mitttelschmerz grew from mild crampiness to sudden stabbing pains that just kind of ripped through my torso without any warning. It seemed like I was constantly uncomfortable the majority of my cycle culminating with my menstrual cramps that were just unbearable at this point and every bit as bad as they we're in high school with cold sweats, nausea, and extreme pain. Luckily, they only lasted for 48-72 hours, which turns out to not necessarily be a good thing, either. Also my cycles had become more irregular going from 27 days to 35 and everywhere in between. This made trying to nail down when I was going to ovulate, next to impossible. To add to the fun, I was growing more and more uncomfortable during the act of trying to make this love child.

OK, so 6 months flew by (not at all, actually...) and I'm in my gyno's office with my husband. He told me I wasn't so irregular yet, that I needed Clomid. I took this kind of hard because I had it worked out in my head that Clomid was going to be my miracle cure, like it was for a friend of mine. One Clomid cycle and bam, she was prego. So then he asked about my pain. I was already starting to get embarrassed for wasting his time, (my doc didn't make me feel that way, I just am sensitive about coming off as a malingerer) and, as I mentioned before, started in with my gloss over about how I survive. The 1000mg of ibuprofen every four hours caught his attention, and BJ was able to involve himself in just how bad my periods were.

My periods had been this way all my life, so I didn't know any differently. Anytime I mentioned it to a medical type, I was dismissed. I had never considered endometriosis because I incorrectly assumed that I would have sporadic mid-cycle bleeding which I never did. I was really angry that three different doctors never took the time to find out just how much pain I was in. Take-home lesson, if you're in pain, go ahead and whine to your doctor until he listens. Oh, and extremely painful periods are not normal or "just part of being a woman." You have my permission to slap anyone who says that to you...

My doctor wanted to perform a laparoscopy. He described it as a "band-aid" surgery, and I'd have two small incisions, one in my belly button and one just over my pubic bone. The surgery is the only way to diagnose endometriosis (endo for short) as it doesn't show up on ultrasounds. I was a little shocked that exploratory surgery was necessary, especially when all I wanted was Clomid.

After taking a week to think about it (da Nile ain't just a river in Egypt), I decided to go ahead and schedule the surgery for February 8th, just after when I expected my period to end, like my doctor wanted. My doctor called me back and explained that in addition to the laparoscopy with possible endo lesion removal I was going to get the full spa treatment. He also wanted to do a hysteroscope, possibly a D&C, and the chromotubation. (I explain these in more detail in my "so you decide to get help" post.) I was kinda like, 'hmm you conveniently left all of this out.' Whatever, I want a baby...

So I sat down with my boss later that week and told him that I had to have surgery. I have found that if you have male superiors, a few tears, throwing out words like vagina and ovaries, and mentioning gynecologist pretty much will get you what you want. He, bless his heart, mentioned that between his two daughters and wife, had a lot of experience with malfunctioning female parts. I have been very blessed to have quite a number of amazing friends, co-workers and relatives who have been such great cheerleaders.

January came, and I spent my spare time charting my symptoms, still trying to procreate, and researching endo. Holy bananas! I had no idea that all this extra pain I was having was related to my possible endo. If it's not bad enough to be in terrible pain for three days out of every month, it also hurt like hell to go to the bathroom. I had found over the previous couple of months that if I did not eat or drink anything while on my period, the pain wasn't quite so bad. I wanted to take as much pressure off my lower abdomen as possible. Who knew this was yet another symptom of endo? I was constantly having what I would describe as a sinus headache of the uterus. I was getting pretty miserable and had been having a lot of trouble staying asleep. I would be woken up with random cramps and pelvic pain in the middle of the night, and not be able to go back to sleep. 'Snot fun.

I also started reading message board responses on infertility sites about endometriosis and surgery, and came out rather horrified. Things in the wrong place, glued to the wrong parts with scar tissue and never working again. Holy crapola! So then I made the mistake of asking my nursing student friend about the surgery and she spouted off facts about ectopic pregancies being more common with endo and sometimes the only thing that could be done was a hysterectomy. Now, I was certifiably scared. Then she tried to soothe me with "It's no big deal they do laps all the time. Oh, and you'd be shocked at the number of people that just walk in and out of the operating room." Oh, geez...The idea of being under anesthesia in stirrups has never exactly been on my bucket list. Now I got full body shudders every time someone mentioned my surgery...still do, ick!

February 1st came and went, and so did the 2nd, 3rd, 4th and 5th...but my period never came. As if I needed anymore problems! My secretary told me about the old wives' tale of parsley inducing your period...so I tried sucking on Parsley for the rest of the week (desperate and super-yuck), but I ended up having to postpone my surgery to the following week. On Friday the 11th, still nothing and I had not slept because of my cramps for two nights. I felt awful and started puking in the middle of an in-service meeting. (I'm sure the director thought I had a hangover...*sigh* if only). I called the nurse and she asked me to come in and do some labs and see my doctor. He explained that I might have to take Provera to induce a period or that I could be pregnant and it was just too early to detect with a home pregnancy test. The last thing I needed was to get my hopes up about being pregnant. He slunked back in after he got my labs back and told me it was negative and he was sorry. He was reassuring in the sense that this stuff happens a lot and I could reschedule as many times as necessary. He also gave me a prescription for Lunesta, and I slept really well for the first time in 2 months.

And lo, the next morning my period came after just 43 days... I guess I just needed to be scared into it. Surgery, then baby, here I come!

Later,
MK