Not that I'm complaining

I've tried to write this post several times, but because I keep checking updates from fellow IF blogs before I start typing, I haven't felt able to go through with it. What do I have to complain about, honestly? It takes about five minutes of clicking around to find heartbreaking, awful stories from women who have lost their babies, whose cycles did not work, who are preparing for life without the children they so desperately want. And then there's me, trucking along just fine on my FET cycle, heading home each night to my healthy son and my loving husband, and I have the gall to start moaning about how terrible things are?

Yup. Brace yourself (or stop reading), because I am totally about to complain. But here's the thing! I don't complain to anyone in real life anymore. I don't talk about this cycle with my husband, my parents, my siblings, my friends, my coworkers. As far as they are concerned, there is no cycle happening, no attempt at another pregnancy, everything is just status quo. (I should clarify: my husband knows that this cycle is happening, but that's all. I do not discuss it with him.) It's my first time really experimenting with denial, and I have to say, it's going much better than I expected. A lack of sympathetic faces in my life means that I don't turn to them when things get tough. And if I don't have the option of getting any sympathy - if it simply doesn't exist - well, I find I don't need it as much as I thought I did. And then at least I can cling to that thought - as bad as it gets, as bad as it has been, at least I haven't burdened my loved ones with my inability to cope.

And what is there to cope with, really? Here's a brief summation of what's happened in the last few weeks:
- Right after my SHG, while I was on the antibiotics they prescribed, I got a yeast infection. I tried OTC remedies unsuccessfully for two days before finally procuring some prescription-only Diflucan (don't ask - let's just say that I managed not to hassle my OB or RE.)
- As the yeast infection was coming to an end, I started bleeding heavily. It lasted for three weeks and was similar to my post-partum bleeding, with clots the size of walnuts. I went through a staggering amount of feminine supplies. Another period? Just more irregular bleeding? Who knows!
- I started Lupron injections and got a headache that never really goes away.
- I had a monitoring ultrasound and bloodwork that looked good enough to move on to the next phase of my FET. The 4-cm cyst had gotten a bit smaller, from what I could tell anyway (the OB's office was under strict instructions not to interpret my results and wait for the RE to weigh in, but then all the RE said was to proceed, so I don't really know what's happening with that.)
- I started taking oral Estradiol and injecting myself with Lovenox, since I'm a clot risk after the DVT in 2012. The Lovenox has given me giant, painful bruises on my belly that I believe I have successfully concealed from everyone besides my husband - and even he didn't see them for the first few days, so artful was my dressing/undressing.

None of this is particularly terrible, but yeah, since we're complaining and everything, I will tell you that I've been doing my usual amount of sobbing behind dark glasses. I feel pretty decent about 90% of the time, it's just occasionally that the self-loathing takes over. I start feeling sorry for myself, and then I hate myself even more for wallowing in self-pity, and usually the cycle continues until something external breaks it. Which is often - I'm crazy busy with work, travel, and life in general. That pace is unlikely to slow down for at least another month, which ordinarily would feel daunting but these days is a very welcome distraction.

Next up: at least one more monitoring ultrasound coordinated through my OB's office, another two weeks on medication, and the transfer itself at my RE's office. I am trying to figure out how to casually bring up the topic of the transfer when my nurse calls me in a few days with next steps... for instance, I don't want to put my legs in the stirrups. Could they do the transfer with my feet flat on the table? And what about my RE himself, is it worth even bringing up whether it's possible to have someone else do it? I get the feeling that his embryo transfer technique is probably the best in the practice, and of course I don't want to have to go through this ever again so I want to do everything I can to achieve a pregnancy on the first try, but I am horrified at having to physically put myself in the same position that I was in for my egg retrieval. I don't know. Sometimes I feel angry and empowered, but sometimes I just feel so defeated - sure, go ahead, do whatever you want to my body, it's not like it's worth anything anyway.

And then... then, in December, I'll find out whether this worked. Either way I will have a whole new set of decisions and obsessions. I'll come back here and complain some more, so get psyched!

5 Things I Didn't Expect About Labor, Delivery, and the Postpartum Period

Little O is almost a month old - I'm so proud of him for thriving, and us for surviving! He's packing on weight like a champ and we're getting better at keeping our household functioning with a newborn as its newest member.

Before the memories fade, I wanted to write down some of the most surprising things about my birth experience in case they're helpful to someone else (or in case I choose to do this again - but that's a different story!)

1. Braxton-Hicks contractions vs. real contractions. 
For most of the pregnancy, I felt not-quite-painless Braxton-Hicks contractions at least once a day. Toward the end of the third trimester, they were very frequent (but never regular, usually coming in clusters a few minutes apart and then easing up for an hour or two.) I spent more time than I'd like to admit looking up phrases on Google like "distinguish braxton-hicks contractions labor" since I was constantly convinced I was about to go into preterm labor. One of the things I read often was that Braxton-Hicks contractions feel like they start low in your uterus and then sweep upwards, but real labor contractions wrap around from your back to your front, or sometimes they seem to move from the top down. As I've written previously, once I felt my first real contraction I realized how different they were, but only in terms of the pain associated with them - every single labor contraction I had went from the lowest part of my uterus up to the top, just like the Braxton-Hicks. They were, however, much more painful and felt very similar to menstrual cramps. If you're trying to make the distinction on your own, I would say that the way you perceive the tightness starting is not the way to go.

2. "You're so tall, maybe that's why the epidural isn't working."
I was pretty clear with all of my caregivers before and during my labor that I wanted an epidural. And I got it, too, which I greatly appreciated. However, several times while trying to fix the window in the lower left quadrant of my belly, the nurses and anesthesiologists remarked that maybe it wasn't working correctly because I was so tall. Huh? For the record, I'm 5'8" (about 173 cm for you metric folks.) I'm tall, but not that tall! I can't imagine I'm the tallest woman who has ever given birth at this hospital, but who knows. Besides, there are lots of risk factors for why the epidural might have been incomplete at first, and it's a common problem that often has a simple solution. In any event, after lots of fiddling and a bolus or two of extra meds, the numbness did spread over my entire contracting belly and I was a much happier mother-to-be. Bottom line: if you find yourself with an incomplete epidural, don't give up - ask for them to do whatever they can to fix it.

3. Careful with that bassinet!
Well, duh, I don't want to drop my precious bundle of joy. Then why is the bassinet so high, and my hospital bed is so low? Once the excitement from the birth had settled down and O and I were moved to a postpartum room, the nurses got me into a nice cushy hospital bed and put O right next to me in what is, let's face it, a modified refrigerator crisper drawer on wheels. Since the nurses and doctors would stand when they checked out O, it made sense for him to be nice and high (think the height of a kitchen counter). And since I struggled a bit getting in and out of bed, it made sense for me to be nice and low. But when I needed to pick up O, things got a bit tricky. I couldn't reach over to get him while still in bed, so I had to either stand up and walk around to the bassinet to fetch him or get up on my knees rather awkwardly while still on the mattress. I tried putting my own bed up as high as it would go, but the nurse got upset at this and came in to lower it because she said I could injure myself trying to get down from there (which, yeah I could, but who would you rather see in a heap on the floor, me or the baby?!) Next time I do this, I'm asking someone to hand the baby to me each and every time, because there's just no good way to get him or her from the bassinet to my arms when I'm by myself.

4. Headlights
Prior to giving birth, I hit up my local maternity store for a nice pretty nightgown that I could wear during my hospital stay since I knew we'd have visitors. I did not, however, pack a nice pretty bra to go with it! I guess that when an infant is spending hours each day sucking on your nipples, they don't exactly go back to their innocuous, soft, no-bra-necessary selves between nursing sessions. Seriously, I looked like I was cold the entire time! I had a sleep bra with me that consisted of a nice, comfy single layer of fabric, but that wasn't enough to preserve my modesty when friends and family started stopping by. Underwires and padded cups are the only way to go, as far as I'm concerned.

5. The sweaty, sweaty night sweats. 
Things were so weird in the hospital that it was hard to tell what was normal and what wasn't, but once I got home, I noticed that during the (very short) times that I slept, I would sweat like crazy. Remember when I was in menopause for a few weeks last winter? It was like that! I thought I was imagining things until I read Mo's post about the same thing, and it turns out that it's a common occurrence after giving birth. Honestly, it wasn't too bothersome (not getting more than 2 hours of sleep in a row was a bigger problem) but it did make it even harder to stay hydrated, which is important for breastfeeding. Keep a glass of water nearby and get ready to do even more laundry than usual, and take heart that it should end soon - for me, it was only about 3 weeks and now I'm back to normal.

Normal... what a crazy idea. Having a baby means embracing the new normal, that's for sure. But I'm saving that for another post!

The Root-e-Toots

As a rule, I try to avoid TMI (Too Much Information) on the Internet. But this is kind of a public service announcement, so today I am going to talk about gas. And no, not the kind you put in your car or use in your stove to boil water.

Pregnant women get gassy, or so I hear. And I have this really good friend who is at the exact same point in her pregnancy as I am, and she says that she's been waking up every single morning for a week now with some seriously painful trapped wind. In fact, on more than one occasion she has talked herself into thinking she's experiencing preterm labor (she's totally paranoid and worried, just like me.) Let it hereby be known that sometimes, an intestinal cramp is just an intestinal cramp. How might you tell the difference? Well, um, give it a few minutes... try walking around a little bit... the answer will probably become embarrassingly clear.

The second thing this very good friend has told me about gas and pregnancy is that there are times that you might feel a lot of activity in your belly - the type of activity you would ordinarily associate with an impending unpleasant gastric event, and which would get you searching for the nearest private bathroom. However, don't let your brain trick you here: it might just be the baby moving around. Gurgle, gurgle, gurgle doesn't automatically mean what it used to, so relax. And stop looking up so many stories about preterm labor! After all, Jessica Simpson had a lot of pregnancy gas, and she turned out okay.

Betas #3, #4, and the Giant Belly of Unhappiness

Good news -  my 3rd beta hCG blood test on Saturday came back at 352, a doubling time of 43.56 hours. I am less pleased with my 4th beta test today, which came back at 650 and indicates a doubling time of 54.25 hours. I am slowing down production, or my embryo is. My clinic seems totally unconcerned but this is very much not the news I wanted to hear. I know, beta values vary widely. I know, the fact that my hCG still rising fairly dramatically and not falling or staying steady is a really good thing. But I am getting very frustrated at the fact that I'm stressing out over this every two days when a naturally occurring pregnancy doesn't go through this kind of monitoring. They have me going to the clinic every other morning at 7:30 AM to stand in the most depressing line in the world and get my arm stuck yet again, then I wait anxiously for results until midafternoon. Couldn't I do that every third morning, or every fourth? I feel like the only reason I'm going to these blood draw appointments so frequently is in case it turns out to be ectopic and therefore possibly life-threatening, which we might spot with consecutive hCG draws (but also might not. Ectopic pregnancies are tricky that way.) They won't schedule me for an ultrasound until my hCG comes back at 2500, which I think we can all agree is going to happen approximately, oh, never. 

These appointments are made way more stressful by the fact that these days, I am feeling pretty sick in the morning. I may have a mild case of late-onset OHSS, actually - around the middle of last week, right when my hCG was first beginning to climb, I started to feel like my abs were really sore. I looked in the mirror and my belly, which is usually pretty flat from my ribcage to my belly button, was sticking out. It has kept swelling like a balloon and is painful to the touch, and although I'm hiding it pretty well under sweaters, I feel huge. I don't look pregnant - it's my entire belly from the bottom of my sternum on down, and although this is a horrible image, I feel like the vibe I'm giving off is more "starving and full of worms" than "glowing expectant mother." I've asked my RE about it twice and both times the answer was that if I don't have shortness of breath or problems urinating, then I should just take it easy and wait for the swelling to gradually go down over time. I don't have any way of knowing, but I suspect that it might be contributing to my near-constant nausea and occasional vomiting. Or that could just be normal morning sickness. Either way, when my belly wakes up at 5:30 AM to let me know how unhappy it is, the last thing I want to think about is how I need to get on the road earlier than usual to go to yet another blood draw. I want as much time as possible to lie on my own bathroom floor and look at my dust bunnies and listen to crappy morning TV from the other room and regret eating last night's pizza. 

Anyway. I am cranky and uncomfortable and that is overshadowing how I really feel about this pregnancy, which is of course grateful and thrilled. I am also spending some time looking at this chart on Betabase.com for some perspective about my probably-fine-but-it-could-definitely-be-higher beta value. And G-d willing, I will keep having good news to report, so stay tuned.

Deep Venous Thrombosis

1. That could be a name for a band; and
2. I've got one. In my right calf. Which is just ridiculous.

What happened was this: on Tuesday afternoon, as I was sitting at my desk minding my own business, my right calf muscle began hurting a little bit. It was as though I had sprained it while running, or had a charley horse cramp. Weird, but no big deal. I was walking normally and it didn't hurt that badly and, yeah, so I hadn't done much exercise lately but these things just happen to muscles sometimes, right?

Except that it didn't go away. Sometime on Wednesday I started to think that I had a real problem, and began looking up my new (almost certainly non-pregnancy-related) symptom. Dr. Google said that Deep Venous Thrombosis, or DVT as the cool kids call it, was a possibility. But! I am not on the birth control pill, and haven't been at any point in this cycle. I am not overweight. With the exception of the past few weeks, I am not sedentary. The leg wasn't swollen or red or hot to the touch. And when I massaged it, it really felt like the muscle itself was sore and not any kind of underlying structure. So I just ignored it, and hoped it would get better.

By Friday morning it was clear that this problem was not going to neatly resolve on its own. I woke up to use the bathroom in the middle of the night and when I staggered back to bed my leg felt like it was on fire. I couldn't get back to sleep because of the pain. I decided at 4 AM that even if this was musculoskeletal, I clearly needed medical help to deal with it. When their office opened later that morning, I called my RE and described what was going on. They said I needed to talk to my primary care provider, who said I needed to get an ultrasound, and it took until 4:30 PM for someone to finally take that little wand to my calf in order to see what the heck was going on inside it.

"Okay. So you do have a clot." The ultrasound tech (and let me just pause for a second to say that I had forgotten how nice it is not to have a transvaginal ultrasound) found a DVT in my right peroneal vein, beginning underneath my knee and extending several inches down my leg. Um, what? But it was true. Even I could see that the image on the screen showing nice flowing red and blue blood on the normal section of my leg stopped almost completely when the tech got to the painful part. Cue me totally freaking out and telling her about the IVF, and I've been on all these hormones, and what do we do now, and all she could say was that she had to finish the exam and then I could talk to the doctor. I texted my husband, who of course also freaked out, and my parents, who did the same thing, and then I went back upstairs and tried to freak out very quietly in my doctor's almost empty waiting room (very fortunately, her office is in the same building as the ultrasound place. Otherwise this could have been even more exciting.)

When my doctor finally saw me - and it was now after 5 PM on a Friday evening so she is a rock star - I was surprised to learn that she didn't want to immediately start me on anticoagulants. (I had decided while waiting that the posted signs about no cellphone use did not apply to patients who were sitting in a nearly-empty waiting room watching the receptionist pack up, so I was back to asking Dr. Google what was safe to do for a DVT in a possibly-pregnant woman, and he had recommended Lovenox injections.) My clot is, happily, below the part of my leg that would put me at risk for part of it to break off and travel to my lungs and - ha! ha! ha! - possibly kill me. And starting me on Lovenox now, when we still don't know whether I'm pregnant, could have long-term effects since I might end up staying on it for the entire pregnancy and beyond. If I'm not pregnant, I would probably be on Coumadin rather than Lovenox, but we can't start me on that until we know I'm definitely not knocked up since it would be harmful to a developing fetus. Right now, she's recommending that we do follow-up ultrasounds every few days to make sure the clot doesn't extend up into the lung-killing section of my leg, plus I'll probably get a blood workup to see if I have any thrombophilia factors that might account for this having happened in the first place. In the meantime, I'm elevating it when I can and applying the occasional warm compress. And although I was really surprised that I didn't walk out of there with a prescription for some kind of blood thinner, or even a note of admission to the hospital, it is true that with this particular kind of clot anticoagulant treatment might not be necessary.

That's not to say that it wasn't exciting to receive calls - on a Friday night! at home! - from my regular Ob-Gyn and my RE. Both agreed with my primary care doctor's plan for now and said that it was crappy timing what with the whole no-way-to-know-if-you're-pregnant thing. And now I'm horribly conflicted about whether I think it would be a good thing to be pregnant this cycle. I mean, no amount of wishing or hoping or praying either way is going to change whether the embryo has implanted, and if it has, we'll take each day as it comes and manage the DVT as best we can. If it hasn't, then I want to make sure I am personally healthy before we make another attempt to create a new little person. I want to have a serious discussion with my RE (in his office, just the two of us, time blocked off on his calendar) about why this might have happened and how to prevent it in the future. His initial recommendation was that we do another cycle immediately while the endometriomas are still small enough to manage without more surgery, but my Ob-Gyn said that the only risk factor I really had for this DVT is that my estrogen levels have been high lately thanks to all the ovarian stimulation. I'd want to know how we're going to manage that in future cycles, and what other changes we can make (for instance, I think we can safely say that I will not be on bed rest after transfer in the future. It's not proven scientifically to help, after all.) I do wonder if this has something to do with my propensity to grow endometriomas, and grow them quickly. And of course if this cycle fails I will now wonder if that had something to do with a clotting problem, too.

At one point last night someone said "You know, you've just become a very interesting patient!" Yeah. I'm very flattered, but I could have lived without the medical mystery. I know that things could be so much worse and I'm unspeakably grateful for the medical care I have been given, and will continue to get. But I will say: this is just crazy. Who would have thought?

What Happened, Food? I Thought We Were Friends

Not burying the lead: all 12 embryos have survived to fight another day. The clinic is planning on a day 5 transfer.

That's the good news. The bad news is that while I had planned to write a chirpy little post about how I was trying to increase my protein intake to avoid  Ovarian Hyperstimulation Syndrome (OHSS), I ended up having a really rough night with the belly pain. I ate an actual meal last night for the first time since Wednesday's nauseapalooza, and I think my GI system did several backflips when it realized it had something substantial in it. I'm sure the doxycycline I'm taking isn't helping matters either. Now I'm racking my brains for ways to increase my protein intake without writhing on the couch for hours - I had a single piece of toast with peanut butter this morning and so far so good. I also brought a high-protein shake to work and it's sitting on my desk, where I am staring at it with apprehension as though it's about to jump down my throat of its own accord and start causing trouble in my tummy.

I mean, at some point my belly has to stop hurting, right? Until then, I'm just going to have to tread carefully and eat whatever I can manage to eat. And I'm also wondering if more dietary protein to avoid OHSS is a good idea at all, since I'm having trouble finding a professionally authored study on this, even though it's all over the infertility message boards as accepted post-retrieval advice. (If you have hard data to back this up, please let me know.) Either way, Gatorade, ginger ale, and Saltines do not a balanced diet make, so I've got to start mixing it up.

CDsomething and I'm Makin' Eggs

Because of my super-long Lupron protocol, I have no idea what cycle day I'm on. But I do know this: today marks my one-week anniversary of stimulating my ovaries, and this is happening, people. I have 14 measurable follicles on my right ovary and 8 on my left ovary. (I realize that in my last post I reversed the count so it looked like lefty was the major producer, sorry about that - just my latent right-left confusion causing trouble.)

The doc who performed my ultrasound said that I'm responding very quickly to the Follistim and I might trigger as early as tonight, but left the final decision to my RE. Turns out he wants to wait one more day and monitor me again tomorrow morning to see if any of the smaller follicles are catching up to their friends, and then probably plan on a retrieval Wednesday or Thursday. I'm really surprised because my RE and I were initially planning on a Friday or Saturday retrieval (and I wanted the extra time to recover over the weekend, which I suspect I now will not get), but like everything with this infertility process, there's just no way to predict how things will go.

So that's the good news. The bad news is that as my overachiever ovaries have been popping out all of these follicles, I've been feeling increasingly worse. The twinges I felt in my belly on Thursday morphed into a constant menstrual-cramp-like pain by Friday, and got worse all day on Saturday. By Saturday night I was also feeling intermittent low-level nausea, which has continued today and which I've also felt when I've had intense menstrual cramps in the past (thanks, endometriosis!) I'm not actually throwing up and it could be much worse, but I've spent most of the day on the couch taking Tylenol and sipping on tea and juice. Work should be interesting tomorrow, but we'll cross that bridge when we come to it. And in terms of days to spend sitting on the couch - it could be worse, I have the playoffs to watch!

What Can I Say, I Enjoy Being Stimulated

Four days in and I am a much happier camper than I was before I started Follistim. Seriously, I woke up the morning after my first dose with a sense of optimism that I hadn't felt in several weeks. I'm sure it was all in my head, but just knowing that I had lady hormones coursing through my veins again - and knowing that I was one day closer to this process being over - made a huge difference in my outlook. My Lupron-induced headache has subsided almost entirely, plus I appear to have had my last hot flash on Monday morning, so that is also exceedingly helpful in keeping my spirits up. My ovaries appear to like Follistim too: this morning's count was 13 follicles on the left and 7 follicles on the right. I have felt a few twinges in my belly, which is annoying but also a good sign that things are moving in the right direction. Overall, I'm doing as well as I would have hoped during this point in my cycle.

But I made the mistake yesterday of listening wistfully to an album on my iPod that I had been rocking out to on a loop during the spring of 2010. I was so happy then. Harry and I were planning our future together and everything seemed so bright. It's funny how sensory memories can be: bulgogi will always remind me of fall 2006, when I discovered how tasty it was and made it for dinner at least once a week. My green cowl-neck sweater will always remind me of my senior year of college, when I bought it as a birthday present for myself and wore it through a freezing winter. And it got me thinking, what will be my dominant sense-memories from this season of my life?

Smell: Kendall Webcol Alcohol Prep pads. I open up the package every night and the tang floats up to my nose to remind me that there are really only 5 minutes every day when I am actively addressing my infertility. And those 5 minutes just reek of rubbing alcohol.

Taste: Karfiolleves. If you haven't tried it, I recommend it - I was really unenthusiastic when I first read the recipe but it turned out to be an amazing comfort food. The dumplings are really buttery and the cauliflower is really soft and the hot paprika gives just the right amount of kick. Stirring sour cream in makes it even better.

Sight: This amazing 3-D painting/sculpture/piece of abstract-but-not-abstract-enough art at my RE's office that depicts a sperm fertilizing an egg. Harry and I both had to contain our laughter when we saw it on our first visit there, because we are Not Mature. One of the nurses noticed our smirks and said that a former patient made it, which makes me wonder what kind of craft project I could give them at the end of this process that they would feel obligated to display. Maybe something made out of cat hair.

Touch: Needles going into my skin! I always think of the Bic mechanical pencils I used to play with at school, clicking the little column of lead almost all the way out and then pretending to give myself a shot as the lead slid back in. Except that this time, I actually go through with it and the needle does pierce right through my skin and into my belly. It's so strange, like living a childhood fantasy in reverse.

Sound: Gotta be Shake It Out by Florence + The Machine. This song basically got me through the first wave of crushing depression that followed my surgery in October and will kick off the infertility mix on my iPhone if I ever get around to making it. (Which I haven't done because - that whole crushing depression thing? Yeah, that leads to some questionable musical choices. I have lately found myself sobbing to Phil Collins, but then, who hasn't?)

Woman's Intuition: Pfft, I wish I knew. I have no intuition about whether this cycle will be successful, I just like including this as my sixth sense on principle.

Anybody else?

Thanks, Menopause!

Not much new to report here, things are still pretty bleak. But after yesterday's depressing post, I wanted to add something that was positive and uplifting. Are you ready?

My skin is the clearest it's been since puberty.

So I have that going for me.

Feeling...

HOT HOT HOT!

The last time I wrote about my leuprolide acetate side effects, I said that I thought I might be having hot flashes. I am no longer wondering if this is the case. Yowza! Bring it on, winter! Seriously, it is mighty cold here today, and I am sitting around in my office wearing a t-shirt waiting for the next wave of self-generated heat to hit me.

What does a hot flash feel like? Well, for me, I'll just be sitting around minding my own business when all of a sudden a hot feeling prickles up from my chest to my face. It's like wearing a ton of layers in wintertime, heading inside but not taking any of them off, and then a few minutes later suddenly realizing how overheated you are. I start sweating all over and the only thing that feels like relief is pulling up my shirt to expose my belly and back to cool air. Of course, if I'm in a meeting or something, I can't exactly do this, but the good news is that the feeling passes in about a minute. Then I get really cold for a few moments, and then my body settles down again for a few hours. It's not like I'm sweating so profusely that I've ruined clothing, and so far nobody has looked at me strangely to ask what's going on. It's mostly just weird. Oh, and my headache continues, although it's more intermittent now.

In a strange way I'm actually kind of grateful that the hot flashes have gained intensity over the past few days, because somehow I managed to convince myself over New Year's that I had been doing the Lupron injections wrong and the entire cycle would be ruined and I would have to start all over and it would be dooooooooooom. (And no, I don't have any real reason for thinking I had done the injections wrong, it was more of a "Wait, was the needle supposed to go in at a 45 or 90 degree angle? And do I need to wait a full ten seconds before taking it out? I've poked a lot of holes in the top of the little vial at this point, does this mean there's air getting in there that will ruin the medication?") The answer appears to be that everything is fine, for now at least.

The question I'm now wondering is - can I stand these symptoms for another week? (And then replace them with different ones?) I was supposed to start Follistim on Jan. 6th but I may need to delay for a just a little bit longer. I'm worried about over-suppression because I've read a few horror stories but my RE will give me the final decision on Friday - he is the expert and we'll have a plan soon.

Lupron Update

The fact that I haven't been posting much about my experience on leuprolide acetate is actually a good thing. Because 'twas endometriosis that got me here in the first place, my RE wanted me on a looooong Lupron protocol - as in, nearly a month of shots before any stimulation will start. Believe me, if I had had a reason to complain, I would have. Because I hate the birth control pill with such a fiery passion, I was expecting to feel the same way about Lupron... but, magically, I don't. No joke, this has been (knock on wood) no big deal.

The biggest thing I have to complain about is a persistent headache. Most of the time it's minor enough that I can ignore it, occasionally it makes me want to lie down and take a nap, but it's really nothing worth writing home about (or, in this case, telling the Internet about.) I have had it since the second day I took Lupron and I really don't think at this point that it's attributable to caffeine withdrawal, but who knows.

I have also had a few strange instances of getting very flushed from my chest to my face and feeling hot without any good reason. Hot flashes? Maybe. There are more than a few post-menopausal women in my life and their experience with hot flashes has been a bit more dramatic, so I don't really feel I can complain - I'm not tearing off my clothing in restaurants while sweat pours down my face. I'm just warmer than usual. And as someone who is chronically cold, a little unexpected warmth in a New England winter is very welcome.

And no, injecting myself hasn't really gotten easier. I haven't resorted to sugar cookies every time (even though, let me tell you, this is the right time of year to find cookies everywhere I look.) It hurts and it's not fun and the only good thing about it is that Harry thinks I'm pretty badass for stabbing myself in the stomach every night. But it's over quickly and it makes me feel like I'm making progress with this whole crazy endeavor, so that's good.

Overall, Lupron? Totally fine. Of course now that I've written this down I'm sure I'll wake up tonight with some sort of bizarre problem like hot dog fingers or spontaneous dental hydroplosion, but so far... so good.

Charlotte vs. the Birth Control Pill

The day after my surgery, my doctor called to recommend that I start taking the birth control pill. It made sense - endometriosis gets worse every time you ovulate, and the BCP stops you ovulating - and because of the timing of my surgery I could have started a new pack of pills immediately. Intellectually, I knew this, and I was expecting to hear this advice, so naturally my reaction was to start crying and begin making vague legal threats about how the only thing that would get me to take the pill was a court order and this is America and there's not a court in the country that will force me to take birth control blah blah blah. So, not a productive discussion.

What I should have said (and this happens to me so frequently that I was thinking of titling an entire blog post "What I Should Have Said" and then writing down all the witty, well-reasoned answers that I always think of right when I'm walking away from a conversation) is that I would prefer not to take the BCP because I find the side effects vastly outweigh the benefits. I don't want to start railing against the BCP, which many women find to be very effective. But for me, the three different types of BCPs I have tried produce a change in my mental state that I find unacceptable. I would rather experience physical pain and discomfort from recurring or worsening endometriosis than feel like I have lost myself, especially if that feeling is intended to be part of a long-term treatment. Hormones mess with my head, period. Other women might not experience this, or might not find it to be terribly problematic, but I do. And since it's my body, it's (still) my choice.

So naturally, instead of taking a low dose of convenient oral contraceptives once a day, I have chosen to stick a needle in my belly every night for ~6 weeks to administer huge amounts of hormones in the hopes of creating a pregnancy that, in turn, will send my hormone levels through the roof for months on end. But it's still a more palatable option to me than just going on BCPs and waiting until I felt "ready" to try an IVF cycle. With my tubes all screwed up, I knew that IVF was looming in my future no matter what, and I didn't see any point in waiting around in a depression for months or years until I felt up to plunging deeper into hormoneville (now with extra crying!) And if this cycle fails, which it totally might, I will need to have another conversation with my doctor explaining why I will not take BCPs while we're waiting to start another cycle. My goal if we get to that point is to avoid threatening legal action, but if it ever came to that, I have an idea about where to get a lawyer.

Lupron: One Week

One week into injecting myself with Lupron, I can say: it makes me have a headache. A low-grade, persistent, usually easy to ignore headache. I did break down and have a tiny amount of caffeine yesterday and although I enjoyed the familiar feeling of artificial well-being and energy flowing through my veins, it didn't make the headache budge. Oh well. Maybe I wasn't as addicted as I thought, or maybe both things just give me a headache and I was doubly screwed?

The other symptom that I have, and I mention this only for the benefit of medical posterity, is that my bazooms are a bit sore. My guess is that this is general I'm-about-to-get-my-period stuff, but we'll find out in due time. The really exciting side effects should start 10-14 days after my first dose, so stay tuned!

Confession

Hi, my name is Charlotte, and I am a caffeine addict.

Phew.

That was surprisingly hard to say! When I was diagnosed with a (benign) heart issue as a teenager, I was told that it would be a good rule of thumb to steer clear of caffeinated beverages. I was very proud of my caffeine-free status for a long time, but over the past year, things started to get out of hand. A mug of Earl Grey here, a small iced coffee there... you know how these things go. It really got bad when I read that green tea helps with conception (although, maybe it doesn't?). I started drinking a cup every day, around 11 AM, when I would start to get hungry but lunch still seemed far away. Yes, green tea has less caffeine than black tea or coffee, but even that was enough. On days that I missed my cup of tea, I felt - could it be possible? - a slight headache. Uh-oh. Withdrawal.

When I started going over my IVF protocol with my RE, one question I asked was whether I needed to make any lifestyle changes. He was surprisingly negative on caffeine in any form while TTC (more so than alcohol), so when I circled the date on my calendar to begin my leuprolide shots, I knew that would also be the end of the road for my daily tea habit. I used up all of the green tea I already had and replaced it with decaf and herbal so I could still have a nice mid-morning warm beverage, and crossed my fingers.

Why do I bring this up now? Because for the last two days, my only symptom has been a low-grade but persistent headache. I hoped it might just be from dehydration, so I guzzled a bunch of water, but that didn't help. The other two likely causes are the leuprolide itself - and it totally could be that, it's a known side effect of the drug - but it could just as easily be caffeine withdrawal. I guess if it continues for the entire time I'm on the leuprolide, I'll know which one was the culprit, but for now I'm leaning towards lack of caffeine. So, in other words, I brought this on myself... sigh.