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?

Stimulation has Begun

You guys! You guys.

I HAVE FINALLY BEGUN TO STIMULATE MY OVARIES.

As of a few moments ago, I am no longer in menopause. (Kind of.) In addition to 5 units of leuprolide acetate, I injected 225 IU of Follistim into my belly. And this comes after a whopping 33 days of downregulation. It's the longest Lupron protocol I can find anywhere on the Interwebs, but it. has. finally. ended.

Welcome back, ovaries! We have a lot of work ahead of us. First order of business: Golden Globes fashion critique. Angelina Jolie: yes or no? I'm leaning towards no, but I still haven't seen a full-length shot of her.

These Meds are Worth More than my Car

As we were walking into the hospital for my surgery, I caught a glimpse of a doctor in scrubs and a surgical cap through a window and I thought I was going to pass out. I said out loud to Harry, "This is the worst," and I almost turned around to go back to the car.

Yesterday, I picked up a Chinese-takeout-sized bag full of hormones, syringes, and antibiotics from the pharmacy. I had the same reaction when I laid it all out on the dining table at home. This is the worst the worst the worst the worst. These are the medications for a sick person, right? Look at how many of them there are! Look at all those needles!

Okay, Charlotte, let's calm down a little bit here. Take things one step at a time. What are these, and what will they do?

First up, the leuprolide acetate. Note that this is not brand-name Lupron, which I appreciate since my copay was significantly lower. This quiets down my ovaries to the extent that they tell my body I'm in menopause, so really, I see this one as an exciting little glimpse into the future. Side effects apparently include the following:

Leuprolide will cause an initial flare in testosterone or estrogen levels leading to bone pain, urinary problems including blood in the urine, and tingling in the feet and hands.
Common side effects: irregular menstruation, bone pain, sweating, dizziness, water retention, hot flashes, headache, nausea/vomiting, and pain at injection site.

Awesome. Next up, I think I can figure out what this one is:

Follistim will get my ovaries out of artificial menopause and into overdrive. Eggs? Did somebody say to make eggs? Hey everybody! It's egg-making time! I'm told this is the most expensive of my medications, so I'll try not to inadvertently confuse it with the cheese and butter it's sharing space with in the fridge. (I also probably shouldn't have accidentally dropped the pen and then kicked it partially across the room when I was trying to gather everything up at the pharmacy, but live and learn.) Side effects:

The most common adverse reactions (≥2%) in women undergoing controlled ovarian stimulation as part of an IVF or ICSI cycle are pelvic discomfort, headache, ovarian hyperstimulation syndrome, pelvic pain, nausea and fatigue.

So we have that to look forward to. Next is a single, unassuming little tube... Ovidrel! This one will make my hyperstimulated ovaries get ready to release all those eggs they just made - and it will be perfectly timed so my doctor can get in there 36 hours later with a scary-looking needle and grab them before they all head off for their various adventures. Ovidrel warns me:

The most common side effects in women using Ovidrel® include abdominal pain, injection site reactions, nausea and vomiting.

But after ovulation, the fun isn't over: for two weeks, and longer if I actually do get pregnant, I get to apply a "unique bio-adhesive gel" to my cervix, Crinone. Not going to lie, this is the only medication I am kind of curious about, because A. it probably won't hurt, and B. unique bio-adhesive gel? Sounds super space-age! Also, I understand that this replaces the progesterone in oil shots that other women have complained about, so I was pretty stoked to see it on my list of meds - even if it will be messy and gross. Side effect info:

The most common side effects of CRINONE (progesterone gel) 8% include breast enlargement, constipation, drowsiness, nausea, headache, and pain in the pubic area.

Let's not forget the various antibiotics I'll take for a few days at different points in this process, or the prenatal vitamins and baby aspirin I'll take throughout, or the additional meds I will have to start if I am knocked up. First, one thing at a time. Leuprolide acetate begins on Dec. 12th.