Tuesday, December 19, 2006

The mental and the physical

Thanks so much for your good wishes. It's quite an astonishing and wonderful feeling to have people that I've never met popping in to wish me good luck. My heart is thoroughly warmed, and to be honest, I needed it.

It's been a roller coaster the last couple of days. I found out yesterday that my father, with whom I am very close, has cancer. There are a million things to be grateful for. They caught it very early. He is healthy enough to have the surgery that should (fingers crossed) cure him. He lives close to one of the best doctors for this type of cancer around. All in all, if you have to have cancer, this seems to be a decent situation in which to find oneself. But, of course, it's terrifying. I cannot even seriously contemplate the prospect of losing my dad. There is a little emotional switch in my brain that flips when I even begin to go there, and does the cerebral equivalent of sticking its fingers in its ears and shouting "LA LA LA I'm not listening LA LA LA..."

We won't know the extent of the cancer for sure until after the surgery, and of course there are always risks of any surgery. I am feeling horribly guilty and sad about not being there right now, and the fact that I probably won't be able to be there for the surgery either, as it's likely to be scheduled for this week. Not that I could really do anything much if I was there, but being there IS something, and I feel dreadful that I can't even do that, being half-way around the world.

In other news, the retrieval was today. It was a truly interesting experience. The clinic that I go to in Korea is worlds apart from my old clinic in California. Wheras my old clinic was small, cozy, and personal, my new clinic is more like a baby factory. It's not really a clinic at all, but rather a whole fertility hospital (actually, in Korea, it's called an "infertility hospital", which strikes me as a refreshingly honest, if jarring, way of looking at things). The place is vast. On a Saturday morning, there will be many tens of couples waiting downstairs to see their doctors, and undoubtedly many more on the upper floors, which have areas for retrievals and transfers, hospitalized OHSS and surgical patients, and the embryology labs. While I do know a couple of the nurses by now, and of course my doctor, I see tons of new faces every time. So, it could be described as a little impersonal, but I don't really see it that way. My doctor and the nurses are very kind, and take a lot of extra time to explain things to me in English or using body language, so I feel very comfortable with that aspect of my care. My doctor actually phones me directly with news, rather than delegating it to a nurse, which I very much appreciate. Also, patients can just walk in any time during business hours to see a doctor. You may have to wait for a couple of hours (if it's your first appointment, after that they rush you right in), but you don't have to wait for six weeks or more, as sometimes happens in the USA. They seem to save time and the patients' money by dispensing with some of the frills that American patients are led to believe are essential. You don't do an "injectibles class" before starting: the nurses just show you how to do the injection the first day that you're actually doing it. You don't spend hours going over paperwork, or having test after test to make sure that your husband isn't somehow going to infect you with an STD in the lab after managing not to do so in years of ttc. They also haven't monitored me as intensely as I've been led to expect. I had a total of three ultrasounds, and only one round of blood work. However, the success rates at my clinic here rival that of the top US clinics, and they take all kinds of patients, so clearly they're doing something right.

Anyway, 9:30 a.m. today found me on the subway with a jar of sperm wedged between my boobs, trying desperately to keep it warm on the way to the clinic in freezing weather. We got there, and I was called almost immediately to the "retrieval area", along with two other women. We were all told to go into a locker room (with actual lockers!) to put on hospital robes, and strip from the waist down. It was a little wierd doing this all together, but was also absolutely fine. Then we were called one by one to have an injection of painkiller. The nurse slapped my butt several times before doing the injection, which was a little wierd, but actually made the injection not hurt at all. Maybe I'll have to have my hubby do that at home with the PIO shots. Fun for the whole family! Then they called me back to the retrieval room. I had heard that in the USA they sometimes tie your legs to the stirrups, but here they just had me put my feet up, and then started putting the speculum in. I was a bit alarmed, and thought they were going to go right in then, but at the last minute, they gave me a lovely shot of demerol in the arm, so I was conscious, but veeeeeerrrryyyy relaxed. Then she went in, and gave me a local anaesthetic before starting the retrieval. The collection from the first ovary didn't hurt. I felt pressure, but nothing that could accurately be described as pain. After a few minutes, she told me to look at the screen. They had a video screen on the wall, and I could see the embryologists working with my first egg! It was absolutely amazing. Unfortunately, I was too groggy to really watch, but I could at least glance at it from time to time and see that there were real live actual eggs coming out of me! Then she switched sides. The second side definitely hurt. It wasn't excruciating, but I could feel the needle moving around, and when she stuck it into a new spot, I felt a painful jab. During all of this, the nurse was an absolute champ. She held my hand, and rubbed my arm, and did everything that she could to make me feel safe. The doctor also asked me every few seconds if I was OK. The funny thing was that I WAS OK. It hurt, but because of the demerol, I couldn't get very emotionally involved with the pain. My ovaries hurt, but my elbows felt fine, and my legs felt quite comfortable, and my face felt quite lovely, so all in all it was very tolerable. Then they were done before I knew it. They mad me lie back for a minute, then transferred me to a rolling cot, and rolled me into a quiet room to recover from the anaesthetic. It took me about 15 minutes to realize that there was another woman recovering to my right (behind a curtain). Then they brought in another to my left, then another, then another. So, I was in good company at ye olde egg factory. After a while, the nurse came in, got me up, and told me that they got 9 eggs! I had been so worried that my follicles would be empty, or something like that, so this was VERY good news. Yeah, I would have also liked a number with two digits (preferably two high digits), but I can certainly live with 9, if the quality is OK (fingers crossed!) I almost didn't mind when she stuck two more needles in my butt (one progesterone, one antibiotic), and gave me the HUGE package of needles and progesterone in oil (PIO) that my hubby will be sticking into me over the upcoming weeks.

The whole experience of feeling the pain, but not minding the pain made me think about the emotional aspects of pain. I think that one of the worst things about pain is the fear associated with it. Pain is, after all, your body's way of telling you that something's wrong, and that you need to deal with it. So, pain that you can't fix is inherently frightening, and the fear, in turn, seems to exacerbate the pain, which of course can make you even more stressed and frightened. During the retrieval, I wasn't frightened at all, thanks to the lovely drugs. So, the pain was just what it was, and didn't take on monstrous proportions in my mind.

I wonder if the pain of infertity is the same way. The pain is real, and can be dreadful, but it's also usually intensified by so much fear. Fear of failure. Fear that infertility will result in childlessness. Fear of receiving an awful diagnosis. Fear of receiving no diagnosis at all. Fear of making the wrong treatment decision. Fear of the treatments themselves. Fear that the treatments will fail. Fear of adoption. Fear of not being able to adopt. Fear that the sadness will damage your marriage, your friendships, your soul. In the end, I think that the pain is usually manageable. It's the fear that can destroy you.


Rose said...

Wow, what an amazing experience!!
I can't believe you actually saw your own eggs...inceredible! And all through a drug-induced stupor - even better! I've read quite a few IVF stories by now, but it's never quite the same when it's someone I know (even though we've never met). Please please let us know how things develop. You have succeeded in jumping through so many hoops so far, keep you chin (or legs!) up.
Rooting for you!

Stephanie said...

Wow, the fact that you could see them working on your eggs is awesome! I would love to see that!
I am glad the ER went well and yahoo for 9 eggs! Will they call you in a couple of days with an update?

I totally agree with you about actual pain and the fear of pain. fear, worry and anxious anticipation of pain make it worse. Now if I could control the fear and worry I would have it made!

Rose said...

Hey, Sara, I wanted to say: I'm so sorry to hear about your dad's cancer. It must be so hard being so far away.
I'm close to my dad too and I can really relate.

Marie-Baguette said...

It is great to know that your Dad is in good hands.I really hope for the best.
Congrats on the 9 eggs and the great surgery! Even though you seem to have been very much drugged up, you were able to follow the process and to recover quickly. That's great! I am keeping my fingers crossed for you. Good luck and kudos for what you wrote on the pain of infertility.

Anonymous said...

Yay for nine eggs! Hopefully you get as many beautiful embryos too.

And I'm sorry about your dad's cancer. Mine had a type of cancer with which he could have lived for many more decades, but he was killed very swiftly by a completely unrelated viral attack. Sometimes these things serve to make us appreciate what we've got.

You make a good point about fear compounding the feeling of pain. Our emotions play so heavily into our physical being that that's most certainly why they're called 'feel'ings.