Tuesday, February 27, 2007

Happy Birthday-updated

A couple of days ago, after an epic struggle with infertility and then hyperemesis gravidarum, one of my favorite bloggers gave birth to her daughter, Leah Catherine.

It's so nice to see one of the good guys win.

Welcome to the world, little one.
Update-February 28th: Yet another happy birthday!

Please pop by and congratulate the new mothers.

My happy ass

I love crin*ne gel.

It's true love, not a schoolgirl crush or a passing fancy. I am passionate about the stuff. Devoted, really. I have now met the progesterone supplementation system of my dreams. It may not be perfect, but it's perfect for me.

I've been around the block a few times. Back when I was a mere beginner at this infertility thing, just starting with IUI's, my first RE introduced me to progesterone suppositories, and I had a pretty serious habit for a while. I diligently kept the bullet-like blobs in my refrigerator, even taking them with me in a cooler on out-of-town trips, less they dissolve into a sticky puddle. Every night from just after ovulation until I was certain of cycle failure, I would awkwardly poke one of those chilled beauties up into my nether regions, eschewing the applicater provided by the pharmacy (what did they think I was, a total wuss?) for the old-fashioned one finger method. Then I'd run to bed, while shoving a bunch of paper towels into my underwear in preparation for the inevitable deluge. Then in the morning, I woke up to a delightful pants-full-of-goo sensation, as during the night I had leaked a volume of fluid that seemed impossibly large when compared with the original suppository. It was an ugly relationship. Unseemly, and ultimately disappointing. So, after the last IUI, during the phase when I was waiting to move to Korea, and "trying naturally" (try not to laugh too hard, I went through the motions like a champ), I made the switch to progesterone cream.

The thing with progesterone cream is that not only does it not work, it's hard to even pretend that it's working. The up side is that my inner thighs (or belly, or inner arms, or whatever other part of my body was the lucky winner in the progesterone sweepstakes) was well-moisturized, but the down side was that I felt like a fool.

Then during IVF#1, I was introduced to the hard stuff. Progesterone in oil injections. The big guns. Not for the faint of heart. The freebase of the progesterone world. I only had a one shot/day habit, but even that was enough to leave me crabby, in constant pain, and emotionally traumatized. Why oh why didn't I listen to Ronny Reagan and just say no? After the negative blood test, it took over a week for the bruises to fade, and several weeks for the pain to go away. Even now, I still sometimes flinch if something brushes against those two tender spots. It doesn't hurt anymore, but the pain left a shadow.

When this cycle started, I was prepared to face PIO again. I'm not a masochist, but it'd take a lot more than a big fat needle full of oil to make me give up my dream of becoming a mother. So, I was taken totally aback when my doctor informed me that the distributor has stopped supplying my clinic with PIO (I guess that even with the volume that they used, profit margins weren't high enough). So, they have switched all of their patients to the gel. She told me this apologetically, noting that "it's just as good, but a bit more expensive."

Expensive. Right. The total cost for a 14-day supply was about $100 US. That's about $7/day that I'm paying NOT to have to stick a big fat needle into my arse. Now I'm normally a pretty frugal girl, but this strikes me as a pretty good deal. In fact, with the savings that I enjoyed on lab fees due to my lackluster performance in the egg production department, this cycle actually ended up being cheaper than the last, even with that pricey pricey crinone gel included.

So, I went home to try it, figuring that it would be just like the suppositories. For once, I was in for a pleasant surprise. Not only can it be stored at room temperature (thus sparing me that fresh icy sensation), but this stuff barely leaks. I can use it in the morning and then go to work without wearing adult diapers. There is a tiny little drop of leakage sometime during the day, but it's barely noticeable. Honestly, if I didn't know it was the crinone, I might just mistake it for some of that cervical mucus that newbies on trying-to-conceive boards are always going on about.

So, don't bother trying to convince me that there are other fish in the sea. I've finally found the one for me.

Friday, February 23, 2007

My embryos ride the short bus

Well, I got a phone call yesterday from a quasi-English-speaking nurse at the fertility hospital telling me to show up at noon today for embryo transfer. After a little victory dance (at least one must have been alive!) I gave myself a stern talking-to about not getting hopes up, etc. With only two eggs, I really couldn't expect much.

Last time I showed up for embryo transfer, I was treated to the vision of four picture-perfect embryos on the big screen next to the transfer station. They were round, multi-celled, and practically brimming with health. They looked like future supermodels, Nobel prizewinners, and Olympic athletes. Well, OK, maybe they actually looked like little blobs of cells, but they looked like really nice blobs.

This time, there were two (TWO!) kind of funky-looking spots on the screen. They were several-celled, but had a decidedly sinister air about them. They didn't look like the perfect models of "gerber baby" embryos. More like "kids, don't try this at home". Nonetheless, I was so happy to see them still alive, that I didn't much care. The transfer was easy enough. The hospital made me stay there on bed rest for 2.5 hours after, which is pretty boring, but again, they made it up to me with a lovely foot massage. Then I was told to go chat with my doctor for a minute.

The doctor said that she had been expecting to get 7-9 eggs, and had been pretty confident that she'd get at least five, so getting only two was surprising. She said that the follicles were there, but empty, and had no explanation for how or why this happened. She also said that one of the embryos was graded "a little lower than average, just OK", and the other was "not as good". Still, she emphasized that anything can happen, and that I still have a reasonable chance of a good outcome.

So here I am, in the two-week-wait after all. Dear embryos, please stick. I don't care what those silly embryologists have to say about you. You're not below average, you're just misunderstood. So stick around, will you? Mommy loves you.

Wednesday, February 21, 2007

I get by with a little help from my friends

Thank you all so much for your wonderful comments. You all somehow knew just what to say. This has been a very hard week for me, but somehow coming here and finding that so many people that I've never even met are thinking about me has made it all a little better. I am so grateful that you were there for me in my hour of need.

Monday, February 19, 2007

So much for hope

They only got two eggs.

I'm devastated. I don't know what happened. The doctor didn't say if the other follicles were empty, or if they had already ovulated. I guess it doesn't much matter.

We'll be lucky if we even make it to transfer.

Groundhog day

So here we are again. Retrieval is tomorrow. All of the normal characters have arrived. The bloating was late, but my belly is now the approximate size and consistency of a bowling ball. I thought that the nipples of fire might give this cycle a pass, but no, here they are. And more annoyingly yet that vicious tease hope has entered the building. She's laying low, because she knows that if she says too much, I'm likely to bust open a can of whoop-ass, but she's still sitting there, smiling at me, and occasionally whispering in my ear. She's annoying.

I can't say that I'm excited about the retrieval. Last time it wasn't awful, but it DID hurt. Somehow I don't think that seeing the eggs (if there are any) will be as exciting as last time. I certainly don't think it'll make up for the pain again. I guess we'll see, though. I keep trying to remind myself that this is a different cycle, and that it may have a different outcome. Still, since I haven't actually let myself think about the possibility of a positive outcome, my imagination is sort of in a bind here. I can't let myself hope, but without hope, this process really is without redeeming features. What's a girl to do?

Saturday, February 17, 2007

A zillion down, four to go

Only four more needles until retrieval!

Friday, February 16, 2007

I blame the lupr*n

It has NOT been 8 days since I last posted. It's just not possible. During an IVF cycle? Me, the inveterate navel-gazer? Say it isn't so! My dog must have eaten all of my brilliant and insightful posts. I don't have a dog? Oh dear.

It has been an exciting week here in Low Places. I've laughed, I've cried. Mainly, though, I've longed for sleep. I don't know if I've ever mentioned this, but I truly love to sleep. I only feel at my perky best if I get at least 8 hours, and I'm even a touch perkier on 9. With 7, I can still manage a smile, but with six or fewer, we're on dangerous ground.

Luckily, my mystery man is also a sleep connoisseur (or dreadfully lazy, depending on your perspective), so normally we make it a priority to schedule in sufficient hours of glorious oblivion. However, things changed when I decided that it was a good idea to take an intensive Korean class while maintaining a full-time job AND doing an IVF cycle. The good news is that it HAS kept me from obsessing about the cycle. I can't. I don't have time to pee, much less to obsess. The bad news is that I'm now bad at Korean, bad at my job, and probably bad at IVF too. Go me!

A quick summary of this week:

Saturday and Sunday: Caught up on sleep. Went grocery shopping. Studied Korean. Tried to remind hubby that I know that he's alive, and that I'm happy about it. Not too bad, as weekends go.

Monday: Class all morning. Ran off to work after. At work until 7. Homework until 11, studying new vocabulary until 1. Insomnia until about five minutes before the alarm went off.

Tuesday: To RE. Follicle scan. Only 5-6 follicles. ACK!!!! OK, a quick disclaimer here. I know that it's all relative. I know that it only takes one good egg. I know that lots of people would give their left ovary to be able to produce 5-6 follicles. I understand that this is not a dreadful response. However, having produced 9 follicles only a couple of months ago, this set off some seriously unacknowledged fears about my ovarian aging. Everybody stops producing eggs eventually. What if my contrary body has decided that now is the time? What if this cycle fails and next time it's 3, and then 2, and then 1, and then....

So, the doctor increased my dosage a notch, and said to come back on Friday. Then I rushed off to class, late. When I walked through the door, the teacher put on an angry face, put her hands on her hips, and said "WHY ARE YOU SO LATE?" I had told her the day before that I'd be at the doctor, and would be late, so I surprised, but I held my ground and said that I was at the doctor, and that I was sorry that I'd been forced to arrive late, and that I had disturbed the class. Then she shouted "ARE YOU SICK?" (Keep this in mind that this is in front of the whole class). I said "not sick, I was in for tests", and skulked off to my seat. A few minutes later, I asked a question about what she was discussing, and she shouted at me again (because she had discussed this topic before I got there). Then she gave us an assignment in super-fast Korean that I didn't understand at all. Everybody else went to work, and I just sat and stared at the page. She walked around the room, looked at my page, and then made a public service announcement to the whole class that I was doing it wrong. At this point, the tears started to well up, and I realized that I was about to lose it. So, I just got up and left. The other students stared in shock, and I admit I felt a bit rude, but given a choice of bursting into tears in class, or appearing to leave in a snit, I'll go for the snit every time. I made it about ten paces beyond the door before I was sobbing. Impressive. NOT. Somehow, my visions of life in Korea hadn't included myself wailing and sniffling in a bathroom stall in a university bathroom. Clearly a failure of imagination on my part. I blame the lupr*n.

It was too early to go to work (and I do usually try to show up sans tears or tell-tale puffy red eyes), so I ended up running all the way home, to weep in my husband's arms for a while. Then I went through all of the de-puffing activities that I could think of, and left for work. Then a creepy man decided to try to grope me as I was walking down the street. Lovely. THEN I got to work and found that my boss had sent me something urgent in an email early in the morning that he needed by noon. It was 2:00. He was very understanding, but it still made me feel wretched. Not the best day ever, in other words. Then I got stuck at work until almost 8, came home to have to try to learn everything that I'd missed in class on my own, and was too anxious to sleep. Yuck.

Wednesday: I went through the day in a bit of a fog. The other teacher was teaching the class, so everything went well. Off to work. Ho hum. Had boss drop a huge load of work on me that has to be done by Tuesday. Yippee.

Thursday: Still no sleep. The mean teacher again. I pretended that nothing had happened (on the advice of a Japanese friend who is a language teacher here, and has a much better idea about the culturally appropriate way to handle conflict here), and so did she. It wasn't too bad. Then I got to work and had another big load of work drop on me. Fabulous.

Today: Delirious from lack of sleep. Another follicle scan: 7-8 follicles. Not great, but better. Whew! I trigger on Sunday for a retrieval on Tuesday. Then, the doctor delivered the second-best news* that I've heard recently. The Korean distributor of progesterone in oil has stopped providing my clinic with an adequate supply, so they're switching all of their patients to vaginal suppositories. Now, while the phrase "vaginal suppository" wouldn't have warmed the cockles of my heart a few years ago, there's nothing like a great big needle in the arse to make a girl change her mind. My butt has been rejoicing all day.

A silver lining to it all: I have some new friends. The Korean class has been a huge headache, but it's also really interesting (when I'm not crying), and is full of very interesting students. I've become quite close with three of the women in the class, which is so nice. So, I can't quite regret the decision to take the class now, since their support and friendship is just what the doctor ordered to help me to keep my spirits up.

So, there we are. A week in the life of the overscheduled IVF'er.

*The best news that I've heard recently is that my dad's cancer prognosis is excellent. His doctor estimates his chances of permanent remission at 98.5%. While I'd prefer 100%, I like that number a lot better than those that I had found via Dr. Google. The treatment will be hard, and will take several months (culminating in a pretty major surgery in April), but it'll be well worth it if it saves his life.

Wednesday, February 7, 2007

The question, revisited

So, today I was sitting in my Korean class...

(Did I mention that I am taking a Korean class? It's all part of trying new things, relishing life in Korea, leaping tall buildings with a single bound thing that I promised myself I'd do in 2007. You know, the new me.)

...when I realized that I'd have to go the RE tomorrow morning for my cd2 scan. Since I have to go in the morning, and my class runs from 9-1, this meant that I had to tell my teacher that I'd be late for class. Now this wouldn't seem like a big deal, but the teacher is VERY strict about us only speaking to her in Korean, and it was only the third day of class, and I really don't speak Korean, so this presented a problem. We had already learned the word for doctor, so I looked up another few key words in my handy-dandy dictionary, and "then bravely shuffled up to the teacher.

"Teacher?" I said.

"Yes?" She replied, smiling benevolently.

"Tomorrow...I...go...doctor...9...return...10...OK?" I stammered.

"Doctor?" she said, pronouncing it rather differently than I had.

"Yes, doctor" I said, using my original pronounciation.

"Doctor?" she said, once again changing the pronounciation.

"Yes, doctor" I said, stubbornly sticking to my guns.

"Doctor?" she insisted rather firmly, emphasizing her new pronounciation.

"OK, doctor." I replied wearily, giving in, and pronouncing it her way.

"What name?" She asked.

I stared at her oddly. Why on earth could this woman care what my doctor's name is?

"What name?" she insisted.

I told her my doctor's name. She looked confused.

"Where?" she asked.

I promptly forgot everything that I knew about locations in Seoul. I was by now sweating profusely, and wishing desperately that I had just waited until tomorrow, and then told her that a dog ate my homework, thus making me late for class.

"I don't remember." I whined.

"What you do there?" She asked. At this point, I started wishing desperately for death, or at least alien abduction. Did I mention that there were a room full of people? Was I really supposed to tell her that I planned to drop trou and be probed? I stared at her desperately. She couldn't be serious, could she?

"What you do there?" She asked again, rather insistently. I didn't know what to say or do. Everyone was staring at me. Finally, I realized that I did have the hospital's info in writing in Korean, on my hospital ID card. trying to be discreet, I pulled it out and shamefacedly showed it to her, while cursing the day that I was born.

"Hospital!" she shrieked.

"Test, only test", I lied, trying desperately to draw this conversation to a close.

"Oh, test. I thought you said {insert word that sounds very much like doctor}"

"I said {my original pronounciation of doctor}"

"OH! I thought you said {her original pronounciation of doctor}. It means office. I was asking what was your job."

Will someone please shoot me now?

Tuesday, February 6, 2007

It begins

Well, it looks like the time has come. I'm spotting heavily, and it's turning into something approximating an actual period, so it looks like I'll be going in for a scan tomorrow or the next day (depending on when the actual red arrives), and then starting round 2. Ready or not, here come the needles!

Thursday, February 1, 2007

The question

I knew that it was just a matter of time. When you're a happily married 37-year-old with no kids, people just don't seem to be able to restrain themselves for long. So, when I was out to lunch with several colleagues, including my boss, it didn't really surprise me when a colleague that I don't know very well suddenly said "Sara, do you have any plans to have a baby?"

Surprised, no. Annoyed? Absolutely.

What on earth is an infertile supposed to do in that situation? Telling the truth would a) mean announcing to my boss that all of those "sick days" for retrieval and transfer are actually optional, that my moodiness is self-induced, and that I'm hoping to be inconveniencing him by taking a maternity leave soon, b) make everybody at the table feel very uncomfortable, and c) involve sharing information of a fairly personal nature with people with whom I'm not terribly close. Heck, there were a couple of people at the table whose names I don't even know!

My reaction? Not good.

I stared at the table, muttered "not right this second", and then immediately changed the subject.


The thing that was particularly annoying about this incident is that I'm normally really open about my fertility problems, when asked in an appropriate context. I don't like to lie, and I don't think that I should be ashamed of a medical problem, so my normal protocol is to just give people the quantity of information that's appropriate for our relationship (close friends--the whole story, acquaintances--the basic info without details). The trouble is that here in Korea, I have no idea how much info is appropriate. Also, in my opinion, asking a personal question like that in front of a large group of people is never appropriate. So, what to do? My boss is actually an incredibly nice man, so I doubt that sharing my situation with him would result in discrimination. However, you never know, and once I tell him, I can't take it back. As for the colleagues that I barely know, why should I tell them something so personal?

The thing is, I DON'T have any plans for a baby. Hopes for a baby yes. Dreams of a baby, yes! Passionate all-encompassing desire for a baby, absolutely. But plans? The word plans implies that we think that we have some control over our fate. These days, I only plan cycles, not babies.

What, me worry?

I don't know if I'm in deep denial, or if I'm actually feeling surprisingly sane, given that my next IVF cycle will be starting any day now. Since sanity has never been one of my strong suits, I'm going to have to vote for denial. Honestly, I haven't thought about IVF, or fertility in general for more than a couple of minutes per day, and when I do think about it, it's mainly sorting through scheduling issues, rather than actually stressing. I'd be worried that denial is a sign of deeper issues, but hey, it's working for me, so why fight it?

One of the reasons that I haven't been thinking about it too much is that I'm so bloody busy. There's been a lot happening at work (all good, just time consuming), and I've also been keeping my second New Year's resolution with a vengeance. In the interest of embracing my life here in Korea, I went out of town last weekend to visit an old Korean village, will be going out of town this weekend to visit some temples, and have signed up for a Korean language class. It may be overkill, but I've realized that it would be so easy to just let the time go by and do nothing, and then have the rest of my life to regret not taking advantage of this amazing opportunity.

The up side of being overscheduled is that I have no time to worry about how this cycle will go. The down side is that if my period comes early, I'm up the creek without the proverbial paddle. I'm supposed to see the RE on the second day of my cycle to have a scan and start suppression meds. However, if I'm out of town when my period arrives, this will be difficult. So, while I normally look forward to starting treatments, I'm hoping that my period doesn't arrive until Monday at the earliest, and hopefully not until later in the week. It's looking good, since I haven't had any PMS symptoms yet, but you never know. My period has proven time and time again that it has a wicked sense of humor.