When Shooting, Less Is More

Monday, 1-18-10 (Day 20)

Dexamethasone (.75mg, oral pill): Have I successfully conveyed how happy I am to not have a working scale in the house right now?

I'm just saying.

Lupron (5units, subQ injection): I'm starting to wonder if it's truly pregnancy brain I'm experiencing, or if I'm just over exhausted from the events leading up to this point. In attempt to keep this cycle a secret, I'm doing my best to keep all appointments and previous engagements as to avoid sparking any curiosity, and so far it's working.

But it's starting to ware me out, and beginning today we'll add in several hours of traveling a day and no doubt numerous false explanations as to why I'm not at work or able to meet someone for a quick get together at the last minute or a trip to the gym.

And so begins the excitement of Follicle checks, E2's, traveling chronicles and little white lies.

Follistim (150units, subQ injection): By now, I should be feeling more than the slight comparison of my ovaries to small water balloons, but I don't. When I walk, I can feel a sort of swishing pressure, as if the tiny water balloons were sloshing inside of me, but it's not necessarily painful, just slightly uncomfortable, so I refuse to complain.

Luveris (1/2ml, subQ injection): I really hope that the addition of this drug a day earlier will show vast improvements in egg quality, and in just a few short days until we'll find out for sure.

Ciprofloxin (500mg tablet, twice daily): After receiving my instructions to begin this antibiotic in the evening, I couldn't find it. I dug through my bag of extra needles, my purse, my car, my closet, and made a frantic phone call to my mother who assured me that it was only an antibiotic so it wasn't a big deal if I didn't start it tonight.

But I didn't want to pay another $60 for a new prescription, so I kept digging.

Finally, after a few hours and a trip up to my work, I found them sitting in a tote next to my desk, keeping company with my church clerk binder, my iPod, and a granola bar.

I was too excited about finding them to contemplate the how's and why's.

E2 & U/S: Because my husband needs to work right now and I'm the one with the ovaries, today my mother and I made the three hour drive south to Sacramento to open up my crock pot and watched intently as the Dr. counted out twenty-three beautiful follicles, a number far higher than we were expecting at this point.

Yet somehow I was still disappointed.

This cycle has been amazing so far. I've felt more peace and hope and joy then any previous cycle of any previous fertility treatment. But the moment the doctor started measuring all of those sporadic follicles ranging from 10 to 20mm in size, I could feel my heart drop.

Because my dose of Follistim was cut in half; yet somehow my rockstar ovaries ignored that fact and produced the same amount and the same size follicles as it had in the past. And while that wasn't necessarily a bad thing, it wasn't the change I was hoping for, and I was instantly terrified of the past repeating itself.

Because the past sucks.

But while I was feeling sorry for myself on the hard table contemplating what this meant, the doctor was busy commending me on responding better to half the dose of medicine and marveling that less-in my case-is indeed more. He confirmed that we need to come back in tomorrow to see the growth progress, because he's determined to push us a little farther this time so we can achieve our goals of more mature embryos.

He then looked up and read my slight disappointment, and I could see his facial features change from excitement to curiosity. I informed him that I understand that producing that many follicles on such a ridiculously low dose of stims was indeed wonderful, but I was expecting less follicles closer in size at this point.

Even as the words came out I knew I was being dramatic, and I assumed the stress of traveling and failed expectations had me all wound up and crazy in the head. But nonetheless, I was in need of reassurance that this was a good thing and that's exactly what I was given. And when I asked him if there was anything I could do to improve my lining, he looked at me like I was insane, so I reminded him that for my last cycle I was sitting at a cushioned 15mm, and seeing that 13.3 on the screen today was a little disheartening.

He just laughed and told me to stop bragging, so I left it at that.

Tuesday 1-19-10 (Day 21)

Dexamethasone (.75mg, oral pill): As of today, I'm still hot chocolate free, and I plan on continuing that pattern throughout the remainder of this cycle.

Lupron (5units, subQ injection): Easy.

Follistim (150units, subQ injection): For whatever reason, I'm feeling amazing today. I expected the water balloon feeling to expand and become more and more uncomfortable, but that just isn't that case.

I literally feel like I could go jogging right now.

But I won't.

Luveris (1/2ml, subQ injection): Another perfect measured draw and injection, so Luveris and I are still good.

Ciprofloxin (500mg tablet, twice daily): I don't remember this from my previous cycles, but this horse pill is sort of making me nauseous. I'm going to try taking it a little later in the day from now on to see if it helps; maybe one around lunch, and another at dinner.

E2 & U/S: I'm not sure what caused the 360 in my attitude, but after seeing the multiple follicles growing on the screen today coupled with the excitement in the doctors voice, I was transferred back to my old positive self. Maybe it was the doctors amazement at my stellar response to half the meds that was so contagious, the findings that my E2 levels were right on track despite the large amount of follicles, or the sight of my mother standing behind my head trying to count out the follicles that she thought were the "good ones" and loosing count, but it finally sank in how wonderfully this cycle is progressing.

My body was made for this.

Most girls are thrilled to obtain more than five or six follicles from each ovary, and here I am complaining because I received an overachiever response on a low dose of medicine of sporadic follicles numbering over two dozen, and I was ashamed of that disappointment. So what if I don't have twenty follicles that are all maturing at the same exact rate and size?

I have to remember the God that created the universe is in control of my body and it's response to all of this medication and stimulation; He's working behind the scenes to make sure every follicle is growing just as it should, and that's the ultimate reassurance for me.

Even as an overachiever.

Wednesday, 1-20-10 (Day 22)

Dexamethasone (.75mg, oral pill): Well, that didn't last long.

On my drive home from Sacramento, I somehow ended up with a hot chocolate in my hand. But if it counts for anything, I didn't finish all of it, and I'm justifying it by saying it was necessary to keep me awake.

Lupron (5units, subQ injection): I didn't know it at the time, but this was my last shot. I'm praying that this cycle brings us our pregnancy and maybe even some frozen embryos for future siblings, so although it was nice while it lasted, hopefully I'll never use Lupron again as long as I live.

Ciprofloxin (500mg tablet, twice daily): Note to self: taking this ginormous pill with food makes a big difference.

Clindamyacin (150mg suppository): And so begins the awkward intra-vaginal inserts.

E2 & U/S: As I lay there with the flimsy pink crepe paper napkin blanket over my exposed girl parts and watched the screen full of too many tiny black holes to keep up with, my heart swelled up with pride and excitement. All of the traveling exhaustion, excuses as to why I wasn't at work and pain from the IVF process was pushed aside as I stared in wonder at the fuzzy black screen and it's contents.

After another long trip down to Sacramento, today's ultrasound showed even greater improvement in growth patterns and the addition of even more follicles, I was given the instructions to stop all shots and trigger tomorrow morning at 1:30am. Knowing how much I wanted to avoid our previous cycles mistakes of under mature eggs but knowing we'd already responded better and given ourselves an extra day, the doctor seemed prepared for an argument that I just didn't have the strength to give him.

Dr: You'd be pretty hard pressed to get me to stim you for one more day, but if you want to push we'll talk.

Me: It's Ok, I trust you. You're the Doctor; I just grow the eggs.

Dr: And you do an amazing job of that.

Me: Thank you.

Thursday, 1-21-10 (Day 23)

Dexamethasone (.75mg, oral pill): Check.

Ciprofloxin (500mg tablet, twice daily): I've officially switched over from a shooting fanatic to a pill popper. So until I begin my PIO shots on Friday, my cocktail of shots has been replaced with a rainbow of pills.

Clindamyacin (150mg suppository): These little rocket shaped suppositories are never fun, but I'll do whatever it takes at this point.

Ovidrel Trigger (1/2mL, subQ injection): Having to wake up at 1:30am to administer a trigger shot is never a good thing; especially when you are absolutely exhausted from a week of traveling in and out of town every single day.

Instead of the usuall HCG intramuscular injection that you have to mix before administering, a lovely donator gave me this much easier Ovidrel prefilled syringe for a less painful subQ injection. I was thrilled with the ease at which I would be able to wake up, open the syringe, push out the air, inject in my pouch and drift back to sleep.

Except it didn't happen that way.

When my alarm went off at 1:28am, I forced myself out of bed and to the cooler I had next to it that held some ice packs and the prefilled injection. I carefully peeled back the plastic casing, removed the syringe, and attempted to pull back before pushing the air bubbles out just to make sure. I'm not sure exactly what happened because I was exhausted and it was an ungodly hour, but I somehow managed to loose liquid out of the syringe and panicked as I watched it drip down my arm.

And to make matters worse, being a prefilled syringe it had no measurable markings on it. Sure, the syringe is printed with the information that it holds 0.5 mL, but I had no way of looking at the syringe and telling how much I had lost for sure. So in a flurry of frustration, I took a picture of what I had left with my cell phone and then injected as quickly as possible, followed speed dial phone call to the clinic's answering service to see how much damage I'd done.

As soon as the nurse answered, she took down my name and number, asked what my problem was and-to my utter and complete horror-promptly transferred me to Dr. Greene himself at what was now almost 2:00am. I will never be able to convey the embarrassment that I felt at waking up the Dr. in the middle of the night, but he sounded perky nonetheless. And after frantically explaining my situation, he simply stated that I should be fine, because some patients are triggered with only half the amount anyway.

That kept me sane for the next few minutes, but since I'm an over analyzer coupled with ever present OCD, I had to do some research of my own. After a few moments of Google pictures of prefilled Ovidrel syringes did no good, I was forced to compromise with an experiment. To ease my mind, I pulled out a 1mL syringe and filled it halfway with water. Then I pushed that water out into the smallest plastic container I could find, and then sucked it back into the empty Ovidrel syringe, leaving 1/2mL of liquid inside the syringe.

As I sat there at 2:30am at my kitchen table, comparing what exactly 1/2mL of Ovidrel in the syringe should look like with the picture on my cell phone of what I had actually injected myself with, I realized I may have lost more than half of the trigger shot.

But I tried to remind myself of our motto this cycle, less just happens to be more because my body is a freak of nature. Hopefully that same theory applies to the trigger shot, because I'm not going to be able to find another trigger shot at 2:30am.

I just have to trust that the Dr. is right, and that God is still in control. I'll try to look back at these past few days and find the will to laugh at the mishaps rather then dwell on what they may mean for the future, and by tomorrow, we'll see the results of a slow cooked cycle involving a super low dose of meds and triggering with slightly less than half of the final maturation hormone.

I'll make an effort to go to bed early tonight, catch up on my sleep, and prepare myself for tomorrow's retrieval; allowing the worries of today to drown in the midst of hope for the future.

Because only half a trigger shot is perfectly fine when less is more anyway.

"A good laugh and a long sleep are the best cures in the doctor's book."

-Irish Proverb