The Avengers, or End of Phase I

Warning: this entry gets a little judgey at times. Please try not to think less of me. If you think you'll hate how judgey I am, just skip it. Thanks.

Today (Sunday the 25) is the first time I feel I can breathe in the last two weeks. Granted, I did just cover my ears while on a train to NYC because there are some small children sitting in front of me and a woman behind me telling her friend that her son is expecting and isn’t that exciting and it’s so wonderful that she’s going to be a grandmother. And at breakfast this morning we sat next to a couple and their infant, noticed that they just shoved a phone in the kid’s face and didn’t talk to him, and then, when the female half of the couple stood up, saw that she had a large baby bump. (Not that I’m judging people who use their phones to entertain their kids. Except I am. Sorry if that’s you. It’s not what I plan on doing. I work with too many 13 year old kids who can’t have a conversation since all they know how to do is use technology. Easier said than done, I know, and I may end up using the technological babysitter more than I plan to when I get there, but for now, part of my crazy is judging others and thinking, sure, they can have kids, but I can’t.)

And just think: this is the normal crazy. This is a step down from the out of control crazy I’ve been feeling most of the week.

The thing with IVF (so far) is that so much happens so fast you barely know your name anymore. You have to know what day of the week it is so you know when to go to the clinic, but everything else is a lost cause. It moves at the speed of super fast; light, tornadoes, jets, trains, Superman. Pick your metaphor. You won’t be wrong.

I've started to think of all of this in a similar vein to the Marvel cinematic universe. At this point, we're facing the end of phase I. Hence the entry title.

Last Tuesday, I went for more bloodwork and ultrasound. My left arm had bruised badly two days earlier, so I gave up my right arm for blood for the first time. That bruised something fierce, so both of my arms HURT. I had an alarm set for 5:30 that morning but woke up at 4:30 for no good reason, so I was exhausted. During my ultrasound, my doctor said I had a follicle that was already 18 mm. That’s big - in fact, she said that we’d probably lose that one as it would mature too quickly and be ready before the rest. (If this all sounds like gibberish, I'm not surprised. Follicles are something that don't get mentioned in high school health class as part of the female reproductive system. I just know they're what eggs come out of when they move into your ovaries, and that's pretty much all you need to know.) I had 3-4 other large ones on the right and a few small ones; the left had a lot less. Doctor said she wanted to see the left ovary respond better to treatment before I took my trigger shot, which is taken 36 hours before egg retrieval. It starts you ovulating.

Yes, all of that is exactly what you want to hear after you’ve been administering shots to yourself for almost a week. That things aren’t going as well as the doctor had hoped. But I had to try to look on the bright side. There were some good follicles. So that was something.

Interestingly, Doctor told me to start taking my third medication that night, the Cetratide which would keep me from ovulating. That was unsettling; I had started taking that on Sunday night, as directed by a nurse from another clinic site. Had that not been on my chart? Also minor cause for worry. But whatever. Doctors are busy, right? They can’t all update/read things all the time. I’m going to a clinic with amazing success rates that’s world renowned. I should just trust them.

A call that afternoon told me to come back in on Thursday morning. Happy Thanksgiving, Pilgrims. Baste the turkey, and me while you're at it.

Needless to say, I was exhausted and in quite a lot of pain throughout the day. We went out to dinner with friends, and I ended up putting my head down on the table for the vast majority of the meal. And possibly crying a few tears as unobtrusively as possible if any babies came into view. I was rude and depressing, but dammit, I was exhausted. (Also, on a totally unrelated note, I had found out that a friend of mine has pretty horrific cancer. That had been a big tear fest, I'm sure exacerbated by the fact that I was taking extra hormones. I wasn't thinking about that anymore over dinner, but that exhaustion was there, too.)                                                                                   

That night, my injections were rough. The first one that I fave myself HURT. When I pulled the needle out, it left a lump the size of a small egg and a bruise that a week later is huge, ugly, and very painful. I was worried and waffled about whether or not I should call the clinic. My MIL said it was normal and it would dissipate. I texted a new friend who's been through this a few times who said that meant the medication had pooled under my skin and I would have to massage it out. That was pleasant over a bruise. Meanwhile, I had two more injections to take, and I messed up the last one. I didn't inject it all, so after I had taken the needle out, I had to stick it back in. A fun night all around.

(Large stomach bruise; some other smaller ones and little pinpricks can be seen if you look closely. The scar on the right hand side of the pictures is from a previous surgery this past May to remove a cyst.)

Wednesday felt kind of sort of normal. I was still in a lot of pain, but my students were so cute in my afternoon classes. It was a half day before Thanksgiving, and we did some fun Harry Potter related activities. By the time the bell rang, there was a smile on my face. It had kind of been awhile.

But as the work day ended, I encountered a few instances of lack-of-support. They caught me off guard. I know I'm lucky to be able to say this, but it was the first time I had come up against this. Thus far, people have been coming out of the woodwork to offer their endless support, people I haven't spoken to in years, people I've never even met; other people who went either through a process like this or had miscarriages but never talk about them have sent me their stories or their prayers or their sympathies.

So these two instances, one right after another, led to an ugly sobbing fest on the way home. I know that I brought them upon myself, by things I said or did. These are people I feel comfortable around, and maybe they just heard or saw a little too much of my sadness or craziness, and they stood up to my own awfulness. Of course I deserved it. They only said things to me that I've said to myself over and over again for the past two years.

These instances on repeat in my head for the past few days. They have broken my heart several times and shaken my trust in these individuals. I find myself looking to justify their actions, as well as my own reactive thoughts. I do find plenty of reasons for them to say what they did, but it hurts to think of just how deeply they do not understand what going through this is like. I know they can't, but I also know that all of these horrible feelings, sad as it is, are valid. I am in some online support groups, and all the women in them have the same awful, visceral reactions to what should be other people's happiness as me. So even though every individual infertility story isn't necessarily a comfort, knowing that others feel this much pain and anger and self-doubt and ugliness at least lets me know that I'm not completely insane.

I laid on the couch for a long time when I got home, sometimes crying, sometimes feeling like I should never speak about this again because I'd inevitably say or do the wrong thing, let someone hear or see something too personal, and everyone would doubt my sanity or integrity or whatever again. I worried what my husband and MIL really thought of me, as they've seen the worst of it. I worried about burning bridges that couldn't be mended for reasons that feel so out of my control, that can't be explained, that certainly can't be understood by the people on the other side of them. (I don't want these people to be able to understand, to be clear. I would not wish this kind of pain on anyone.)

Thursday morning I had to be up early again for another blood work/ultrasound visit. Even though I had to go to the weekend clinic, a lot of the regulars from my clinic were there, so that made me feel a little more at ease. During the ultrasound (as the case with all of them has been), the doctor called out some numbers, follicle sizes, as well as ovary and uterus dimensions, to a woman by a computer, who typed them in. Several of them were larger than the troublesome one from Tuesday - what would that mean? Should I ask? It's true; the clinic doesn't always give you the gory details of what's going on. Part of me wants to ask, but part of me is scared of answers. What if the answers this time were that all of my follicles had grown too fast and I would get nothing this month and I would have to go through the whole process again? Not to mention, this is their job. They know what they need to. Should I just let them do their thing and trust them?

The doctor told me that I'd probably be  "triggering" that night, which was enough to make me lose my appetite. In my magic box of meds, I had three syringes with ridiculously long, thick needles that there had not been talk of yet, so they had to be for this occasion.

What I thought I'd be using

I asked to speak to a nurse about the trigger shot, to which there was some resistance, but they finally allowed it. That nurse was at least able to tell me that that big sucker was the mixing needle (which I had secretly been hoping) and that I'd just screw a regular needle like all the others I'd been using on after mixing. *Phew*


What I would actually be using

A phone call around noon told me yes, I would be triggering that night definitely. 9:10 pm, and be at the clinic 7:40 am on Saturday for my egg retrieval surgery.

The rest of Thursday and Friday were pretty normal. Triggering was a huge relief; I only had to do one injection that night, and it meant that an end to this was in sight.

Friday I didn't have to be up early to go to the clinic, and I didn't have to take any shots. Hallelujah.

I spoke to someone on the phone that day who has been through this process in the last year using the same clinic I did. She assured me that it does sometimes seem like they're withholding information, but in the end, they know what they're doing. She had an actual genetic problem, so she did not end up with many viable embryos to use for implantation. (We don't have any genetic issues that we know of, thankfully.) She had one embryo transfer, and it stuck. So she's a big proponent of this.

Also, she laid out the entire rest of the process for me, so I have a better idea of what to expect. There's some real weirdness coming my way, though. I think I've mentioned before that the upcoming progesterone shots are dreaded by all due to how painful they are. I assumed they would start after the embryo transfer, but no - they could start a week or two prior. And continue for eight weeks. Yay, she whispered, waving a tiny flag of defeat. So eight weeks of <possible/probable> severe pain to look forward to.

The implantation was also described to me. That's a procedure that you're not anesthetized for. They wheel your chosen embryo into the room in an incubator similar to what a baby is kept in, despite the fact that it is a tiny collection of cells. Then they give you a picture of it. What am I going to do with a picture of something that's not even visible to anyone who's not a medical professional, hang it on my fridge? And what if the procedure doesn't stick? Then I have a picture of a baby that almost never was, a reminder of the failure that I've been through. And I'll know the gender of this poppy seed sized ball of cells, which makes it all even more real. UGH.

Saturday morning, we had to be at the clinic by 7:40. (Everyone at work told me to take it easy and rest over the long weekend, which is hilarious, because I had to be to the clinic early three out of four days, not to mention have surgery. But yea. I'll take it easy. Thanks for the reminder. I mean, sleeping in just once would have been nice.) My husband go to, sorry for being crass, wank in a cup while I got to go down to prep for surgery.

(I have probably been on this rant already, but how is it fair that men get to have a moment of pleasure while I get to have IVs shoved in me, blood taken, other things uncomfortably inserted, put to sleep, and have eggs vacuumed out of my uterus? Of course, as hubby and I joked last night, men get to do that "pleasurable" thing while thinking about small children. Yeah, just touch yourself while thinking about a little girl/boy. Ha. So that's a little less pleasant.)

I wasn't at all nervous, which was refreshing. Anesthesia usually freaks me out. I was led into a room with eight beds cordoned off by curtains. That was when I got to really see this baby factory in all its glory. There were a bunch of women there all at the same time, and while everyone did their best to keep information private, you're going to overhear things when your partition is a curtain. I overheard the anesthesiologist's spiel to someone else before she gave it to me. I heard another woman at a front desk making the same call over and over again, reminding women that their transplants were happening later that day. I changed and sat on the bed, cold without having enough blankets to wrap up in.

(Such a me moment, though. I was reading a book when I heard a distinctively familiar drum beat in the background. I knew without knowing that it was the Backstreet Boys. I listened hard for a few seconds and was able to place "As Long As You Love Me," so that made me feel a little better, too. If ever there are signs that everything's going to be okay, it's some BSB pumping through the speakers.)

I met with a nurse, the doctor performing the surgery, and the anesthesiologist. They all gave me a different piece of what was going to happen as well as what to expect afterwards. I had agita about removing my nose ring, relatively new and slightly infected, but at least I was allowed to keep that in. (Seriously. This is the kind of shit I worry about. It had been plaguing me for days. In fact, I had watched videos on how to remove it and brought a small stud earring with me in case I couldn't get it back in.) The nurse came in and decided the right arm didn't seem as bruised, plus it was closest to her, so with a bit of struggle, pain, and an almost need for someone to come help, she got the IV going. I did start crying as soon as the anesthesiologist came in. Not really sure why...

...except that I had been told recently that a friend of mine might need a break from seeing me at this time because it's difficult for them. I hate that I thought this (please don't also hate me, readers), but as I was waiting there on the bed, cold, bruised, anticipating the insertion of an IV into one of my two very bruised arms, I couldn't help thinking, Yeah. This process is really difficult for someone else. Me undergoing anesthesia and all the other trimmings that go with this surgery is so hard for another person. (Please forgive my awful mind. I know it's more complicated than that.)

Jon was allowed to come in and wait with me until I went in for the surgery. At least I had him there to hold my hand and cuddle me. It helped a little.

When it was my time, I was walked to the bathroom - they want you to pee, I guess, before they put you to sleep and poke around in your lady parts. Then I was walked into the operating theater, just as big and intimidating as any other I've been in (I've had surgery twice before, more major than this). I climbed onto a step stool and was instructed to sit on the bed with my butt in this little hole. Then I swung my legs around and put my arms out as if I were being crucified. (I do not remember having cross shaped arm rests before.) An oxygen tube was put lightly up my nose. I started to feel some pressure in my chest, and despite the discomfort, I told myself, It's just anesthesia. This is how it always feels. Breathe normally. You'll be okay.

And then I woke up. Hovering above my face was a piece of paper on a clipboard with a bit "8" written on it. "Shauna?" a voice from behind the board came. "This is how many eggs we retrieved."

I started bawling.

I had heard about egg retrieval from two people prior to having it done. One of them had had 21 eggs, and one had 30. Eight felt like a crushing blow. The nurse quickly told me that 8 is nice and normal, a pretty average number. Okay. But it's a lot less than 30, and I had so been hoping.

Meanwhile, in the bed next to me, I heard another woman being woken up. She was told that one of her ovaries was close to her skin, so even though they were able to vaginally remove some eggs, they also had to go in through her side to get one more. They showed her whatever her number was, and she and her husband didn't sound happy, either. Some more comments told us why; they only had five eggs retrieved. I felt so bad for her and wanted to pull back the curtain and hug her. I have often been reminded since then that all it takes is one, but that's one embryo, not one egg, and there are a lot of steps to go through before finding out if those eggs are valid and will make a baby. The more the better.

At least five made me feel selfishly better about myself.

The nurse, while a lovely human, politely rushed me back into the bathroom. I stumbled in kind of woozily and did my thing, and then I was sent home. There was a lot of couch napping that day. Amazing how anesthesia for a short procedure can put you on your ass for awhile.

If this were a movie, the initial problem would pretty much be resolved at this point, right? You can't make a baby, let's use you as a science experiment, inject yourself, be in a ton of pain, have your hormones rampage through you, and then lay eight eggs. Like a chicken.

The "happy extra resolution" scene came later. In all of this chaos and crazy, Jon and I have started looking at houses that we may want to move into. Our house is lovely and has been wonderful to us over the past seven years, but it's a small two bedroom joint. The rooms are big, and it's comfortable enough, but we would like to have more room for our children to grow up in. We're also looking for a higher ranked school district than the town we live in. Not to mention how much fun looking at real estate online and going to open houses is. (I'm not even being facetious. You know you're an adult when...) The previous weekend, we had seen a house that had surprised us in an awesome way, and that afternoon, we brought my parents back to see it. We may be putting a bid on it, which means putting our house on the market, which means staging the place to make it look not like it's crammed with all of our crap (except for the basement) when people come to see it.

Seriously. Our junk is everywhere.

Several people, my realtor and MIL namely, have asked if this is the right time for us to be doing this with all that we're going through. Listen, is it ever a good time to buy a house? Would it be better to be packing up when I'm actually pregnant? Or when we have an infant? At least now, it gives us something to take our mind off of IVF hell, something positive to think about.

Roll credits.

But wait! There's always a post credits scene, right? This one occured 7:30 am Sunday morning. We were laying in bed, already awake, despite my desperate desire to sleep in. (Another sign you're an adult: 7:30 is sleeping in.) The phone rang, and I answered it.

The clinic was calling to tell us how many of our eggs fertilized and became embryos.

Five.

Even though eight eggs seemed awful, five embryos felt really good. I haven't heard of a lot of people having more than five.

You know what that means?

Right now, in some petri dish in some lab in central NJ, Jon and I have five teeny, tiny babies growing. Five of our babies are alive. I mean, kind of. Despite whatever you feel about when life really begins, that is a strange phenomenon to wrap my head around. I think about it sometimes, and it makes me smile.

This does not, of course, mean that they're all going to make it through the next few stages.

But it's a start.

Fade to black.

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