Five days after starting the Menopur injections, I returned to Kaiser for my second ultrasound. It had been less than a week since my first ultrasound, though frequent visits are necessary to carefully monitor the growth of follicles and egg development. Because the drugs may overstimulate my ovaries, I could be at risk of producing too many eggs. We all know what that means, I could be at risk of becoming the next Octomom. Yikes!
I was excited to discover what was going on in my insides. Back in the ultrasound room, tucked away at the end of a long hallway in Kaiser's Reproductive Endocrinology Department, I sat restless awaiting my doctor. Instead of my doctor however, I was seen by a nurse practitioner. Hmm, ok. Familiar with the routine, I laid back, propped my feet into the metal stirrups and relaxed my knees apart. As the NP inserted the probe we followed its journey throughout my uterus, around my ovaries, and saw....absolutely nothing. Boo. Even after gliding back and forth from the right ovary to the left, maneuvering the probe this way and that, pressing firmly on my abdomen to get a better view, we still saw - nothing. Dislike.
Sweetly, the RN comments, "Well, it appears your uterus is very quiet and your ovaries are being patient and taking their time." Ugh. Really? That's all fine and dandy, but seriously after 10 days of injecting myself with hormones designed to purposefully stimulate follicle growth, there really, truly isn't anything? Say what!? I just don't get. The NP asks me to get dressed and meet her in her office. I pull on my clothes, pick up my pouty lower lip and trudge down the hallway.
In her office, the NP tells me that she is going to continue my regiment of Lupron and two vials of Menopur for the next three days and she will see me again on Tuesday. By then, she explains, we should see some action. (For goodness sake, I hope so!) On my way out, I hit up the 4th floor pharmacy, fork over my credit card for another batch of Menopur and kiss another $240 bucks good bye (not too mention the $127 I paid for the sonogram to view ABSOLUTELY NOTHING!).
Back at the ranch, I take a hit of Menopur each night, and slowly I begin to feel the awakenings of follicle development within the depths of my body. I've become very attune to my body's reproductive system since I started this journey. I can read every tinge, twitch, cramp and gurgle in my belly well. I was sure that when I went in for the next ultrasound that there would be a party going on in my ovaries - and I was positive the action was happening on the left side!
And boy was I right on! Tuesday afternoon, same place, same sonogram machine, same NP. On my back, propping my head up to see the monitor, the NP points out two fuzzy black dots inside the left ovary - follicles! Woo hoo! She makes a few clicks with the mouse and measures them - 10 & 12mm. Not bad, but the optimal length to pop out an egg is 18-20mm. She moves on to examine the right ovary...she looks, and looks....and looks, and looks. And nothing. She seems perplexed, which worries me. Um, where's the party? She tries slanting the probe up, down, all around, pressing her palm into my abdomen and still nothing. Humph.
After the exam, I meet the NP in her office. She is pleased with the progress, explaining that at my age we would hope to see at least 2-4 follicles. Now that my body is developing these very precious egg factories, the NP instructs me to give up all aerobic activity (eek!) and she would like me to continue with the same dosage of Menopur for another three days. We all know what that means! Cha ching! $$$$$ Back to the pharmacy I go. Handing over my Mileage Plus United credit card, I think of all the miles I'm racking up and where baby and I will go someday. I leave Kaiser that afternoon happy for my two follies and a bit worried about the vacant lot on my right side.
For the next three days I am antsy, crawling up the wall and pouting like a little kid. I've been so active this summer, going to the gym, dancing, and religiously attending Bikram yoga classes that I was going stir crazy not able to exercise. I did what I could - took long walks, only danced slow hulas and switched over to Hatha yoga (minus the inverted poses). As I watched the girls sway their hips, looked on as my yoga peers held their bridges, and dilly dallied with wimpy barbells, I reminded myself that it was all necessary to protect the little follies on the inside.
The day before my appointment, I decided to request a visit with my doctor instead of the nurse practitioner. I'm sure she knew her stuff and was performing the ultrasounds to the best of her ability, though I just felt like I needed to see my guy. Perhaps the last two visits with the NP - the first visit a big fail with absolutely no development and the second visit, the mystery of the right ovary - discouraged me from wanting to see her again. Call it bad juju, I guess. I was informed that the nurse practitioners regularly perform the ultrasounds, though my doctor happened to be on call that day, so they would accommodate me. Yippee!
Earlier this afternoon, I went into Kaiser feeling positive, uplifted and sure that I was going to get a good report card. Sure enough there was a follicle on my right side! It was just a baby one, at 9.5mm, nevertheless there was something there, which made me again wonder whether the NP was being very diligent in her practice. Though this little guy won't be of much help this cycle, it was comforting to know that my right ovary had some life to it and rid me of any discouraging thoughts.
On to the left ovary. The two follicles that the NP had discovered at the last appointment had grown considerably; 17 and 19mm! These were very promising and Dr. Huang was pleased with the progress. After completing the exam, I was surprised when he informed me that by the end of the day the follicles would grow another 2mm and I would be ready to go! I just needed to pick the day I wanted to be inseminated - Sunday or Monday! Wow, just like that!? I get to pick? What a change from the guessing game I once had to play with the ovulation testing kits!
Since neither day was better than the other (chance wise) I went with Sunday, the lesser of my busy days. The doc asked me to meet him in his office after getting dressed. As soon as he exited the room, I hopped off the reclined chair and did the happy dance. I was thrilled with the progress, ecstatic that this meant the end of injections and giddy with excitement to try to get pregnant again! It's been awhile since the last cycle - May - and I've been looking forward to this day all summer long!
In his office, Dr. Huang explained the procedures for the final injection - a dose of one final hormone that will trigger ovulation - to be taken at precisely 10pm that evening. I was told to cease all intake of Lupron and Menopur, but to continue the Estrodiol pills. He sent me down to the pharmacy to pick up the last of my hormones and two boxes of suppositories to take for two weeks following the IUI (those sound like good fun). He gave me the "ok" to proceed with my regular physical activities, including dancing! Hooray! I left his office with a spring in my step, and a smile on my face that not even the $200 expense at the pharmacy could take away!
So now, it is Friday evening, and it is done. I bailed on a date to stay home and give myself the final injection, the trigger shot, just over an hour ago. I am hoping and praying that this injection will indeed be the final shot. I can't bear to think of repeating the hormone treatment. Over the next day, my little egg (or perhaps two eggs; one from each follicle) should be making its way into my fallopian tube where it will hang out and await fertilization by the sperm, soon to be introduced to my body this coming Sunday. I pray that this is my time. #8, my lucky number...we'll have to wait and see. Pray for me!
Saturday, August 20, 2011
Friday, August 19, 2011
A Summer of Syringes
There I was, Sunday evening in my kitchen, staring aghast at the paraphernalia strewn across my kitchen counter top.
I felt as if I had walked into a laboratory and should have been wearing latex gloves, goggles and a lab coat. Being the overly thorough individual that I am (ok, anal), I read the directions on how to mix the hormones for the millionth time. Moving slowly, pausing frequently to reread directions, and taking deep breathes, I followed the instructions step by step.
First, I injected 10 units of air into the Lupron, then drew up 10 units of the drug to mix in the first vial of Menopur. After the Menopur powder dissolved, I gently rolled the vial between my palms to be sure the drug had dissolved completely. Then, using the same syringe, I drew up 50 units of sodium chloride (saline), injected it into the vial of Menopur, and again drew up another 40 units, as a total of 90 units of saline was required. Since my dosage required two vials of Menopur, I then had to draw up the entire solution and mix it with the second vial of Menopur. Once the concoction was complete, I was ready to be injected!
Disposing of the mixing needle in my Sharps container, I used a clean needle to draw up the solution. This is when I bumped into my first obstacle. The solution was at least 90 units, though the syringe could only hold 50 units. Was I to inject myself with 50 units or the entire 90 units? After scouring the packet of information, holding a phone consultation with Jules, and turning to the Internet to determine a safe dosage of Menopur, I decided to take the full 90 units. Since the syringe could only hold 50 units however, this required me to stick myself twice! Luckily, I had a ridiculous supply of syringes, so I was able to use a clean one each time.
The next morning, still unsure of whether I made the right move, as the thought of sticking myself twice every evening seemed absurd (geez, sticking myself just once is absurd), I called Kaiser the first thing in the morning. The nurse confirmed that I was to take the full dosage using the 100 unit syringes supplied by the pharmacy. Uh, say what!? Excuse me, did you say 100 unit syringes!? "Oh honey, did you use the 50 unit syringes that came in the Lupron box?" the nurse asked. Oops. Why, yes I did.
I wasn't aware that the large bag containing the extra syringes I picked up from the pharmacy the day before were larger than the ones I had been using. Doh! Well, the good news was that I hadn't overdosed. The bad news however, I was left with a horrible black and blue bruise for the next week, that faded to a lovely brown and mucus green in time for an outdoor show in which my Tahitian costume exposed my mid-drift. Nice.
The next evening, I was sure to use the proper syringe. The 100 unit syringes were far scarier. Double the size, double the pain. Not only was the barrel wider and longer, but the needle was thicker and longer - eek! This time, there was more than a pinch and it was necessary to hold the syringe into my flesh longer in order to release the entire 100 units of the solution. To this day, 17 days of injections later, I still cringe at the sight of the needle, breathe deep before plunging it into my skin, curl my toes as I firmly press on the plunger and wince at the sensation of the liquid being released into my body. Even after removing the needle from my skin, the pain is not over. For a good 10 minutes after, I can still feel a burning sensation and much irritation in the area in which I poked.
Thankfully, I have gotten far more skilled as the days have gone on. I am referring to the directions less frequently, getting quicker at mixing, producing fewer air bubbles and other than small, subtle grayish bruises, I haven't left any large, black and blue spots on my belly as I did the first night. I am careful to alternate to the left and right side of my belly and to not puncture an area I've already injected. Still, as the motions of preparing and injecting get easier, the emotions related to each task do not get any easier.
Each night after giving myself my injection, I am overwhelmed by the lengths I have gone to get pregnant. "Wow!" I think to myself. "Really? Have I truly gotten to this level?" "Am I seriously paying oodles of dollars to stick myself every night with a needle!?" Thus far, I've not cried over the pain of injecting myself with a needle. Yet, when I consider the extreme measures I have undergone to get pregnant, I've shed a tear more than once.
journey who have gone to further extremes than what I am currently undergoing to get pregnant. Of these women, many have gotten pregnant after enduring the struggles and now have beautiful, blessed babies and children. And it is then, considering the outcome, that all the pricking, pain and problems make every moment worthwhile.
- A lengthy packet of directions detailing how to give myself the injections and how to mix the hormones
- A vial of Lupron (used to suppress my pituitary gland from secreting the hormone that triggers ovulation)
- A bottle containing 30 tiny blue pills of Estridiol (to counteract the Lupron, as Lupron depletes estrogen)
- Two vials of Menopur (the hormone used to stimulate my ovaries)
- A vial of Sodium Chloride (saline to mix and dilute the Menopur)
- Two 50 unit syringes (one for mixing the hormones, the other for injection)
- Alcohol swabs
- Red Sharps container to dispose of the syringes
I felt as if I had walked into a laboratory and should have been wearing latex gloves, goggles and a lab coat. Being the overly thorough individual that I am (ok, anal), I read the directions on how to mix the hormones for the millionth time. Moving slowly, pausing frequently to reread directions, and taking deep breathes, I followed the instructions step by step.
First, I injected 10 units of air into the Lupron, then drew up 10 units of the drug to mix in the first vial of Menopur. After the Menopur powder dissolved, I gently rolled the vial between my palms to be sure the drug had dissolved completely. Then, using the same syringe, I drew up 50 units of sodium chloride (saline), injected it into the vial of Menopur, and again drew up another 40 units, as a total of 90 units of saline was required. Since my dosage required two vials of Menopur, I then had to draw up the entire solution and mix it with the second vial of Menopur. Once the concoction was complete, I was ready to be injected!
Disposing of the mixing needle in my Sharps container, I used a clean needle to draw up the solution. This is when I bumped into my first obstacle. The solution was at least 90 units, though the syringe could only hold 50 units. Was I to inject myself with 50 units or the entire 90 units? After scouring the packet of information, holding a phone consultation with Jules, and turning to the Internet to determine a safe dosage of Menopur, I decided to take the full 90 units. Since the syringe could only hold 50 units however, this required me to stick myself twice! Luckily, I had a ridiculous supply of syringes, so I was able to use a clean one each time.
The next morning, still unsure of whether I made the right move, as the thought of sticking myself twice every evening seemed absurd (geez, sticking myself just once is absurd), I called Kaiser the first thing in the morning. The nurse confirmed that I was to take the full dosage using the 100 unit syringes supplied by the pharmacy. Uh, say what!? Excuse me, did you say 100 unit syringes!? "Oh honey, did you use the 50 unit syringes that came in the Lupron box?" the nurse asked. Oops. Why, yes I did.
I wasn't aware that the large bag containing the extra syringes I picked up from the pharmacy the day before were larger than the ones I had been using. Doh! Well, the good news was that I hadn't overdosed. The bad news however, I was left with a horrible black and blue bruise for the next week, that faded to a lovely brown and mucus green in time for an outdoor show in which my Tahitian costume exposed my mid-drift. Nice.
The next evening, I was sure to use the proper syringe. The 100 unit syringes were far scarier. Double the size, double the pain. Not only was the barrel wider and longer, but the needle was thicker and longer - eek! This time, there was more than a pinch and it was necessary to hold the syringe into my flesh longer in order to release the entire 100 units of the solution. To this day, 17 days of injections later, I still cringe at the sight of the needle, breathe deep before plunging it into my skin, curl my toes as I firmly press on the plunger and wince at the sensation of the liquid being released into my body. Even after removing the needle from my skin, the pain is not over. For a good 10 minutes after, I can still feel a burning sensation and much irritation in the area in which I poked.
Thankfully, I have gotten far more skilled as the days have gone on. I am referring to the directions less frequently, getting quicker at mixing, producing fewer air bubbles and other than small, subtle grayish bruises, I haven't left any large, black and blue spots on my belly as I did the first night. I am careful to alternate to the left and right side of my belly and to not puncture an area I've already injected. Still, as the motions of preparing and injecting get easier, the emotions related to each task do not get any easier.
Each night after giving myself my injection, I am overwhelmed by the lengths I have gone to get pregnant. "Wow!" I think to myself. "Really? Have I truly gotten to this level?" "Am I seriously paying oodles of dollars to stick myself every night with a needle!?" Thus far, I've not cried over the pain of injecting myself with a needle. Yet, when I consider the extreme measures I have undergone to get pregnant, I've shed a tear more than once.
journey who have gone to further extremes than what I am currently undergoing to get pregnant. Of these women, many have gotten pregnant after enduring the struggles and now have beautiful, blessed babies and children. And it is then, considering the outcome, that all the pricking, pain and problems make every moment worthwhile.
Thursday, August 18, 2011
Holy Hormones!
Goodness, where did the summer go!? Just one, final week before school begins! Why is it that 10 weeks during the school year drags on, while 10 weeks of summer sails by in the blink of an eye? Guess it's true; time flies when you're having fun! And yes, it's been a fun summer!
Sadly, I didn't get to travel internationally, as I have the last three years, and that's ok because there was much to do at home! I'm thankful my girls and I were able to visit my family in Hawaii (the first time in four years), go on an amazing road trip to Canada with Nips, visit my Dad in Oregon, and reconnect with a special someone from the past.
Of course, there has been work amongst all this play! On August 2nd, a week into my road trip with Julie, I started the dreaded hormone injections, preparing myself to get pregnant, for the eighth time. Since the vials of hormones needed to be refrigerated, I packed the meds in a cooler, alongside our snacks of salami and cheese while on the road, and requested that the front desk of each motel or hostel we stayed at take good care of my medication during our visit.
So, the evening of the 2nd, in the common room of our Portland hostel, Jules and I sat across from each other at a table, with the vial of Lupron, an alcohol pad and a syringe in between us (I'm sure we must have looked rather suspicious). I am still thanking my lucky stars for having Jules with me during my first few days of injections. Though I had practiced administering the shot in a class, over a month ago, I was nervous, doubtful and hesitant. Jule's nursing skills came in very handy and I felt more confident having her around. Honestly, even if Jules didn't have the skills of a nurse, I would still feel more comfortable with her there.
After reviewing the packet of information I was given at the injection class, Julie showed me how to draw up the liquid from the vial into the syringe, and inspect and get rid of any air bubbles. When the syringe was ready to go, I stood up, pulled up my shirt, got a good grip of chub from my belly and aimed the syringe at my belly like a dart. Remembering that it was less painless if I inserted the syringe quickly, I pressed the needle firmly into my flesh and released the 10 units of Lupron into my body. Done! Nothing more than a pinch, yay! After the deed was done, I wrapped the meds safely back into our portable cooler, and stored it in the frig in the common room. For the next few days on our trip, Jules looked over me less and less until I was confident enough to do everything on my own.
As expected, three days after starting the injections, on the drive home, I started my period. And boy, did I! After three months of birth control pills to prepare my body for the hormone treatment and skipping my period for three months, my uterine lining was overflowing! In fact, I had been spotting every day for the last month! Good grief, my body released like I was a 11 years old having my first period! And of course, my body decided to let go three months of menstrual bleeding high in the Cascade mountains, on a road with the most twists and turns I've ever driven, miles from the closest gas station or Starbucks! Let's just say I'm super thrilled I decided to purchase the leather package on my vehicle!
As directed, I called the nurse at Kaiser to make an appointment for an ultrasound. That Sunday morning I found myself in a familiar corner room of Kaiser SF, housing a clunky sonogram machine, awaiting my doctor half naked with a blue, plastic drape over the lower half of my body. After whirling into the room, slapping on a pair of latex gloves and inserting the probe, my doc spent a whole two minutes examining my insides before declaring my uterus healthy and ready to go. After dressing and meeting him in his office briefly, he sent me down to the pharmacy to pick up the next batch of hormones.
2 minute ultrasound & 5 minute doc visit = $127
10 vials of hormones = $288.50
healthy uterus = priceless
That evening, with twice the amount of drugs and twice the number of needles resting on my kitchen counter top and no Julie to guide me, I had a mini panic attack...to be continued!
Sadly, I didn't get to travel internationally, as I have the last three years, and that's ok because there was much to do at home! I'm thankful my girls and I were able to visit my family in Hawaii (the first time in four years), go on an amazing road trip to Canada with Nips, visit my Dad in Oregon, and reconnect with a special someone from the past.
Of course, there has been work amongst all this play! On August 2nd, a week into my road trip with Julie, I started the dreaded hormone injections, preparing myself to get pregnant, for the eighth time. Since the vials of hormones needed to be refrigerated, I packed the meds in a cooler, alongside our snacks of salami and cheese while on the road, and requested that the front desk of each motel or hostel we stayed at take good care of my medication during our visit.
So, the evening of the 2nd, in the common room of our Portland hostel, Jules and I sat across from each other at a table, with the vial of Lupron, an alcohol pad and a syringe in between us (I'm sure we must have looked rather suspicious). I am still thanking my lucky stars for having Jules with me during my first few days of injections. Though I had practiced administering the shot in a class, over a month ago, I was nervous, doubtful and hesitant. Jule's nursing skills came in very handy and I felt more confident having her around. Honestly, even if Jules didn't have the skills of a nurse, I would still feel more comfortable with her there.
After reviewing the packet of information I was given at the injection class, Julie showed me how to draw up the liquid from the vial into the syringe, and inspect and get rid of any air bubbles. When the syringe was ready to go, I stood up, pulled up my shirt, got a good grip of chub from my belly and aimed the syringe at my belly like a dart. Remembering that it was less painless if I inserted the syringe quickly, I pressed the needle firmly into my flesh and released the 10 units of Lupron into my body. Done! Nothing more than a pinch, yay! After the deed was done, I wrapped the meds safely back into our portable cooler, and stored it in the frig in the common room. For the next few days on our trip, Jules looked over me less and less until I was confident enough to do everything on my own.
As expected, three days after starting the injections, on the drive home, I started my period. And boy, did I! After three months of birth control pills to prepare my body for the hormone treatment and skipping my period for three months, my uterine lining was overflowing! In fact, I had been spotting every day for the last month! Good grief, my body released like I was a 11 years old having my first period! And of course, my body decided to let go three months of menstrual bleeding high in the Cascade mountains, on a road with the most twists and turns I've ever driven, miles from the closest gas station or Starbucks! Let's just say I'm super thrilled I decided to purchase the leather package on my vehicle!
As directed, I called the nurse at Kaiser to make an appointment for an ultrasound. That Sunday morning I found myself in a familiar corner room of Kaiser SF, housing a clunky sonogram machine, awaiting my doctor half naked with a blue, plastic drape over the lower half of my body. After whirling into the room, slapping on a pair of latex gloves and inserting the probe, my doc spent a whole two minutes examining my insides before declaring my uterus healthy and ready to go. After dressing and meeting him in his office briefly, he sent me down to the pharmacy to pick up the next batch of hormones.
2 minute ultrasound & 5 minute doc visit = $127
10 vials of hormones = $288.50
healthy uterus = priceless
That evening, with twice the amount of drugs and twice the number of needles resting on my kitchen counter top and no Julie to guide me, I had a mini panic attack...to be continued!
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