WTF Side Effects??

Fuck. I was so jazzed about not having to take more stimulating injections that I didn't even consider the possibility of side effects from this teensy amount of Lupron. What could I possibly get from 10 measly units? I didn't even look up if Lupron had side effects. 100% my bad.

The shot itself went off well. Teensy needle that barely hurt, the site was a tad sore but nothing awful. About 2-3 hours after taking my first dose, I started to feel off. First it was a head ache that kind of crept up out of nowhere. Then my back started to ache. Then my right knee. I couldn't figure out what was going on until I asked E to look up the side effects an hour later after I started getting light headed.

I should really have done my due-diligence. These are only a few of the "common" side effects:

• acne, increased growth of facial hair;
• breakthrough bleeding in a female child during the first 2 months of leuprolide treatment;
• dizziness, weakness, tired feeling;
• hot flashes, night sweats, chills, clammy skin;
• nausea, diarrhea, constipation, stomach pain;
• skin redness, itching, or scaling;
• joint or muscle pain;
• vaginal itching or discharge;
• breast swelling or tenderness;
• testicle pain;
• impotence, loss of interest in sex;
• depression, sleep problems (insomnia), memory problems; or
• redness, burning, stinging, or pain where the shot was given.

This is not a complete list of side effects and others may occur. (Source)

I'm going to have to call or email the nurses if I continue to feel this shitty. Hopefully I'll get used to the medication and the side effects won't continue, I'm going to be useless if I feel this way for the next two weeks.

Zonked Out

Today I am completely and totally zonked out. I think I felt okay for the first couple hours of the day but since then I've been exhausted. My head and eyes feel so heavy, I feel like I could sleep the whole day away and still be tired.

Although the medication dosages have been exactly the same, I'm definitely getting side effects earlier with this second cycle of IVF.  With the first, it was probably a good week of stims before I felt any different than a slightly poked version of normal. This time, it only took about 2 days for me to start getting heartburn and bloating and now that we're on day 6, I'm so, so tired.  An exhausted, half asleep lump who looks like they swallowed a fat, firm balloon.

I'm so thrown off that I was actually late for my shot this evening. Since starting the IVF process, I've been vigilant about keeping on top of my injections. My alarm goes off at 9am/pm, I immediately grab supplies and prep my shots, and they're done by 9:30am/pm. This evening, I managed to get everything wrong. I was so tired I could barely stay awake so I took Milou for a nice walk in the finally cool, fall air. I came back at 8:40pm, thinking about my shot with a solid 20 minutes to spare, and then got distracted by a phone call from E.

E was on his way home from work and was hungry. I checked the fridges and cabinets but we didn't have anything that could be easily prepared for dinner. I then had the wonderful idea to give my sister L a ride home from her restaurant and bring home Japanese food. Sounds good right? Delicious food, no prep, easy peasy! Except somewhere in there I'd completely forgotten about my shot.  And then my evening shot event was somehow deleted from my calendar, which means no alarm. Whoops.

I was sitting outside L's restaurant, listening to my Harry Potter audio book for the 5 millionth time, when I looked down at my clock and saw 9:30pm. It took a few minutes to click

...huh, it's 9:32, hope she gets out soon, I'm hungry....9:37...huh...FUCK!

I freaked out a bit, called E who reminded me not to freak out, and then shortly thereafter my sister got off work. I zoomed home as fast as I could, skipped getting the delicious froyo I was planning to buy,  prepped the shot and finally got it done by about 10:05, half an hour late. My beef was stone cold by the time I got to it and I'm still upset with myself and completely exhausted again.

How could I forget for even a second that nothing is normal when you're doing IVF -_- Everything runs on such a strict schedule and here I am acting like I can go do whatever I feel like. Blah. I'm going to go sleep now so I don't accidentally miss my morning shot and next appointment.

SO ITCHY

My HCG symptoms finally went away and I was feeling really good! I could wear my pants again and was basically back to normal when it was time to start up birth control pills again. I'm used to the pills making me feel exhausted and hormonal but this round came with an unexpected and miserable side effect.

Bane of my existence right now

Almost immediately after starting the pills, I broke out in small, ITCHY, red bumps. I'm used to having rashes, I get contact dermatitis all the time from detergent, chemicals, all sorts of things you touch by accident, but those rashes are usually gone in a couple days and they aren't too itchy. This rash makes me want to scratch my skin off with a fork and I've had it for a week - I can't seem to get rid of it!

Thus far I've tried cortisone cream, coconut oil, tea tree oil, benadryl gel, benadryl pills, and the left over anti-fungal cream from when Button caught ring worm at the vet. They all soothe the itch temporarily but don't seem to be helping the rash. The anti-fungal may actually be upsetting it but I'm not sure.

It started under my right breast so my first though was heat rash or retained detergent in my bras. I soaked all the bras and washed them by hand while airing out my skin. Instead of going away, it spread down my belly and is still as itchy as ever.

SO ITCHY. You can tell when I've scratched it :(

At the same time the boob rash popped up, the same itchy, red bumps appeared in my right groin area where I usually shave and on my thigh. I mistook it for razor burn until it started itching and didn't go away with a cool compress and some coconut oil moisturizer. Then I thought it must be from my pads, I was on my period and last month had an awful reaction to the latex in my pad adhesive - maybe I was having a reaction to this brand too?

At this point, I have no idea what's causing it. Since it popped up with the birth control my current theory is maybe a skin yeast infection? You usually see them as diaper rash in babies but you can get them from birth control and antibiotics. If so, the anti-fungal should help it but like I said before, I'm not sure if it's helping or hurting. It's hard to tell since I've been on so many medications and it could just as easily be some hormonal or immune reaction. It's also right where I lay on my side to sleep so it could be detergent in my sheets? Ugh.

I hate you rash. So much.

The only things I know for sure are that it's not contagious, it's only on my right side and it itches like a bitch. It's your standard nondescript red bumps so I'm not sure if I should make an appointment with the derm yet. In the past, they see red bumps, tell me it's contact dermatitis and to basically wait it out. If this is a birth control reaction and the price of success I'm willing to grin and bear it, but I'd really like to get it cleared up before I start stims.

I think I'm going to ask S, my nurse midwife/acupuncturist if she knows what it is and how to get rid of it. If she says I need to see the derm, I'll make an appointment ASAP before I scratch my skin off.

Birth Control ZzzZzzZzz

Today is day three of my birth control suppression phase for IVF #2 and I am SO. TIRED. I know that drowsiness is a side effect, but there's something about the combination of period hormones and birth control hormones that makes me feel like an absolute slug. My eyes feel heavy and sore and I'm pretty sure I'd fall fast asleep if I closed them for more than a few seconds. Zzzzzz.

The stims got really uncomfortable near the end, especially when I added in the trigger and my waist line blew up like a blimp but I think birth control still makes me feel the worst. In addition to being super, super sleepy, the combination of hormones and PMS has made me SUPER grumpy. I'm usually easy going and I let things slide off my back, but lately everything is bothering me. I just want to seclude myself with my cats, my dog, E and craft things like quilts, cloth diapers and paintings.

Of course, quilts and paintings take time, money, materials, space and skill, none of which I have at the moment. I don't think I've touched a sewing machine in 10 years but that isn't hampering my desire to start sewing owl and nature themed blankets. Not to mention, we need to actually be pregnant with a healthy baby to have an actual need for owl quilted blankets, so we should probably tackle that hurdle before I break out the sewing machine.

Adooooorable Owl Quilt

There is no way I should be anywhere near a quilting project but the hormones are insisting otherwise. In case anyone else falls in love with this owl quilt and has actual skill with a sewing machine and the ability to stay awake, you can buy the pattern here.

Day 6: FOUR FROSTIES

We have FOUR frozen embryos!!! FOUR potentially healthy embryos that could grow into four potential babies! The two early blastocysts from yesterday continued to grow beautifully overnight and they were able to biopsy and freeze them this morning.

Original Photo came from here

I am so over the moon! The doctor said I responded so well that you can barely tell I'm a DOR/FXPOI patient :D It took a whoooole lot of meds, but it will be so, so worth it if these embryos are healthy. I need good chromosomes without Fragile X or trisomy problems.

Our breakdown for our first IVF cycle:

• 12 days of BCPs
• 3 days off
• 11.5 days of 600iu Menopur, 0.83mg Omnitrope, 1mg dexamethasone, 5 days of Cetrotide
• Novarel trigger - 10,000 HCG 

 This protocol resulted in:

• 14 follies
• 11 eggs retrieved
• 8 mature eggs fertilized
• 6 embryos
• 4 frozen day 5/6

My mild OHSS symptoms are starting to resolve today as well. I still got up to pee three times last night, but I think the swelling in my abdomen has gone down a little this morning which means the HCG must finally be leaving my system, I didn't test out the trigger since there was no reason but it would have been interesting to see how long it sticks around. Maybe I'll test it out next cycle to see if it really takes 10 days to get rid of it. The horrible acid reflux is also starting to go down, I don't feel like I'm going to throw up stomach acid, which is awesome. I know I got off a lot easier than many people do  so I'm not complaining.

Now, we need to do the whole thing alllll over again. The big question is, do we take a month off or start right back up with this upcoming period? I've been looking into it and research has shown there's a definite synergistic effect in back to back cycles, especially in really low AMH/DOR/Advanced maternal age patients.  The cumulative effect of both cycles ends up being greater than the sum of both cycles - if the med effect from cycle one is 2 and the med effect from cycle two is 2, the cumulative result is 5 instead of 4 in the second cycle. I think that's why Dr. D was leaning that way until I got 4 awesome embryos.

The wild card here would be cysts, last cycle I had the most stubborn follicular cysts on the planet that took two periods and two weeks of birth control to resolve. I don't know if I'll have them again this time since they aspirate the follies during my retrieval, which you'd think would mean no more cysts but who knows. It would definitely make the decision for me though, if I have cysts hanging around on my next CD2 baseline ultrasound, I have to take a cycle off.

Day 4: Acupuncture and Patience

Today, I'm finding it difficult to be patient. We don't get an update on our embryos and I know they're in the most difficult phase of growth where many embryos are often lost. Last we heard, four were doing very well with 7-8 nice, even blastomeres (cells) and two were growing nicely but a little slower with only 6 nice, even blastomeres.

On day 4, we need those embryos to be in the Morula stage, the last phase before they grow into blastocysts, form the blastocoel (fluid filled cavity) and start differentiating cells. Today, and possibly tomorrow if they're slow growers, they should have between 10 and 30 cells.  They might even have begun compacting like the embryo below, which is where the cells start squishing together like the embryo below.

Nice quality Morula

Hopefully they'll make it through the morula stage and grow into nice blastocysts tomorrow. If they're not quite there yet it's still okay as long as they're progressing. They'll be allowed to grow to day 6 when plenty of embryos are frozen and I probably won't sleep until we get the call. As blastocysts, they should be dividing into the inner cell mass (ICM), the Trophectoderm (TE) and the blastocoel (fluid cavity), which gets bigger as the embryo expands.

Nice Blastocyst

We need good cell differentiation to get a clean biopsy of the embryos for PGD. They need to sneak some cells out of the TE on the side there, the cells that will become the placenta, so we can test the fetal DNA for abnormalities.

Since there's nothing I can do to help my embryos grow, my distraction for today was a much needed acupuncture appointment. I haven't been since my retrieval and it's supposed to really help with recovery and the symptoms of OHSS. I laid down on the table, S took one look at my belly and said "Oh boy, you're definitely hyper stimulated". Clearly other people think I look 6 months pregnant too.

I already knew that I probably had OHSS but it's still a bummer to have it confirmed by a nurse. I also woke up sore this morning, my hamstrings and back felt like I'd worked out, and S said it's because of all the fluid I'm retaining. The fluid is responsible for my bloat, my repeated peeing, the heart burn and now the muscle soreness. Oh the joys of IVF.

Dr. D's nurse also called today to ask us about aCGH testing for our embryos and to see how I'm doing. I told her we'd probably base our decision for chromosome testing on the number of embryos we get, our lab doesn't really need an answer until they have all of our biopsy samples but as long as we get a good amount from each cycle I think we'll probably go ahead and add it on. If we only end up with a couple of embryos from each cycle, I'm not sure if it's worth doing, but if we get six lovely frosties each time I'd say it's worth the extra $2500.

As for next cycle and the crazy bloating, she said Dr. D usually takes a "flush" cycle in between IVF cycles to allow all the hormones to flush out of your system. It would also give me a good amount of time to order my meds from IVFMeds.com so I wouldn't be doing things so last minute. She made a note for Dr. D to chat with me about it tomorrow when he calls with our embryo update, so I'll probably be holding my breath until the phone rings tomorrow morning. I so, so hope our six embryos are doing well, I worked so hard for them and I won't be able to relax until they're safely biopsied and frozen.

Day 3: Growth Report

We got our growth report this morning and our embryos are still dividing! We have 4 that look really good with nice, even cell division and 2 that look good but are growing a touch slower. We also have 1 that fertilized but is pretty far behind the others with only 2 cells so we're not sure if that little guy can catch up. E is calling it our runt, Wilbur, but I don't think there's any chance of him catching up.

Original Photo came from here

I talked to Dr. D about our next cycle and he thinks we're on track to start in about 6 weeks. I didn't get to really clarify what that means since I later realized it could mean taking a month off or not taking a month off. If I get my period in about 2 weeks, then go on birth control for about 2 weeks, then stim for about 2 weeks, that's 6 weeks right there. I was asking if we'd take 6 weeks off doing nothing before starting the next cycle but I don't think I got that across. I'll have to bring it up again another time.

I also asked about the crazy bloating which he said is probably from the HCG as well as the estrogen. He said I should expect it to stick around in my system for at least 10 days so I don't see this belly going down anytime soon. I have no illusions about the physical side effects of infertility and the IVF process but it would be nice if I could save some growth for a baby.

As far as recovery goes, I'm feeling a bit crappier today than yesterday. I'm still only mildly sore but I have a weird nauseous/imminent cold feeling that probably wasn't helped by the fact that I woke up every 2 hours to pee and didn't get great sleep. I'm not sure where I could have picked up a cold since I've been taking it pretty easy and not going anywhere but I can definitely feel it hovering at the edges of my throat. Hopefully it's just the hormones because I can not get sick right before our next cycle.

Day 2: Recovery

Thus far I think I've been pretty lucky with my recovery. I'm still good with just a couple Tylenol or Advil every 4-6 hours and if I don't take it, there's only a minor ache of discomfort. I never really had any bleeding, nausea, constipation, or serious pain. I know every egg retrieval is different and I don't want to jinx it for next cycle, but I hope I can get off this easy next time. Maybe it's my reward for having such a shot heavy stim cycle :)

The two symptoms I am experiencing at the moment are two I could definitely do without. For starters, I'm still super, super bloated and uncomfortable with a belly the size of a watermelon. Possibly even more bloated now than on retrieval day.  I haven't tried to wear my jeans yet but I doubt they'd button comfortably right now, even my loose jeans would cut right across my ovaries. This is probably still mild OHSS so I've just got to grin and bear it and hope it goes down.

In the same category, my grapefruit sized ovaries must be pushing on all sorts of things because I'm getting awful heart burn. No matter what I eat or how I sit, I have the worst acid indigestion. This is another one of those things you just have to wait out, so I'm popping Gaviscon like candy and hoping that it passes quickly. I just ran through my last bottle so getting more is first on my list of things to do tomorrow.

My secret weapon

For anyone else getting ready for an egg retrieval, I absolutely think that the crazy amount of water I've been drinking has played a big role in why I've felt okay. I drank 100-150oz the day before the retrieval and another 100-150oz the day of. I've been drinking at least 100oz a day since and despite the anesthesia, it's probably physically impossible to be constipated with that much water in your system. I know a lot of clinics push laxatives after a retrieval but I prefer to avoid that stuff if I can. In this case, I think the water is a pretty viable alternative. Plus, peeing every 10 minutes, while also tied to OHSS, helps clear the extra hormones out of your system which should mean less bloat and misery. I'm still sleeping with my feet up on a pile of pillows as well, which is supposed to help all the excess fluid drain.

The acupuncture has probably also played a roll. Even the regular treatments that just keep all your energy and such flowing normally can really help with clearing out your system. The surgery center was a little weird about herbs so I stopped drinking my herbs a couple days before the retrieval and I just started back up again today with my acupuncturist's blessing.

The embryologists try not to bother the embryos on days 2 and 4 so I sadly didn't get an update on my embies growth today. They should be growing and dividing with at least 4 cells so that they can reach 6-8 cells tomorrow. I'm on pins and needles waiting for tomorrows phone call and I'm hoping and praying that all six are still growing well.

 

Original Photo came from here

ETA: I totally forgot to talk about boobs! My boobs are SO SORE. They feel awful if I'm not wearing a bra, which luckily is almost never since they're on the gigantic side and I never go braless. This is probably from all the hormones too and just another thing I have to wait out :(

 

Getting Ready For My First Egg Retrieval!

According to this mornings blood draw, the HCG trigger was properly absorbed and I'm good to go for a Monday morning retrieval! I'm so excited/nervous/bloated/sore/tender that I don't know what to do with myself. Time seems to be crawling and flying by at the same time and I still can't button the jeans that were falling off my ass a week ago.

I never understood what people meant when they talked about sore ovaries and IVF bloating until now. I guess I never made enough eggs in my previous cycles for my ovaries to swell up like balloons but they're definitely there now. I'm not concerned about serious OHSS (Ovarian Hyper Stimulation Syndrome), it's definitely a mild case, but I look like I'm at least 6 months pregnant, it hurts to bend over and my lower back is tender too. I'm also peeing like crazy since I need to keep guzzling water to ward off OHSS. 

Mild OHSS usually comes with the following, per Mayo Clinic:

• Mild to moderate abdominal pain that may come and go - Check!
• Abdominal bloating or increased waist size - Check!
• Nausea - Check!
• Vomiting - No, thank goodness!
• Diarrhea - No, but I'd take it over the projected constipation O_O
• Tenderness in the area of your ovaries - Check!

Things don't get dicey until the pain and nausea/vomitting turn severe, you get dizzy and you start packing on 10lbs per day. While I probably look like I've gained 10lbs per day,  I'm definitely still in the normal-mild category. I'm ready to get these eggs out though so we can make some beautiful embryos!

Our trigger for this cycle was Novarel, which contains 10,000 units of HCG, way more than the 1,000 units in my last trigger, Ovidrel. Just think of the positive pregnancy tests I could get with this much HCG running through my system!

Stock photo since I used mine last night

I'm unclear as to why the manufacturer felt the need to include such a huge bottle of diluent. Even splitting it into multiple doses, I can't imagine any circumstance that would require 30mls of liquid. Since I was taking the whole dose, I used just 1cc of liquid with the powder and injected it into my belly at exactly 10:45pm.

Like the Menopur, this one is definitely a stinger. It burned going in and unlike my other injections, has had a lasting effect. My skin is red, hot, and tender even 18 hours later and I can't stand anything touching it.  Major ouchies.

I try to avoid posting photos of my bare flab, especially crazy bloated bare flab, in public places but I figured it was better to be honest about the reaction so other people know what to expect. The photo ended up washed out, but my reaction is red/purple, streaky, raised and hurts like a bitch. But again, it's unfortunately normal.

Since my retrieval is only hours away, I'm trying to get everything ready tonight. You're supposed to drink large quantities of sport drinks like Gatorade or Powerade, but since I'm not super into those, I'm going for PH water and other electrolyte infused waters. They're supposed to help flush the hormones out of your system so the OHSS symptoms don't get worse and go away quicker. You also have to watch out for super constipation from the anesthesia which I'm really, really hoping to avoid. That sounds like the last thing you'd want when you have tons of needle holes in your lady bits and ovaries.  I'm hoping tons of regular water, PH water, watermelon and soup are enough to ward off that unpleasant side effect.

I'm also prepping soft, stretchy clothes to wear tomorrow since my jeans feel awful and tight. I've got my lucky panties, rainbow cheetah print trimmed in hot pink lace that I've worn to all my IUIs and I'm thinking of upping the ante with new blue, puffer fish toe socks with googly eyes and pink glitter shoes. Now that's a lot of good luck :)

Since I'm still crazy hungry despite the incredible bloat, I think E and I are going to get some meaty take out for dinner. I'm craving steak like nobody's business and once midnight comes I'm cut off from food and water. 

Please send all the positive vibes, thoughts, prayers, and energy you can muster my way tomorrow morning. I've got everything crossed for these follicles to contain healthy, mature eggs that fertilize perfectly and turn into healthy, viable, Fragile X free embryos. I know that's a tall order but come on follies, I know you can do it! We need some healthy blasts!

(Non)Pregnancy Symptoms

I have no idea what it feels like to be pregnant since I've never experienced it first hand, but I can definitely say with confidence that I'm not a fan of the symptoms of being not pregnant. The periods coming off a medicated cycle suck in so many ways, and I feel horrible on this birth control.

I was on birth control for almost 10 years and had a really good fit hormonally. It was a pretty low dose pill, somewhat obscure, and I could take it without side effects and feel good. What I somehow managed to forget was the initial first year of trying to find the right fit. Different pills, different doses, different hormones, months and months of feeling crappy. It wasn't my idea of fun.

Each clinic has prescription agreements with different companies. Kaiser used mostly Ferring, for Menopur, Endometrin, Ovidrel and the current bane of my existence, Sprintec. I asked my nurse about taking my original birth control but she said no, Kaiser only uses Sprintec birth control pills for infertility cycles, which contain a different form of estrogen than my old pills. I am not a fan. I don't know what USC Fertility uses, but thus far Dr. K has kept me on the Sprintec.

Thus far, mixing birth control with coming off a medicated cycle has got me:

• Cramps, cramps and more cramps. These come for free, without the birth control. 
• Insomnia, it's taking me at least 1-2 hours to get to sleep every night. 
• Exhaustion. I feel like I need a nap every day or like I can't wake up in the afternoons, even though I'm still getting a good amount of sleep despite the insomnia.
• Bloating, because it's impossible to escape from. It's a side effect of everything.
• Stomach pain, because I can't escape from that either. Definitely from the birth control now. 

Underneath the annoyance, I'm somewhat amused that I would have more uncomfortable side effects from a comparatively low dose oral hormone medication than from several daily injections containing enough hormones to make an elephant ovulate. I guess it makes sense since we know I'm estrogen deficient and sensitive to synthetic estrogen whereas I seem to respond only grudgingly to mass quantities of FSH and LH. Still, you've got to appreciate the irony.

We're about a week away from my next ultrasound now, so I'm wishing and hoping with everything I've got that the cysts are gone and there are tons of antral follies.

A Day Off

Wednesday, E decided to take the day off. He was supposed to be in Anaheim by 8am, an unpleasantly early call time,  in the middle of a 20+ day stretch of work and he seriously needed a break. He got someone to cover for him and we planned a boring but productive day that started with sleeping in.

The primary item on our agenda was supposed to be taking our cars in for repair. E's car is making an alarming squeaking noise from somewhere in the wheel well and my air conditioning, which I just had repaired not even a year ago, decided to stop working and then start up again. A car rental was supposed to cover E while his car was in the shop, but there was an unexpected issue with scheduling. Instead of spending the day dealing with the cars, we ended up with the entire day to ourselves.

So, what do you do on a gorgeous day off in Los Angeles? You go to the beach of course!

Although there are countless gorgeous beaches in the LA area, E and I decided to spend the day together as a family, and that meant finding a beach that was doggy friendly. There aren't many beaches that allow dogs in the water and on the sand, so we pointed our car towards Rosie's Dog Beach in Long Beach, CA.

Rosie's Dog Beach is basically an unfenced but roped off 4 acre section of the beach that is open to off leash dogs. It's not exclusively for dogs and there's no dogs allowed on the beach on either side of the roped in area, but that specific section is the perfect place to spend time with your furry friends.  Milou isn't a big fan of the water but had an absolutely fantastic time strolling along the beach, saying hi to all the people and dogs, and plucking up the courage to get her paws wet. She trotted along next to us, checking in every few seconds to make sure we were staying together, and sniffed sand, shells, and washed up kelp to her hearts content.

(Source)

Considering how many dogs visit the beach every day and thus use it as a bathroom, the beach is surprisingly clean. Owners are very careful to clean up after their charges and everyone is committed to keeping the beach nice. We didn't see any trash or poop and 90% of the dogs there were perfectly sweet and friendly. There was one little dog lacking in manners, but he was more interested in guarding his towel and yapping at passersby. A second dog who showed up later, a large pittie,  was also rude, so we ended up leaving after a couple hours when it became clear that his owners were going to be staying in our area. He was a little too exuberant and growled when he didn't get his way, definitely more the fault of his owners, but Milou wasn't a fan and we'd already been there a while.  The rest of the beach goers were wonderful, they all played together in the water and sand, chasing balls and romping in the waves. We will definitely be going back the first chance we get, though I'd suggest a week day when it's a little less busy.

After the beach, we dropped by The Yard House for some yummy lunch. They have a large patio that backs up against the pier so you can bring your dog and tie them up next to you. Luckily, we got a friendly manager who complimented us on our "service dog" with a wink and let us keep Milou under our table in the shade where she alternated between sleeping and sniffing the delicious, food scented, air.

We got home in the evening just in time to brush the sand off our feet and head to Milou's obedience class. Milou and I were both exhausted and yawned our way through class but she did very well anyway. It was such a nice distraction in the midst of E's crazy work schedule and all the difficult decisions we're trying to make. Infertility can be all consuming, even when you're not in the middle of a cycle. Considering that it's so embedded in my subconscious that I'm dreaming about egg harvesting, IVF, and embryo quality, a day at the beach was a really nice change. 

Today is day 4 of birth control so I have 10 more days of pills before my next ultrasound. I've got my fingers crossed that my ovaries are recovering nicely and absorbing all those old corpus luteum cysts like they're supposed to. Come on ovaries, I need you to get your act together so we can try again.

TWW: We Meet Again, Endometrin

This morning marked the beginning of Endometrin round two. Oh most hated adversary, we meet again at last. I knew this day would come.

dun Dun DUN!!!

I know that this particular medication shouldn't be a big deal, it's not an injection or something particularly painful, but it's still, by far, the most obnoxious medication I need to take. Let's run through the side effects according to the manufacturer:

• mild nausea, vomiting, bloating, stomach cramps;
• diarrhea, constipation, bloating;
• dizziness, drowsiness, tired feeling;
• pain in your vaginal or rectal area;
• pain during intercourse;
• loss of interest in sex;
• breast pain, swelling, or tenderness;
• joint or muscle pain;
• increased night-time urination; or
• vaginal itching, burning, or discharge.

If you look carefully, many of these symptoms mimic early pregnancy symptoms. A super cruel joke to play on the woman who is desperately hoping to find out she's pregnant, examining every cramp and hiccup as a possible indicator that this cycle was a success. Others are just horrible sounding, and I count myself lucky that I only experience the mild ones. Last cycle I had to deal with bloating, cramps, tiredness, all the time peeing, crazy sore boobies, and the lack of sex and general grossness that comes with having a pill up your ladybits that dissolves throughout the day, necessitating the wearing of panty liners. Can we saw EW? EW.

At least my injections were a brief inconvenience, a moment of pain that was mostly gone in under a minute.  Twice daily Endometrin, on the other hand, is the gift that just keeps on giving. For a minimum of two weeks, and a maximum of 10 weeks if I do get pregnant. This is one medication I could seriously do without, if I wasn't willing to do anything possible to get and stay pregnant.

Little cells that should be dividing in there, this is all for you. E, I apologize for the lack of sexy time in your future. Only 8 more days till I can pee on a stick and hopefully find out that we're pregnant (if it's not too early), making all of this worth it. I can't give headspace to the next leg of our journey if we are successful, so I'm focusing everything on that positive test. 

Update: I took an HPT this afternoon and got a clear negative, which means the trigger is flushed out of my system. Any positive we get should be genuine from here on out!

Ouchie

Today was another tough day physically, I don't know if it's the Menopur or the acupuncture herbs/diet but I've just felt rotten. Stomach ache, nauseous, bloated, tired, sore back, the whole rotten spectrum and the stomach ache/abdominal pain is definitely the worst. I suspect it's probably a combination of both which makes it nearly impossible to get rid of since I can't stop taking the Menopur or the herbs. I've tried eating bread, taking advil, eating more bread, curling up in a ball, drinking tons of water and I finally capped it off with some soup which seemed to help the most. I'll try eating a more normal meal for dinner and see if I can banish whatever this is for good.

I will probably mention it to Nurse C tomorrow morning just in case it might be mild OHSS, but I doubt it very much. OHSS usually comes with loads of eggs, 20 not 5 teensy ones, and I haven't taken the trigger shot this cycle so I don't have any HCG in my system. My ovaries also don't seem to hurt, probably the only part of my stomach that doesn't, and they looked perfectly normal sized at my last appointment. It's probably the shit ton of Menopur I've started injecting over old needle marks -_-

Despite feeling like shit, I'm still really looking forward to my appointment tomorrow. I've got everything crossed that those 5 little follicles are growing into 5 bigger follicles that will become mature eggs. I'm just not sure how much growth I should expect since we suppressed egg development with birth control first. Is this going to be a long and slow cycle? Today is day 6 of stimms, how much longer will I need to go? Once I inject my 4 vials tonight, I will have 22 left, or 2.5ish days. That's enough for tomorrow (Wednesday), Thursday and Friday morning, bringing me to 8 and a half days of injections. I'm ready to buy another 20 if need be, but I hope we won't need much more than that.

Blah

Today was much more of a blah day then yesterday.

I woke up to what definitely looked like a light period, complete with miserable cramps and since E and I are dog/house sitting, I had no pads and there is apparently not one single Advil or Tylenol in the house. Today makes day 11 of this month's "period," which sucks no matter how you look at it. It started as soon as I stopped the progesterone like it should have, but then I started the birth control on CD 2. I bled through CD 4, spotted through CD 7, and then thought it was done until I stopped the birth control. I was being too optimistic since it started right back up and I've been spotting CD 14 - today, CD 17. I feel like I should be looking this up or asking other people following an IVF-ish protocol if they've experienced the same thing, but biologically it makes sense. Stupid period, why don't you go disappear for 9 months -_-

After determining that I would need to go buy some supplies, I felt rushed through this mornings shot. I was running late to meet up with our old vet to pick up our animal's charts and had tried to stick myself three times before realizing that the needle must be a dud. It acted just fine when I primed the injection, but must have been dull or slightly bent since it absolutely refused to go in. Ouch. I'm now one needle short, since I had an exact amount, and am going to have to buy more next time I'm at Kaiser.

Won't you throw my ball for me? See how cute I am in this tiny bed?

Revisiting the topic of side effects, I can't tell if I didn't get enough sleep or if the Menopur is making me crazy tired. I feel drowsy, like I can't fully wake up, and I can't seem to shake it off. I tried napping, was unsuccessful, and have felt "ugh" and "blah" all day. I would try to put it more eloquently, but I can't summon the energy required to do so. Blah it is. Poor Milou seems to be feeding off my energy,  she's been laying around looking at me all mopey and sad, even though she had her favorite class, Agility, today.  Now I just feel guilty that I'm bumming out my puppy, completing the circle of "blah".

Blah puppy. Sorry Milou

Update: I just administered my evening injection and was greeted with the unwelcome sight of little round bruises :( I was really lucky with my first cycle and managed to not get a single bruise on my belly. This time I have one on each side to go with the little red pin marks from the blunt needle and my previous injections. I really hope they don't linger, the designated injection area is so small that I'm going to have to inject on top of bruises if they don't fade quickly.   

TWW: Owie

Over the past couple days I've been carefully avoiding thinking about anything TTW related. E had a rare day off, which we enjoyed doing a whole lot of nothing, and I've been keeping busy with work. Aside from the endometrin twice a day, and drinking my acupuncture herbs three times a day,  my plan not to think about it (much) was going pretty well. Until about 3am this morning.

E and I had gone to bed early, around 12:30 and I was sound asleep and dreaming until my dream suddenly turned very painful. I don't remember exactly what I was dreaming about, but I do remember dreaming that I was tossing and turning because my abdomen hurt. Then, to no one's surprise, I woke up tossing and turning because my abdomen hurt. I'm no sissy when it comes to pain, I usually have a pretty high pain threshold, but whatever was going on in there hurt and didn't seem inclined to stop.  Half asleep I got up and went pee, thinking maybe my bladder was just full, but the walk to the bathroom was enough to wake me up and realize that something was definitely going on.

(Source)

It definitely wasn't cramps, it was higher than my uterus, and felt higher than my appendix too. Once I got past the overwhelming feeling of "pain" it seemed to be worse on my right side, so I wondered if it could be my gallbladder or kidney stones, though I've never had any problems with either before, or if it could be an ectopic pregnancy or a ruptured cyst. It seems too coincidental that it should happen now when we're in the middle of fertility treatments and it didn't feel like an upset stomach either.

Finally, after tossing and turning and clutching my abdomen for some time, I decided that if the pain didn't subside within the next 5-10 minutes, I was going to wake up E and we were going to the ER. He was already somewhat awake, since I felt help patting me in his sleep, but I didn't have any bleeding and it didn't seem life threatening.  I gave my body a stern talking too, sipped some bubbly water, and finally feel asleep just a few minutes before my self imposed deadline. Thank goodness.

This morning I woke up and felt fine. No pain, no soreness, it's like it never happened. I'm definitely going to bring it up at my next appointment, but I don't think it warrants a separate visit. E was trying to think positive and told me it might just be really strong implantation cramps and I didn't have the heart to tell him my uterus doesn't hang out with my gallbladder. Fingers crossed for super strong implantation cramps!

TWW: Eff You Endometrin

I don't have much to say today expect that I kind of hate Endometrin. If it doesn't stop fucking with me soon, I will... do nothing and continue taking it anyway because it's helping keep my potentially there pregnancy alive. I'm only 6 DPIUI, right in the zone for implantation, and it's way too soon to be having any side effects, but the progesterone gives you all kinds of pregnancy symptoms that makes you feel insane. I'm pretty sure my boobs might just fall off my chest, I'm still crampy, and it's also conspiring with my Menopur to make me feel extra fat. Eff you Endometrin, but please keep supporting my potential, maybe there, pregnancy.

Fatty McFatty

I'm also too afraid (read chicken shit) to pee on a stick and see if the trigger is out of my system yet. It's been about 8 days since I took it, but since it can hang around for something like 13 days, I'm scared of getting my hopes too high. In theory I should be able to see the line getting lighter and lighter until it's gone, and then any line after that should be a real positive. Maybe I'll check and see how light it is on Saturday, 9 DPIUI, and 11 DP Trigger. It should be pretty nonexistent by then.

Jinx

At my ultrasound appointment yesterday, the nurse asked me if I was having any side effects from the Menopur I've been taking. Apparently it can cause cramping and a whole lot of other unpleasant side effects in many people. I was happy to report back that I felt just fine, no cramping, and the injections *didn't even hurt OMG yay!* as long as I did them slowly! I felt like I could ride off into the sunset on a rainbow shitting unicorn on because I felt great! *insert some rainbows, sunshine and glitter shit here*

Ha Ha. Not.

Yeah. Because that's not painting a big huge target on my back for fate.

So, naturally, the second I left the doctor's office I started to feel sick. Then I remembered that I had had some digestive upset when I woke up that morning, but I'd attributed it to nerves. I sucked it up, blamed nerves again, and went to my acupuncture appointment. I told my acupuncturist, S, all about the insurance woes and my low estrogen and she told me she'd already received a call from my RE, Dr. K, that morning.

Dr. K actually called S, personally, because she believes in what she does. Even though S sees Dr. K's patients and is a Nurse Midwife at Kaiser, S said she's never had a doctor personally call about a patient before. Dr. K asked her to please do whatever she could to help me, to try and get as much blood flow to my ovaries as possible because we have to help my follies develop and get my estrogen up or this wasn't going to work. This really choked me up, I don't know how my chances are looking for this cycle but I really love my infertility team. I couldn't ask for better, more supportive doctors.

With specific marching orders in hand, S began my treatment to clear out the cold and phlegm and get my blood flowing. I also told her about my weird stomach pain so she added on a stomach treatment for that. And for the first time ever, those needles hurt. She put the first one in my foot and my leg nearly jumped off the table. "I'm sorry," she said, "you're much more sensitive today. The Menopur can do that, make your skin much more sensitive". Ow.

This was the 4th time I've done acupuncture and the first time it's ever been uncomfortable. Each needle hurt a bit going in and was sore during my hour, although I was able to ignore it and focus on visualizing all my energy going to my ovaries. S strongly believes that you need to put positive energy out there so I'm sending every positive thought I've got down to those follies. Afterwards, the points in my left wrist and left foot were actually too sore for me to put my watch or sandals back on, another first. I usually feel relaxed and refreshed after a session, not sore.

Before I left S also told me that she had a patient who might have some extra Menopur. She had been planning to donate it to another woman who ended up not needing it so it might be available for me! This would be so, so wonderful, with the increase to 5 vials a day, I don't think the stash I just bought is going to get me through this entire cycle. I might also be one of those people who are slow to stimulate and require a couple extra days of injections, which would mean I'd definitely be short.  I should know on Monday if she still has the Menopur available.

As for the side effects, they continued for most of the day. S's stomach treatment worked for a couple of hours, but the general stomach pain eventually came back. I didn't feel nauseous, crampy, and I didn't have ovarian pain, my stomach just hurt. The injection was also much more painful last night, the needle itself was really uncomfortable for the first time and it took me a good 5 minutes to inject all the liquid. Even though the acupuncture hurt, I somehow wasn't expecting my injection to hurt and was completely surprised when I stuck the needle in and my skin went OWWWW. I hope this is a temporary side effect because I have at least 5 more injections to go.