Tuesday, July 31, 2012

The -real- final countdown

Today is Tuesday, and Friday is Heather's pregnancy blood test.  If it's negative, it'll be the last pregnancy test she ever takes.  She's tempted to game the system.

If you've read the blog through previous generations of potential pregnancies, you'll know that Heather has no wherewithal when it comes to observing the official timeline.  Nine days is too early to test.  Wait for your period or two full weeks.  Patience is not my beloved's strong suit, and I don't believe she has ever made it two weeks for a pregnancy test.

This has been an ongoing back-and-forth between us, as I beg for two weeks of hope before facing results-which, so far, have only been negative.  I don't want to hear bad news any sooner than I have to, especially when the bad news doesn't even count.  After a week, you're definitely going to get a negative, so why do you want to do that to yourself?

But this is the same woman who would like to open her Christmas gifts a week early, forgoing the ritual I treasure.  And it's in the same spirit of ceremony that I want to sit down in her office with the door shut to listen to our voicemail Friday afternoon, instead of squinting at (imagined) pink lines on a pee strip for days beforehand.

The most ridiculous element of the whole thing is that we were warned specifically at our IVF class not to bother with home pregnancy tests because they could be influenced by the remaining traces of hcg from the Ovidrel trigger shots we administered just before egg retrieval.  As of today, that was 13 days ago exactly.  Sunday night, Heather, overcome by desire to both learn the secrets of her uterus and, I suspect, make some use of the dozens of pregnancy tests living in our bathroom closet, snatched up her iPad to dispute my warnings.

"Listen!  This lady did her test only ten days after the trigger shot.  They say it only stays in your system ten to fourteen days."

"Well," I said, "it's not fourteen days till tomorrow, and there's no point having a half-answer-or a bad answer-when we'll get an official result on Friday."

This did not register at all.

"Okay, this lady says that she did her test after ten days, though, and she got a pale pink line.  You just have to watch and see if it gets darker."

"Heather, the nurse in the IVF class said that you'd just be kidding yourself to test in advance."

"Yeah, but this lady says that it's about a week if you get a 250iu shot, ten days with 500, and fourteen with 1000.  What did we do?"

"Hell if I know, babe.  They were pre-filled syringes and I just put 'em in like they said.  There were two, though, so it must have been at least 500iu."

"Why don't you know?  How do you find out?"

Overcome with the adrenaline of baby-making research and rebellion against my ideas, Heather hopped out of bed.  I began to drift off.  I think at some point she came back and tried to tell me something else, eventually giving up when all my responses were "Dude, you're supposed to wait.  Stop it."  And I'm pretty sure she tried to fall asleep, then left again.  I can tell you that, when I got up Monday morning, records from MetroDrugs were strewn across the countertops.

Maybe, she told me later, she could take the tests every day and see if they got darker.  I expressed disapproval, but I'm not sure she heard me.

Today we're supposed to get our toes done between naps.  Wednesday night Heather has dinner out with friends.  Thursday night, we're going to see a movie.  By my estimates, that will kill about six hours of the seventy between now and the voicemail.  Thank god for the Olympics.

Saturday, July 28, 2012

Crossing over


We’re less than a week from Heather’s first—and maybe only—pregnancy test, and we are melting the fuck down.

Once she pointed out that this was truly her last chance, things took a sober turn.  I want to comfort her, but I want to raise her child, too, and it’s not really something you can minimize anyhow.  You can’t comfort somebody who’s looking at the end of her thirty-year-long dream.  Yes, we talk about all the trips we’ll take and how we’ll drink and she’ll smoke, but we don’t even like drinking.  Even in Amsterdam, through the cloud of smoke, we’ll know she can’t have a baby. 

It’s exactly that attempt at self-soothing that’s getting us into trouble lately.  “Think positive” is the mantra, maybe visualizing a pregnant belly or infant.  “Snuggle in,” I tell the embryos.  You can’t imagine the message with good news without imagining the bad one, though.  “Hi, this message is for Rachel and Heather.  We just wanted to let you know that this cycle did not produce a pregnancy…”  I hear the nurse’s kind voice and intonation so clearly.  Do they call you directly if you are pregnant? 

Funnily enough, they gave us a customer-satisfaction form as we left following Heather’s egg transfer.  I think they want to be sure you fill it out before you get the test results.

Thursday, July 26, 2012

Tongue-biting


Today hasn’t been the best one, as I literally bit my tongue while eating a bland sandwich* and failed to do so figuratively when Heather questioned me about some weird news from Nashville. 

Yesterday, Heather had an estrogen/progesterone test at the lab here in Memphis, and we checked our voicemail in Nashville to see if there were any messages about it.  There weren’t, but we didn’t know if they were going to update on that anyway.  My beloved had left her cell phone at the house, and of course that was the number they called.  If I did this baby thing over again, I would just give them my number and leave Heather’s out of it.  Alas, it’s too late now, and of course what Nurse Jordan said was, “Oh, well, I’ll leave a message in your voicemail.”  Nary a message, nor a chance to talk to anyone in the office at 7PM.  Fuck.

Tuesday, July 24, 2012

Can't you see the sunshine?

Heather is ostensibly bed-resting today after yesterday's egg transfer and she's doing just fine.  What she definitely is not doing-- definitely-- is crying over Team USA's triumph in the hockey film Miracle.  That's not something she would do.

What she would do, however, is tolerate my snuggling against her (albeit with tender accommodation of her everlastingly-sore breasts) with a hand placed over what I imagine to be her uterus.  She's reported to me that embryos are something like 1/100th of an inch in size, and I'm guessing they aren't receptive to my baby-talk, either, but I feel like we have to put those encouraging vibes out there.  Hence the inspirational movie that Heather most assuredly did not cry over.

Sunday, July 22, 2012

Insurance

My mom and I made a date to see Magic Mike today, both of us hampered by partners in pain and on drugs.  Mom has been stuck with my dad during knee surgery and its aftermath, and I have the great pleasure of sharing in Heather’s reproductive process, so this is kind of a caretaker’s-day-out situation.  Don’t tell Heather; she thinks I’m just doing it for my mom.

Saturday, July 21, 2012

Quick like a bunny

As of yesterday, we have two embryos with the desired four-or-more cells, two approaching it (all four, according to the embryologist's voicemail, are grade B), and the fifth is... grade C.

I was subsequently told by a nurse that there's no way to know whether little #5 can catch up, but a cursory web search suggested that the really slow-developing embryos were probably a little fucked-up anyhow, so perhaps that's not meant to be the object of our life's work after all.

With four-- the two "approaching" maturity, the embryologist, would probably catch up-- Heather and I are back at the question of PGD.  She is leaning heavily, I believe, towards canceling the test and just getting all the embryos we can, but I'm listing in the opposite direction.  Diseases aside, abnormal embryos are much more likely to miscarry or just not implant at all, so, yeah, maybe skipping PGD would mean we had two embryos left for a second cycle if we needed it, skipping PGD might also mean we will need it.

The lab is scheduled to do the biopsy on day four, tomorrow.  They were left instructions to call us before they did anything.   Heather and I have to decide before then.

Friday, July 20, 2012

Prime numbers

Five eggs fertilized.  I don’t know what happened to #6, but the message from the embryology lab said they ICSI’d five and all fertilized.  Having had very iffy luck so far, Heather and I are both over the moon.  We’ll wait till tomorrow to see how the embryos develop, then they’ll make decisions about PGD and whatnot.  Who cares.  We’re enjoying the first good news we’ve had in a while.

Of course, the good luck was tempered by Heather's day-long sojourn at the toilet, vomiting up her morning doxycycline, Wendy's chili, and a variety of other items.  Nurse Jordan dispatched me on an evening Walgreens run to get nausea medications, saying that, if Heather couldn't hold anything down, she would have to go to the ER.  "I don't want to go to the hospital!" said Heather.  She didn't, but she's an exhausting sick person, so I'm optimistic that she has food in her belly again.  

Waiting today for more news about how the embryos are developing.

Wednesday, July 18, 2012

Oh, dude

You'd think I'd be done posting today, but my sleep schedule is fucked.  Heather was roused earlier, took her pills and the PIO shot (painlessly!), sent me to Walgreens for Tylenol because her fuck-up girlfriend didn't pick up the pain meds from the pharmacy in time, and now has fallen back to sleep on the couch.  It wasn't even the Tylenol PM-- and that much is worth noting simply because I wanted to force the sleeping stuff on her so she'd stop making sad faces at me for forgetting the prescription.  Rachel FTW.

The thing that has belatedly occurred to me as I contemplate a late-night snack is that I will have to be the first to listen to the embryologist's message.  Heather knows the message will be in our mailbox at noon, and she knows how to access it, but I feel pretty confident that I'll be the one dialing.  Should we put it on speakerphone and listen together?  That would have to be better than telling her.  Still, I'll have to watch her face when she hears the numbers.

We spent a lot of the afternoon talking about the next steps-- how many eggs we thought would fertilize, etc.  "You know," I said, "If you'll remember, there were a couple weeks when we thought we'd gotten pregnant after the first ICI.  We said it had to happen to somebody and maybe we're the lucky ones who'll beat the odds.  That didn't happen, but what if it happens now?  We haven't caught a break yet, so maybe this is it.  Maybe all the eggs will fertilize perfectly, and then four of the embryos will pass PGD.  It has to happen to somebody."

So we're going with that.

Groggly II

It's nearly 9PM in our backwards-ass household, where people sleep in the daytime and collect syringes.  And that backwards ass has big circles in the upper-right quadrant of each cheek.

Heather is still in bed and not excited about getting up.  "You can go right back to sleep," I told her, but she muttered that she needed thirty more minutes.  Listen, lady: I am more than happy to let you sleep while I watch unending re-runs of Big Bang Theory, but let's knock out these new meds first.  (That, anyway, is how it goes in my head; I'm not sure how to approach someone as drugged and sleepy as she is.)

Groggly

I'm about to fall asleep, but I will briefly say that we have been up since before 4am and that a nice nurse drew circles on Heather's ass cheeks with a marker.

They only got six eggs.  It's not great.  According to the handout they sent with us, they'll go forward with implantation if there's at least one embryo of four cells or more.  If they only have a few good ones, PGD will be canceled (and, hopefully, refunded) and they'll just put whatever they've got into Heather's uterus.

They plan to fertilize the six eggs via ICSI, and by tomorrow at noon we'll find out how many developed.  Meanwhile, Heather is drugged to the hilt and has collapsed with her decorated butt cheeks into bed for what I assume will be another eighteen hours.

Tuesday, July 17, 2012

Baby, I'm howling for you

Tomorrow is Wednesday, and Heather is scheduled for her egg retrieval at 8:45AM. I am excited, and Heather is traumatized.

Monday morning, she had yet another visit to the Memphis clinic for an ultrasound and estrogen test. She had several follicles over 20mm, as well as some stragglers—about nine "measurable" ones in total. You can tell things are getting serious since they're now recording the follicles in centimeters rather than millimeters. All afternoon we waited for news from Nashville about the results: Was it time for the trigger shot? When was the egg retrieval?

In past, it took till the afternoon for the test results to arrive in Nashville, so I occupied my morning with an e-mail to Nurse Jordan. It wasn't so much that I expected her to e-mail back—their office is disappointingly phone-centric—but Heather started spouting out questions and I was afraid I'd forget. Anyway, otherwise it was just empty waiting.

Later I gave in and called. I left a message. (Dude, that would be the best drinking game: sit down with a bottle of Grey Goose and the last six months of this blog, then take a shot every time messages or voicemail are invoked. It's awesome.) Debbie, the receptionist, asked if she could tell Jordan why I was calling; I endeavored not to say The same baby-making bullshit we always talk about. Does it really need to be more specific than that? The options are test results, medications, and treatment plans. There isn't much more to it. The time I asked that the office not specifically refer to Heather as a lesbian when dealing with the Memphis office, the other receptionist got all antsy and said she'd just give the nurse our number.

When I heard back from Jordan, she confirmed that we should go ahead with the trigger shot that night, then come to Nashville for egg retrieval Wednesday. We went over the questions from my e-mail, including:
Q: Do larger follicles mean higher-quality eggs?
A: Nope. A larger follicle might mean the egg is more mature, but it has nothing to do with quality. Quality decreases with age and fattening up the follicles won't change that.
Q: Will you take out all the eggs, or just harvest from the bigger follicles?
A: We will take everything we can get.

The part that caused Heather to be traumatized is something we already knew, but she had either forgotten or blocked out.

Sunday, July 15, 2012

The fear of the lord

My mom, irreligiously, says sometimes that a situation will "put the fear of the lord in you."  There's a reasonable amount of panic mixed into baby-making, but sometimes even the heathens among us feel it's reached epic proportions.

Thursday, realizing we were low on Follistim cartridges, we spoke to Nurse Jordan in Nashville about ordering more and how much.  She said we should have enough to get through Saturday morning, but we couldn’t be sure till Friday morning’s lab work-up.  Anxious after Jordan’s casual mention of cancelling the cycle, Heather leaned on the tech to tell her what her follicle stats were; I took the numbers, called Nashville and spoke to yet another nurse—although likewise a very pleasant one—to get advice about the Follistim.  She said that they hadn’t gotten the lab results to be sure, but sounded very optimistic about the follicle information I offered.  She said would let me know by 2PM how much to order.  I, of course, had Heather staring at me through all of lunch, so I called at 2:15.  I left a message.  They called back to say that the results had just gotten in and were in the hands of doctors, but we should get enough Follistim to get through Tuesday morning.  Okay.

Thursday, July 12, 2012

Well, for heaven's sake

Today has been medium-sucky.  Maybe.

All night, doubts about our medication supply irritated me the same way my goddamn bra strap did all day, and once Heather was in bed and the house was quiet, the bra was gone so I just had the doubts.  I started calculating and recalculating how much Follistim we needed compared to how much Follistim we had.  There wasn’t much left, but there were no clear notes telling me how much longer Heather would be on it.  Sometime around 2AM, I dragged out our old sample calendar, trying to figure out where we were in the drug timeline.

Tuesday, July 10, 2012

Make it so.

Every week or so, a co-worker forwards to everyone at the company an e-mail with sales tips from one of those guys who thinks he’s a selling guru.  I am in no way interested in selling, and, to my mind, the e-mails offer up that same repulsive hyper-confidence and smarminess that give salespeople a bad name.  I resent this guru for his attitude first, and his writing style second.  Comma splices right and left, guys!  C'mon.  Maybe when you're God's gift to capitalism, you don't have time to punctuate thoughtfully.

Friday, July 6, 2012

A shot in the dark

Oh, man, I had an awesome morning.

Yesterday afternoon we got back from Nashville with enough time to float in the pool before late-day naps.  The suppression check was pretty mellow: a blood test, pelvic ultrasound, and medical history.  Despite a family history chock-full of cancer, Heather came out rosy with the regular medical history, having had no surgery or other disorders in her past.  The worst revelation was that penicillin made her itchy.