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.
The bitch of it is that “everybody is different,” blah blah blah, so Heather is on higher doses of both Lupron and Follistim than what the sample calendar shows, with no more specifics about that timeline from the Heather-specific plan that we were given.  All we knew was 20iu of Lupron and 300iu of Follistim, twice a day—nothing about how many days it would last, or whether the dosages would change.  If they dropped the dosages, for example, we might be able to stretch our current supply, but if it was stable and lasted into next week, we needed to figure out how to get more drugs soon.  Soon.

The calendar didn’t do anything to soothe my night-owling paranoia, so I e-mailed Jordan, one of the IVF nurses in Nashville, yearning for details and reassurance.  What she said was that Heather was already on the maximum dose of both drugs, so there was no chance it would go up, and that we should be sure to have “at least” enough to get through Saturday morning, but probably we’d need more.  What the holy hell…

Unsurprisingly, Heather was unsatisfied by my report—not just by Jordan’s response but by my estimate of our hormone arsenal.  “Are you sure that’s all we have?”  Heather has a remarkably shrewd way of asking questions that makes me wonder if I know WTF I’m talking about, even when I do. 

I e-mailed Jordan back, promising that I would call if I didn’t hear back from her at lunchtime.  We occupied our Starbucks run with discussion of follicles—How many are normal?  How many should we expect before retrieval?—while I squinted mightily at my iPhone, trying to do some research.  Halfway through the squinting, the browser disappeared as a dreadful alarm went off, signaling that Nurse Jordan was calling.  I say it awkwardly because it makes me feel awkward; I believe that everything should be done by e-mail if at all possible, and doctors’ offices routinely hurt my feelings with phone calls. 

What I got out of it was: “If your ultrasound results tomorrow morning are sucky enough, we will cancel the cycle and you’ll be stuck with whatever drugs you have, so don’t order new ones yet.”

Heather, sitting next to me, heard only my side of the conversation, which included the word “cancel,” and she began to look very grim.  Later she wanted to know why I hadn’t put Jordan on speakerphone, but to be honest speakerphone is like an accelerated version of general telephone suckiness and I was already stretching.

According to Jordan, while Heather did have 17 follicles on Tuesday, none of them reached the 10mm cut-off point for a mature follicle.  If none of them, or not enough of them, cross that line, it’ll be a good indication that she won’t have enough eggs to make transfer worthwhile.  There’s kind of a rough 1 to 1 ratio of follicle and egg, and 17 eggs would be pretty cool, but scrawny follicles don’t make for worthwhile eggs, of any quantity.  Allegedly, follicles grow 1 or 2mm a day, and if Heather’s follicles were, say, 7mm on Tuesday, they could be legit three days later. 

The question for us is how anxious and miserable to be in advance.  The word “cancel” does a lot of damage to baby-making morale, and I’m doing my best to assure Heather that it’s all hypothetical and she shouldn’t be discouraged based on such early tests.  It’s too soon to panic, I tell her; tomorrow's results could be great.  But that bottom lip is out, and she's miserable about the test.  

I'm miserable, too: if the results are good, I need to get more drugs right now.

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