Tomorrow is the Day: Random Thoughts the Day Before

Work has been wicked busy (and good), thus I haven't had a whole lot of time to perform my usual obsessiveness during this period. With the weekend here and time so close, it's starting to creep in. I flip between wanting to look at baby stuff and then quickly switching to something else.

Tomorrow night we are celebrating my son's birthday - 21. (Holy crap - when did that happen?!?) His actual birthday is not that day, but he already had plans on his birthday (free sporting event tickets with great seats!) and I had a choose a different night. It didn't occur to me that I was choosing the night that could be either a very sad or very happy one for us. I'd hate to steal his thunder or put a damper on such an eventful birthday. Though now that I think about it, he would be thrilled at the good news. When I mentioned my poor date choice to my husband he became slightly surly and thought I was already thinking negatively; I quickly assured him I was not. 

Add dinner to tomorrows schedule of things, and then I saw that friends need help sewing costumes with a recital they are having next week. I was supposed to be in it, but I bowed out of the recital once I realized that it would be too hard with to do with the IVF cycle. Still, I had to explain that I probably couldn't help with the sewing aspects tomorrow either. I hate that, but it is what it is. Almost no one in that group is aware of our infertility problem and I can't imagine getting the phone call in the middle of all of that. Not to mention I'm sure my husband wants us to be together for that moment. 

By far this has been our best cycle and some part of me wonders if we had had the opportunity to do it here earlier (instead of India), if the results wouldn't have turned out better for the other cycles. We will never know for sure, but I suspect it may have. The cyst probably killed my first cycle and we would have waited if we weren't already in India. After the second cycle we found out that BCP lowers chances in women my age, something that is hard to avoid when you have to fly across the world and time everything. Actually, had I known that prior, I probably would have just flown out earlier and not taken any. Maybe. I'm not sure if we could have been that flexible with my husband's schedule. Who really knows except that this last cycle, which should have been the worst, was my best. By far. 

Sad to think that this is our last cycle with my eggs. Not to be Debbie-downer (I am hopeful), but if it doesn't work then we are in limbo for awhile. We will go to egg donation, but who knows when we will be able to do that or the logistics of it. While I won't feel a disconnect from any future baby we have that isn't biologically tied to me, I will feel a disconnect from my husband and his family. I don't know exactly how to explain that statement and any attempt to try would probably muddle it up even more. 

Plus , I so genuinely want to see what a mix of our genes would produce. Like most couples, I think we will/would make beautiful babies that will/would go on to do great and wonderful things. I would miss seeing the flicker of mischievousness from my Grandfather,  the possibility of light blue eyes (that have never changed due to any marriage mix), and the beauty and intelligence that I could point out from so many that came before me. Children are wonderful no matter where they come from, but there is something longing in me that wants the physical reminder of my loved ones that have passed to carry on in our future child. 

Sad to think it's our last cycle and a relief. Cycling is harder than I imagined and you have to put so many restrictions on yourself. So grateful to be able to resume wine, regular caffeine  and long hot baths. To not take a daily dose of supplements that make me rage/cry/get acne/grow more facial hair/etc.. Grateful not to have to pump more hormones and all the fun things that go with that. To not have to worry about gaining more weight; wondering if I need to buy a new wardrobe or just put my body on hold for yet a few more months. This week I was finally able to make appointments to get a cavity filled (anesthesia) and see my dermatologist (where most things Rx'd are no-nos for IVFers).  

My eggs are literally all in one basket. It can go either way. We transferred many embryos, but not more than the embryologist felt comfortable with. On one hand that makes me excited because it gives us a higher chance, on the other hand it makes sad thinking that our chances are so low to begin with that it's ok.  

Deep breath. 

Off to take a bath and think happy thoughts. If happy thoughts don't come, there's always my fallback: Grey's Anatomy. That sh#t's addictive and engrossing. Have lots to keep me busy today, so I need to get off the computer and try and dive into that. Tomorrow is the day and hopefully we will have great news. 

60 Second Update

Embie we didn't transfer didn't make it. They left a message on my phone and I didn't feel the need to call back. It didn't upset me - not one bit - totally expected.

Tomorrow I go in for my check up appointment. I've been a little worried because I am still cramping, but I guess I shouldn't be surprised since I'm prone to infection AND I didn't take my doxycycline the night before my transfer like I was supposed to. Told the nurse on the day of transfer (when she asked about it). Completely slipped my mind to take it even though I told myself probably 20 times (and my husband at least 5)! Had to take it after dinner and dinner was after the reminder alarm went off. Damn you ADD. Oh well. I guess if I had to forget one medication -that was the one to forget.

G.C. says she is doing great except for a sore bum. LOL. I feel so bad for her. She told me that the night of the first shot that she kept procrastinating when her husband tried to give it to her. Made him keep practicing on the orange an hour past the time she was planning on taking it. Then when she finally got the shot she couldn't believe that she had been so worried over it that whole time. That it was nothing compared to what she had built up in her mind. Still, too many shots will give anyone sore spots. There wasn't an unbruised spot in my prime belly-shooting area by the time I was done. Hurt to wear pants. Sans pants (or skirt) probably isn't good for the office. Now that I think about it - why didn't I wear a dress???

That's it for now. Tomorrow is checkup for me and Sunday is prego test for G.C. Some moments I don't think of it at all and other times I wonder how wise it is troll craigslist for my dream crib. Well "troll" as in window shop, not as in act all douche-y. Why am I explaining myself? You all knew what I meant. I starting to ramble which means I need to hurry up and get to bed. Still a ton to do.

Night all!

Giggle Moment

2nd cycle tummy shot. Little red dots are from the shots.

Hubby and I burst into giggles the other night while in the middle of mixing my meds I exclaimed, 

"GET IN MY BELLY!"

After the strange outburst, we were a little worried I might spill some of meds from random giggling. 

Hard to be all serious after that. 

Day 11 - Trigger Night

Same disclaimer as Tuesday regarding this post. Half of this was written quickly at work just to get the stats up and the other half was written quickly at home where I have a zillion things I need to do. I don't have time, patience, or the general "sit down and write pretty" warm and fuzzies tonight. (Still want to post the info though.)

Let's us begin...

Ultrasound done by doctor today. I don't remember this doctor's name, but she reminds me of tall Jennifer Garner. It's kinda funny. Funny weird, not funny haha. (I've always loved that phrase.) I've met her before and she is the new doctor at the practice. 

Lining is grade 1 at 7mm. (This doesn't matter in my case except to show that my hormone levels are good.) 

Note: they looked at the right ovary first this time.

right ovary:

14mm

17mm

19mm

14mm

3 that are <10mm

left ovary:

18mm

18mm

16mm

17mm

18mm

Looks some were hiding on the right that have perked up. One of the small ones on the left decided to join in the game as well. 

Depending on my blood levels, we may wait another day before the trigger shot. Will know this afternoon. 

I was out of meds and so my nurse gave me some from the office. Said if I don't have to use them, to bring them back. They didn't charge. 

--Evening update

Triggering tonight. My progesterone is 1.3 and my estrogen is 1779. The nurse explained that when the progesterone starts rising and gets above 1, it indicates that the eggs are getting ready to release (something I did not know previously.) My hCG shot is scheduled for midnight. Haven't watched the videos for that one yet - better get to it! Dose is 10K. 

Tomorrow morning I go back for another appt. They are taking blood and going over the pre-op instructions. Not sure if I get another ultrasound, I was in my car about to leave when they called. 

My GC will start her progesterone shots tomorrow night (ouch.) I still cringe knowing how her shots are big and intramuscular. Super suck. Our transfer is slated for Tuesday. Not sure why we are doing a 3 day instead of 2, but I've put it on my list of questions. 

I've asked 2 other questions that I am awaiting answers on. 1 is regarding assited hatching: do they think it is warranted in our case. The other was about ICSI. I was surprised to find out that they did not have it planned for us. That's a bit startling given I have a low ovarian reserve and we've used it both times before. I've asked for clarification. If there is little downside, and a potential upside, then I don't want a small fee standing in the way. Plus, I've read studies where it can significantly impact small follicle/egg success. 

As good as my numbers look, I was reminded on how good they looked last cycle. In fact I had 12 good sized and 14mm one; only 4 eggs were retrieved. I guess I have to hope that they will have better equipment/process/tweaks of protocol here to release good eggs. Hate to put it that way because quite frankly, my last cycle in India was waaaaayyyyy less stressful than this one here in the states, but a little part of me is hoping that something will be better here. 

My post-op visit (that's new!) is scheduled for the 22nd. Our pregnancy test scheduled for the 27th. That seems kinda early, so I told our GC to expect that she may have to come in for a second one. With her starting a new job only a month ago, it's better for her to know the possibiliy of these things in advance. Heck, I know I would want to know that too. 

Saturday is retrieval day. I've been so busy, I haven't had time to worry [too much] with google or otherwise. Our appointment is at 11am, but we have to go in at 10:15 to speak with the doctor. It's weird to see all these different doctors and nurses. I haven't even seen our doctor since our cycle started, and now she won't even be doing the retrieval. Sigh. I know the other doctor is considered awesome and I've met him once before, but it's still hard. In India I saw my doctor and the same nurse every day. 

That's it. Gotta go hussle and get things done. Haven't even had dinner yet. Wish me luck!

Begin at the Beginning...

From: http://aliceinwonderland.wikia.com/wiki/King_of_Hearts

“Begin at the beginning,” the King said very gravely, “and go on till you come to the end: then stop.” 
~Alice in Wonderland

I feel so behind on blogging about what is going on.  Ok. Let's start at the beginning. Or at least the beginning highlights of IVF cycle #3.

Christmas Day I starting on my Viville-dot .1 estrogen patch. The instructions were to change it out every other day until I started my regular cycle meds. Once I began those, I was to leave the last patch on for 3 days. 

Day after Christmas I started my protocol of injecting Ganirelix 250 mcg for 3 days. 

Friday night (12/28) my period started, and that brought me into the ACRM office on Sunday morning to do our baseline ultrasound check: 11 follicles. 

Monday (12/31) I started my Bravelle (6 vials of 75UI) and Menopur (2 vials of 75UI). You can see my discussion about that process here.

Friday I had my ultrasound and was introduced to my new nurse. Our old nurse/third party coordinator was promoted to Director of Nursing (or some similar title) and I was a little apprehensive of having to start with a new nurse. Even though our old has frustrated me a few times. Both nurses were there on Friday and I was actually pleasantly surprised with our new nurse. My fear was that she was going to be a total noob, but I couldn't have been more wrong. Apparently she was the former Director of Nurses took 6 months off, and was coming back as the new third party coordinator. She instantly made me feel at ease with her knowledge and bedside manner. Brava because I was very irritated with my clinic that day. 

The ultra sound showed 6 follicles growing on my left ovary and 3 on my right. All in the 10mm category. She explained BEFORE the ultrasound (which was really smart in my opinion) that it was very early and the number we were going to see that day could change. Not to worry if we only saw a few. At 9, I was pretty happy. 

After the ultrasound, I requested to meet with the financial coordinator. She was supposed to have called me back on Wednesday after speaking with her manager about a mistake they made, but did not. This meeting ended up with manager joining us and I will save that for another post. Suffice to say, I was not pleased about a mess-up and I let them know. 

The rest of the day saw me at work, running around trying to get required IVF forms notarized, and finalizing the attorney items. A busy day indeed. The mountain of forms you have to go through is staggering. 

Saturday my GC had her ultrasound and mock transfer. All went well, but neither one of us was informed before hand that she would be having this mock transfer. I'm guessing it was a bit of a surprise for her. 

Which brings us to today. (Shew.) Another ultrasound and blood work. Lining (where I have it) is striped and at 7mm. There are 4 follicles on the left that are 10mm or greater, and 3 on the right. Several smaller ones that may still be recruited. We will know more at my ultrasound on Tuesday. Blood results came back this afternoon and estradiol is looking good in the 500s. As long as it was in the 300's that was a good sign. 

That pretty much brings everyone up to speed. Well, everyone that reads this anyway. Not technically "the end" but a good place to stop for tonight. :-) 

Time Out for this Message about Meds

I'll freely admit now that despite what one might think, doing IVF with surrogacy in India was much easier for me. Administering meds is a prime example. I simply went to the clinic every morning, laid on a cramped patient table, and let them stick a bunch of needles in my belly. Some days hurt worse than others, but overall not too bad and the security of having someone who does this every day for years was great

Here in the US, you do it all yourself. The ordering, the mixing, the injecting. The day of my first ultrasound I was supposed to have injection training, but then I found out they wanted to charge an extra $160.00 for the training. Our pharmacy has online videos for our specific meds, so when they told me of the extra charge, I declined. Chances are I wouldn't remember what they said  when I got home anyway and would have to pull up the videos and instruction sheets. I ended up watching a bunch of videos from a bunch of different websites and then picking the best one to show my husband so he could watch me and make sure I was doing it right.

Video from my pharmacy on injecting Menopur.

This gives you a bit of an idea, but I had a lot 

more vials

Basically the process is:

• sterilize counter and tops of vials 
• wash hands thouroughly and carefully
• get syringe and remove the big needle
• attach a q-cap
• add a little over 1mm of air to the syringe
• puncture sodium cloride and push in air. This helps draw out the needed +1mm of liquid back into the syringe
• puncture vial of Bravelle and add liquid from syringe. Make sure everything dissolves, but don't shake too much. Add back to syringe, making sure to get all the liquid
• repeat with adding the newly mixed liquid into the next vial of Bravelle. 
• repeat with all vials of Bravelle and Menopur. Should still only have about 1mm of liquid in the syringe when done, but all 8 vials will now be dissolved into that 1mm of sodium chloride.
• remove q-cap and attach smaller needle for subcutaneous injection
• alcohol wipe your belly, make sure no air is in syringe, pinch a fatty area of your belly, and insert needle at about a 90 degree angle. 
• slowly inject medicine. 
• make ouchy face

No one really warns you that some medications in the vials dissolve better than others (no rhyme or reason) or that liquid can get caught in weird places in the vial. They don't tell you about your heart skipping a beat when you almost drop a syringe full of $500 meds. They don't tell you that it will cross your mind on several occasions "shouldn't someone more qualified be doing this?" They may have gone over this in the $160 training, but somehow I doubt it. 

Third Party Coordination Goes Awry - Meds Edition

A few weeks ago I had to figure out where to order my and my surrogate's meds from. ACRM recommended 3 pharmacies and called the Rx in to all 3, allowing me to compare prices and such. One of these pharmacies, Village Fertility Pharmacy, actually had the forethought to test my insurance coverage even though I told them it wouldn't be covered. Thankfully I was wrong, so we went with them (a huge bulk of mine were covered!) I ordered both mine and my surrogates meds, shipping to our respective homes. Mine took 1-2 days. 

Since we paying ACRM extra money (~$3100) to do "third party coordination", I naturally thought that if I ordered the meds, that they would do more of the "coordination" and stuff. Honestly, they have not done a good job with this. Repeatedly I feel like I'm running around like a crazy person doing the bulk of the coordinating. With my ADD and new job, this is terrifically difficult for me. 

When my GC came in for her appointment on Monday, they gave her a written Rx for her meds and told her to fill it. No one thought "hey, we've already placed an order with the IP a few weeks ago, maybe we should check on that." The reason I found out? The nurse copied me on an email to the GC that said "You don't need to pick up the Lupron in your original order." All of a sudden I was like "Is this a double order???" The nurse emailed me at first and said that maybe the fertility pharmacy sent the Rx to Kroger. I asked my GC, and she said no - no one told her  about the previous med order and ACRM just gave her the Rx when she went for her baseline ultrasound. She was suppose to start meds that day and not one red flag was thrown up. A few back and forth emails, and it was apparent that no one on their end was really keeping tabs on this. 

Truthfully I should have checked that her med order went through smoothly weeks ago when I got mine. I had informed my nurse that I had received mine, but then got violently ill and forgot to double check if our GC got hers. I had no reason to believe she didn't and I guess with all the balls I am juggling, that was another one I dropped. I'm terrible at organizing these types of things, which is why I didn't mind paying the extra money to the clinic to do so. And I really don't consider $3100 a small fee to do this. As I am sure you have already guessed, our GC did not receive her meds from Village Fertility and it upsets me that I feel like I'm having to do the bulk of "third party coordinating" while paying them a chunk of extra cash. (Yes, I know some of this goes towards the medical aspect, but we were also told it goes towards things like this.)

All of this resulted in frantic phone calls, in the middle of a workday, with my very public cube, to multiple people. This is sucktastic for me to have to do at a new job. Village Fertility Pharmacy said they did not ship the GC order because they had left 2 messages to set-up a profile for the GC and she did not call back. My GC said she never received the messages and I 100% believe her. I asked Village why they didn't call me when they couldn't reach her, and they admitted they should have. (As a side note: I am very forgiving when people admit mistakes and then do whatever they need to do to correct it - Village did this.) Village apologize and after I altered the order (minus the no longer needed Lupron and minus the already procured Estrace), they were able to ship out overnight. 

In the long run, I think the mess-ups of everyone (me, the clinic, and the pharmacy) saved me money, but that still doesn't give me a warm and fuzzy. Especially mid-cycle. I'll write more later on my HUGE upset about a screw-up in charges. It's a freaking shame because we adore our doctor over there. 

Cycle Limbo Part 2: Return of the Cycle

UPDATE

Nurse called. As long as my SIL can come in tomorrow and get an ultrasound - then we are proceeding as planned. Whoooooooooooooooooshhhhhhhhhh.

When the nurse initially called, she kind of presented it as my option with the knowledge that if my SIL's lining isn't thick enough upon transfer day, than the transfer won't take. Normally they want 11-14 days of the estrace to insure a thick lining, but they don't want to start the estrace until a untrasound and blood work on her confirms everything is a go (eg, no cysts, hormone levels good, etc..) My last cycle gave me only 12 days before transfer. She asked me if I wanted to go forth.

At first I asked questions about how would we avoid this next time if we waited. She said that normal protocol was to control the GC's cycle with BCP/Lupron overlap. Then I asked the follow up question that surprisingly, I think was a bit unexpected: why did we not do it this time? This was a little harder to answer, but the short of it was - they/she didn't want to start medications (including BCP) until all the initial testing had been completed. Of course my logical reply was: Does BCP effect the testing. Answer: No.

So getting past all that, I realized she expected an answer from me about whether I wanted to start or not. Here is where I lost it. Crying the cry only someone that is mildly dehydrated and still slightly sick can manage. My guess is that over the phone it sounded somewhat like a choking horse.

Normally when I get really upset, my sensibilities leave me, but they did not this time. I put the question back to her: "What you are telling me is that I have to choose between my chances lowering further from waiting a month, or take a chance that the lining won't be thick enough." She said she would speak to the doctor and call me back.

I laid the options out like that for a couple of reasons, but the main one was that I really didn't know which is riskier. One would think that a month wouldn't make a world of difference, but women in my age bracket know differently. My AMH dropped drastically in a very short period this year. Conversely, I don't recall our surrogates getting estrate (or similar) that long in India prior to the transfer, so I'm not sure if it is a booster/fail-safe thing or what.* From a medical perspective, since my GC and I started menses within 24 hours of each other, one would think at 29 years of age, her lining would be reasonably thick for ovulation at the proper time anyway.

After speaking with the doctor and both reviewing my records, the nurse called back. She stated that as long as my GC could come in for ultrasound tomorrow (she can), then we would continue the cycle as planned. We nailed down a few of the other details (like when I would start my big gun meds) and now I feel a crapload better than I was feeling. Earlier I was trying not to let panic surge, but I was having a hard time. I would have waited another month if I had to, but honestly, I am ready for this to be over and done with. The emotional and physical, even things you don't let anyone else see, is astronomically draining.

*Originally I thought the Indian surrogates did take meds from the beginning (from my own research of surrogacy), but I had my husband ask the Indian lady directly and she said that she only been told to start medication a few days prior to the transfer. My husband and I now debate if this was a protocol thing, problem with the surrogate, or other. 

Petition For Mandated Fertility Coverage

For those interested:

This petition was created with the hopes of raising infertility awareness and request that each state mandates infertility coverage including diagnostic testing and treatment as well as the cost of medication.

https://petitions.whitehouse.gov/petition/petition-approve-fertility-coverage-every-state/PL3BTLvw

Running and Running

Yesterday was a day that started with me waking up in the middle of the night - running to the bathroom. Several times. I couldn't even see what time it was because the clock was slightly obscured and I was afraid any movement would have me running back to the cold tile.

Course that's the kind of thing that makes you afraid to sleep. So there I was, wide awake, trying my best not to do that little gaggy-thing you do before you throw-up, in fear that the muscle contraction would make me poo in my PJs. I had my Hello Kitty's on after all. Fortunately nothing like that happened and I was able to keep running when needed. By 7:30am, I was exhausted. 

During this time I was wondering to myself (and to my husband, whom had much pity on me), how this could have happened. My son had a violent bout of stomach problems for most of the day 3 days prior (and of course I was with him on Christmas), but my husband didn't seem to think that sort of thing was contagious. I remembered differently, but I wasn't exactly in a state to argue or even think straight. More than likely, he mused, it was the Thai food I brought home the night before. 

A little voice inside me feared it was a reaction to my Ganirelix. I've never had it before and wouldn't that be a disaster if we had to figure out a change of meds at the last minute? While I've never had quite the exploding reaction to any other meds (unless you count the time my mom made me take cough syrup and I instantly barfed), I still have a weird history of medicine reactions. Can't take anything from the Cipro class of antibiotics. Well, I guess I COULD in an emergency, but I would be freaking out and asking my husband repeatedly why he was looking at me funny (paranoia is only one of the lovely reactions it causes.) 

Turns out I just had my son's stomach flu. Spent most of the day in the bed (and bathroom), but by 5pm (and a forced dose of  1-2 mg of Melatonin to make me sleep), I was able to come downstairs and eat. (BTW: Melatonin is supposed to help us infertiles, but golly it sure does pack a wallop with me.) Was weak as all get out, but I feared shot #2 less than I thought I would. Perspective I suppose. Now a day later, EXCEPT FOR MY STUPID PERSISTENT COLD, I'm all better. 

Kinda makes me wish I had these:

Photographer and story behind pic here:
http://www.flickr.com/photos/mararie/2137142469/

P.S. If you are a regular reader of my blog and are wondering about the answers to the questions I asked my nurse the other day, I updated the post to reflect the answers. Here it is: Day 1.5. I thought that would be better than to write an entire response post that are a few short sentences. 

Day 1.5

Yesterday Santa brought me a nasty cold. Wee! I managed to make it through the morning's festivities, but alas, was couch bound for the rest of the day. (On a separate note, the movie Mulholland Drive sucks - don't let anyone tell you differently.)

Nevertheless, I began my pre-cycle meds as described in my RE schedule. Namely I started the Vivelle-dot 0.1mg patch (estrogen), which I take every other day. Tonight I will add on to the patch and start a 3 day course of Ganirelix 250 mcg injections. Double wee!!!

I tried to think of a time in my life when I gave myself a shot and came up empty. Even with my couple year course of allergy shots as a kid. Even with my 2 previous IVF cycles in India. Ugh - I guess I should have checked for extra practice needles in my box, although now that I think about it, who the hell wants to take extra shots, practice or not.

Next step is "Await period Day Of Cycle 1 = First day of continuous menstrual flow (spotting is NOT day 1)". Great. Many times my periods are only spotting (due to my previous cryoablation surgery.) How should I determine that? So in typical "omg" last minute panic and realization that I have new questions, I sent the below email to my nurse. Hopefully they will get me some answers today.

UPDATE: rather than write a separate post on my nurse's answers, which were prompt, I'll just type them in red by each one. Nurse ended up calling me directly when I was at work, so my responses are just a quick summary.

P.S. Clearly I don't know how to count...But at least I caught it before she did. 
---------------------------------------
1.) Started the vivelle-dot today. Do these have to be changed out the same time (every other day) or can I change it out with my nightly shot (I put it on in the afternoon)? -->yes - that's fine

2.) It looks like I am suppose to start the Ganirelix tomorrow, but I am not positive because the date is wrong on your documentation (I think we may have previously discussed this on the phone, but I'm not positive now.) Please verify and send an updated copy. Also, please let me know if there is anything special I need to do/know regarding the shots. For some reason I thought we were going to have training on it, but we never did.-->tonight. around the same time. 

3.) I have been battling a very minor cold the last 2 weeks, but yesterday it took a turn for the worse. Today it is in full fledged mode. Please notify the doctor and let me know if there is anything I should or should not take for it. -->Take lozenges, any Tylenol line, robitusson but no DM, sudifed

4.) Last week I wrote you regarding an approximate drop-dead date for when the surrogate's cycle could start (and thus you would have to have a contract in hand.) Haven't heard back from you on this - please let me know. The lawyer has submitted the rough draft to us. --> earliest Friday. You have 2 1.2 weeks before her injections start. If she hasn't by Friday, call Mikesha on Friday. 

4.) Dr. Carpenter approved my taking supplements for the last few months. I need to know if and when I need to stop taking these. In particular the DHEA (75mg per day) as it is a hormone and I don't want it to interfere with the other hormones I am now taking. -->yes --continue taking all

5.) My 2 previous cycles I had cysts prior to the start of cycle. The first IVF cycle, we had to aspirate the cyst as it was interfering with my hormone levels (and consequently would have ruined the cycle.) I need to know if we need to do an ultrasound or blood tests to make sure this isn't occurring again. Dr. Carpenter is aware of my previous history with this. -->will come in on day 2 or 3 for ultrasound and bloodwork. Check it then. 

6.) My blood tests are complete. The FDA ones should be faxed to you directly from Quest. The remaining ones were done at Emory. Please let me know if I need to sign a release for you to get them. I believe you already have it on file, but since it is a new doctor, I am not positive. -->need to fill out a record release for emory to send over to ACRM. She will email. Email back to her or fax.

7.) The ACRM email system appears to remove emails after a certain period. This is very confusing and I worry that I might miss some documentation. It is also difficult for me to log on to the ACRM email system when I am in the office. If possible, I would prefer to use regular email rather than your website email system. Please copy my husband on return correspondence as well (his email is included in the CC line.) -->yes - that's fine. 

Thank you and I hope you had a great holiday.

Mad Dash to the Finish Line

I don't know who Mr. Pipo is, but this image rocks.
You can get it here: http://commons.wikimedia.org/wiki/File:Mr_pipo_clock.svg

Yea, yea, yea. The ole "I've been a blogger slacker" post. The "I've been too busy" post. The "Too emotional with all that's going on in the world" post. Whatevs. Get to it.

We are on full throttle for surrogacy to start next cycle - which means hopefully the end of this month. (Crap - no drinking on NYE!) I've been a mess trying to get everything done in time, but we really wanted to pay as much as we can this year for tax purposes. Since I didn't work for 8 months this year, much more is applied. 

Plus, let's be real, every month for me counts now. My AMH is like .7 and my FSH is 12.7. Not good. Not horrible, but not good. This will be the last shot with my eggs - period. If this doesn't work I'll crawl into a hole until we are able to consider the donor egg option. 

I have to say that having my first 2 surro cycles in India did not prepare me for the complicated mess I would  have to endure here in the US. In India we just had to show up and they directed us for everything else. Here we are on are own and have to stay on top of things like a frenzied squirrel. Crimmy, I'm even going to have to give myself shots. With my ADD, this is not encouraging. 

Some of the things I've been juggling: 

• Coordinating 4 individual schedules with tight deadlines on when specific things have to be done. Guess who's schedule always gets the shaft (to be expected.)
• Countless phone conversations occurring middle of the day, for a length of time, that has me leaving my trusty cubicle to go hide talk in a conference room. Lest my cube mates get to hear me go on-and-on about the FDA required STD tests I have to take. "Yes, I need you to add Chlamydia  Gonorreia  HIV, Hepatitis  PPD, ... to my blood order. Oh I'm sorry, you want me to repeat that LOUDER for the 3rd time? Ok."
• Working with 3 different pharmacies to find out which can give me the best price, without sacrificing reliability/comfort level of getting all the right things at the right times. All of this again on the phone during business hours. All pharmacies have been given the Rx by doctor and are ready to ship ship ship. "Yes, I'm confirming the order. OH WAIT, you are with whom?"
• Phone interviewing lawyers with experience in surrogacy to see who can meet our tight deadline (are you sensing several themes yet?) 
• Going BACK AND FORTH with my new primary care physician office to try and convince them to add STD blood tests to my blood order for my physical. This way there is a chance insurance will cover it, but I had to go back and forth with them for about 2 weeks. Otherwise it's a couple grand out of pocket.
• Getting a physical so that additional items will be covered under insurance that wouldn't under my RE.
• Multiple doctor visits. Blood drawn yesterday AND today because I had to use 2 different labs. Trying to juggle all these without raising a flag (hopefully) at my new job has been an incredible feat. I'm a contract employee and want to go perm when my contract is up in April. 
• Psych evals - and while I appreciate the "concern" over my emotions, it really was a total waste of time/money for my husband and I. Everything that was discussed in the group session we had already discussed with them privately. I totally "get" why you would want to have one with the surro and the surro spouse, and even a group one, but I don't think every IP couple needs to have this done. Especially if you've been through the process before (even in another country). Thankfully the doctor put the ones for hubby and I as a "family counseling" code - hoping insurance will at least cover that. 
• Trying to get surros insurance documentation to make sure there is no surrogacy exclusion. Not their fault, but company's fault it is taking so long. 

There is more I am sure, but between balancing that and everything else in my life, my brain is kinda fried at the moment. I still have Christmas shopping to complete. Hell, I haven't even gotten all my cards out yet. 

On a Happy Happy note. Insurance covered a HUGE portion of my fertility medications. The pharmacy (Village Fertility) checked on a whim for insurance coverage (even though I told them it wouldn't be covered) and apparently a big chunk was. Had to pay just a little over 1K out of pocket - which is awesome since it was looking to be about 6.5K. She explained that even though we have BCBS for medical (THE SUCK for infertility treatments), the pharmacy is different and is quite good. Covered under Medco, formerly Express Scripts. I guess the lesson is: always check to see if insurance will pay. Even when you are sure they won't. 

On an unhappy note - I had no idea that the attorney was going to be so much. 2500 for the surro agreement (REQUIRED) and then another 4K if we make it to the second/third trimester. They have to go to court and petition that our names are put on the birth certificate. Otherwise we would have to adopt our own child. GAH! Oh well, I guess we should totally HOPE/PRAY/RAIN DANCE that we are so fortunate as to get to shell out the money in the future. That would be a good thing - right?

That's it for now. And to prove how busy I am at the moment, I'm going to publish this after only "checking" it once for mistakes. That's HUGE for me. Normally I read it and change it 10x. THAT'S HOW BUSY I AM. Or crazy. You choose. 

Where Can I Get My Drugs?

No seriously. Who has the hook up? I need advice on who the cool [read: GOOD], reliable, fast online/mail order companies for fertility meds? Fairly certain that the email I just read from our clinic was saying that I will need to order mine (and our surrogates) in the next few days.

Here was the reply when I asked about getting the meds:

Once you are ready to get started, I will send this prescription to a mail order pharmacy and they will call you to set up payment and shipment of the medications.  You will need some of them within 14 days of starting a cycle.  The others you will need a few weeks after that.  I would recommend getting the meds as soon as you are ready to proceed.

Honestly I don't know if that means 14 days before my next cycle or 14 days after my current cycle start - which now that I think about it, is the same thing really. Since my period started on Sunday, that means I need to get the full list and make the purchases.

I hate having to rush rush rush everything, but it looks like that's where we are now. Have no idea about what happens with being able to claim this on taxes for anything that spills over to next year. I know you have to reach a minimum percentage of your income to claim medical, but can you only claim what is OVER that percentage, or do you to claim the first part too? I'm trying to figure out how vital it is we make our Dec 31st deadline. It's vital from an old eggs perspective, but I don't know how much it will end up costing us if we can't claim it all on our taxes this year.

Any tidbits you guys can throw my way I would really appreciate. The last two days of trying to balance 4 individuals' schedules for treatment, make sure everything is asked/answered for our upcoming cycle, work, getting a plumber out (yay! We have water!), make a community meeting that we will be a named plaintiff in, more work, AND cart my 12 year old Min Pin back and forth to the vet for dental surgery (9 extractions!) has my head spinning.

(BTW - my Min Pin is a total hillbilly now. All of his front teeth, bottom and top, were rotting due to age and not enough space, and had to be removed. He won't show me now and is working the cheese angle.)

No wonder I need a good hook up for meds. Give me a heads-up and I'll keep it on the D-Lo. 

In Today's Surrogate News...

image from: here

The long awaited surrogate news is here! 

Our surrogate and her husband are still gung-ho - YAY!!!! Ms L went for her hysteroscopy and HSG testing Thursday and Friday. We haven't heard the official news from the clinic yet, but she is under the impression that everything came back great. Double yay! I'll let myself have that little bit for now.

On the flip side, my surrogate and her husband, both whom are very close to us, are having trouble quitting smoking. If she doesn't quit soon, then it will be a no-go. Quitting smoking is super-tough and she feels awful that she hasn't been able to quit yet. Was there myself once-upon-a-time and it sucks.

We went ahead and asked them if they wanted to try Chantix (we'd pay for it) and made sure with our clinic that it would be ok for them to take. They both wanted to give it a shot and we were happy when our RE said it was ok. We were about to go meet them on Saturday when our water heater expansion tank sprang a leak. Fortunately showered just minutes before the leak was discovered... 

Anytime you find a large puddle of water on your floor you should probably be concerned, but honestly I was more concerned about meeting with Ms.+ Mr. L. We called a friend and my dad to ask some questions, turned a faucet valve that was connected, let hot water run out in the sink, placed a bucket under the leak, and left to go meet them. 

Meeting went great - picked up Chantix Rx and then grabbed dinner with both of them and their little one. Afterwards we had a get-together at a friend's house where it was pretty paramount that we show our face. It's a close friend (he introduced us!!!) and we think we weren't invited to his wedding a month ago because we have been soooooo MIA - we hadn't even met his now-wife until last night. They had been dating for a little over a year. When we returned home much later we found the leak still going strong. A little digging around outside and in the garage led to the discovery of another valve to turn off ALL water. The first one turned out to be just for hot water. 

I hope the Chantix works. It helped me quit smoking years ago, but I know some people report serious side effects and can't take the medication. Chantix is not covered under their insurance either, but Mr. L's doctor gave him a $75 coupon. Oddly enough, Ms L's only have her a $40 one. Weird huh? We were able to use the $75 one. 

Now we go full speed for the other things. On the schedule of phone calls tomorrow is lawyer (required by our clinic), blood work for all, and psych tests for all. Wait what was that last part??? Yea, our third party coordinator said that we would have to ALL have a psych eval. Having a psych eval doesn't bother me (it probably should!), but after 2 failed surro cycles in India I really don't understand why it is necessary. I sent an email to our third party coordinator asking about the necessity (ie. requirement), of this for my husband and I. If it isn't required then I really don't see the need to spend additional monies on it. We didn't have it in India and I don't feel like we need it now. (The surrogate did have one in India and I understand why it is required here.) 

And I'm not sure how we haven't really talked with the financial coordinator at our clinic thus far, but I guess we need to schedule that as well. Sigh. At least then we will know better what to expect. Our original information from the clinic did not include costs for surrogacy. That becomes an entire new list of line items. 

I don't know how I'm going to take off all this time from work. All day psych evals? Appointments at an attorney office? More medical stuff? I don't know how our surrogate is going to be able to take the time off either - though of course we will give her money for any missed work. She starts a new job next week and while we are both super-duper tight with her boss, I think it's still awkward to take time off when you first start at a company. Even if the boss is totally ok with it. 

Sigh. So that's the update. Prior, I steeled myself to expect the worst with her hysteroscopy/HSG tests and now I feel unexpectedly elated. Even after feeling all doom-and-gloom about the cigarette stuff for the last week and a half. I'm still going to be cautious about getting too excited with regards to that, but I've let myself be hopeful for the weekend.

Course not having water it beginning to suck. Guess I should put "plumber" on my list of phone calls for tomorrow. Wouldn't that be funny if that was the phone call I forgot to make tomorrow? (I refused to pay Sunday plumber rates.) My BFF called earlier and said we could take a shower at her house if necessary. Since she could smell me all the way from there... She's a keeper. :-) 

Slacker, Community Peeps, 10 Second Rant, & ICLW

I confess. Super Slacker on the post reads today. Mostly because I didn't get home from a meeting with some local community folks (and then dinner) until almost 10pm.

The short of it involves them asking us to be a "named plaintiff" against a big box store that wants to move in right next to me. They need someone who lives close and I don't think you can get much closer than we are. Did we acquiesce? Damn straight. My quality of life goes down the tubes if the stupid mass retailer moves in. So much for me liking my privacy (both as a named plaintiff and/or if they move in.) Le sigh.

It probably doesn't help that I missed taking my supplements most of last week and now that I am taking them again, I have to deal with side effects. Rage Balls with your side of DHEA anyone? Hopefully it will pass quickly. While I have that going on, I'm going to use it as an excuse to go into a 10 second rant on something that drove me bonkers last week. 

10 Second Rant:
I am not a grammar Nazi. I swear I'm not. If you want to know the truth, I'm fully aware that my own grammar isn't that fabulous most of the time. But I hate - really, really hate - when someone's is awful. (If someone is disabled, from another country, uneducated, or similar then they totally get a pass.) There are blogs I can't read anymore because of the writing. Not minor things, but things that make you want to poke your eyes out.

I want to read the story, not try and decipher the jumbled up mess. Maybe it's because of my ADD, but when it's a jumbled mess, it's HARD for me to read. In the end, I just don't read them; it's too frustrating.

And I'm willing to bet, at least a quarter bet, that I am not the only one. That actually makes me a pretty crappy and judgmental person, but I can't help myself at times. I wish I could. This is the part where if I was smart I would erase this whooooolllleeeee section. 

End Rant

If you are visiting from ICLW then
A.) Sorry you had to see that rant. I'm not normally like that I swear. Ok, maybe sometimes.
B.) What took you so long? (LOL Just kidding) and
C.) You might want to start HERE instead for a tiny blurb about me and better posts to read. Except you are at the end of this one already so you might as well stay here.

Today's Readings:

1. (Still) Trying to Conceive: Languages
2. Hobbit-ish Thoughts and Ramblings: Sunday Night Chit-Chat Recovery Mode
3. Crazycatladywantsbaby: I Must be Stupid - TMI Post
4. Bébé Suisse: What does a girl have to do to buy a Doppler around these parts?
5. Follow Every Rainbow (nope - need permission. :-(  )
6. Team Harries Beat Infertility: Willingness to Wait
7. Tesseract: Eighteen Years
8. Thought Provoking Moments: Well, Well, Well
9. Genuine Greavu: the "A" Word
10. the misadventures of missohkay: When World's Collide
11. My Fertility Blog: And Then There's Good News

You have questions...We have answers

Actually I need your answers, so if any of this sounds familiar please post your experience/knowledge in the comment section.

On Tuesday night, I attended a seminar at my old clinic ACRM, here in Atlanta. I described some of it here and also pinky-swear promised to post the questions I posed to the new doctor during the Q&A session. (Ok, I didn't really pinky-swear, but I wrote I would, which is almost like the same thing.)

So here are the questions I asked.

1.) Can endometriosis affect the outcome of an IVF cycle if the woman is using a surrogate?
A.) Yes it is possible. [Sadly I have forgotten the reason behind it. I believe she did mention that there could be an effect on the eggs in a follicle and thus less eggs retrieved, but for the life of me I can't remember if she said certain things or if I am confusing it with stuff I have read.]

2.) Besides cost, what are some of the downsides of using ICSI?
A.) There have been studies done of the offspring conceived by ICSI and it was noted that the male children had a higher rate of sperm problems. Whether this is a cause of the ICSI or due to genetics (ie, the father having sperm issues thus ICSI was used) is unknown. 

[This one I already knew the answer to, but I wanted to make sure there wasn't anything else I didn't know about. Primarily because our clinic in India uses ICSI as a default with no extra charge (unlike here in the States).]


3.) How long after a laparoscopy, do you need to wait to start an IVF cycle?
A.) Generally the recovery time is short and we like to do the next cycle as soon as possible. Especially if the woman is older.
[I know they can't do it the same month as IVF, so I'm guessing that means you just have to wait until the next month.]

I'm getting conflicting statements about #1 and I'm a little concerned about it. Everything I read regarding endometriosis and IVF revolves around the woman carrying the baby, there is very little info for women using a surrogate.

My new OB/GYN did not seem to think that endometriosis would be a problem for me (with regards to lowering my IVF success rates) since we weren't using my uterus. In fact he thought there was a low likelihood that I had it since some of my symptoms were relieved with my cryoablation. He advised for me to find out if the cyst I had aspirated during my first IVF cycle was a chocolate cyst. He did mention at the end of our lengthy consultation that he did not specialize in reproductive endocrinology, so I'm guessing that was his out if he was wrong. The only surrogate cases he probably has is if someone walked into his office who IS a surrogate and already pregnant. Also this WAS before they locked me in the bathroom.

Conversely, Dr. GS on SIRM's forum indicated endometriosis could cause a problem in my case, but it was hard to tell if he understood that I would not be CARRYING the child. Even though I definitely mentioned it. (I am awaiting on a response for that clarification.) He mostly pointed me to articles that either talked about the problems in the woman's lining (and toxins activated in it) or in one case a long article he wrote with one tiny sentence that suggested a gestational surrogate would be a better option. That seemed to contradict his reply to me. Anyhow, I've awaiting clarification.  [UPDATE: Dr. GS did reply and state he missed the part about gestational surrogacy. He said that in the case of immunologic implantation dysfunction, it wouldn't apply to me, but an endometriotic cyst would affect egg quality.]

The REASON I'm even asking is because I don't know if I should be tested for it. We have decided to cycle again, but this may be my last one and I want to optimize my chances. If endometriosis can affect my eggs pre-aspiration, then it seems like a good idea to be tested and get any problems fixed. On the FLIP side, scheduling and doing a laparoscopy  plus recovery time could add a couple of months to the process - thus lowering our chances. PLUS some doctors advise against laparoscopic surgery for poor responders as it can further lower your ovarian reserve and raise FSH levels.

What to do, what to do. Time to go have a real one-on-one with our ACRM doctors again.

As I said at the beginning, feel free to chime in. 

Day 1 and 2 with the doc

Some of my meds

Yesterday was my first visit with the doctor. We thought we were going to have to aspirate my cyst, but Dr. P thought we should check my hormone levels first. We would only aspirate if the hormones were off.

 Last cycle I had a 3cm cyst and my estradiol was way off. I only had 3 follicles and we had to aspirate in order to proceed and get my hormones back in line. Once it was aspirated (general anesthesia - ACK!), we saw 14 follicles. Not exactly sure how that works (were they hiding???, why were we able to see more later on the unaffected ovary?), but that made the initial panic of 3 follicles easier to deal with.

This time I knew I had a 5cm cyst walking in. Turns out it had reduced to 2cm, but I only have 5 follicles currently showing. 4 and 1. My hormone levels came back normal, so we opted not to aspirate. Dr. P ordered an AMH test, and I get the results back tomorrow. Truthfully, I am a bit horrified to get the results back from that one. The follicle thing I can not worry about and simply hope more "appear", but a bad AMH right off that bat will crush me.

We are starting off with a stronger course of meds this time, though the Gonal F is at the same range we started last time (we increased it halfway through last time). 4 shots to the belly right now. Here is the breakdown:

gonal f - 375 IU

luveris/lutropin - 75 x .2

lupride/ leuprolide - 1. mil IU

human chorionic gonadotropin (hCG): HOCOG - 1250 IU

I started researching some stuff yesterday and then I just stopped. It was too depressing and I don't think it is doing me any favors right now. Hopefully my AMH has not tanked (it was 1.7 in February) and then I can be cautiously hopeful. Not even sure if cysts can affect AMH, but I'm too afraid to keep looking. 

Today I'm ok. Got shots in the belly and then socialized a bit with some other patients. For some reason, buying dog food to leave for homeless dogs (I especially worry about the lame ones) made me feel better. I don't know why, it just did. Maybe because it gives me a little bit of control or maybe it's because I feel like I can do a little tiny something to help. Right now I need a super simple way to make myself happy and that did it. I'm sure there are plenty of more laudable things I could be doing right now, but that comes with such complications at times and often tons more stress. 

I'll confess that in the last few weeks, I have, on occasion, semi-prayed. Given my atheist/agnostic ideology, this is quite complex to me internally. Not posting this because I want I bunch of comments regarding religion (quite the opposite), I just thought since it is part of my journey that I better fess up. If you are religious and are reading this, feel free to send your prayers, good vibes, or whatever else my way. I need all the help I can get. :-)

That's it for now. 

Special Lady Cocktails

When I first was swept up by the internet infertility tornado, I remember reading forum posts from other hopeful women. Falling on a theme (as I often do), I obsessed over the ridiculousness of women taking all kinds of crazy pills - usually without having a doctor recommend them. OMG! DO YOU JUST TAKE ANYTHING YOU FIND ON THE INTERNET??? Some posts swore by the helpfulness while others confessed that they worried it may have hurt. Once discovered, some doctors gave full-on lectures how it was not appropriate for the poster's situation, only to find out that someone else (usually another doctor) in their clinic had told them to take it. Truthfully, I was personally affronted that such naivety and desperateness could drive women to arbitrarily take anything in an attempt to conceive.

The picture above is from MY house. That's right, Ms. Holier-than-thou is ...well, the same as everyone else.

At first it started small. My first pill was THE PILL, and I was told I would have to take it by my Indian doctor to make sure I was synced properly for my IVF treatment. Fair enough. I called my OB/GYN and promptly got a prescription. Let me mention here that I do not like taking birth control pills (bcp) as not only does it make me gain weight and experience occasional nauseousness, but sometimes I experience additional glum side effects (depending on the brand). Fine - whatever - I set my alarm on my phone to give me a daily reminder; particularly because my history of remembering to take medicine on a daily basis is pretty dismal. Especially BCP. Our local IVF doctor also advised to add a pre-natal vitamin (another item bound to make me nauseous) and I immediately relented as I ran to our local Publix.

Baby aspirin and acupuncture were added to the regime - the latter being something I normally would have scoffed at a year earlier. Doctor semi-recommend it and so I shelled out the cash. My husband gave me the big-eye, but I'm guessing he recognized my fervent look and said nothing. 100 bucks a pop for 6 weeks = not cheap. What can I say except I wanted no regrets.

IVF treatment #1 was dismal. 2 eggs retrieved, only 1 fertilized. Even that 1 took a damn long time to fertilize.

Now I am prepping for treatment #2. In typical fashion, I have been obsessively researching similar cases. Not just blog posts, but academic papers and any type of current research I can lay my grubby little eyes on. A clinic in India recommended 25mg of DHEA for 3 months. I rush to pull up the scientific documentation and realized all of the research is really based on a tiny Tel Aviv study. The study showed a significant difference in live birth rates with women who were poor responders and took 75mg of DHEA for 40 days vs women who did not. A follow-up study had additional encouraging results. Screw the 25mgs -I only had about 40 days till cycle, I was going to go full boat - 75mgs it is! [I would like to make a note here that I was not able to take the full 75mg initially because of side effects. I had to build up and even now I have minor side effects.]

Next I read how melatonin could also help woman with poor ovarian reserve and immediately I was hunting down more articles and recommended amounts. 3mgs seemed to be the magical number, but that amount knocked me on my butt. Still 1-2mg was doable and thus it was added. Combining it with the DHEA means I sleep really well, but I'm groggy as all get-out when I wake up. Heaven help me if I don't get a full 8-9 hours. Oddly enough, my friend says she takes 10mg all the time and it barely helps her sleep. What can I say? I'm a lightweight.

Did I stop there? Heck no! I was on a search that day and after reading some articles (which I can not find at the moment) regarding myo-inositol, my amazon shopping cart increased. Among other things, myo-inositol was suppose to help women with cyst issues and a giant cyst almost caused a no-go last cycle. My OB/GYN found a cyst last year and I began to wonder if some of the pain issues I had felt over the last year were cyst related. GIVE ME MYO-INOSITOL NOW!!!

There were a few other things on the list, but these 3 new items had good scientific data to back them up and they applied to women with similar (if not exact) conditions. The other pills I noticed my fellow women-at-arms were taking were either less scientifically regarded or didn't apply to me. Besides, as I mentioned before, I'm a light weight and I wanted to see how I was going to handle this new concoction.

Which brings me to last week. I'm not quite sure HOW I ended up at the Rainbow (read: hippie) Grocery store - but all of a sudden I found myself at the cashier's stand with CoQ10, some fancy fish oil supplements, and yes even some Royal Jelly that was well hidden in a jar of honey. And some awesome low-sugar dried mango. And a yummy nut mix. And Activated Charcoal that I told myself would be good to have on hand if my dogs ever get into something they shouldn't. Somehow I think my subconscious was trying for an easy excuse to get some for me. You know. Just in case.

"Just a spoon full of sugar..." (or honey) 

RAAAAWWWWRRRR

Ok, confession time: I'm a tad afraid that my hormones are making me feel a little roid ragey. I'm not used to taking birth control pills (BCP) and I'm certainly not used to taking DHEA, both of which contain hormones. This morning I feel unusually weepy, and often I feel unusually RAWR!!!! Add that I am probably PMSing and it's a mighty good thing that hubby is at the office today.

I'm hoping it will level off soon; the bad parts, not the good parts. On the good side I think I am getting darn good sleep at night (not normal for me) and I don't feel exhausted during the day like I normally do. DHEA is supposed to help people with chronic fatigue syndrome and I am wondering if the deeper sleep at night is why. How long has this been a problem for me? My mom still tells stories how she worried I would be kicked out of kindergarten because of my requirement for 2+ hour naps.

If the Fedex man likes me today, then I should receive my Melatonin. Hopefully that won't throw me back to wanting to sleep all the time. Sigh.  I wonder if I should go back to acupuncture. It didn't seem to help one bit and I wonder if the occasional massage wouldn't be just as effective (and appreciated more.) Then again, the acupuncturist also could help me wade through the RAWR.

If someone had told me a year ago that I would be taking all kinds of weird supplements and dropping $100 a pop to the local acupuncturist, I would have told them they were off their rocker. Next thing you know I'll be traveling to a rural town, in a foreign country, without my husband, navigating the intricacies of basic every day things, for the privileged of shots in my belly. Oh wait...

"Shot to the heart" - er no

Tonight I get my big bee sting shot in the arse at 11:30PM. Ack! The belly shots have been bearable (mostly), but I've been a little apprehensive about this one.

(BTW: 6 follicles for those of you keeping score. Ranging in size from 16-22.)

Maybe if I sing Jon Bon Jovi's "You give love a bad name" song (in my head), it will help. I can hear it now "Shot to the butt, and you're to blame..." Hmmm, maybe giggling while a needle is coming towards me isn't such a hot idea. Oh great. Now I'm going to have a giggle attack. Those always come at the worst possible moment.

Wish me luck!

UPDATE: It was a shot in the belly and it was easier than one of the daily shots I had been getting. Easy-peasy. I had gotten myself so worried over the butt-shot from a IVF memoir book I read (said it was like bees stinging you all over your body and that one woman punched her husband in the nose after receiving it), that the idea of it was 100x worse than the reality. I did manage to embarrass myself by laying on my belly ready to expose my bum when the nurse kindly told me to turn over. Very typical of me. My husband grinning ear to ear. :-)