Wednesday, December 26, 2012

All Is Calm - All Is Bright

This year has been one of the most joyful and peaceful Christmas seasons in my adult life.

I have loved having my family close and it's been beyond amazing to have so much hope and happiness all around. Magic has been everywhere and it has felt really nice to just sit back and soak it all in this month. Truthfully, I can't bear the thought of it ending.

So it won't.

I had a really good conversation with Dr. H last Friday night when he called to tell me that he had to unexpectedly leave town due to the illness of his aging father. Unfortunately, he would not be able to perform our transfer but he was kind to call and we had a great conversation about what would happen from that point forward. He had just briefed his associate, my former Reproductive Endocrinologist (RE), and although he would be on a plane when the report came out from the embryologist, he promised to get a briefing as soon as he landed on what took place. I very much recognize that this isn't what most people experience with their RE and I feel immensely blessed to be in such capable and professional hands.

On Saturday morning Mr. Thompson and I went in for our 3-day consult with his replacement Dr. B and the Embryologist, Dr. R. With 7 of the 16 fertilized eggs being "excellent" & "good" quality embryos and the rest being "fair" or "poor"...we had some important decisions to make.

Transfer at Day-3? Wait and see what made it to Day-5?

Last time we only came out with 2 Day-5 Blastocysts despite so many eggs... so this time we were understandably a little more conservative. We went back and forth because different doctors do different things and certainly have different opinions based upon different experience.

Dr. B had an opinion and would have waited until Day-5... but I kept asking what Dr. H would do.

If we went with a Day-3 transfer, Dr. B would have transferred 3 embryos... but I kept asking what Dr. H would do.

In the end we decided to transfer 2 embryos on Day-3 and freeze the remaining 5 good ones so we could have future options.

Future options???

Yeah, that was Mr. Thompson's decision and it nearly floored me when he said it in the doctor's office. You heard me right, Mr. Thompson wants future options.

After all, it's what Dr. H would do.

So we transferred two embryos - a 12 cell and an 8 cell. With a wink, Dr. R (Embyrologist) told us we were doing exactly the right thing (and oh by the way he said, Dr. H would NOT have transferred 3!).

The best part was that while we waited after the nurse prepped me for the transfer, Dr. R opened the door to the embryo lab in an obvious display of holiday spirit and walked us through all of our petri dishes and step-by-step of the assisted hatching of the chosen two. He put his microscope on a TV monitor for me, and from the lab (a few steps from the operating room and where I could see him) we watched the whole process on the big screen from his microscope. The Assisted Hatching was way cool and I can't tell you how many times the groovy Dr. R said, "Isn't this righteous?!" like a giddy five-year old on Christmas morning.

After he was done and while we were waiting for Dr. B to come in so Dr. R could suck them up into the catheter for transfer (which we also later saw as well), I asked Dr. R about his new incubators which Dr. H had told me about over the phone. That was when Dr. R did something that surprised us all by inviting Mr. Thompson to come check it out. The nurse's jaw dropped and she incredulously whispered, "I haven't even been allowed back there in that lab!". Mr. Thompson got a first hand look and saw the new gazillion-dollar incubators, which are some of the first of their kind in the US. They keep a pretty tight control on the lab so this was cool. (Don't worry Mr. Thompson was "suited up" and sterile.)

Our transfer ended up going without a hitch with Dr. B so now we wait...

In a perfect world this is what we are waiting for:

1 Day Past Transfer (DPT) - The embryo continues to grow and develop, turning from a 6-8 cell embryo into a morula (not sure how this works with ours because they were already a 12 and 8 cell...)
2DPT - The cells of the morula continue to divide, developing into a blastocyst
3DPT - The blastocyst begins to hatch out of its shell
4DPT - The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus (Today!)
5DPT - The blastocyst attaches deeper into the uterine lining, beginning implantation
6DPT - Implantation continues
7DPT - Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
8DPT - Human chorionic gonadotropin (hCG) starts to enter the blood stream
9DPT - Fetal development continues and hCG continues to be secreted
10DPT - Fetal development continues and hCG continues to be secreted
12DPT - Levels of hCG are now high enough to detect a pregnancy (January 3!)

Crazy, huh?!

As far as those future options, we froze the remaining 5 excellent/good quality embryos and let the remaining "fair" and "poor" continue in the lab to see what would happen. Dr. R called this morning with a report and we had another 3 "fair/poor" embryos change their mind and make it to a Day-6 Blastocyst, so those went into the freezer on Christmas as well.

Wow! 2 transferred and 8 frozen. Can you believe it?

All is calm. All is bright.

Saturday, December 22, 2012

P.S. You'll Shoot Your Eye Out!

After almost 6 years of marriage and 7 years of working together/"hanging out"/dating, Mr. Thompson kinda-sorta wimped out on me.

The nurse has graciously given me my progesterone bum shots for the last few days but it was up to Mr. Thompson last night. As we say in the West, she "handed him the reins" (as in the reins to the horse).

But as I laid on the bed with my backside exposed...singing Christmas carols to take my mind off of the pain that was sure to come....Mr. Thompson finally announced that he just couldn't do it.

 Not with a needle that big.

With more than a little panic, he asked if I could call our elderly neighbor to do it. I said "no".

He asked if I could call my friend a few houses down. Since she is very pregnant and the last thing she needs is to be doing is jabbing big needles into my even bigger butt, I said "no".

So he asked if I could call one of my nurses from work. Since nobody at work is supposed to know about this (yeah right!) I said "no".

My friend that lives 30 minutes away? No.

My sister who lives over an hour in the other direction?  No. (her exact words were "hell no" after I at least asked...)

And so he finally took the reins and did it... but like Ralphie in the Christmas Story, I think he cried the whole time he was beating me up.

Which is why as a consultation prize I got a Christmas Story Leg Lamp night light.

Sure beats a lollipop, right?

Sunday, December 16, 2012

Let It Snow! Let It Snow! Let It Snow!

I love Sundays.

I was able to take a long winter's nap this afternoon which felt blissfully good.  Especially considering everything that my body is going through right now. 

We ask a lot of our bodies during IVF and it certianly takes it's toll.  Kim over at the A.R.T. of Making Babies recently summed it up perfectly from a reproductive point of view..."shutdown, turn on…grow my eggs, all of them really fast. But stop, don’t grow too big, or ovulate for that matter, just get big and ripe and hangout until I tell you so. Ok, I am sending someone in to take you away from your natural environment and put you in a dish, get along with the sperm, now ya hear? Ok you're going back in, get ready, I am going to slide you down this tube. Now take all of these hormones to ensure you have a nice cushy uterine lining and also make sure you can support a pregnancy, in case the embryos decide to implant. Not to mention these drugs which will thin your blood, these will prevent clotting, oh and these will shut your immune system down, so you don’t attack the embryos."

So I guess it is no wonder that I'm feeling a little uncomfortable today.  Yesterday's ultrasound/blood draw went well...but they said "one more day". Today's ultrasound/blood draw went better...but they said "one more day".

And so I guess we are waiting one more day.  Hurry up.  And wait. 

I'll go back in the morning and hopefully things will go well so I'll do the "trigger" shot tomorrow night that will tell my ovaries "go!" for retrieval on Wednesday. 

Speaking of ovaries...they are huge and UNCOMFORTABLE!  I'll spare you the medical mumbo-jumbo but today they stopped counting at 30 follicles (eggs) on my right ovary.  Most of the follicles (eggs) are measuring between 15mm-17mm and ideally they want them to be 18mm-20mm so things look great when you consider that most are of the same size right now (not too big - not too small - and growing at the same pace).  I hate this high number though because it's all about quality...not quantity!


To make us all feel a little better I'm going to share another bit of favorite holiday merriness...


While you are sitting next to that Christmas tree relaxing (after an hour of yoga in the dark - go Jess!) and pondering the greatness of all things holiday/hope related...sip some delicious eggnog.  To make it extra-good, here is my special recipe:
  1. Make a trip to Pier 1 Imports and buy a really great mug.  I started this tradition 16 years ago with special friends in NYC.  On the most difficult of days in Brooklyn and Queens when everyone's problems became our own (such is the life of work in the inner-city) friends and I would swing by Pier 1 to lift our spirits with a great new mug.  (Thanks Noelle for the one pictured above!) 
  2. Come home and turn on all muted lighting (tree, tin star, Sentsy candles, gas fireplace, Christmas Story Leg Lamp, etc.)
  3. Retore your Santa candles (pictured above) to their rightful place (more on that later...)
  4. Dock your iPhone to Pandora's Christmas Traditions
  5. Pour yourself a glass of eggnog (I go 1/2 egg nog, 1/2 milk)
  6. Add what you will.  (For me, I prefer a little vanilla and nutmeg. Yum!)
  7. Sit down, put your feet up and think about all that great snow that is piling up outside...

Wednesday, December 12, 2012

So Let It Be Said, So Let It Be Written

Dear New Phlebotomist-girl: 

You should have listened to me when I told you the the left arm, center vein is the only one that will work.  You can't feel it - but it's there.  Deep.  But don't feel bad - I'm used to blown veins by now.  I've just never had six at one time...
Sincerly,  Me

Beyond the minor battle wounds, I'm happy to report that everything else checked out at today's 4th monitoring (blood draw/ultrasound)  appointment.  Estrodial is 548 today so eggs are on track.  25 follicles counted on the left and 11 on the right (the goal is at least two - so yeah, you do the math).  The biggest follicle is measuring 13.85mm and the majority are around 10-11mm, which is good because everything is at a similar growth stage (that means more mature eggs at the same time hopefully).  I'll start the antagonist shot tonight which will mean 3 daily shots beginning tonight.

(For those of you new to the IVF process... you take "Stimulation" shots for approximately the first seven days to grow follicles (eggs) at a rapid pace....and then add an "Anatagonist" shot so the eggs can mature without premature ovulation.)

Mr. Thompson is out of town this week and I have to be honest, although I miss him... I think I may be a little more gentle at giving shots as I don't wind up like I'm throwing a baseball before the needle strike.  Once I get over the fear of actually pushing the needle into my own belly, I surprisingly do pretty well.  (but shhhh don't tell because this is my way of including Mr. Thompson in the process, which he loves).  The progesterone shots in the bum are an entirely different matter however.  Not looking forward to those which will start next week.


On the merrier side of things...

I seriously do have a fetish with beautiful hand-blown glass ornaments.  Love. Them. All.

But I am very specific in my selection.

 There are however, six exceptions currently on our tree...

 The year of love.  This ornament was given to me by my mother as a wedding gift and is the only non-glass ornament we have. (2007)

 The year of healing.  Mia was born 2 days before Colton and I just haven't had the heart to switch a tiny glass pony for our glass Chocolate Lab. When everything was so dark - Mia made it all bright again.  (2008)

 The year of the bagpipes.  This is the year I finally started lessons - a lifelong dream.  (2009)

 The year of the soldier.  My little brother joined the United States Marine Corp and my entire family made memories in California when we attended his boot camp graduation - parents and all eight children. I love my family but I'm especially fond (and extreamly proud) of Little Brother.  (2010) 

 The year of eternity.  Mr. Thompson and I went to our holy temple and became sealed together for time and all eternity.  It was a wonderful time to recommit to our vows and commitments.  (2011)

The year of doing what you love and loving what you do.  This is the year that I made a career change back into Emergency Services, and Mr. Thompson gave up his sleep as firecalls started coming in all night.  I'm so glad that he supports me in everything that I do and love... both personally and professionally.  (2012)

I looked for a test tube ornament for this year but couldn't find one.  If we are really lucky - maybe I'll have a good reason to find one by next Christmas 2013.


I Am Like A Star Shining Brightly...

It's 3am and I'm sitting here by the tree listening to Celtic Women. (side note: in my next life, I'm going to be a River Dancer.)

Mr. Thompson is out of town this week with work which is probably why I can't sleep.  I get used to him leaning his fully body weight on me at night, which really bothers me...until he isn't there doing it.  Funny how that works.

So here I sit.  Pondering.

Out loud.

IVF Update:  At our Suppression Check last Tuesday (Dec 4th) my uterus lining was too thick (7mm) so Dr. H prescribed a progesterone shot (two actually) to get my cycle started and (hopefully) clear things out.  My lining should have been less than 5 mm at that point, so we opted to delay things a few days while they tried to get this thing kicked off right keeping a fresh cycle option open.    The nurses tag teamed me (both taking a side so there was just one giant poke) and boy-oh-boy do those intramuscular progesterone butt shots hurt!  Soooo not looking forward to the day when Mr. Thompson is on the end of that big stick again.

Dr. H really didn't care it it worked or not because he is still not totally convinced that I'll have a fresh transfer based upon my history with OHSS (hyper-stimulation).  If you recall, it was really bad last year and almost landed me in the hospital with a pretty serious condition (and reminds me that I still didn't buy the extra insurance. Duh!).  So his goal of this cycle is good eggs and to keep me away from hyper-stimulation in the process - a difficult task considering how bad my PCOS (polycystic ovary syndrome) still is...but my goal is most definitely a fresh transfer so I needed my uterus to play nice.

Thankfully the shots did the trick and all is well.

I started stimulation injections on Friday, Dec 7th and at my 3rd blood draw/ultrasound yesterday everything is charting on course.  Dr. H has really invested a lot of time into fine-tuning my daily injection cocktail and I have to confess - I love that man.  I'm his only "in-process" patient right now (because he opted to do me independently from the "batch") which means that I could single-handedly screw up his Christmas (for that I am infinitely grateful!).  He is really invested into making this work and has gone above and beyond, multiple times over.  I think that I am his most challenging patient and luckily for me, he's Japanese and loves a good challenge!  Seriously, I'm grateful for such an amazing doctor who is one of the nation's best.

My estrodial blood draws have gone well to this point measuring 24 (1st), 92 (2nd), 259 (3rd) so things are good with the eggs...but I do have 22 follicles on the left and 18 on the right.  No es bueno for hyper-stimulation so we are watching it closely.

As of today, our expected retrieval is next Tuesday, Dec 18th...with a transfer on Sunday, Dec 23rd... and a (positive!) pregnancy test on Friday, Jan 4th.

Fingers (toes and everything else) crossed.


Since my obvious goal is to be a bright, shiny Christmas's bit of holiday goodness comes to you compliments of my favorite shop in Old Town San Diego.  It is the most delightful little tin shop, owned an operated by an old Spanish lady who is the most exquisite craftsman.  The benefit of Little Brother being stationed at Camp Pendleton is that that I get to visit and buy beautiful tin stars... (and if I could figure out how to incorporate tin cactus into my home decor, I'd have a house full of those too).

Saturday, December 8, 2012

In The Quiet Of Time

"Mary kept all of these things and pondered them in her heart." - Luke 2:19

I love that scripture.

Out of all the verses in all of the books, this one is a favorite.  It is a sentence that has always spoken to me in a simple - yet powerful - way.

After all that Mary was presented with in finding out that she, a virgin, would bear the Christ child... what did she do?  She "kept all of these things and pondered them in her heart."

I think that my reaction would have been to question the angel in greater detail, shout the news from a rooftop (or blog), or curl up in a fetal position and cry.

Obviously, I have a lot to learn from Mary.

I think about that every morning at about 5:30am when I wake up and sneak downstairs, turning on soft Christmas music so I can sit next to my tree for an hour or so as dawn arrives.  Pondering.

I think about it again every evening, as I come home and jab a few needles into my abdomen, recovering with a cuddle on the couch as Mr. Thompson and I watch dusk fall.  Pondering.

And what do I ponder?

Probably a few of the same things that Mary thought about in her own quiet, peaceful moments.  Namely, the goodness of my life, God's great love for me and what has to be a very specific plan for my journey - no matter the IVF outcome.

Different - yet same.

My quiet, peaceful moments have come as I've hung stockings...

and garland...

and treasured hand-blown glass ornaments... (still working on some of the windows)


It's come as I've baked cookies and visited neighbors.  As I've made dinner dates and scheduled Santa visits. 

Instead of lamenting on fear, disappointment or sadness like holiday's past,..this year I am more fully committing to the enjoyment of every sight, sound, smell, taste and touch during this - the most wonderful time of the year. 

After all, even an inch of space taken up by fear, sadness or worry, is an inch of space where faith, happiness and peace can not reside.  I've been pondering that.

And I'm determined to take my space back.

I have every reason to hope.  So why spend it being distracted by the unnecessary chatter of life? Especially when that unnecessary chatter distracts me or drags me down.

Not.  Gonna.  Do.  It.

Not this Christmas.  Not with this freshly cleared uterus.

This month, I've traded in for person-to-person contact.  No contest in which one is more meaningful.  I had an actual conversation with a neighbor over cookies; I sent a gift card to help an old high school buddy who is adopting a cancer family this Christmas in memory of his sister who passed away to cancer last month, including a note that told him how much his friendship has meant over 22 years and how proud I am of him; I rang up a friend I haven't spoken to in 15 years but who I instant message with a "love and miss you" every week or so.  I love FB but I realize that quite possibly I've exchanged quality for quantity - meaningful for quick.  And oh yeah - I waste a lot of time making that trade-off.

This month, instead of blogging - I've been journaling.  Under the tree. With an actual pen and paper...uncensored and authentic.  At minimum, it's been more gratitude-inducing.  At maximum, I feel my Aunt Retty smiling.  She became a kindred spirit when I stumbled upon her old journal entry that was written 100 years ago.  As I read about her infant loss, it helped heal me of my own.  Someday - I hope that I can do that for someone that I don't know, yet love.  Chances are, that won't happen through anything I write on Viva la Vida. 

This month, instead of television - Mr. Thompson and I snuggle.  A lot.  Like newleyweds.  And I must a result, I've accomplished in 8 days what I couldn't do in 6 years.  I've finally taught him to love the Greats - Bing, Frank, Andy, Nat.  And even... Kenny Rogers (who in fairness had a good Christmas album in the 80's).  For Mr. Thompson who has had a great allergy to Christmas and all things Christmas related (thank you bad childhood)... you have no idea what has been accomplished.

There was no fight as we put up the Christmas tree this year.  He willingly (dare I say, with excitement) got us in the car, paid the money for a tree (not nary a peep about "waste") and even threw in fresh garland, and a door wreath for good measure when Lil' A and I batted our eyes.  When we got home he didn't forget that it was on top of the SUV and then yell at us after that great scraping sound of wrecked tree and garage door.  He didn't even throw his chain saw on the ground when it wouldn't start.  Instead, he took said chainsaw over to the neighbor's house to help with their stump removal because for the first time ever, it started on. the. first. try. 

Clark Grizwald has arrived. (for which and Lil' A gave me two thumbs up behind his back.)

These are the things that I'm pondering this year.

I have every reason to hope, celebrate, sing and praise... and I'm throwing myself into it fully. Without distraction.  I don't know where that leaves this blog because I'll be honest, it feels kind of nice to just let it all "be".

To keep all of these things and ponder them in my heart.

Merry Christmas.