I am a dork

I am such a nerd that I have created a separate twitter just for IF-related updates. My twitter username for said updates is, predictably, notaclowncar, so feel free to add me there if you wish (I haven't changed it in the sidebar, and I have the clowncar twitters protected).

Anyway, I keep wanting to tweet IF related things, but I can't because my chezperky twitter acct. is followed by too many real life friends and links to my facebook status... so... I made a separate account.

Because I'm a nerd.

But I'm a 21st century girl and I believe in taking full advantage of the Web 2.0 culture, so there you go!

Off to bed with me.

Oh, by the way, my cleaning lady? Or, ex-cleaning lady, I should say, left me a message saying she'd still like to clean my kitchen for Pesach (at no charge to me) this week. One thing she IS very good at is turning things over for Pesach. Tempting...

Good to Go

SuperNurse called. 

I said, "Please tell me my P4 doesn't say anything stupid today."

"It was 3.8, which"
"Thank G-d!"
"-which means that you ovulated."

"Right.  'Cause I gotta tell you, I've been acting all kinds of irrationally the last few days."

"uh huh.  And so... I'm supposed to say this is... different than usual?"

"Hey now!"

 

Yep, I love my nurse.  She rocks.

 

By the way, there still isn't a mobile in Room One.  I have to figure out what to do about this.  My current strategy of humor and cookie withholding is clearly not working.

 

Also, I peaked in on a bunch of cyclesista blogs from the list of when my IVF#2 started... and realized that right about now?  I should have been going to transfer.  And I'm not.  I'm starting all over.  It made my heart sink a little bit, for the first time.  I hadn't realized that I was a bit bummed about having this whole shebang get benched for a while.  Turns out?  I can't cover *everything* up with my sarcastic wit.

 

I am wishing all of you the best of luck with your retrievals, transfers, IUIs, and two week waits.  I hope every one of you gets a positive result and that I'm the only one left standing.

And Here We Go Again

So.

Here we are again. I have to be up in six hours to have bloodwork drawn to find out if I can start Lupron again for IVF#2 (Take 2) aka IVF 2.1 or whatever you want to call it.

So the bloodwork is simply a P4 check. To see if I ovulated. Because, you know, after all that, and after injecting my buttock with 10,000 units of hCG I just might not have ovulated, right? But I can tell you with absolute certainty that I ovulated. Why? Because I've been snapping at my husband for no good reason since Thursday. My saint of a husband who can literally do no wrong except for about 10 days before my period. Because I've been all sniffly and teary-eyed over the stupidest stuff.

Because I fired my cleaning lady 12 days before Pesach in a fit of rage at her inability to clean my house properly. Which, I should add, is nothing new. She hasn't been actually cleaning my house for about 2 years now (she's been working for me for four). Oh, but Friday morning she asked me for the nine-bazillionth time whether I'm pregnant yet. And I lost it. But I didn't fire her. No sirree. Because that would be stupid. But then I came home to discover that the outside of my oven was filthy and clearly hadn't been cleaned in weeks. So I called and fired her.

Twelve days before Passover.

Yeah. Because that's rational, right?

So I have little doubt that tomorrow Ye Olde Fertility Clinic will call and tell me that I have most definitely ovulated and that I am set to start the evil drug (Lupron) on Wednesday. And I should expect my period on, oh, about the most stressful day in the universe (next Monday or Tuesday). You know, right before Passover.

Did I mention that I fired my cleaning lady?

Twelve days before Passover?

And right before starting IVF #2 Take 2?

Yeah. If Ye Olde Fertility Clinic even tries to suggest to me tomorrow that I have not, in fact, ovulated yet, well, let's just say that heads will roll!

And.... canceled

• Trigger shot tonight.
• Bloodwork in a week to check my P4 (you know, to make sure I actually DID ovulate. Because with 10,000 units of hCG in my system, you know, I might not. Because this is ME!).
• Start Lupron April 1 (April Fool's, anyone?)
• Expect period... oh, around April 6th or 7th.
• Probably return for Lupron Evaluation around April 8th.

Er, at least we think.

What doesn't jive is that SuperDoc had said something about there being three weeks involved somewhere. But my nurse doesn't have any idea what he's talking about. So for the moment, she's going with the theory that I'm starting Lupron April 1 (this part we're clear on) and then waiting for my period and doing a new LE and getting this show on the road.

Um, except Passover starts the night of April 8th. So... starting stims April 8th? Not the best timing...

Frick.

And now I need a new label... do I call this upcoming cycle IVF#2 again since well, IVF#2 never actually came to fruition? Do I call it IVF#2.5 since it's not quite exactly the first time I started out trying that cycle? Do I call it IVF#3 which seems disingenuous since I never made it to the IVF part of IVF#2? Help!

Closer to Cancelled

Not to be confused with "Closer to Fine".

My lining, she is not wafer thin - she is 10.1mm and I have a lovely 18.6 follicle. Or maybe it's a cyst. But it's probably a beautiful follicle. We'll see what my estrogen is, but either way, it probably means triggering tonight and starting Lupron again in 9 days.

Dr. C. was covering monitoring today. I told him that the last time I saw him was when he was standing there, mouth agape while M (sonographer extraordinaire) was telling me there were three in there. "Oh my, was I the one who gave you that news?" Yep. Well, no. It was actually M. But yeah. He was the doc that day. And actually, I've seen him since, but I think only in passing. We had a lovely little chat and I showed off pictures of my kids.

And, of course, I delivered sour cream chocolate chip poundcake. Because I rock.

Not *quite* Cancelled... Yet.

Well, my E2 level didn't go up as expected, which probably means those two gorgeous follicles aren't as gorgeous as they look. Typical for me. Whatever.

My E2 level was 98.3 (down 0.7 from Tuesday, but essentially that means it's stabilized, not that it's gone anywhere). My P4 level was 0.75. So I'm not gearing to ovulate any second as SuperDoc had feared, and I get to stay on the Lupron through the weekend and return on Monday (Lucky Me!!). The likelihood is still that I will ultimately end up cancelling this cycle, but I guess we have to give it the old college try, right?

Of course, right.

Anonymous asked if I could try the old fashioned way since I've got those two follicles hanging out - there are a couple answers to that question:

1. The first is, the two follicles are both on the left side, which was the tube that was blocked in my last HSG. Assuming that wasn't a fluke - that would preclude them being useful.
2. Assuming the blocked tube WAS a fluke, I'm not doing anything at this point that involves two follicles on purpose. If you think I'm being extreme, that's fine, but I'm dead serious. I am petrified of ending up with twins - my perinatologist scared the crap out of me in December when I saw him and he made it clear that a twin pregnancy is not an option for me.

Tagging along with that question, Anonymous asked if, in light of this development, whether it would make sense for me to try on my own for the next cycle and see if I ovulate all on my lonesome. A few thoughts:

1. If anovulation alone were my sole problem, sure, maybe. But it's not.
2. If I were uninsured and needed time to pull together money for a cycle, sure. But this cycle is already paid for. My portion of this cycle has already been paid for, it's just being deferred until whenever we DO get started, so the money has already been set aside.
3. I ovulated every single month from the time my HOMs were 6 weeks old until they were about a year old. Then I started spreading out to about every 6 weeks. I used no birth control. I even did my best to, um, make the best of our... timing. I did not get pregnant in that entire time.
4. If there were something inherently healthier about getting pregnant spontaneously vs. via IVF, then sure, maybe there would be some advantage to waiting another month just to see. But aside from slightly lower birth weights in IVF babies (even singletons), there doesn't appear to be any inherent health differences in IVF babies vs. spontaneously conceived babies. So why wait?
5. If I *am* ovulating on my own, I can just as easily TTC spontaneously later, after I don't have insurance covering my cycles, as I can right now. So what's the difference?
6. What SuperDoc implied to me was that it is, oddly enough, the Lupron itself responsible for my response so far. His words were that sometimes in women you get the opposite reaction to the Lupron than what you're hoping to achieve. Note, I'm not so sure about this one, because, honestly? I sort of started tuning him out right around the time that he started making fun of me for always being opposite girl.

Anywhozit, it's just more fun for me. A girl's gotta get her Lupron fix somehow, right?

Stupid Body

Yeah, um, hello? Stupid body. Per SuperDoc, "Sometimes on Lupron you get the opposite effect that you're hoping for... What I was afraid of last time was that you're ovulating on your own despite the Lupron." Meanwhile, M (Sonographer Extraordinaire) was frowning. "She's thickening..." (referring to my endometrium, damn that endometrium!)

Seriously, how does this happen? I can't manage to ovulate on my own without the ovary-suppressing Lupron. Now I'm using Lupron to beat my perky ovaries into submission and what happens?? Goodness!

So instead of my endometrium staying wafer thin, it has thickened by .4mm. That may not seem like a lot to you, but it's enough to make my doctor frown and the student that was with him shrugged her shoulders in exasperation also. Oh, and my beaten-into-submission-non-perky-ovaries?

Riiiiiiiiggghhhhhtttt!!!

Two, count 'em, Two perfectly formed, gorgeous follicles. 12.4 and 14.7 mm follicles.

No numbers back on the estrogen level yet, but odds are good that it's gone up, not down. So the answer is to trigger with the hCG shot and then re-start Lupron 9 days later and then I'll come back for a re-check 2 weeks later. So we're looking at about a 3 week delay. Whee!

On the other hand, did I really want another summer pregnancy anyway?

More Thumb Twiddling

I have another go at my Lupron Evaluation in the morning. I have a weird feeling that nothing will have changed, though I'm not really sure why I feel that way. Le Sigh. Stupid body. Stupid Lupron. Stay tuned...

Exhaustion

Wait, does Lupron make you beyond exhausted?

really?

About that Assisted Hatching

By the way, it turns out the reason I had assisted hatching was because I had a Day Six transfer. Apparently, they do Assisted Hatching on all day six transfers. Standard Operating Procedure.

So... no dramarama. Nothing particularly wrong with George, other than he was a slow grower who, well, wasn't particularly userful in the end. But that's okay - his siblings weren't particularly useful either, were they? Sorry, George. Not trying to diss you or anything, but you really didn't hold up your end of the bargain, did you?

Thumb Twiddling

Not much to report on the fertility front. My head is pounding AND I have a toothache. This is not making me very happy. I am not thrilled about this development. But the toothache, I'm sure, has nothing to do with my fertility (or lack thereof). Though it might have to do with the fact that I'm constantly clenching my teeth from the throbbing in my head. Sigh.

Still hate Lupron. Shocker.

Received a good response from RESOLVE after I wrote to them asking if they knew anything about the Maryland Personhood Amendment:

---
RESOLVE has a policy statement on Personhood bills and amendments, and can be found here:http://www.resolve.org/site/PageServer?pagename=ta_pap_personhood

There are actually about 13 states that have some level of Personhood legislation in the works. To be honest, we have heard from a number of sources in Maryland that this bill will not go anywhere, however, we really should update our website and let folks know what is going on. We have a very small staff and with so many states taking action on a variety of issues we have had to pick and choose how we spend our time. We have been working on 2 other bills in Maryland that improve the current insurance mandate, as well as other bills in GA and MO that are directly affecting infertility treatment. If we get information that a bill is not going to go anywhere, we know we can put it aside and the outcome will still be favorable. I realize that is not going to please everyone, but all of our advocacy work is done by me and a handful of volunteers scattered around the country (about 3-4 people). I don't have any designated staff person on advocacy, and I try and do the best I can while running the organization as well. The legislative session can be a very busy time for us - especially this year with so much outrage regarding the Octuplets and now the personhood issue popping up in more states.

Thanks again for contacting RESOLVE. If I find out any further information about this bill I will let you know.
-----

Other than that, not much going on here in boring Perky-land.

Ninety Nine (edited, twice)

What? No, really, WHAT?

99?

That's my estrogen level. Seriously, when I'm not on Lupron and I have actively growing follicles, I barely have estrogen that high.

Now I have the most boring looking ovaries I've ever seen, I'm on 20 units of Lupron a day, and... what? My estrogen is double what it needs to be?

Stupid body.

No Follistim or Luveris tonight. No dropping the Lupron dose in the morning. Status Quo for now. Return for re-check on Friday. Yeah. I can't believe I failed the Lupron Eval. Man.

Edited to Add: Shit, wait, you don't think it was the Nectar of the Gods, do you? Seriously, I really only had one a day. Once I had two in one day. But seriously? One 12 ounce can a day can't have done me in. Could it?

Edited, Again: Yes, it could potentially have been the increase in caffeine level that affected my estrogen level. I will note, however, that I drank probably 4-7 cans of coke per day while doing my six IUIs and never had any affect on my estrogen level. Admittedly, back then I simply had a constant blood level in my caffeine stream. Perhaps I am more sensitive to caffeine now than I was then, since I nearly never drink caffeine anymore (I don't ever drink coffee or tea and I hadn't had a coke in months before the last couple weeks). Should I ask my doctor about it? Meh. Possibly, but I'm simply going to cut out the Coke and suffer through the headaches until Friday.

As for whether I need another re-check before Friday - not really. He's leaving it until Friday to give the Lupron more time to work. The only reason to get a recheck before Friday would be if there were serious concern about over-suppressing me between now and then, and there is not that concern. It's just a few more days lost on my schedule, is all. But all that means is that my beta isn't going to fall on Pesach - which it was going to do before - so now at least I won't have to push that off. Right? See? Silver linings all around.

Then They Came For Me

When the Georgia Senate Bill 169 was introduced, a friend of mine asked me why I was so up in arms about it. "After all," he said, "You don't live in Georgia. It doesn't affect you."

Doesn't affect me? Really? First, I don't believe it's true that just because I don't live in Georgia the bill doesn't affect me. But even if we postulate that it's true that it doesn't affect me - does that mean we should sit idly by while other states create laws we believe to be morally unacceptable?

What of Martin Niemoller's words:

First, they came first for the Communists,

And I didn’t speak up because I wasn’t a Communist;

And then they came for the trade unionists,

And I didn’t speak up because I wasn’t a trade unionist;

And then they came for the Jews,

And I didn’t speak up because I wasn’t a Jew;

And then . . . Then, they came for me . . .

And by that time there was no one left to speak up for me.

While I admit that in most cases, I'm content to sit back and let others do my work for me. For the most part, I'm willing to let people far more competent than I be the indignant ones. I am not an activist. I am not a take-charge person. Heck, I failed at even Taking Charge of My Fertility, for crying out loud. But when Georgia introduced SB 169 something in me simply... snapped.

And now? Maryland? Gah.

Maryland hasn't done anything nearly as drastic as the garbage that Georgia pulled. They've done something far more subtle, and (in my opinion) almost more dangerous. Maryland has introduced House Bill 925, the so-called "Maryland Personhood Amendment," a bill that would amend the Maryland Constitution "to establish that the right not to be deprived of life is vested in all human beings, irrespective of age, health, function, physical dependency, or method of reproduction, from the beginning of their biological development."

This amendment would, essentially, give a fertilized egg legal rights.

This would lay the groundwork to ban abortion in Maryland, should a federal ban on abortion ever be lifted (with the current make up of the Supreme Court - I wouldn't be shocked to see the already shaky Roe v. Wade fall). It certainly could lay the groundwork for restrictions on abortion to be put in place in the state.

And - it could lay the groundwork for legislation limiting access to emergency contraception, etc. Imagine that.

Closer to home - it could also open the door to legislation like the Georgia bill which limits on ART and human embryo stem cell research. It could even affect laws surrounding embryo adoption/donation.

NARAL has a form that you can fill out (if you live in Maryland) to send a letter to your delegate protesting the bill. Or, better yet, you can email your representative in the Maryland House of Delegates. You can find your representative in this list.

I know there are plenty of you out there who will disagree with me. And I'm okay with that. I do believe that two adults can disagree and stay friends. Please do feel free to respectfully disagree with me in the comments section. But hateful comments will be removed, please understand that. Any, and all, respectful comments are welcome, regardless of whether you agree with me.

Lupron Eval and Fudge Delivery

Okay, so? How many of you thought I was wrong and there would be a mobile in Room 1 today? How many of you had more faith in Dr. S. than I did? Admit it! Well, you would all be wrong. Wrong, I say! He's off on a cushy vacation on some tropical paradise while his patients lie bored on a table staring at... a blank ceiling. Seriously.

What. Is up. With that?

Dude. Seriously? There are going to be serious consequences for this - and I don't just mean that he didn't get fudge today. I have on good authority that my fudge was pretty damn awesome, though I admit I wouldn't know myself. But no fudge for him!

Now to think up some appropriate consequences for him.

And now on to the fun stuff. My lining is nice and thin (5mm)- I'm told this is a good thing. Truthfully, I'm a sucker for data, and as much as I hoard it, this is one piece of information I've never paid much attention to - the starting lining thickness. I've never really much cared about it. Mine's always been fine and I've never much fretted about it (though I remember once or twice it was alarmingly thick... but whatever... it thinned out soon enough, so it was all good). Somehow very little about the whole fertility/IVF process feels intrusive to me anymore. But there's something about this doctor telling me the thickness of my endometrial lining that feels awfully... up close and personal. I know that sounds ridiculous. There I am with my legs up in stirrups, chatting away about mobiles and whatever. I've appeared on the local news, and spoken with a reporter for a national newspaper about my fertility issues. I write a blog about my daily cycle details for crying out loud. And yet, the thing that feels up close and personal is the thickness of my endometrial lining?

Go figure.

Anyway, whatever. My lining is good, my ovaries, they are quieter than I've ever seen them. Not so perky.

Much fudge was delivered. And I even delivered an adorable gift to my nurse. No, really!







Does it get cuter than this??






My nurse was already having a really tough day, even that early in the morning so, it turns out, I made her day. Go me. And the fudge was just a bonus.

"Admit it," I said, "You don't have any patients as cool as me."
"No way!"
"Aw, you're not just saying that are you?"
"Definitely not!"

Anyway, unless I hear otherwise from her, I'm to start Follistim 166IUs, and Luveris 50 units tonight. And tomorrow! Tomorrow! (I love ya, tomorrow!) I drop the Lupron to 10units! (You're only a Day! A!Way!)

(cue orchestra)

Ahem.

On a more serious note, Maryland sucks. Stay tuned for why.

Nectar of the Gods

It's possible that some of you have been reading various iterations of my blog long enough to know that there was a time that I had quite the affinity for Coca Cola - herafter referred to as the Nectar of the Gods (or, simply, The Nectar). In fact, I was quite offended to discover during my pregnancy that it tasted disgusting to me, and a few of you found out the full extent of my loyalty to The Nectar when you foolishly suggested that That OTHER INFERIOR so-called-Cola product *cough*pepsi*cough* might be a reasonable substitute.

Well, since then I really haven't had much Coke in my life. Though I could say in all honesty that I was a full-blown Coke addict (not THAT kind of coke, silly! The yummy caffeinated cola kind!), I really don't touch the stuff all that often anymore. Now, it is simply a special treat now and again.

But here's the thing!

I have discovered a very important use for The Nectar. It turns out that caffeine actually is the one thing that actually helps these stupid Lupron headaches. Um, well, a little bit, anyway. Look, I'll take ANY little tiny bit of relief I can get, okay? Mel was actually the one who told me that caffeine would help Lupron headaches. "But," she cautioned, "only if you have enough caffeine that it raises your estrogen so much that it sort of defeats the purpose of the Lupron." So not really a good solution.

Obviously caffeine wasn't a good option. This cycle, I happened to have a Nectar one day when I was in the middle of a terrible Lupron-induced stupor/headache and while the headache was still horrifically bad, it DID take the throbbing out of my eyeball, so it no longer felt like I had a jackhammer slicing through my right eye. Definitely an improvement. I have, therefore, felt absolutely no inhibition about drinking a coke or three per day since then. Go me. (I'm kidding about the three)

That being said, yesterday I found a far more effective way of avoiding the Lupron headache. Yep. I forgot to take my Lupron until mid-afternoon. By the time I took it, I'd already had a Nectar, so I didn't get a headache right away. The headache hit me in full force at about 3am. Getting out of bed this morning was nearly impossible. Today's headache was far worse than usual and no amount of caffeine was going to help it. My Nectar had failed me.

There is, however, light at the end of the tunnel. Tomorrow should be my last day on 20 units per day. I have my CD2 monitoring appt. and I should start Follistim and Luveris tomorrow night and then drop to 10 units of Lupron Wed. morning. Plus, with higher starting doses on the stims, my estrogen level should go up faster, so the Lupron headaches should subside faster regardless of the drop in dose. So it's all good. Right?

Last order of business - who wants to place bets on whether Dr. S. has gotten a mobile up in Room 1 yet? I'm betting on a Negatory.

No fudge for him if he hasn't gotten it up yet. I made fudge for everyone else though. With nuts.