One Day at a Time

That is the new mantra over here. Just one day at a time. Because looking ahead or trying to plan things ahead during IVF is a joke.

I went in this morning to have my cyst aspirated and to get another blood draw to test my progesterone.

The cyst aspiration went better than expected. I expected it to be horrible. It was extremely uncomfortable and at one point, when they put in the needle, it hurt. The whole thing lasted maybe 15 minutes. It was really surprising how much fluid they drained. After they did a blood draw and I met with my nurse again to go over my tentative appointment schedule in case I was cleared.

Unfortunately right after the procedure they gave me an antibiotic, which was obviously necessary, but made me really sick. My stomach was empty by the time I took it and I started to feel horrible on my way home. Thankfully I ate something and after about an hour and a half I felt better.

After a few work meetings in the afternoon I decided to go to the pharmacy and pick up my prenatal and to pick up my refill of BCP just in case. While I was waiting for them to fill the prescription my nurse called and informed me that my progesterone was at 2.4, and in order to go forward with this cycle it needed to be 2 or lower. She instructed me to start BCP immediately and she would let me know how many days to take it (but probably around 21).

So this cycle is over right as is started. And now it’s back to waiting and hoping and praying that my next cycle works out. At the pharmacy I felt like crying, but now I just feel numb. I know its not the worst thing ever to wait another month, but it’s so discouraging to have things go south literally on day one.

Thank you everyone for the support and nice comments. Much appreciated!

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Game Paused? (Updated)

Infertility is a rollercoaster. There are loops ahead that you just don’t see coming. Road blocks in your path that could derail you at any moment.

Honestly I expected my baseline appointment yesterday to just be a formality. One hundred percent of me believed there would not be an issue. ONE HUNDRED PERCENT WRONG. I have a cyst. The doc called it a functional cyst, and thanks to Dr. Google I now understand that a functional cyst is caused by a follicle that doesn’t property release an egg and seals itself off causing a cyst. I had an ultrasound in December and at that time, no cyst. I have now had two cycles, one on BCP and one not, and now I have a cyst.

So what does this mean? That depends. They immediately took my P4 (progesterone) and E2 (estrogen) levels via blood test. Since it was 5pm the results will be back sometime this morning.

If my E2 is high and my P4 is low, I go pick up another pack of BCP and take them for 21 more days and hope the cyst goes away.

If my P4 is high and my E2 is low, the doc thinks that what I am experiencing right now isn’t actually my period and I have to wait for a “true” period for my body to naturally shed the cyst. I promise you this is my period. This result is the most unlikely.

If both are high, I go on BCP.

And then there is the desired result….both are low. IF both come back low I can go in this afternoon and have the cyst aspirated (drained) and move forward with Lupron tonight. From what the nurse described to me, having a cyst aspirated is similar to what they do for a retrieval. They go in with a needle via ultrasound and drain the cyst (which is on my ovary) by going through the wall of my uterus. The largest difference procedurally between the two is the time it will take, and the fact that I will be doing it the “natural” route…..nothing for the pain. And there will be pain.

There is one other little complication in all of this….my nurse is off today and tomorrow is the only day this week that I absolutely cannot miss work at all for the entire day because my boss is flying into town first thing in the morning and we are touring properties together. That means if my levels come back low I have to have the cyst aspirated this afternoon. And I’m relying on another nurse to help make that happen. It’s sort of amazing to me that they already scheduled out my next three monitoring appointments for next week, but they would not just pencil in an appointment for me today just in case I need to come in. Right now I’m just hoping and praying that the levels come back low and that by the time we have the results there are still appointments available.

This is the kind of anxiety that the fertiles do not understand. Sure I get the big picture. I understand that this may just be a month delay and it’s not the end of the world. Believe me, I get that. But seriously I have been mentally preparing myself for this cycle for a while now. It felt like forever just to get here and now we have only just started and there is already a complication. And even if it works out I still have to go in for a painful procedure, and try to juggle my life and career around all of this.

Deep breaths. Lots of prayers. This may be a long morning.

Update:

The results are in and as it goes with infertility the least likely situation is the way its turned out.  My E2 levels were good and low.  My p4, however, was higher than they wanted.  They like to see anything under 2 and mine was 2.88.

The plan is to retest on Friday and aspirate the cyst as well.  If the P4 level is good I will be able to start Lupron on Friday and Stims on Sunday.  Lots of prayers please!!!

 

Surgery Day

I have never had surgery before, except getting my wisdom teeth out, which was a whole ordeal in itself. Given the whole pre-op “you could lose your ovary” information I stayed really calm. To really put that in perspective you should know I have to take valium to get a cavity filled.

The weekend before we had a BBQ on Saturday where I definitely drank more than I should have, likely just due to nerves.  We spent the rest of the weekend laying low.  I got a pedicure and didn’t eat much because I was instructed to “clean out” my system.  Monday I started my soup diet (a great friend was sweet enough to bring me a pot of homemade chicken noodle) and Tuesday was go time.

My surgery was at noon, which is so annoying with the whole “no food or water” thing.  I tried to sleep as late as I could which wasn’t that late.  We left earlier than we need too, to be there an hour early as instructed.  I was calm, but also not in the mood to just sit around and wait at home.  I wanted to just get it over and done already!

We stayed in the car in the parking lot and listened to some of my favorite Christian music for a few minutes since we were so early.   It always makes me feel more at ease.  Once we went in it all went pretty fast.  I signed in at the front desk and forked over some cash to pay the surgery center.  Thankfully this was actually partially covered by my insurance (a lot of the previous tests/visits are not covered), and I had hit my deductible so insurance kicked in at 80/20.  Even paying just 20 percent out of pocket was several hundred dollars.  L

My husband and I sat in the waiting room for a few minutes and they came to get me.  I am still not really clear why they didn’t invite him into the pre-op area.  Every other person there had a significant other or family member with them.  They did the usual, weight, blood pressure, temp ect.   Then asked me a million questions, and again I got to get all fancied up in a hospital gown.  All of the nurses were so very sweet.  They really made me feel comfortable.  At one point the surgical nurse asked me if I had come alone.  When I told her my husband was in the waiting room I think the pre-op nurse realized she made a mistake and she went to find him.  I am not sure where he had gone off to but she came back and told me he wasn’t in the waiting room (later I found out he went to get food).  The time went really fast and Dr. M came in to exchange pleasantries and ask where my husband was (because it was so awkward he wasn’t next to me!).  Apparently Dr. M. went to the waiting area and by that time he had returned because Dr. M came back to verify that was him by what he was wearing.  Minutes later I was being wheeled into the operating room.  I moved from my pre-op bed on to the table and that was it. My butt hit the table and LIGHTS. OUT.

Next thing I knew I was in recovery finally with my husband by my side.  And I hurt. BAD.  Obviously this part is a little fuzzy as I was coming out of my anesthesia but I do recall being given some crackers and water so I could take a pain pill.  Unfortunately those didn’t stick around in my stomach very long, so the kind nurse gave me some nausea meds in my IV and I drifted off again for who knows how long.

The next time I woke up things were slightly better.  I didn’t feel sick.  I did feel pain.  The very sweet nurse kindly told me that “this would not be a pain free day”.  I sipped a little more water and over the next hour actually started to feel a lot better (relative to where I started of course).  The nurse gave us some home care instructions and said we could go home!  This was great news because it was still before rush hour, and I get motion sick on my best day so sitting in traffic after surgery would probably be a disaster.  My husband went to pull the car up and I hopped in to my sweet ride (ie Wheelchair).  The nurse told me to I should use the bag they had kept my clothes in as a “just in case”.  Good call on her part.  We made it no more than 20 feet before the crazy nausea set in once again.  What a rough ride to the car.  Thankfully since I could lay down in the car on the way home, that part actually was ok and I didn’t feel sick at all.  I finally made it to bed, took a real pain pill, and passed out.  What a day.

Pre-Op Day

My pre-op appointment, which was scheduled with absolutely no input from me, was supposed to be on a Wednesday. Wednesdays and Thursdays are the most inconvenient days for me work wise. I travel every week for work, Tuesday-Thursday. Tuesdays I have some flexibility on what time I leave, but Wednesday and Thursdays are not flexible. Actually not traveling those days involves me trying to find someone to cover part of my job because someone needs to be present to cover it. Thankfully I at least had some advance notice so figure things out, and literally to train someone to cover my spot (also for the time I would be gone for surgery). What a hassle.

At the last minute they changed my appointment from Wednesday to Thursday. At that point it didn’t really matter I guess, because I already planned on not traveling that week. I am more just annoyed that there seems to be very little respect for the fact that people do have jobs and lives to schedule around. I totally understand that my health is way more important, but not having things change at the last minute would be great.

Anyway enough complaining. I went to my pre-op appointment on Thursday, and it wasn’t what I expected (whatever that was). Basically I went back to Dr. M’s office and he explained to me every single thing that could go wrong. I should also mention that my husband was not there with me. His boss was in town so he couldn’t come to the appointment. So there I sat, by myself, while he told me how my cyst might be attached to my bladder or my bowels causing damage, and that the cyst may rupture while they were trying to get it out. Not to worry though. Apparently they just wash everything out. He also said “it’s much easier to remove a cyst on the ovary if you remove the ovary and tube too”. UM WHAT!?! I’m not really interested in what might be “easier”. I would like to keep my ovary if at all possible thanks. I think it was just a poor choice of wording on his part. He did follow his statement by saying “of course the goal here is to have children so we are going to try our best to keep your ovary intact”. So at this point I was officially freaked the F out. I know they have to tell you the worst that can happen, but geez. I then had to sign my life away, acknowledging that he told me the information, and of course that I wouldn’t sue him if one of those terrible things happened to me.

After our fun little chat, it was time to get dressed up in one of those oh-so-stylish hospital gowns and hop back in the stirrups for another ultra sound. If only i could have my lady parts up on the “big screen” every day. And by “big screen” I mean the wall mounted TV in the exam room. Dr. M. confirmed my left ovary was in great shape and I had an egg about to release (it was day 14 of my cycle so it was right on), and my poor little right ovary was still being overtaken by the cyst. He also said from the ultra sound picture he was pretty sure it was a dermoid cyst. Before I left he handed me copies of all of the forms I had signed, three prescriptions to fill, and an ultra sound photo of my cyst. Of course I went home and immediately hung it on the fridge. OR NOT. Do people ask for these things? What is the purpose of having an ultra sound photo of this thing? Again, awkward.

First Adventure to the Fertility Clinic

In late July we went to our first appointment at the fertility clinic. First we met with Dr. M. in his office. We talked about our test results from the tests ordered by my OB, and he recommended a fertility vitamin for my husband, and thought that IUI with clomid was a good place to start for us. Then we went on to the exam. We went into the exam room and I had an ultrasound done. Dr. M started by looking at my uterus, which looked to be normal, then my left ovary, and then…..we got to my right ovary…..and he sort of stopped speaking….for like 3 minutes. It went from being a guided tour of my lady parts to stone cold silence. He started to draw on the screen with his little pen and finally spoke. I had a cyst. Now, cysts are actually really common, but at the time I did not know this. The cyst was on my right ovary and was basically “taking over” reducing my poor little ovary to a slight crescent shape. Dr. M. also couldn’t tell what type of cyst it was, but he thought it was probably a dermoid cyst, or possibly an endometrial cyst. He flipped on the lights and basically said I needed to have it surgically removed, handed me some literature on laparoscopy and hysteroscopy and said someone from his office would call me to schedule, and that was that. Appointment over.

You never really know how you’re going to react to this kind of news, especially when you don’t fully understand it. I think its safe to say, that the first thing I experienced was shock. I will be honest, it was the LAST thing I expected to hear. It never entered my head that surgery could possibly be in my near future when I walked in that building. So my husband and I left, and headed to work. On the way I called my mom and had a very calm conversation about the news. As I parked my car in the lot at work, I think it started to sink in a little more. I got into my office and put my stuff down at my station, and walked up to my boss’s cube. Before I could get one word out something snapped and I started sobbing. SOBBING. In the middle of the office. Poor guy. I have a great relationship with my boss, thank goodness. He swiftly pulled me into a conference room and I absolutely broke down. Hysterical girl crying. How embarrassing! Really how thankful am I that he is such a good guy. Without sharing too many details I told him I had gotten some bad news and I would need to be taking some time off in the near future to have surgery.  He was very supportive, and just wanted to make sure I was okay.  He suggested I take a little time out and walk to Starbucks.  Actually he also offered to let me go home for the day and work remotely for the day.  Eventually I took him up on that after realizing I was getting absolutely no work done.

On my walk to Starbucks I finally pulled myself together. How exactly was I going to handle this workwise? Was I going to tell people details? Or just that I was going to be out for medical reasons. Really you can’t say that to someone you work with every day without them asking questions, and I wasn’t sure I wanted to bust out words like Ovary to my male coworkers. Awkward. I decided I would just say I had a cyst in my abdomen (sort of true) and leave it at that, unless i happened to be talking to a female coworker who was a friend. The response I got was interesting. Men asked no other questions. Women, however (those female coworkers who I did not consider a close friend to fully share), were more apt to ask questions. I actually had one colleague directly ask me if my cyst was ovarian and if I had gotten a second opinion because she was scared they were going to perform a full hysterectomy. She suggested I go to a famous cancer center in Boston before proceeding. The C word was never mentioned by Dr. M. so I wasn’t concerned that cancer or a hysterectomy were a possibility. But really, yikes.

The surgery scheduler was hopeful to get everything scheduled for mid-August. Unfortunately the surgery center didn’t have availability in August at all, so it was set for early September. A week later I got a letter with my scheduled time, three pages of labs to get drawn, and instructions. Part of this letter, however, said that the surgery had to be done in the 6-12 day of my cycle. Doing my cycle math, even with an irregular cycle, there is no way that the date scheduled would fall in day 6-12. Absolutely no way. I was frustrated to say the least. Obviously you have to give you cycle history when you go to the first appointment, so they must have the date of my last cycle start. So why on earth would the schedule for early September?? Well the first few conversations I had with the scheduler didn’t give me the warm and fuzzies about her to begin with, so I decided to email Dr. M. directly and copy her. He assured me with the procedure I was going to have it didn’t matter what cycle day I was on. Great news, but why did the letter make such a big deal about it then!? After that email, it was never brought up again, but just the stress of possible changes was stress enough.  UGH,