Breakdown

It happened. I had my first official breakdown this morning, in my OBs office. Yup. That was me. The crazy lady crying in front of a stunned OB. This breakdown was several days in the making, and as KG said when I called him after the appointment, "It just sounds like you had a cry inside you needed to let out." Apparently so. This is a long one, so get comfortable.

Let's back up.

Over the last week, I have been feeling tremendous pressure about finding child care for The Nugget. I had 3 people in the span of as many days ask me the dreaded question, "Have you looked into child care yet?" Cue. Panic. Even though, to me, it sounds totally insane to look at day care when you are 15 weeks pregnant, apparently in Boston it is totally necessary. I started googling, talking to friends, and making some phone calls. Indeed, several places said that now is the time to look for September 2013. Yup, over a year in advance. So, I made some appointments to visit a few places in our area. Oh, and guess what else? You need to be ready to cough up nearly as much money per month as our rent for full time infant care. Again, cue panic. Since staying home is not an option for me (or KG) this is the reality. We'll just have to suck it up and eat ramen for a while.

So there's that.

I'll preface the next bit by saying I am a person who likes direct instruction. Don't make me guess what I should do. Just tell me exactly the right thing to do and when to do it. I follow directions like a champ. Teachers tended to love me for this reason. I generally did exactly what they asked, in order to get a good grade. Open ended assignments? That's another story.

On to today's appointment.

I saw the OB we met last month. Again, she was a bit late (30 mins) but was warm and friendly. All started well, with my uterus measuring just right and The Nugget's heartbeat sounding loud and strong. She said my blood pressure was "on the high end of normal" but that might have been from feeling annoyed that she ran 30 minutes late. Anyway, she told me not to worry about it (then why tell me?). Then, she asked if I had questions. She didn't know what she was in for.

I started off by asking about why my ovaries are still quite large from IVF (they mentioned it at the NT Scan). She kind of brushed it off saying it would go away after the baby and they wouldn't do anything about it now. I'm okay with that I guess, but it did leave me wondering.

Then I asked about exercise. How much should I be doing? For how long? Again, I felt like I got vague answers. It started out okay. She said I should be exercising every day (holy shit!). Then, I got the standard, "Don't do anything that makes you uncomfortable, breathless, too hot, etc." Okay, that's all fine. But, when I pushed her to tell me how long each day, etc. I got, "Whatever feels right." If I knew what felt right, I wouldn't be asking. It feels awfully right to sit and watch Real Housewives instead of going to the gym.

Next, was the heaviest topic. I've written before about the fact that I am on prescription medication for anxiety and depression. I am on very low doses and have consulted my psychiatrist and two years ago (when we began TTC) I even went to a special clinic that deals exclusively with pregnancy and psychiatric medication. At the time, everyone recommended I stay on my medication, even though they are Class C, because the risk of having a depressive or panic episode was overwhelmingly likely, especially postpartum. The research generally shows that the risk to me outweighs the risk to the baby and that the chemicals that the body of a depressed mother releases can be more damaging to the baby than the meds. They also said the amount passed through breastmilk is less than through the placenta, so it shouldn't be a problem. But, I wanted to make sure this OB is on board and that breastfeeding will not be an issue at the hospital. Now, I know this is a complicated issue and honestly the research sucks in this area because they aren't randomized studies. It may not be a clear cut issue at all. But again, instead of giving me a straight recommendation, she wants me to meet again with the clinic. I asked if she has other patients with this issue (she does - many) but she said it is all dependent on individual circumstances, etc. This is all true. But FUCK, I just wanted her opinion and she just wouldn't give it to me.

Then, it happened. I broke down in tears. I didn't see it coming and still don't really know why I went over the edge. She was stunned and thrown by my reaction, as was I. She babbled a bit and I agreed to make the call to the clinic.

Lastly, I decided to press my luck and ask about nutrition advice. Are there specific food groups I should be focusing on more than others? Protein? Calcium? I have all the books with some of this info, but I wanted to know from her experience if she considers some things more important than others. What did she say? I should go see the nutritionist. Another appointment. Another question unanswered. I think I'll just make a greater effort with leafy greens.

Did I mention I am meeting tomorrow with an endocrinologist because she didn't want to tell me when to go off Metformin (for PCOS, not insulin issues) without his opinion?

No one tells you how scary all this pregnancy stuff is. The thing is, I am petrified that I'll do something wrong with this pregnancy, that I'll personally make a choice that will harm this baby. And it seems that with so many of these pregnancy-related things, there is no one right answer. There is only making "comfortable" choices or doing what "feels right." Apparently this is true from everything from choosing a car seat to the question of getting an epidural. For someone like me, that is just about the worst thing I can hear. How the hell do I know what's right if I've never done this before?

Are all OBs like this? Do they all refer you out for tough questions? Are they only good for listening to a doppler and measuring your uterus?

Hell, I have a doppler at home...

By the way, today didn't start off like this. It's actually a really happy day: KG and I have been married for 7 years as of noon today. We are going to a fab restaurant to celebrate later and shake off this mood. Happy Anniversary, KG. You are the best partner to this batshit crazy lady I could ever ask for.

I'm here...

...trying to expose only a few people to the level of crazy that is happening in my head this week.

Trust me, you'd thank me if you knew.

The RE's office wouldn't let me come in early to do the beta, so I am still waiting until Friday to see what's what.

Let's just say, the Fabulousness household should have rubber walls right now. I'll post more about the details of this week in a few days. Seriously, I forgot what the effect of the TWW is like, because I really haven't had the opportunity to have a true TWW in a very, very long time.

Oh, and so much for how well PIO shots were going. The shots have now created MAJOR knots at my injection sites. Not only are they painful, they freak me out a little. Yes, I am using heat and massage, but it looks like I'm just lucky that way. I mentioned the pain to my acupuncturist, who quickly fit me in today. That woman worked some magic, because they are quite a bit smaller this evening than they were this morning. This is the closest I've ever come to being able to "prove" the value of the money I'm spending on treatment.

Only another day and a half to go.


By the way, a big, big congrats to Belle on her BFP. Congrats lady!


Now, back to the Bruins playoffs.

Random IVF questions for my bloggie buddies

Since I have never made it to transfer before, you'll have to excuse all these really practical, boring, detail oriented posts I've had going on the last few days. This one is no exception! :)

Could IVF veterans answer these for me please?

1. When we do the PIO shots (KG is a pro - these haven't been bad for me), I get a little bit of oil that leaks out...are we doing something wrong?
2. Do I really need to drink 32 ounces of water for transfer? Would 20 do? I'm afraid I'll burst before the procedure!
3. How many of you transferred 1 embryo? The doctor is emphatic that if we have any to freeze, we should only transfer 1. This makes sense to me because I am not prepared for twins at all and multiples carry a higher risk of preterm labor. But, as many of you know, it is a difficult choice.
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As of today, 15 of our embies are 6-8 cell, and "perfect" according to my doctor. This is exceptionally great news.

So, why am I still so scared something bad will happen?

I rock + a little riot girrl action

I have not felt this good about myself since I learned to tie my shoes. I managed, for the first time ever, to give myself my own injection. I had no choice (aka I was waiting on the school nurse and she was running late) but I did do it. Therefore, I am awesome today.

On that note, I was a huge fan of riot grrl bands in high school. A more famous examples was Hole, but less famous (and far better) examples include bands like Bikini Kill, Bratmobile, L7, and my favorite, Sleater Kinney. All that music made me feel powerful when I was a teenager and it still does to this day. Here is a rockin' example that will leave you drumming on your desk. Here is Sleater-Kinney's "Little Babies." Enjoy!

Back to the Grind

Any teachers out there?

If so, you know how it goes when you return to school after winter break. Any hopes I had of slowly readjusting were dashed within a few minutes of the kids walking in the room! My teaching partner and I quickly got overwhelmed as we looked at our plan books and realized that we needed to quickly plan in a ton of assessments for upcoming progress reports and get several major curriculum projects kicked off. To those not in the classroom, this may sound like minor issues. But, when the tasks involve 26 children, it is daunting.

You know those progress reports I mentioned? I teach in a private school, so those progress reports involve very long narratives, bulleted strengths and goals in every subject, and checklists of skills. Altogether, I write between 12,000-15,000 words when all is said and done. The parents are paying major bucks for tuition, so they expect lengthy and detailed information on their kids. Although I feel like writing the reports is a major strength of mine, it takes at least five days of writing, spending 5-6 hours at a time at my laptop, on top of the prep time to review my notes and samples of their work. Not to mention correcting new work as it comes in.

All of this, on top of actually teaching my classes, tutoring, and doing normal administrative duties.

Needless to say, even in my seventh year of teaching, I get really stressed in January.

I suggested to my dad that he buy me a massage, to alleviate said stress. He agreed! I go in at noon for a 90 minute massage.

I. Can't. Wait.

Needless to say, my blog might be neglected over the next 10 days or so.
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So, in IVF #1 news - here is the latest:
• His Royal Fabulousness (aka KG, because I am lazy) and I met with my RE's nurse for a lesson in all my meds. It was really helpful to watch her mix meds and such in front of us. She commented on what a relaxed, non-squeamish guy he is, and I had to agree. I don't know what I would do without him giving me these shots.

• I start Lupron tomorrow morning. On days I am home, KG will do the shots. On school days, my school nurse will do them. She has three sons from IVF herself! I stay on Lupron through the last several days of BCP (last pill on Jan. 12th) and then get a period while on Lupron.

• On Jan. 17th, I have a baseline ultrasound and bloodwork scheduled, then I start Gonal-F and Menopur the next day. I wish I had asked why I can't do an ultrasound now, to make sure the cysts are gone, before I start Lupron. Anyone know the answer to why they have me start Lupron first?


• I do stims and Lupron until my hcg trigger (aka BIG ASS NEEDLE #1).

• Egg retrieval is the day after, with embryo transfer either 3 or 5 days later, depending on how the little suckers fertilize. Can't wait for transfer. Transfer = valium.

• Fun progesterone in oil (PIO) injections start after transfer, along with estrogen patches, antibiotics, steroids, and other fun stuff.

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KG said the sweetest thing the afternoon of our meds lesson. In the most earnest way, he thanked me for being willing to go through all of this to make our baby. I'm telling you, that boy melts my heart sometimes. You should have heard the sweetness in his voice.

Now, if that sweetness could include him giving up alcohol with me this cycle, THAT would be something.

So, although I am not excited, I am feeling like it is time to get this show on the road. I'm as ready as I will ever be.

Holy medication delivery, Batman!

Holy. Shit.

I got my shipment of IVF meds nice and early (starting Lupron on January 8th!) and nearly had a heart attack. I don't even know what some of these meds are!

Here is what came today:

Gonal-F (my old friend)
Menopur
Doxycycline
Leuprolide Acetate (Lupron, right?)
Pregnyl
Progesterone for PIO injections
Vivelle patch (?)
Cefoxitin (?)
Methylprednisolon (?)
Diazepam (Yes!!!)
and an assload of syringes, some scarier than others.

I will be given lots of instructions when we get closer to starting the meds, but if any of my IVF veteran readers can tell me what (?) meds are for, that would be very helpful.

If only they could triple the dose of diazepam, I would be all set.

In other news, I haven't seen the Sporker for the last two days and we leave for Aruba on Saturday. Joy!

Needles

I am no fan of needles. Never have been. This began when I was 8 and had my tonsils out. I was scared to begin with, and the sadomasochistic nurse put the IV in my hand without numbing it first.

In adulthood, although I always get blood work when I need it, I always have intense fear. I have to look away, breathe deeply, and avoid the humiliation of passing out. Sweating and crying are common.  To make matters worse I have had several inept nurses try to draw blood and leave me with bruises. They tend to blame me for this problem. Occasionally, I have a gifted phlebotomist or other medical professional who has no trouble at all.

Then, when I went for my first D&C after the miscarriage, I had a horrific IV experience. The nurse who was assigned to me tried to get the IV placed TWICE without success. Each attempt included an injection of numbing agent first. That means 4 needles later, and the IV was not placed. Finally, another nurse is able to place the IV. That means it took a total of 6 pokes. 6. 

So, needless to say, I have needle fear. This wasn't helped by the fact that my last blood draw at the RE's office did not go smoothly.

But, after months of setbacks, we finally got the go ahead to start injectable medications, leading to an IUI. This is good news. There is a much higher chance of the treatment being successful than anything we have tried yet. But, then there is the needle.

The first night, after watching the YouTube videos reminding us about how to give the shots, I sat with the syringe in my hand shaking. I tried over and over again to give myself the shot. The inner dialogue went something like this:
"Real women don't need a man to give them the shots."
"I should be able to do this! This will help get us a baby!"
"That needle is huge." (It isn't.)
"How the hell do diabetics do this?"
"Would my stomach or my leg hurt less?"
Etc. Etc. Etc.

Deciding I couldn't do it myself, I handed the needle over to Kev. We started a count to 3 several times. I couldn't seem to get to 3. After 2 venue changes, and much whining, he said, "This is going to happen one way or another tonight." So, after 30 minutes, while hiding my face, we counted "1.....2......3!"

Then....nothing. It didn't hurt. I barely felt it. But what I did feel is like I am an idiot.

But, somehow, the anxiety ramped up even more the next day. In my head, I knew it wouldn't hurt. But, that irrational fear just took over my brain. I started to really wonder if I could ever do IVF if I need to. From many infertile friends, I know THOSE shots are horrific. However, that night, although I shake and fuss, I allow Kev to get the shot done in half the time. Progress.

The third night, I make a major breakthrough. After prepping the shot, I looked at hubs and said, "I'm counting to 3. Just do it."

2 minutes. Done.The ensuing nights are similar.

I might still be lame for not doing it myself, but I'll take bravery in little bits and pieces.