It's the drugs, I swear
In four days I start Lupron. In my mind, though, the cycle is already well underway. I'm already wound more tightly than...than...some excessively tightly wound thing...and obviously already suffering from the breathtaking cognitive lapses that plagued me last time.
Last time around, nobody told me that the worst side effect from all my medication would be that I'd lose my fucking mind. The drugs really should come with a warning label: While using this drug, patients should not operate heavy machinery. Or shower.
A quick flip through my journal reminds me that not only did I take the car up two one-way streets, jumped the curb at least twice, burned myself on the iron, nicked my hands with a chef's knife, grated my thumb into a pile of Parmesan cheese, and set off the smoke alarm so often it sounded like we were at DEFCON 2, I also apparently forgot how to use toiletries.
The documentary evidence seems to show that one morning in the shower, I shampooed my hair as usual, rinsed it, and picked up the conditioner...which I then dispensed into my hand and proceeded to rub all over my body. I couldn't figure out why it wouldn't lather.
Five minutes later, I applied hair product to my face, for that bouncy, manageable look that turns heads on the street.
"And I can't be sure," I wrote on February 21, "but I have the strong
aroma suspicion that I applied deodorant only to one (1) armpit."
Stuck in the middle with you
I just performed the inaugural injection of this, my second IVF cycle. Even as we speak, the Lupron is coursing through my veins. I am imagining myself as the Incredible Hulk, with my clothing hanging around me in fashionable tatters as the bloat and the emotional upheaval turn me into a raging green-skinned beast.
Don't make me hormonal. You wouldn't like me when I'm hormonal.
(Assuming you'd like me otherwise.)
The worst side effects I had from the Lupron last time were occasional headaches (and I think the worst one was actually a bit of a vodka hangover). As long as I remember to drink more water than usual, I should be fine.
The actual injection was nothing. The shots don't bother me — at least not until later in the cycle, when I run out of virgin flab to pierce. I've found that my inner thighs and abdomen are the most hospitable territory — very little pain there, unless you get too close to the navel. None of this candy-assed icing the area beforehand, or warming the syringe, or daintily swabbing on numbing cream, thanks. The pain's no worse than an insect bite, and certainly not worth complaining about when you consider the big picture.
I'm somewhat concerned that in our attempt to create more eggs we're decreasing the Lupron as opposed to increasing the stims as I thought we'd discussed, but I am trying very hard to turn off my brain and let my doctor do the thinking. I grudgingly admit that he probably knows a tiny bit more about manipulated reproduction than I do. My ovaries are merely putty in his competent hands.
For the first time today the acupuncturist stuck needles in my face, a veritable bouquet of stainless steel sprouting up between my brows.
As the first one went in, I vanquished the temptation to yell, "Ow! My third eye!"
You can tell how committed I am.
On your marks...
This morning I went for my baseline ultrasound and bloodwork after ten days on Lupron. We expected to see no follicles developing on my ovaries, and my estradiol level needed to be below 100.
All quiet on the ovarian front, and my E2 has been effectively bullied down to a timid 24. We're cleared for takeoff.
I'm starting stims tomorrow and will go back on Tuesday to peer into the murky cavity of my abdomen once again.
Day 2: Mental block
Day two on stims, and my right ovary is already complaining. It's been sending up indignant twinges since this morning.
Even so early, this cycle feels very different to me. I have a definite mental barrier that's making the injections more difficult: I sit there and poke myself gently with the needle, reluctant to just shove it home. Once it's in, I press the plunger slowly, instead of resolutely sending the medication off. At some level I'm feeling a real resistance to going through with it this time, and that's very different from before.
Day 6: Team player, my ass
This morning's scan wasn't promising. I've cried all day, leaking tears since I left the hospital. I even cried through acupuncture. The tears ran into my ears, and when I tried to wipe them I dislodged several needles protruding from my cartilage. (The acupuncturist was very kind, offered some thoughts about loss and unfairness. I hate to say it, because it's not like me to neglect such a ripe opportunity for gleeful mockery, but it was not creepy in the slightest.)
The scan showed that my right ovary isn't really rising to the challenge, and while I have several teeny follicles on my left, I also have a single malevolent giant that will probably require us to cancel the cycle.
The suppression drugs (Lupron, in my case) are supposed to keep your ovaries from developing a dominant follicle. What you really want is a bunch of them all the same size, developing at the same rate: a clutch of team players. When one leader decides to upstage the rest, it can keep the others from growing. It can cause also ovulation before retrieval — poof, no eggs, no cycle, no refund.
Because my clinic uses a team approach, I don't see the same doctor each time. The doctor I saw this time was one I hadn't met before. She was very emphatic about the likelihood that we'd cancel, but said they'd discuss it at the team meeting later that day.
I was somewhat relieved this afternoon to hear that my regular doctor wasn't necessarily convinced that cancellation was necessary. (I say "somewhat" because I wonder whether even unhappy certainty would be better than just not knowing. The anxiety is relentless.) He suggested that I continue the drugs and return on Friday to see what's going on.
If we have to cancel, we could still convert to IUI, but given that our problem is fertilization, I don't think that buys us anything. Good money after bad; on this Paul and I agree. By waiting until Friday to make a decision, the only thing we have to lose is a couple of days' worth of injectibles.
Oh, and my sanity. But that's okay, because I'm not really using it for much anyway.
Day 8: Whatever gets you through the night
The relaxing and effective ways in which I am coping with the likelihood of a cancelled cycle:
- Wrenching my shoulders up into a twisted shrug only Chang and Eng Bunker could love
- Producing oceanic tides of stomach acid
- Standing up, sitting down. Standing up, sitting down. Standing up, sitting down to gauge the relative jolt sent through my ovaries by the shock.
Day 9: Limboland
Still stuck in limbo, as nothing truly definitive occurred at this morning's appointment. I appear to have 4 good follicles on the left, plus the big bad one, and 1 good one on the right. I've dodged cancellation for the moment. That's the good news. The bad news is that we can't guarantee that the big one won't cause me to ovulate before retrieval. It's a risk.
I grilled my doctor on whether he thinks we could do better on another cycle (ignoring for the moment the dominant follicle, which he said might be the result of the lower dose of Lupron but could also just be a random occurrence). Answer? Unknown. Based on my first cycle, it seems my ovaries respond slowly, but we don't really have enough information to assume any kind of overarching pattern.
Lazy and unforthcoming. Me all over, really I should be pleased that my ovaries aren't trying to buck the trend.
So if the other follicles continue to grow, and if the big one doesn't cause ovulation before retrieval, and if I don't do a half-gainer off a building before then, I guess we'll just keep plugging along until the path becomes more clear. Let the hormonal rages commence.
Day 10: Zen and the art of mucus cycle maintenance
I just wanted to say that I have never seen so much clear, stretchy mucus in my entire life.
By that, I mean I think I produced more in a single day than in the last 20 years combined.
I love Paul enough not to make him look.
Day 11: Itchy trigger finger
The doctor's office is so different on a Sunday. You know everyone in the waiting room is there for IVF, and not for routine OB/GYN care. Everyone was quiet and self-contained, and it seemed so tense that I had to fight a perverse urge to swagger around the room bellowing, "So! Whaddya in for?!"
It's kind of good that I am me. Otherwise I'd have to hate me.
But I digress. I personally was in to have my follicles counted. The doctor located four likely-looking follicles. Two were large-ish, two were slightly smaller, and then the rest were mere bagatelles. I hauled my ovaries out of bed at 6 on a Sunday morning for this?
Later on the phone the doctor told me she didn't think we could buy any more time, and advised that we trigger that evening. She said she thought we'd get three decent eggs, four max. It wasn't too late for us to cancel.
Paul and I agonized over it for a few hours. We finally concluded that we wanted to go ahead — that even if we ended up with only two embryos, we'd have improved on last cycle. At this point that was our focus, that and trying to make something worthwhile out of the last week's stress.
The doctor called back to get our verdict. When I told her, she said, "I think that's a good decision. So you should go ahead and do your trigger shot now."
"Now?" I said, startled.
"Yep, for an 8:30 retrieval Tuesday."
Now one thing you may know about me if you've read earlier entries is that I'm almost psychotically compliant. So Paul and I marched off dutifully to do the shot. It didn't occur to me until half an hour later to count the hours: the trigger's supposed to be given about 35 hours before retrieval. We'd done the shot at 4:30 PM...
...making retrieval necessary at 3:30 AM Tuesday.
Obviously something's wrong. The strange thing was that I, normally anxious, didn't feel an angstrom of panic about this. Their mistake; they'll make it right.
After all this ridiculous drama, I'm wretchedly ambivalent about going ahead, because this cycle has been a clusterfuck from the word go, but also hugely invested in doing so. Otherwise the last three weeks of anxiety are going to feel like an enormous, upsetting waste.