2013 A New Year for Trying

It’s been some time since my last post. I confess I have not been in the best of spirits since my complication in December. In my last post, I was still holding onto a bit of hope for our miracle embryo but again, it wasn’t our time yet as we found out on Christmas Day, our embie didn’t implant. 2013 is a whole new year for trying to conceive.

Since I was already feeling down, sad and slightly traumatized after everything, my wounds needed more salt rubbed into them, apparently. During the day, hubby and I attended a Christmas party with more than a hundred people. Some people knew I had been in the hospital and asked how I felt. It was pretty hard not to break down and cry in front of them, but I somehow managed to keep it intact (mind you I was only feeling 80% recovered). Then during secret santa, our newlywed friends announced they were 4 months pregnant. 4 months pregnant after their wedding 5 months ago! It was one of those days you never want to replay. Everywhere I went, someone else was telling me they were having a baby. When hubby and I arrived home, one of the workers in the building informed us he and his wife were expecting their second child in March 2013. I told my husband if another person told me they were expecting a baby that I would scream. My sanity was dangling by a thread.

New Year’s came and we stayed home to relax so I could recover more. 10 days later, I decided I was ready to face the “what’s next” meeting plus we had questions we wanted answers to related to the complication. Hubby and I met with our RE and talked for 40 minutes or so. The weird thing is, there are only 2 topics that stuck to my head; donor eggs and third cycle. Well, when donor eggs came out for discussion, I had no words because I was in shock. Hubby immediately responded that we felt we were not at that point yet. Nonetheless, she told us to think about it because it would still provide us with a child that was half ours biologically speaking, without placing me at risk for complications again. I’m still working my head around the donor eggs. Of course if possible, I would still like to try to have our own biological children. In terms of a third IVF cycle, she’s prepared to have it play out this way:

  • Protocol similar to 1st IVF cycle
  • Add co-culture procedure (only a few centers do this anymore)
  • Stay on estrogen patch before stimming meds and after transfer
  • Stop stimming meds earlier when follicles reach about 15-16mm

My RE did say that our chances for success with IVF now have gone down to 20% when they were about 40% for cycles 1 and 2. The Clomid trial for the 2nd cycle didn’t help our embryo quality in any way. It seems the 1st protocol yielded more and better quality eggs.

Our RE also informed us this complication I experienced was rare and really seen in women with greater quantity follicles (where I only had 4). For some reason, my body failed to stop bleeding where it should have.

She checked my abdomen via ultrasound and found very minimal blood and fluid left. If I wanted to go ahead with co-culture, I was able to regardless of when I wanted to start a 3rd IVF cycle. Co-culture requires a biopsy of the uterine lining to harvest then freeze the cells until time for transfer. The idea is these helper cells may increase chances of embryo implantation by adding growth factors or removing toxins from the medium. This has to be done at least 1 month in advance of an IVF cycle as a biopsy and without anesthesia.

At this point, I’m barely able to keep back the tears. After everything, it just wasn’t what I wanted to hear. She brought me right back to when she told me I should receive a blood transfusion!

Since that visit, I’ve been trying to keep busy. I went through days of severe depression, self-hatred of my body, oh and of course, tons of crying. I somehow thought my days as a nurse driving myself so hard for so long had somehow taken a toll on my body. 13-hour days, 5 minute lunches, standing on my feet, juggling 40+ patients a day, referrals, treatments, and all this in a very stressful work environment had caught up to me. I’m only 38! This year, I promise to really love and take care of myself; to say yes to myself more. I’ve decided, I’m the patient now.

I still have to try. I need to think positive. I haven’t reached my end yet.

Hope and success in 2013 for me and all my friends. xo

Complication after IVF Retrieval – part 2

Monday 7am- 11:30pm

(20 hours later post IVF retrieval) By 7am, I was in so much pain, it hurt with each breath in and out. Apparently, bleeding into the belly is very irritating and causes your body to produce prostaglandins which are responsible for pain. At 7am, the Attending physician came by to see me. He was not happy with what he saw. I was in terrible pain. I had only had 1 bag of saline. I was feeling thirsty and not looking well at all. He spoke to us briefly and explained my RE will try to stop by after her office hours at a satellite office. After he left, there was a shift change and things got better from there; at least on some levels. The next 16 hours were filled with more blood draws, a second IV, and even a Foley catheter! Many residents from the GYN service also came to see me, so many that I lost count. My torso pain started to subside by 12 noon, I was waiting in the ER for a bed. By 11pm, a bed became available and I was transported to my own private room. My RE was really great and supportive. She made phone calls to try and get me a room sooner.

 

Monday 11:30pm – Tuesday 11:30am

I could not sleep after being admitted to the floor. I admit, the quiet was very welcomed after spending 24 hours in the noisy ER. My abdomen had gotten quite distended and was making it uncomfortable that I could only lie on my back. I managed some shut eye only to be awoken by one of the doctors around 5:30am. Sleep is not something you get a lot of while staying in the hospital. Another blood draw shows by 11am, I had lost even more blood. At this point, I am in danger of having a heart attack. My RE recommended a blood transfusion. Immediately terrified, I started to tear up and cry. I was so scared. None of us wanted a transfusion but none of us wanted me to have a heart attack either. My RE and the other doctors felt confident the bleeding had stopped and luckily I did not require surgical intervention. How crazy is this???!!! So I conceded to the transfusion because I could feel my head start hurting and I actually started to not feel well overall. I knew what needed to be done. The rest of the day was spent in bed with 2 units of blood slowly infusing. I tried to look at the bright side saying to hubby that at least these types of life saving measures are available. One bright moment in this long journey was 1 of the 2 eggs retrieved matured in the lab and fertilized. Our little miracle embryo. The next day would tell if I would be strong enough to undergo transfer. So of course, I was on a mission to get stronger in case the embryo continued to divide and was viable for transfer. Hubby and I definitely felt this to be surreal. In the next 24 hours, I became strong enough to leave the hospital. My RE felt resting at home would be better than the hospital, so she discharged me. Thursday morning, we anxiously awaited for the phone call from my RE. She said the embryo was a viable one and that I should come in for transfer. After all we had been through, we had 1 embryo to place back. Hubby and I started calling the embryo, our miracle embryo. Although it’s only a 10% chance for success, we’ll take it for now.

Since last week, hubby and I have only just begun to process what happened and what lies ahead for us. I can only focus on getting stronger, getting my endurance back and hubby focuses on taking care of me and then work. We plan to speak to the RE about what happened. We just want to make it past these 2 weeks.

Please keep us in your thoughts and well wishes. It has been 1 crazy week.

 

Complication after IVF Retrieval –Part 1

When hard or challenging situations happen to you, you always wonder, “Why is this happening to me?” and you never believe that it would actually happen to you. I want to share what happened to me after our IVF retrieval this past Sunday in December 2012. Here’s the time line of events:

 

Sunday 11am-4pm

Retrieval finished by 11am and discharged home without complication. Hubby and I went home, had lite lunch and I took a nap because I was feeling tired. At 4pm, I awoke to some lower abdominal cramping, which I thought was normal because of the retrieval and took 750mg of Acetaminophen and went back to sleep. I did have one dose of Tylenol 975mg around 11am after retrieval.

 

Sunday 6pm – 11pm

Around 6pm, I did have the urge to empty my bladder so I got up out of my bed, sat up and slowly walked to the bathroom with my husband which is about 10-12 footsteps away. I was already feeling slightly dizzy. I sat on the toilet, emptied my bladder as well as had a bowel movement. I was in a lot of abdominal pain and was feeling very constipated. Later I learned this was due to the medications taken during the IVF cycle. I had never experienced constipation like this before. The need to strain was especially hard with the pain, and within a few minutes after sitting on the toilet, I started to feel extremely dizzy. After I finished my business, I stood up and felt so dizzy I needed to lower myself to the floor. In addition to feeling dizzy, I would sweat profusely and feel as if I was going to pass out. I literally saw stars. My husband said a few words to me and I could not even hear him. I called my husband to come pick me up and bring me back to the bed. I wasn’t sure what was happening and why I was dizzy. My first thought was I was reacting to the anesthesia or pain killer since that was the last thing I took by mouth. Within 10 minutes of laying down, my dizziness subsided. I thought this would be temporary so I drifted back for more sleep. At 8pm, I again needed to empty my bladder so I asked my husband to help me up. This time, I was dizzy within 15 seconds of sitting up and I was feeling worst. I actually had to lay back down to feel better first. My husband has an office chair with wheels and had to place me in the chair to wheel me to the bathroom. After emptying my bladder, I immediately asked my husband to place me back in the chair and hurry me back to the bed. I was very dizzy before reaching the bed. My husband told me later, I appeared as if I were having a seizure because I was shaking and my eyes were rolling up to the top of my head. After about 15 minutes and lying in the bed, I was no longer dizzy and felt better. I was no longer actively profusely sweating.  My husband and I were getting a little worried and even researched the side effects of the anesthesia and pain killer I had taken. When you look up medications, the side effects could be endless and all encompassing. I decided I was hungry and asked hubby to make dinner. I was able to eat a few bites of rice, fish and vegetables. As the night progressed, I was getting more and more worried and asked hubby to call the doctor on call. He called back within 15 minutes and got the details from hubby. He said he wanted to speak to the Attending physician who then called us. After going over the details of the day since we got home, he said the best thing to do was to go to the Emergency Room. I knew I couldn’t even walk to our car parked outside, so we needed to call an ambulance. My concern at this point, “Are the EMTs going to take me to the hospital I had my procedure in?” When you call 911 in NYC, they EMTs are not required to take you to the hospital of your choice. They can take you to the closest Emergency Room. Luckily, the EMTs were very understanding and took me to the hospital where I had my retrieval because it wouldn’t make sense to take me anywhere else.

The EMTs were great, they took me to my hospital after taking my vitals. I had never been in an ambulance before! It was kind of scary, dark and cold. Plus it was pouring outside on the way to the ER. What a day thus far! I was scared but feeling good that I was going to the hospital in case my condition turned worse. You don’t want anything to happen to you over night while sleeping.

 

Sunday 11pm – Monday 7am

Hubby and I must have arrived in the ER sometime after 11pm. After receiving report from the EMTs, a nurse came by to check my vitals and checked my blood sugar. She asked me what happened and we told her the events that led up to that point. The Attending physician was in touch with the ER and the covering physician was on his way to see me. I was quickly wheeled into one of the patient areas covered only by a curtain where a doctor came and drew my blood. This was necessary to evaluate my blood count. More doctors and nurses came to speak and ask us again to recall the events of the day and also my medical history. My covering doctor finally showed and spoke to us as well. He soon left perhaps an hour later. Tests were ordered and I was to stay in the ER. Around 2pm, I was taken for a sonogram. At this point, I couldn’t sit up without feeling extremely dizzy, had extreme abdominal cramping and started to feel pain on the tops of my shoulders. I had never been in so much pain in my entire life. I have a high pain threshold but even this was way beyond my breaking point. The doctors didn’t want to give me anything because they didn’t want to mask anything if another symptom arose. It was around 3pm at this point. I have not taken any pain meds since 4pm Sunday afternoon.

This is 11 hours later.

The sonogram was extremely hard for me. Moving from the ER bed to the exam table was horrendous. The worst was when the technician asked me to empty my bladder before doing the transvaginal  ultrasound after the external ultrasound. Between the pressure on my abdomen and the poking of the device was enough to almost make me pass out. I nearly did pass out when I experienced another dizzy episode when turning on my side to empty my bladder getting onto the bedpan. The profuse sweating and almost fainting sensation hit me again. It was so frightening. I can only imagine what my husband was going through watching me. Poor thing. He must be traumatized too after all this. My husband became my hands and helped me to undress, mobilize and clean me up. Finally, when the test was done, I was brought back to the ER, behind the famous curtain. It was at least 30 minutes after I had returned, still my nurse had not returned to connect me back to the monitors and my husband didn’t know how to connect me. He went to look for her but she was no where to be found. Despite my pain, I could still manage to think clearly and know this wasn’t good. If my blood pressure was to drop any lower, it could mean I was getting in serious trouble. Near 4 pm, another nurse came to draw more blood. I asked him if I could have an IV because I was feeling dehydrated. He said he would have to ask my nurse. I overheard him asking my nurse who then asked “Is she hypotensive?” I was pretty appauled because I wasn’t even connected to the monitors that measure my blood pressure! Close to 4am, my nurse did come to bring me a bag of saline to infuse and I asked her to please reconnect me to the monitors. Could you believe my disbelief?!!! By 6am, the infusion had finished and she came to take the finished bag away. I was in so much pain on my front torso, I didn’t bother saying anything to her. Sometime before 6am, another doctor came to draw more blood. They informed me and hubby, I had bled into my belly and would be admitted to the hospital.

IVF Cycle #2 – Part 1

Here’s an update on our IVF Cycle #2 and what’s happening. Cycle # 2 started when I received my LH surge using the home digital ovulation kit. I called the center nurse and she instructed me to start wearing Climara patch #1, exactly eight days later. I was to change the patch every other day until the infamous period came or if no period came by the fourth patch, I would have to just go in to the office. I wore the patches as instructed through the 3rd patch when Day 1 came. So on Day 2, I went in to the office to start my monitoring. During this visit, I met with an IVF nurse who reviewed my protocol and answered any questions. If the blood work and ultrasound looked good, I would get the green light to start. In this 2nd IVF cycle, my doctor did make some changes for hubby and me. One change is the addition of Clomid. Hopefully, Clomid will enable my body to find the best quality eggs for this IVF cycle. We won’t know if the Clomid provided any benefit until my doctor sees the embryos to assess for quality. Luckily , all my results were good so we could proceed with the protocol. This is what the first half of the 2nd IVF cycle looked like thus far:

 

Day 2: Blds, U/S, Start Clomid 50mg x 2 tabs between 7-10pm

Days 3-4: Clomid 50mg x  2 tabs each night same time frame

Days 5-6: Clomid 50mg x 2 tabs, 300 IU Gonal F, 150 IU Menopur each night

Days 7: Blds, U/S, 300 IU Gonal F, 150 IU Menopur

Day 8: 300 IU Gonal F, 150 IU Menopur

Day 9: 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 10: Blds, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Days 11-12: 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 13: Blds, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

At this point, I do have 4-5 follicles growing in the Right ovary varying in size from 9-12mm. My Left ovary has only 1 follicle slowly growing. I did have a nice break during days 2-6, but this week, it’s daily visits with monitoring by an Attending physician.

Day 14: Blds including a CBC, U/S, 300 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Day 15: Blds, U/S, 225 IU Gonal F, 150 IU Menopur, Cetrotide x 1 cartridge

Stay tuned for the rest of the cycle! And wish us luck!

IVF CYCLE #2. On Your Mark, Get set, GO???

It’s been a little over a month since my last post and many events have transpired. Recently, Hurricane Sandy hit the NY/ NJ / CT tri-state region, many lost power, lost homes and even lost family members. The Lower East Side lost their electric during the 1st night of the storm and Tribeca was black for nearly a week later. We had to evacuate to the Upper West Side of Manhattan to ride out the storm. Luckily, despite the power surges and light flickering before high tide; our neighborhood held on to power. The effects of Sandy have been pretty devastating and we are all still working to press forward to recovery and rebuilding. I have to admit, it was pretty crazy to see water levels rise as high as they did downtown, traces of nearly 5 feet high outside of 90 West Street (markings on building walls), or the water filling the entire South Ferry Train station, to the ceiling! You really need to see it before you can believe.

Also in the past 2 weeks, many of you have heard the great conflict in the Middle East with explosions and nearly 2 countries on the verge of war.

So why am I talking about all this? I have to think about life sometimes, with all the good, the bad and downright ugly. I guess lately, I have been feeling troubled in terms of all these terrible things that happened and do I feel any children I bring into the world will really be safe. I know for sure in my heart, I want to have children. I only worry about the kind of world they will grow up in. Do you think of this sometimes?

I do admit to be a rather empathetic soul, which I suppose doesn’t help me but these are the things I think about from time to time when I see so much suffering (I think about Breezy Point, NY).

Needless to say, it has been a little challenging, getting back into the swing of things, eh hmm, our IVF CYCLE but we know now is the best time to try again. I have come to understand that life is uncertain, and there are no guarantees (except death and taxes!) but this will not stop us from living, loving nor learning.

So, ROUND 2 it is, On Your Mark, Get Set, GO!!!