Wednesday, December 22, 2010

Not this time

Going out of town instead of hanging around, waiting for the call ended up being perfect for us. True, it was on my mind a lot, but there's nothing like hanging out with Mickey and Minnie to take your mind off of things. Unfortunately, when you leave the land of magic and pixie dust reality sets in.
We spent this morning waiting and waiting for the call. And it finally came. Not this time. No baby for Christmas. Sigh. I guess there was a part of me that expected this. As I've mentioned a couple times, it seems like for the past few years very little in my life has gone as "expected". Even the IVF cycle didn't go as expected. And so while I was praying and hoping that the flip of the coin (our 50-50 odds) would land our way, when it didn't I wasn't totally shocked. Funny from someone who always prides herself on being an optimist. I guess sometimes even the optimist becomes a realist. Aaron and I are both sad. And I know "Lisa" is sad too. She wanted so badly to give us "the best Christmas present ever." She was so sweet when she called me today.
It's weird, I feel like I've suffered a loss, but I'm not sure how to categorize it. It's not like a miscarriage or something. But looking at the picture of those two embryos and feeling like they were a part of Aaron and I, and the joy that comes with that. Yet, they never implanted. They never really were a "baby". They only existed in the petri dish. But they were hope. They were potential. And for right now that hope is gone. And that's where the loss lives.
As I mentioned, we don't have any frozen embryos. Another IVF cycle would be very expensive. And we don't know why we got so few embryos during the last cycle. So right now things are up in the air. We've got an appointment with our doctor next week and will talk about options.
I don't want to make this sound like a complete downer. It's not. It just "is what it is." For now, I'm trying to regroup, mourn this little loss and then refocus. It's time celebrate the birth of another baby, the amazing baby born in Bethleham. It's the hope and promise from that baby that we will take comfort in as we head to the next step.

Monday, December 13, 2010

Hilarity in the face of surgery

I am a big believer that when one has an option, choosing to laugh is one of the best options out there. Don't get me wrong. There are so many appropriate times to cry, mourn, worry, etc., and I would never say that anyone should deny their emotions. At the same time, there are times the opportunity arises to choose either to go down the path of those emotions or laugh, or, while on the path of one of those emotions, to pause, look around, and stop for a laughter break before continuing on.

There is no doubt that this entire process has been hard. I'm trying so hard not to be anxious until the 22nd. I'm trying so hard not to be angry for all of the medical challenges I've faced in the last several years. And most of the time God has brought me to a place of peace. And sometimes I need to cry and rail against the "unfairness" of it all, though truth be told fairness is highly overrated, and I think life seen through our eyes is often more "unfair" than "fair" so I'm not sure why we ever thought life should be fair in the first place. But I digress.

Anyhow, three things happened on the day of the surgery to retrieve my eggs that I wanted to share them with you all. Enjoy!

1) Yes, I can sleep through a party
From the time I was young, my mother stated that I was such a deep sleeper someone could throw a party in my room, and I wouldn't wake up. Well it turns out, especially on the day of surgery, I can! I had some trouble sleeping the night before, however I set both of my alarms to get me up in plenty of time to be ready when my parents came to get me at 6:30 am. I had to be at the clinic at 7:15, and Aaron was working so my parents agreed to drive me. It is very important to be on time. Because of the medications, there's only about a 1.5 hour window to retrieve the eggs before it's too late. Well, it turned out Aaron got really sick the day before and called in to work, however because he was sick and we didn't want me to get sick, he slept in the guest bedroom. Now, recall that I said that I set both my alarms. I have been known to sleep through one alarm, thus I have 2, including one positioned far enough away from the bed that I have to get out of bed to turn it off. I finally fall asleep, and the next thing I know, all hell has broken lose! The light in my bedroom is on, both of my alarms are blaring, the doorbell is ringing continually, our dog is barking like crazy, my cell phone is ringing and Aaron is shaking me awake. Yes. I had slept through my alarms. Thus, when my parents got there and I didn't answer the doorbell, they began ringing it continuously. This caused Winston (the dog) to begin barking like mad. Which woke Aaron up. My parents also began calling me on my cell phone. And naturally I slept through all of this. It was Aaron shaking me awake that did it. I rolled over, looked at the clock and saw that it was 6:32. Oops. Options at this point: 1) panic, 2) swear, 3) laugh at the absurdity of it all. Needless to say, I chose option 3, although I can't say all of my family members did (in order to protect them, each of their choices shall remain secret!).

2) I'm the Queen of Pop!
We finally get there, I'm in pre-op, and the nurse anesthesist comes in to speak with me. Now, for those of you who aren't in the medical field I should share, it is a well known fact that certain personality traits tend to go with certain medical specialties. Pediatricians never really grew up. Radiologists enjoy looking at films more than patients. Surgeons have a god complex. Needless to say, anesthetists and anestesiologists are exremely precise people, and thank goodness for that! In the OR they are the ones who are actually monitoring what is going on with your vitals and changing medications in milliliters to help you either not wake up while your belly is cut open, or enter a permanent sleep. So, back to the anesthetist. She mentions matter of factly that she will be using Propofol to keep me alseep. Propofol, Propofol, Propofol, I think. Where have I heard that before? Then it hits me and I say, "Propofol? Isn't that the drug that killed Michael Jackson?" And so the nurse anesthetist starts into a 5 minute soliliquiy on how, (summed up) "Yes, but according to his doctor the amount he gave him was so small that, honestly it couldn't have rendered him unconcious. So the doctor believes that once he left the room Michael Jackson gave himself a bolus of the Propofol that actually killed him. And it also says clearly on the label that the drug is only to be used by trained personel in the operating room with proper monitoring and his cardiologist clearly wasn't trained in anesthesia and shouldn't have been using it any way....." Finally this comes to an end. And I look at her with a sweet smile and say, "Oh. Well, actually, I was just wondering if I was going to get a single, sequined surgical glove."

3) Let's talk about comfort (may be uncomfortable for some people if you don't want to hear all the gory details of the OR)
So I'm in the OR. They've already given me a bit of happy juice, relax me, and I'm getting into position. Then someone, I can't remember who at this point, says, "OK, now before we give you the last bit of medicine to put you to sleep we want to make sure you're comfortable." Now, many of you know, I sometimes I do we say...low filter to begin with. And I had been given some happy juice at this point, so any remaining filter is gone. So while any good patient probably replies (if they say anything at all), "Oh, ok." I say, with a smile on my face as the inanity hits me, "Comfortable? You want to know if I'm comfortable? Well let's see. I'm laying her on a surgical gurney in nothing but a thin hospital gown 12 sizes too big, under which I'm naked as the day I was born, and you've placed my entire lower legs such that my hips are at a 90 degree angle and my knees are at a 90 degree angle so that you can see directly the area that you need, although you have strategically covered me with a warm blanket which I do appreciate, but you are about the render me unconcious, and then insert a very long needle into an area no needles were ever meant to go and yank several eggs out of their happy ovarian follicles. So, comfortable? Well, not really!" Now, as this monologue progressed everyone in the operating room began laughing, which actually was quite comforting, as they all began to realize the absurdity of asking if I was "comfortable." Finally one nurse said, "Ok, really, we just want to make sure you're positioned appropriately because it's a lot harder to reposition you if you are unconcious." To which I replied, "That, I buy. Position away and then render me unconcious!"

Sunday, December 12, 2010

And then there were two...

The day 3 transfer went off without a hitch....sort of. I mean, the transfer went off without a hitch. Getting to the transfer was kind of crazy. However, given everything we've gone through to get to this point, I had actually mentally prepared myself for things to not go as planned today. I figured it was better to be pleasantly surprised if things went perfectly than panicked if something came up. And no, that's not pessimism you hear, but, given everything up to this point, realism!

I was driving in, ready to pick "Lisa" up at the train at 12:00, when I called her to let her know I was going to be about 5 minutes late. Well, that was going to make absolutely no difference. Because she was running about 2 hours and 30 minutes late. Yup, she was only in Kelso, WA. Apparently the train had engine problems, and they were finally in the process of hooking up a new engine, but she would get here about 2:30. My first thought (so happy to think about the well being of others first) was that if she was going to be on a form of transportation and having engine trouble, I was glad it was a train and not a plane. My next thought was....CRAP! Because we were supposed to get to YFCFT21C at 2:45. We had planned to have nice, leisurely time after she got in, hang out, and then head up there. Well that was out the window. Fortunately the clinic knew what was going on, but I HATE being pressed for time over these things.

So I headed to the hotel to check in for her. Now, I understand the need for security measures, it makes sense. And the hotel reservation was a little confusing, it was made in her name, but it was made under my address and with my credit card. So when I got there, they wouldn't let me check in. ARGH. I was able to get "Lisa" on the cell phone, and Lisa gave them permission to let me check in for her. Great. But then they wanted her to confirm a detail, like the credit card number used, or the address. OK, hello! I had given them the credit card, and my driver's license with those numbers on it when I tried to check in! And, of course, Lisa doesn't know those things off the top of her head. So, in the ultimate act of why-can't-common-sense-prevail-every-now-and-then, I asked for the phone back. I asked Lisa to grab a pen and had her write down my address. I then handed the phone back to the clerk and Lisa told the clerk that information. Sheesh. But I was able to check in.

It was a good thing too, because I had some reading to do. The thing is, all along, Aaron and I really haven't wanted twins. It's not that we're scared of having twins once they're here (although Aaron may disagree a little bit with that), but our main concern is the health of Lisa and of the babies. The chances of being born low birth weight, and premature increase about 50% with twins. And LBW and Prematurity are associated with a host of other challenges. So all along we've really been saying we wanted to implant just one embryo. And now we were on the verge of implanting 2. Being the thorough person I am (or crazy, as others may put it) I had gone to PubMed, the computer summary of all the articles published in medical journals, and searched for articles on ivf twins and possible complications. I printed two of them, and wanted to review them to make sure we weren't possibly creating a situation we couldn't handle in the future. After reviewing the articles and talking with Aaron, who had joined me by that point, we decided we were ready to go forth. If one embryo looked fantastic, we were only do one. If they only looked ok, we would do two.

We headed to the train to meet Lisa, and the train came poking into the station at about 2:50. We made it to the clinic by about 3:10. Total craziness. Then, the amazing things started to happen. They told us our embryos weren't the highest quality, but the second highest quality at this point. Ok, we'll implant 2. Then they showed us a picture of our two embryos. One is 10 cells in this picture and one is 12 cells in this picture.

I couldn't believe it. A picture of our two embryos. Now for a moment of gloating, ha ha! Take that all of you who conceive naturally! You get your first picture at the first ultrasound. We got ours at 10 and 12 cells! Totally crazy. The interesting thing is, Aaron told me later that, although he thought it was weird (I assured him I didn't think so), he immediately felt a connection to that picture of our two little embryos. I was just entranced. And because we were talking about 2, not 3, I felt the need to rename them. Thus Larry and Curly (or whichever two these were) became Holly and Ivy after the Old English Christmas Carol, The Holly and the Ivy. (I don't know if that was because it's Christmastime, or because they were on a green background ;>). And frankly I can't wait to pull that picture out in about 14 years when we have 2 strapping teenage boys and tell them, "See boys, when you were just this little we called you Holly and Ivy! Isn't that sweet?" and hear them reply, "Mom!" ;> Yes, already planning on how to torture them when they're teenagers. Now THAT's thinking positively!

From that point on, it really went like clockwork. They had to check Lisa's bladder a couple times because it had to be full to do the transfer. And Lisa, bless her, after she was undressed from the waist down, but totally covered, let Aaron come in and sit by her head with me to see the entire process. When they zoomed the microscope in before they sucked them up in a catheter I could see that they had been busily dividing, and were now even more cells than they were in our picture. So so cool. And we could see the ultrasound of her uterus as they transfered the embryos, and could see the embryos entering the uterus! The transfer went beautifully according to our fertility doctor. And after 15 minutes of lying down, Lisa was able to get up and get dressed.

We had decided that since she had come up alone, we would spend a girls' night at the hotel, order in room service, watch some movies and then I'd go home and pick her up the next morning to go back to Portland. We did have our girls' night, but there was no movie watching at all. Nope. We talked. And talked. And talked some more. For about 5 hours straight. We talked about growing up, we talked about the families we grew up in, we talked about our current families, we talked about our jobs, we talked about so many things! And the conversation was so natural, not forced or anything. I love how we're becoming friends. The thing is, that wasn't necessarily going to happen. I didn't need for that to happen for me to be happy with surrogacy and our experience. But it is SUCH a bonus. She really is an amazing woman. And her husband cracks me up. Last time she came to town the two of them, and the two of us went out for dinner and spent 3 hours at the restaurant. Again, it's just another sign that God had this woman specifically planned for us. How wonderful.

So the sad news we received this morning is that our 3rd embryo didn't survived to a point at which it could be frozen. It just stopped growing, which can happen. That was one of the reasons they wanted to do a day 3 transfer. And now I am so glad we did. And that we transferred 2 embryos instead of just one.

So this is our shot, at least in this stage of the game. No frozen embryos to fall back on. The pregnancy test is on December 22nd. And I'll let people know either way. So instead of sitting around chewing our nails down to the quick, Aaron and I have decided as soon as I finish teaching my last class, and have my last doctors appointment, we're going to head out of town on a mini-vacation so we can be completely distracted!

My friend Michael, whom I've mentioned before, always encourages embryos to "Grooooooooow!" That's with 9 "o"s, one for each month of gestation. So little Holly and little Ivy, grooooooooow!

Wednesday, December 8, 2010

Please Pray for Larry, Curly and Moe

Hi All,
I am planning on writing a newsy blog about yesterday's egg retrieval, however I need to get this out first. Yesterday we got 6 eggs. 5 were mature, and only 3 fertilized. This is not exactly the news we had hoped for. Because my mother didn't have any problems getting pregnant at 33 and 36, we never anticipated that this would be a problem. Given the fact that I had so few follicles to begin with compared to what one would normally expect in a 33 year old and then 3 achieved fertilization, the doctor thinks that for some reason we are dealing with some unanticipated infertility. Whether or not this is related to my underlying condition or for some other reason, we really don't know.
They do embryo transfers at day 3 and day 5. On day 5 they can choose the best embryos, however, given the fact that we only have 3 to begin with they want to do the transfer on day 3, which is this Friday. We will know a little bit, but not too much about the quality of the 3 embryos at that point. Because of this, they are also recommending that we transfer 2 embryos. We've been talking all along about transferring 1 with Lisa, and I'm really hoping she'll be ok with transferring 2. Technically according to our contract it is our choice, but seriously, this is HER body, and we want her to feel comfortable.
The statistics at this point with a day 3 transfer with 2 embryos: 50-55% chance of pregnancy with a singleton, 25% chance of twins. I'd like the statistics to be higher of course, but we're looking at the flip of a coin.
So friends, please pray for our little embryos (whom I'm calling Larry, Curly and Moe). Pray for Lisa, that she will be totally on board with 2 embryos. Pray that we achieve pregnancy. Pray for Aaron and I. I'm really just sad right now. Nothing about this journey has been easy. I guess I was hoping that once we got the pros involved everything would come together. Pray that the Father's will would be done, as we know it will.

Jeremiah 29:11-12 "For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future. Then you will call on me and come and pray to me, and I will listen to you."

Thank you,

Sunday, December 5, 2010

Is this how a chicken feels?

I'm going to start out by saying something that may tick some of you off, so I apologize for that. But here goes. I've never really had PMS before. Things were pretty easy for me. However, call me Miss Empathetic now, because I FEEL for those who have PMS. With the doses of hormones I've been on, the last week has been really weird. I felt cranky and weepy, and wondered was it A) The end of Thanksgiving and hanging out intensely with my family, B) Worries about getting to this point, C) The hormones or D) I was losing it and about to go off the deep end. Fortunately my nurse coordinator reassured me that while it was most likely a combination of A-C (but not D, although others in my life might disagree ;>) C was a big factor. Whew.

So the chicken thing. I've been going to the doctor every other day for the past 12 days for a date with the intrusive ultrasound machine. And each time I go in we get a peek at my follicles. The medication that I give (see previous entry!) causes the body to produce more than 1 egg in a month. Each time I go in they measure my follicles to see if they are getting bigger or big enough to harvest. It's all about my eggs! However, in my case, at least my eggs are in 2 baskets, so to speak. ;)

The thing is, I don't think the chicken ever really thinks about her eggs. They pop out, get carried away, and she continues around the barnyard (I'm thinking of a happy free range chicken) pecking up worms and enjoying life. And yet for the last week I've had my eggs on the brain quite frequently (sounds like a weird breakfast dish). Sure, twice a day with the shots. Then every time I go into the doctor's office. Then, particularly, about 2 days ago when my "baskets" started to ache. Thank goodness I had a friend go through this less than a month ago and she mentioned the bloating and feeling odd. Otherwise I, once again, would have wondered if I was going off the deep end. I suppose it makes sense. These follicles are growing inside me, and whereas in any given month a woman usually has 1, about 2 cms round, I have a handful. And, to be blunt, it sort of feels like I've got two bags of marbles sitting on my pelvic floor. In a way, it's kind of cool. It's sort of a psudopregancy. Right now my bladder feels really full even when it is completely empty, and my tummy is a bit hard. Perhaps it's a poor substitute for actually being pregnant, but at least I kind of get what it might feel like, at least a little bit.

Now, for the not so good news. I don't have nearly the number of follicles they'd like to see. Today I had about 5 mature follicles (it all depends on their size) and 3 other ones. The mature follicles are most likely to contain a mature egg. The smaller follicles may, but, from what I understand, probably will not. So, in a best case scenario I'll hopefully get 5 good eggs. The thing is, most people have between 15-20 follicles at this point. Oops. Guess my body missed getting that message. OK, we know I have a funky body. That's why we're doing surrogacy. But until we started the stimulation of the follicles, there was no indication that I might not produce a good number of eggs.

So, I'm worried. I know that I shouldn't be. But I'm being honest. I am. About 70% of the mature eggs will fertilize, so we may have 4 embryos. I keep reminding myself, all it takes is 1. The other thing that's interesting is Aaron and I have been praying and talking through all of this about embryos, and the thoughts about when life begins. Is it when the sperm and egg meet? Is it when they are in a habitable environment? The answers just aren't clear. What I know is that I wouldn't feel comfortable with our embryos frozen forever. And that's just me. I'm not saying anything about the choices anyone else makes. That's totally up to them, and I respect any choices people make. Believe me, until you've been in this position, you really can't understand what it's like. We pretty much agreed that we wanted to create as many embryos as we can "use" be it this round, or with the idea of a sibling. If we had many eggs retrieved we probably wouldn't fertilize them all. And maybe this is one of the ways God is working. Maybe He's limiting the number of embryos that are being created. I don't know, but the thought has crossed my mind. What I keep reminding myself is that ultimately this is all in His hands.

So here's the schedule, Tuesday, they retrieve the eggs and they get their groove on with Aaron's swimmers. Then, on Wednesday we'll know about the quality of the embryos, how many got fertilized, who's looking good, etc. The transfer will either be on Friday or Sunday, depending on how the embryos look. I'll keep you all updated. Thanks so much for your prayers. I can't believe how supportive you all are!