The Follicle Dance…

I made that obligatory trip to the pharmacy again, the one I mentioned earlier with the great people.  I have to say that it was tough to walk in there for round 2 because all your cards are on the table with your pharmacist…there’s no bullshiting them, but every time I go in there, I can count on having at least one good laugh.  The woman at the counter is great, a real card and cracking up with her became a regular habit.  The astounding $5,000 however, is not so funny but I’ll take it where I can get it. 

So, the dance begins.  Every other day I make my way to the new Stork’s office where he always conducts the ultrasounds and has a nurse writing the information.  After a while it became like clockwork–I knew the nurse’s names, signs, and marital status.  Kind of pathetic, huh?   One thing that remained consistent across the board was the jitters that I felt with every single visit.   The constant torture of wonder…were the follicles growing, how big would they be, would estrogen be rising appropriately, would this cycle fail also??  Ugh…it never ends, the fear, the anxiety–who gets through this?????

 

It’s an egg thing…

Sorry it’s been so long since my last posting, but I’ve recently started a new job so my head has been elsewhere, which is a good thing.  Being trapped in self pity isn’t a great idea and well, at some point, you have to return to the land of the living.  I will also add that diving into work and pursuing professional dreams has helped my plight be somewhat bearable.  And, I do the kind of work that is really an act of service, that is, people are truly benefiting and getting better opportunities as a result of my job and my skills and like it or not, I get a lot of pleasure as a result. 

So, back to IVF #1 and the new storks, as I like to call them.  I mentioned before that in addition to my cyst surplus as a result of our first IVF attempt with Dr. Wonderful, I also received more devastating and shocking news about the state of my uterus.  It turns out that one of my ovaries doesn’t even work, doesn’t produce any follicles and quite possibly,  A RESULT OF THE SURGERY THAT I HAD WITH THE FIRST DOCTOR.   Dr. Stork said to me, “yes, unfortunately when you have an endometrioma removed, a piece of the ovary is cut out and can cause that ovary to stop producing follicles altogether, making it very hard to become pregnant.”  Shocked was an understatement of how I felt at that moment, and though I wish I could’ve learned this lesson on something else like a nose job or a botched face lift, I realized at that very moment that I was going to get a second opinion on every single thing from here on out concerning my fertility.  I was so angry that I hadn’t been warned of the possible consequences of this surgery, and even though I can’t blame my infertility on this entirely as there is no way to know for sure, had I been told, we may have a very different outcome today…shameful, just shameful.

So we resolve to put the past behind us and start again with a new attitude, new perspective and most importantly, a new stork!  In addition to the clumsy follistim pen and lupron, we added menapur the mix, 2 tubes to be exact and now my daily injections are up to three shots before bedtime. 

 

 

 

 

IVF #1

I think I’ve emphasized a few times the importance of getting more than one opinion if necessary and wow–that was a lesson I had to learn the hard way.  It’s funny because I’ve always tried to be smart about these things and as thorough as possible, getting all my questions answered, but what I was about to find out from the new storks raced through me like an electric shock, leaving me numb.   I’ll get to that in a little bit, but first, a description of the new doc’s is in order.  If I had to choose one word to describe the office culture and patient experience, it would be COMFORTABLE!  I went in for my first appointment and since the last cycle had been cancelled due to poor response, this new RE wanted to check my uterus and make sure there were no cysts–guess what????  He said that  usually when a cycle is cancelled, the birth control pill is prescribed so that the follicles do not become cysts and prolong the next cycle but of course that hadn’t been done.  He looked puzzled and said, “who was your doctor again?”  When the husband called Dr. Wonderful’s office to find out why we hadn’t been prescribed the pill, his nurse responded, “oh he doesn’t do that here.”  What! Is she serious? What does that mean?  It means that I’m stuck with two cysts…and have to wait six more weeks to start the next cycle.  I guess I can’t really blame Dr. Wonderful for that, he is the doctor after all and if he thought it were best for me to have cysts on my ovaries then who am I to argue?  NOT….

I also want to add that something amazing happened when I went in with the new storks to have an ultrasound–they came with me!!! And, they brought a nurse every single time so that she could do the writing, not me.  Brains and beauty…:)

 

 

 

 

    

Chivalry still exists

After several sleepless nights and a few emotional meltdowns, I knew that I had to get into action by looking for other solutions.  What I really needed was to jump into a lifeboat, and take a guess who is always waiting in a ship nearby throwing out those lines time and time again…friends.  Friends are key in this story because it is they who I have turned to to protest my unresponsive uterus, to share the spiritual bankruptcy, the extreme ups and downs, and most important, to share the things that should never be said out loud.  I called up one of these ”lifers” and asked for her opinion, and I hoped that her own daunting fertility stories would shed some new light.  A revived feeling of excitement and hope swept over me when she uttered the words, “I adore my doctor–he is a class act.”  And then I met him and added handsome and charming to that description!  

If it walks like a duck…

How can I say this tactfully, if something doesn’t feel right, look right, or sound right–IT’S PROBABLY NOT RIGHT!  My husband and I were unsettled from the gate with our first RE, but we ignored our gut feelings since this doctor came highly recommended with an impressive resume.  We figured that he knew best, not us.  If one lesson in particular stands out to me thus far, it is to trust my intuition no matter what and rely on my God-given instincts.  However, I will say that feelings are not facts so always keep perspective but never ignore a feeling that occurs over and over and over again.  Choosing a fertility doctor is not like choosing a dentist, it should be treated as one of the most important decisions you can make-with the same care as choosing a life partner.  

Add poor responder to the list

At the end of my ultrasound on day 5 of my cycle, I was told to stay and have a meeting with Dr. Wonderful about my non-responsive uterus.  I fearfully took baby steps down the long hallway to his office, wishing I could just disappear.  I was feeling my first painful sting of failure which I thought I might never recover from.  As I sat there awaiting my emotional execution, it occurred to me that maybe I would never have a child, but then I remembered the words of a dear friend who trudged the fertility path for nearly a decade until they got pregnant.  She always says that “anyone who wants to be a mom, will be a mom!”  I clung to the endearing words of wisdom and deep down in a tiny little itty bitty place, I knew everything would be okay. 

He walked in, sat down and asked me condescendingly, “so, how are you?”  Interesting time for a psych evaluation I thought, but I responded, “I’m fine, thank you.”  And then out came the words that I would never live down, never escape, and would permanently define my status in the IVF community:  “Well Mertle, you’re what we call a “POOR RESPONDER.”  I said, “excuse me, poor responder, what do you mean by that?” (not really wanting to know)  He explained that my ovaries were not stimulated by the hormones, they didn’t work, no follicles grew.  He then said, “I knew we would’nt get ten from you but I thought we would at least get five.”   Oh my God, talk about feeling squashed-at that moment I reached a whole new level of humiliation, one I didn’t even know possible.  When I asked him what the next step should be, he cavalierly responded by saying that we can try again next month but that he may or may not do anything different with my treatment.  In other words, I will likely fail again do to my uncooperative uterus.  Talk about a “poor response”–I guess they all do read from the same handbook.

At that moment it occurred to me that perhaps my poor responding self should get the hell out of this clinic and run as fast as I can—best response I could think of!  The greatest lesson I learned in this part of my experience–GET A SECOND OPINION!!

 

And then there were none…

I anxiously awaited my fifth-day appointment with a sinking feeling that things weren’t going well.  It actually hadn’t occurred to me until then that IVF would not work, I was definitely too far removed from that concept at this stage.  Again, I sat in the waiting room with all the other women who were trudging this path and watched them slip into different rooms, one by one as they made their way through the assembly line.   The day-5 nurse called me in and put me in a room with a robe and said, “you know the drill.”  As I sat there I wondered, who would be doing my ultrasound today, would it be someone I’ve even met, would it be someone who actually worked here?  I hoped it wasn’t the guy who drew my blood but at that place, anything was possible. 

Sure enough a technician walked in and what a shock, I’ve never met or seen her there before.  I think it may have been her first day, maybe even her first ultrasound since she wasn’t very savvy with maneuvering the stirrups, and her bedside manner might as well have been scripted from Mad Libs, insert whatever noun or adjective is on your mind.   “Put em’ up” she said, so I knew she at least read the manual but her best line was just a moment away.  As she looked at my empty uterus and confirmed my fear that no more follicles had grown, I guess she wanted to soften the blow by then saying, “man, you sure got the gas thing goin’ on.”  Did she just say that I have gas???  Ummmm–what is the response here–nice of you to notice. I just spent the last five days taking shots that cost me $5000 and bloated me up like a balloon, only to fail to produce even one follicle but thank goodness she noticed my digestive track is doing just fine–one class act. 

My unsung hero

After three days of mastering the Follistim Pen along with a daily Lupron injection, I’m off to the baby factory for the first ultrasound–their assembly line has a whole group of people just for this, I actually never saw the doctor for these, if fact, I wouldn’t have believed he actually existed if it weren’t for that first charming consultation.  I go in to the room and disrobe, something I got very used to, and the technician said to me, “ok, put em up,” another one of the phrases from their customer service handbook.  She brings the monitor up, and just when I thought the place couldn’t really get any tackier, she puts a piece of paper and pen on my stomach and asks that I write down the information she relays to me so she doesn’t forget.  Is she serious?  Keep in mind–it’s dark, and I’m not exactly in a good position for writing!  I did learn that I can however write without actually having to see anything.  Think they don’t top that one, just wait til my fifth day appointment.   

On a sadder note, only two follicles were growing, one on the right and one on the left but both small and clearly not growing as they should.  Of course, knowing so little about the process, I didn’t think much of it and was told to continue the injections for a few more days.  I made another trip to the pharmacy–by the way, fantastic pharmacy and great people working there.  I always leave there with free chocolate for good luck and at least one good hysterical laugh.  I became friendly with the girl behind the counter, and we just saw the humor in all of it which helped lessen the sting when I was paying the bill.   

 

 

 

Not your typical inoculation

I got my box full of baby antidotes home and propped it up on the table and before I could do a thing, my cat was the first to sniff it out.  One by one, I pulled each bag out, five different bags containing different sized and shaped syringes, boxes of viles and one thing that looked like a pen which came with video instruction.   I slipped the video in and pulled out the pen-like object, hoping to follow along with the lesson.  A nice lady came on the screen and talked me through injection but failed to mention the spring that the tube is placed over and before I knew it, the spring sprung the $400 tube across the room and landed on the snout of a very curious golden retriever–all four animals then surrounded the foreign object in hopes that it may be edible.  I quickly ran over and rescued the over-priced medication, hoping it wasn’t too late….yikes!

I diligently followed directions for the next three nights, squeezing my belly and injecting hormones in a 45 degree angle as instructed.  I noticed immediate bloating and a slight mood change but always keeping the big picture in mind.  I realized that my body had been completely taken over by the “baby factory,” and my uterus was under their spell. 

 

Invitro Fertilize Me…

After the surgery which removed an endometrioma and polyp from my uterus, I had about two weeks in bed and then another two months in waiting to begin the first IVF cycle.  Lets just say I had no idea what was in store for me and it was quite a challenge to get any information from the “baby factory,” they simply didn’t have time to spend answering questions.  They sent me a calendar in the mail which had a bunch of words on different dates which could’ve been written in Chinese for all I knew-I soon found out they were names of drugs, better yet, SHOTS that I would be injecting on those dates…

And the hits just keep on comin’….

What I will never forget is that first trip to the pharmacy (and I say first because there were many to follow.) When the Pharmacist came out with my box of drugs, I literally looked behind me because I thought they were for someone else.  I said to her, “Do I really need all of this stuff for ONE cycle?”  She kindly replied, “oh dear no, this is just for the first 3 days.”  To add insult to insult, the bill came to an astounding $2756.43–did I mention I stayed sane during all of this?  

I seriously considered a major career change during all of this, fertility pharmaceuticals is making a killing on us infertile mertles..and after I watched the video on how to use the Follistim Pen–I realized I was a pawn in a billion dollar market. 

 

Daily baby shot…