And Mortality

The mortality part of this blog has been underrepresented of late, so I am linking to an Open Salon piece about the last days of an Alzheimer's patient. Not for the faint of heart.

Suitcase Update

Suitcase has arrived. Dexamethasone ingested 1:26 a.m.!

A Cautionary Tale

I am sitting in my hotel room with my dog, waiting for my suitcase. They say that it will arrive by 12:30 a.m. so I am going to stay up until 12:30 a.m. to see if they are telling the truth.

The truth is that I made a mistake. I put my pills in checked baggage. It was a direct flight. How could they possibly lose my luggage if the luggage and I were on the same plane?

Well, apparently it is possible. Apparently one of two things happened.
Either
1) United lost my luggage in the Denver airport or
2)The flight had too much checked luggage and someone decided my suitcase was less important than someone else's.

When I called United this morning they told me I would have my luggage by 6, so I did not redorder my pills or buy new underwear. Then, at 6, after CCRM was closed, they said the suitcase would arrive my 10:30p.m. At 10:30 p.m., they said it would arrive by 12:30 a.m.

So now I wait.

In other news, this morning I went into CCRM for my bloodwork and ultrasound. The follicles are still growing: 10 on each side within a similar size. Dr. Surrey lowered my Gonal-F dose to 75 tonight, and my Menopur to 1 ampule tomorrow morning.

Things I miss from my suitcase:

Dexamethasone
Clean underwear
the sleepmask that lets me sleep past dawn
my daily disposible contact lenses

A Little Something Extra

Well, I have arrived safely in Denver and have given myself my evening shots. Unfortunately, my suitcase did not arrive. This is a mystery to me, since I took a direct flight. But the airline people have no idea where my suitcase could be.

On the bright side, it is surprisingly easy to travel with medical liquids and needles. I just put them all through the scanner and no one said a word about it. For my purposes, this was a great relief, but I didn't necessarily feel safer in my air travel.

At least the Enterprise Car Rental people are on top of things. Not only did they rent me a car, but their rental car airport shuttle is ready for any emergency, including Bloodborne Pathogens. I wasn't aware that this was a problem on rental car airport shuttles, but I am happy that Enterprise is ahead of the game.

Like Soup

For some reason, I haven't been able to stop thinking about an episode of the cancelled sitcom Arrested Development entitled Beef Consomme. In the episode, teenager George Michael, who suffers from a secret attraction to his cousin Maeby, asks his grandmother whether they are really related.

NARRATOR: George Michael, having failed to get the information from anyone else, made the ultimate sacrifice and went to visit the keeper of the family secrets.

[Cut to the penthouse kitchen, where George Michael stands on one side of an island. On the other side, Lucille prepares tea.]

GEORGE MICHAEL: So, uh, it's about Maeby.

LUCILLE: Oh! That's a lost cause. But you get what you pay for, eh?

GEORGE MICHAEL: Yeah. Wait, what? What do you mean, "pay"?

LUCILLE: Fertility tests, lab fees, donors and implants. She's not real. She was made in a cup. Like soup. (pours tea) A hundred and thirty-thousand dollar cup of soup. How do you like them egg rolls, Mr. Goldstone? All I know is it took an extra year before we could add a den.

GEORGE MICHAEL: So are you saying we're not directly related?

LUCILLE: I'm saying she already spent her inheritance getting here.

Watch the whole glorious episode here.

High Anxiety

Earlier today, I was looking for some instructions on how to mix Menopur, when I stumbled on this preface to the requisite document:

At Ferring, we understand that having to mix and administer your own medication may seem overwhelming, and increased stress and anxiety levels can potentially hinder your treatment. We want to make it as easy and stress-free as possible.

In a survey among members of RESOLVE, The National Infertility Association, patients who were prescribed multiple injection methods (needle and syringe plus pen) experienced higher levels of anxiety when handling, preparing, and injecting their medications.

And in fact tonight, as I prepared for shots #2 and 3, I did feel stress and anxiety.

Shot #2 was 300 of Gonal-F. It's a pre-loaded pen, so it does not require any mixing. But I found it difficult to push the button that administers the medication, and once I did push it, the result was more painful, in a stinging way, than any of the other meds I am taking this cycle. I have a vague memory of repronex also being painful in this way.

Shot #3 was Lupron, down to 5 units.

So for the day:

a.m.

One Folgard pill

Two vials of Menopur, injected

p.m.

One Folgard pill

One prenatal vitamin

One baby aspirin

One dexamethasone

5 units Lupron, injected

300 Gonal-F, injected.

3 squares Green and Black Organic chocolate

Ready, Set, Go!

Yesterday I got the word that the cyst had disappeared and I was ready to move forward with this IVF cycle.

So this morning I started my first stimulation shot of IVF #3--Menopur.
I added a photo of the Menopur paraphernalia at right. You will notice three small vials in addition to the Menopur box and the two needles. Two of those are the Menopur powder, and one is the sterile diluent, which I think is just a fancy way of saying saline solution, which in turn is just a fancy way of saying salt water.
The Menopur comes in powder form and I have to add 1 ml of diluent to one vial, using a long needle, and wait for it to dissolve before sucking the mixture back and adding it to a second vial of powder. Then I suck that mixture back up, and unscrew the long needle and screw on a short needle. Then I ice my belly, wipe a spot down with alcohol, and inject.

It has been nine months since my last fresh IVF cycle, and once again, this morning, as I was mixing these powder and very nearly accidentally stabbing myself with the wrong needle, I remember why I am not a chemist.

Tonight, Gonal-F.

What IF?

Keiko Zoll won a Team Resolve award for this video:

What IF? A Portrait of Infertility from Keiko Zoll on Vimeo.

Thirty Days of Lupron

I remember the days when I was starting my second IVF cycle and thought that two weeks of lupron was torture. I was naive then.

If my current cycle goes as planned, I will be on Lupron for 30 days.

But let's review.
As you may remember, I started lupron back at the beginning of June with the idea of doing a retrieval at the end of that month. Sadly, my period did not arrive on schedule and thus, I ran into the one week of the year they close the lab, and I was unable to move forward. So that was 11 days of lupron for nothing.

Now, I have been on lupron since Day 24 of my cycle, which was July 6, and since my body decided to gift me with an unprecedented 38-day cycle, I have now been on Lupron 16 days, and I have not even started my stimulation shots. AF came yesterday, so I called CCRM and we set up a "calendar" and I bought my ticket to travel there on Monday.

This morning I went in for an ultrasound, looking forward to starting my stimulation shots and generally getting on with my life.

The ultrasound showed plenty of follicles: 14 on the left side and 12 on the right. The local doctor said he also saw an old, ruptured cyst, but that it would not affect my stimulation. I got my blood work done, and started waiting for the phone call from CCRM.

The CCRM nurse said that the cyst was borderline and my estradiol was slightly high at 66, so, while they weren't going to cancel my cycle at this point, I would have to stay on Lupron until Friday, when I will have another ultrasound and bloodwork to see if the cyst has shrunk. If it has not shrunk, it would interfere with the stimulation, so they would cancel the cycle.

The protocol calls for me to be on Lupron all the way until I take my trigger shot, approximately 10 days after I start the stims. So if my math is correct, that's 30 days of lupron. And that is not counting the 11 days from my last failed attempt.

I am tired of being on lupron. I am tired of shots, and I haven't even started the thrice daily regimen of lupron, menopur, and gonal-f.

I put in a request with Bear for some of his fool-proof puppy play therapy, but he, too, is tired of the effect Lupron is having on the mojo of the house, so he chose to rest on this chair instead.

Tonight, more Lupron, more dexamethasone.... Wish me luck!

The Sound of Silence

Great article in Self about women's silence about IF treatments. I have certainly thought a lot about this in terms of my desire to hide in my closet on my birthday and my inability to return the calls of my pregnant friends. (Hi Friends, I'm sorry!)
I had not considered the implications for changing health care policy. If you are going through IF, I hope you will join or donate to Resolve.
The thing I'd really like to know is why the article's statement that the interviewee might work "behind the scenes" in infertility links to this article. Really, what am I missing?

Lupron Left, Lupron Right

I started my shots of Lupron 8 days ago, and yes, I am cranky. I also have a headache. This is the third time I have been on this particular drug. The first time was during my second IVF cycle last fall. The second was just a month ago. That cycle was postponed, so I took an extra 11 day of Lupron for no reason. Good times.
Every night, I give myself the shot after icing my belly, and I record the event in my calendar. Sources say that you should alternate the side of the belly you inject every day. This isn't a huge deal with Lupron, because the site itself isn't very bothered by the liquid, but it becomes more important when you add in the other shots later in the cycle because they cause redness and irritation and large welts that span the valley of the oblique muscles. All I can say is, I don't know how anyone does this without an ice-pack.
For now, it's just a running line on the bottom of my day planner: Lupron Left, Lupron Right, Lupron L, Lupron R. And I wait for AF, so I can add more needles to my repertoire.

Desperation IVF

This essay, about the decision of a husband and wife in their early 30s who decided to go through IVF to freeze embryos to use when they are financially stable, is causing quite a stir in the fertility chat rooms I frequent.

The article refers to IVF after 35 as Desperation IVF, and IVF before 35 as Preservation IVF.
Her language does trigger a negative reaction in me, but I'll admit that she may not be as smug as I perceive her. It may be jealousy, or the lupron, or the desperation.

In short, yeah lady, I do wish I'd vitrified some embryos when I was 30. I also wish I'd fallen in love with my husband earlier. I also wish we'd gotten pregnant when we started trying.

But how nice for her that this worked out.
And if I had a daughter, I would show her this article so she would know about her options.

On Friendship

I've read a number of memoirs over the past year, including those of Joan Didion and Elizabeth McCracken. The latest one to inspire me is Ann Patchett's amazing tribute to her friendship with the late Lucy Grealy. Every page was gorgeous and heartbreaking, but this quote in particular has stuck with me:

"Even when Lucy was devastated or difficult, she was the person I knew best in the world, the person I was the most comfortable with. Whenever I saw her, I felt like I had been living in another country, doing moderately well in another language, and then she showed up speaking English and suddenly I could speak with all the complexity and nuance that I hadn't even realized was gone. With Lucy I was a native speaker."

I had the opportunity to see some old friends this summer, and I had this exact feeling. Thank you, Ann Patchett for describing this so perfectly.

P.S. Erin, I miss you.

Nicest Rock Star Ever

Since we are still on a break from all shots and hormone-altering substances, my husband and I drove up to Portland to see his friend Rhett Miller who was doing a show with his band the Old 97s.

I've only met Rhett a handful of times before, and I had already concluded that he was the nicest rock star ever. What I wasn't expecting was that over dinner, the three of us would have a really frank conversation about all of the troubles my husband and I have had over the past year, and that Rhett would say all the right things about my father's battle with cancer and our fertility deal.

So, if you like alt-country, or if you just want to see a great show, check out the Old 97s tour schedule.

P.S. This is the first time I have had dinner with someone while other restaurant patrons are surreptitiously snapping photos of my dinner companion with their iphones. I asked for permission to take this one.

My husband is the one on the left.

Who would you say is the nicest rock star ever?

Cribs vs. Beds: Parenthood's all-out war

I am not a parent, but I found this hilarious.

Cribs vs. Beds: Parenthood's all-out war