Nuchal Translucency and Facebook

We had our nuchal translucency scan this morning, and it went swimmingly. The neck measured at 1.something, which is good (they want to see less than 3, although the tech told us most Down’s babies measure closer to 6). We saw the nasal bone (also good because Down’s babies often don’t have a nasal bone at this point). The abdominal organs are almost all in the abdomen now, having migrated from the umbilical cord. The heart was beating at 161. We saw two hemispheres of the brain. Saw a genital nub, but it’s too early to tell if it will grow larger into a penis or shrink into a clitoris. We saw little webbed hands, and wee tiny feet that waved and kicked.

Because I’m still under 30, my risk of trisomies was low to begin with, but now it should be even lower with the reassuring scan.

**********

Most of us know how hard it is to be ambushed by Facebook announcements, especially as they seem to come in groups, just after your latest BFN or right around the due date of a miscarriage. Facebook has impeccably shitty timing.

For a long time I promised myself if I was ever lucky enough to get and stay pregnant, I would just skip the cutesy/smug Facebook brag. (And side note here, getting pregnant does not, at least for me, make me like the announcements any better. Seriously, y’all. You’re fecund. We get it. How marvelous for you, etc. Shut up with the beribboned, sparkly announcements)

But now I find myself trying to figure out how to let people know what’s going on in our world. We’ve told our families and close friends, but I do want some way to let less close friends know, many of whom are scattered around the world. I considered phoning (don’t have most people’s numbers, and hate talking on the phone) and email (ditto on not having many emails, and that seems kind of cold, no?) and have come full circle to Facebook. Dammit, Facebook is friggin convenient. How annoying.

But I need help figuring out what to say. I obviously want to be as sensitive as I can to those struggling, and I’d like to acknowledge our own struggle to get where we are. I’m considering the following, but would appreciate any insight, recommendations, edits, additions, etc.:

“Tammy and I are absolutely overjoyed to announce we are going to have a baby. We are so grateful to our doctors, nurses, and embryologist for helping us get this far. Below is a picture of our embryo at 5 days past fertilization, and our fetus at almost 13 weeks gestation. I am due in January, and we cannot wait to meet our little one.

And with the announcement, post a side by side picture of the day 5 blast with our most recent scan.

One final note, those friends/family members that I know would react to the announcement with complicated feelings have been told already, via the medium we thought would be easiest for them.

Thoughts? Skip the pictures? Or skip the embryo picture but include the fetal scan? What would you want to see, and not want to see if you were reading my page?

Insurance Can Kiss My Ass

I have no insurance coverage for infertility, other than an initial diagnostic appointment (that doesn’t include any, you know, diagnostic tests like blood work, HSG, ultrasound, etc., because that would be too fucking logical). Everything else was 100% out-of-pocket. I am so envious of those of you who a) live in states where there is mandatory coverage and b) can utilize those benefits. We used to live in a state where there was coverage, but HAHA SUCKERS it didn’t apply to us. It only applied to those individuals who used their husbands sperm. i.e. no lesbians or single women or hetero couples with severe MFI who decided to use a donor. Because obviously, those of us in the previously mentioned categories do not deserve to have children. Obviously.

ANYWAY, moving on swiftly. I had an experience today that reinforced my need for an insurance vendetta.

As I stated above, I have no insurance coverage for infertility; no monitoring, blood work, ultrasounds, procedures themselves (IUI or IVF) and definitely no prescription drug coverage. HOWEVER, once I got pregnant (ultrasound tomorrow to confirm that I am, in fact, actually still pregnant and not newly awakened from a month-long delusion/psychotic break) certain medications that I took for infertility (estrogen, progesterone) are now covered due to my pregnancy “status”. When I called to order more drugs after my BFP, I told the pharmacists my new “status” and asked joyfully what the co-pay was. The pharmacist responded that they needed to have my doctor’s office call my insurance company to confirm that I was, in fact, pregnant. This was a month and 3 refills ago. Each time the pharmacist tells me they’re going to call over to my doctor’s office and ask THEM to call my insurance company. Of course, they don’t fucking do that. Today I got a little royally pissed off vexed in a MOST ladylike way, and told them what was up.

30 minutes later, I got a call from someone at the pharmacy asking if I was pregnant. OMFG. I only told you all that a fucking MONTH ago. She promised that she would call over to my doctor’s office to have them confirm the dates of my pregnancy, so they could retroactively reimburse me for money paid out-of-pocket for the last 3 refills. An hour later I found out that my doctor’s office would only confirm my pregnancy as of May 29th, and I had called for a refill on May 28th. So that $400 haul of drugs won’t be covered.

Reading over what I wrote, maybe I should be more irritated at the pharmacy and my doctor’s office, instead of the insurance company. And yes, the pharmacy definitely dropped the ball on this one. And I’m going to have a little chat with my doctor’s office tomorrow to see WHY they claim me pregnant on May 29th when I had my positive beta on the 24th. But you know what? All of this mess would have been avoided if I had coverage in the first damn place. God.

**UPDATE: I just got my meds delivered to my office building (damn right they deliver) and the workers in the mail room made many HILARIOUS jokes about my “drugs”. HA.HA. Hilarious. Lets talk a little louder about my DRUGS when the CEO is just down the hall! Fabulous idea.

It’s Aliiiiive

I just got a call with my second beta (that was done 4 days after my first beta, due to the long weekend).

First beta (at 10dp5dt): 372
Second beta (at 14dp5dt): 2032

That’s a doubling time of 39.19 hours.

The nurse that called me said this was “good.” My next appointment won’t be until I’m between 6 and 7 weeks pregnant (if I make it that far*) to see a heartbeat.

No more betas!?! No more appointments for over a week?! I feel adrift. Can I come in for blood draws for fun? What about visiting my old pal, Monsieur DildoCam? Or could I come in to breathe the heady, intoxicating scent of sadness and fear that permeates the waiting room? I’m still generating plenty of that pungent elixir to contribute. What if your stores are depleted without me around??

Another hurdle has been cleared. I keep trying to tell myself that I’m farther (further?) than I’ve ever gotten before. But poor Tammy had to talk me back from the ledge over and over this weekend, repeatedly fielding my teary questions of “what if it’s dead?” “what if it doesn’t double?” “what if I’m a fucking lunatic for hoping this would ever work?” (that last one was only in my head)

But so far**, my fears have been for naught. I am assured by What to Expect When You’re Trying to Freak Yourself the Fuck Out that our baby is the size of an orange seed right now. The heart is beginning to function at a rudimentary level, although it will be a few weeks until we can see it on an ultrasound if we get that far.***

Tammy and I also engaged in extremely risky behaviour this weekend: we looked at baby stuff while we were at Target, and talked about a possible/future/maybe nursery.

And THEN I held my friend’s baby for hours on Sunday, wiping her little teeny baby butt, kissing her baby toes, rocking her to sleep, and drinking in the perfect sweet/sour baby smell of her head.

Is it possible that I actually, maybe, possibly might end up with a baby of my own? Boggles the mind.

*I have GOT to stop doing that. Industrial strength asshole = me.
**That was the last one. Promise.
***Ugh. I’m the worst.

Heavenly Day

Heavenly Day
By Patty Griffin

Oh heavenly day, all the clouds blew away
Got no trouble today with anyone
The smile on your face I live only to see
It’s enough for me, baby, it’s enough for me
Oh, heavenly day, heavenly day, heavenly day

Tomorrow may rain with sorrow
Here’s a little time we can borrow
Forget all our troubles in these moments so few
All we’ve got right now, the only thing that
All we really have to do
Is have ourselves a heavenly day
Lay here and watch the trees sway
Oh, can’t see no other way, no way, no way
Heavenly day, heavenly day, heavenly day

No one at my shoulder bringing me fears
Got no clouds up above me bringing me tears
Got nothing to tell you, I’ve got nothing much to say
Only I’m glad to be here with you
On this heavenly, heavenly, heavenly, heavenly
Heavenly day, all the trouble’s gone away
Oh, for a while anyway, for a while anyway
Heavenly day, heavenly day, heavenly day

**********************************************

The doctor called with my beta results. As of this morning, my hCG was 372. With my last pregnancy it was a 17. Obviously, this could mean absolutely nothing for the long-term. I could miscarry this baby just like the last one. But today, at least, I’m chosing happiness. I’m chosing joy. I’m chosing peace.

Stick around, little one. Your mamas can’t wait to meet you. We love you already.

I Held Out for as Long as I Could

So this happened.

tests2

Beta wasn’t scheduled until Tuesday, but I broke down and emailed my nurse yesterday, begging her to let me move the blood test up. She agreed, so my beta is tomorrow morning (when I will be 10 days post a 5 day transfer, or 15 days past ovulation).  I guess that makes me officially 4 weeks pregnant today.

I don’t really know what to think or how to act. I’m excited, of course, but I’m also scared out of my mind. There’s a large part of me that feels detached, like this is happening to someone else. I feel like I’m watching a movie, sitting back and saying, “Huh. Well, that’s interesting”. Tammy suggested I feel this way because I’m scared it won’t work out, that I’ll lose this pregnancy like I lost the first one. She may be right. Which is why I wanted to move the beta test up. A strong beta number will help to ease my mind (a tiny bit). And if it’s strong, I’ll worry about the second beta doubling appropriately. And then I’ll worry about the 6 week ultrasound to see a heartbeat.

I told a friend of mine yesterday that I was pregnant. He responded that since I was doing IVF, he didn’t realize it was a question if I was or wasn’t, that he thought it was a “done deal”.

HAHAHAH! At “done deal”!!!! OMG. Wiping away tears of laughter (and a little bit of bitterness). Don’t I fucking wish it was that simple. Take some drugs, get lots of beautiful embryos, pop one or two or three back in, and just wait to find out how many! Then have a blissful, worry free pregnancy, a textbook delivery, and a happy & healthy baby.

God. I fucking wish.

Anyone have suggestions about how to be calm/happy/enjoy the moment while I wait for my beta number?

 

Edited to Add: Sorry the bottom test is so yellow. That’s disgusting. No idea why it’s so yellow (I did pee on it, but why has it gotten so yellow? Barf.) Also, I cropped the picture to take out the pee stick part. There were droplets (DROPLETS) visible, and I do have some pride.

Things that Irritate Me Today

ITEM:
The fact that I take a fist full of vitamins daily. I’m too paranoid to stop taking them.Vitamins(clockwise from the top red one: prenatal + DHA, fish oil, estrace, colace (I *heart* colace), royal jelly, CoQ10 x2)

ITEM
The fact that I can’t remember if I took my estrace this morning. And I’m having an internal panic – do I take another one just in case I DIDN’T take it? Can you overdose on estrace? Do I NOT take one in case I DID remember to take it? Called my nurse but she hasn’t responded yet. Grump. Anyone have any suggestions?

ITEM
The fact that I had this email waiting for me when I got to work (excerpt):

Over the past couple of days they have had “heavy” coverage of [redacted] issues on their web site and also, I noted in the “paper” edition of this morning.

NO. Just NO. Your quotations license is revoked. I award you no points, and may God have mercy on your soul.

ITEM
The fact that my clinic starts counting the two-week wait when you have your transfer, not when the embryos are made. So REALLY I have a two-and-a-mother-fucking-HALF week wait.

The Pirate has Commandeered the Mother…Ship

The transfer went well yesterday. The appointment was set for 9:15, but we had to be there at 8:45. Due to the general suckitude of the traffic, we decided to stay in a hotel 1/2 a mile from the clinic, and that was an AWESOME decision.

Tammy has to travel for work more often than we’d like, but the upside of this is that she has hotel points. Cashing in those suckers was SUCH a good idea. We didn’t have to pay for the room (which is good, because we have no mas money after paying for all this IVF shit), got to sleep in, had an awesome breakfast at the hotel, didn’t have to sit in traffic, and got to the clinic in literally 3 minutes.

When we got to the clinic, I was told to put on booties (AGAIN WITH THE BOOTIES) but didn’t have to change into anything else. Except take my pants off. (Isn’t that a given?)

booties

They made Tammy put on booties as well. On one hand, I don’t really understand WHY we had to put on the booties, but it made it seem more sanitary (I guess? Like are they worried they’re going to drop the blast on my dirty foot?).

I got another ID wrist band.

wrist ID

And then the doctor came in and ran us through the stats:

23 eggs retrieved
18 mature enough for ICSI
15 fertilized normally (I found out an additional one fertilized abnormally – WTF is that? I didn’t even know that was a THING)
Day 1: 14 in the 2-4 cell range (GOOD) 1 at 7 cells (BAD)
Day 2: 14 still growing at the appropriate pace
Day 3: Down to 12 – 2 have slowed down and don’t have as many cells as they should
Day 4: No update, they just leave ’em in the incubator (MY BABIES ARE ALL ALLOOONNNEEE)
Day 5: 5 at the transfer/freeze stage (blastocysts), 5 more just one step behind that they’re going to watch until Thursday and potentially freeze.

The doctor strongly (STRONGLY) recommended that we transfer 1. Tammy and I had discussed this ad nauseum, and were still somewhat divided. (HA! Get it?! I made a cell division joke! Divided?! Cell division?! Nevermind…) We decided to wait and hear the doctor’s recommendation to help make our final decision. My waffling decision making on this issue looked something like this:
Transferring 1
-Same pregnancy success rate at my clinic as transferring 2 (60%)
-Would be easier on my body to carry 1
-Would be nice to be able to focus on one baby at a time
Transferring 2
-Would get the whole “having babies” thing out of the way in one go – only have to go through this (emotionally, physically, financially) once
-It would be fun for our kids to have a friend to grow up with that was their age.
-The “luck” factor. If my chances are roughly 60% with this IVF, what if we transfer 1 and it wasn’t THE one? What if it was the unlucky embryo? Wouldn’t transferring 2 give us more of a shot?

But like I said, the doctor STRONGLY recommended that we transfer 1. And Tammy was STRONGLY leaning in that direction also. The doctor got me to agree by telling me how much higher the miscarriage rates are for twins than a singleton. Now, I know as much as the next person that miscarriages can happen regardless of how many are in there. But having experienced one, I’m fairly desperate not to go through that again (my heart goes out to all you RPL ladies. You are so strong and it is so unfair. I’m so sorry).

So one it was. And it was a beautiful one.

Perfect Blast

Internet, meet Captain Jack Sparrow. It is currently chilling (hopefully NOT chilling – get to WORK young man*. We’ve got IMPLANTATION to do) in my uterus. They put a picture of it on a TV screen while the embryologist brought it in. Tammy’s first comment was “look how big it is!” Mine was “look how tiny!”

Speaking of wee, you must have a “moderately full” bladder for the transfer. And by “moderately full”, they mean HOLY GOD YOU ARE ABOUT TO PEE ON THE DOCTOR LOOK OUT. I actually asked the doctor if anyone had ever peed on her during transfer and she said only once, but the woman was under sedation for the transfer and didn’t have control over her bladder. Then she told me she used to be in obstetrics so a little pee and a little poo don’t faze her. “Now VOMIT on the other hand, I don’t do so well with,” she said. (Duly noted. I will aim my vomit on the nurse.) I only had a FEW panicky moments when the damn nurse pressed on my stomach with the ultrasound wand, but I was distracted by the small flash of light in my uterus, which was the moment the doctor ejected Captain Jack into my uterus. You can’t actually see the blast, of course, but the flash is the fluid surrounding it.

After 5 minutes of laying still, and about 5 minutes of blissful peeing, I went home and I climbed into bed to do my 24 hours of bed rest. Normally I enjoy nothing more than some downtime to laze around and read or watch movies. But yesterday I was bored as hell. Apparently sometimes I can be a wee bit stubborn and contrary. Just a teeny tiny bit.

The next two weeks are going to be agonizing.

*We both for some odd reason think it’s a future boy. NO idea why. But IF this sticks, and IF it’s a girl, well, Captain Jack Sparrow is still a badass name.

Day 1 Report, Plus WTF Happened Yesterday?

As I said in my groggy, blurry post yesterday, I had 23 eggs retrieved. I just got the day 1 report:

23 eggs retrieved
18 were mature enough for ICSI
15 fertilized

The doctor said that’s a higher than average fertilization rate, so WOOT to that. Right now we’re aiming for a 5 day transfer, but we’ll (ok, they’ll) watch for the appropriate division/development over the next couple of days while we decide. A nurse told me that the average rate of drop off between fertilization and transfer is 50%, so that would leave me around 7 to mess with (1 or 2 to transfer, 5 or 6 to freeze).

I’m feeling a lot better today than I did yesterday. I don’t know why, but I fully expected to LEAP out of bed as soon as the retrieval was done. Now I’m all, HAND OVER THE DRUGS. Let me back up though, and run through the day. I found these play by plays extremely helpful before I went through it, so I hope others benefit from my reading this. If not, sorry! That’s five minutes of your life you’ll never get back!

My retrieval was set for 8AM at the fertility office 45 minutes from my house. HOWEVER, we had to be there at 6AM, and traffic in this city is absolutely ass-tacular. I wanted to leave an hour and a half to get there. Tammy’s argument was that traffic wouldn’t be THAT bad at 5AM, and we didn’t need to leave THAT much time. So she woke up at 4AM to shower and get ready, while I lay in bed (having showered the night before but woken to her alarm) and FUMED because she wasn’t getting ready fast enough. How had she not read my mind to know that we’re going back to the original plan of leaving at 4:30?!

Tammy very helpfully talked me back from the edge, and we left at 5. And then got there at 5:30. We were literally the first people in the parking lot. Poor Tammy. She asked me a few times if I was SURE the nurse said to be there two hours early. And we couldn’t go sit in Starbucks while we waited because a) are Starbucks even open at 5:30? and b) I couldn’t eat or drink anything. Boo.

Anyway, we finally went inside when a few other couples showed up, and sat in the waiting room, all nervously sneaking glances at each other. You could tell who was there for egg retrieval – fuzzy haired, bespectacled, sans makeup, etc. I’d seen plenty of these women during morning monitoring, and it was pretty funny seeing them in their natural state.

We were called back fairly quickly to the recovery room where I changed into a hospital gown, booties, and cap. DEFINITELY a good look for me, let me tell you.

IVF Feet

A nurse came in, confirmed my identity and gave me a wrist band.

IVF ID

Then an anesthesiologist took my medical history (“ever had anesthesia before?”) and hooked me up to an IV bag of fluids. He said this would make me feel better later.

IVF Feet & IV

And then we waited. The doctor doing the retrieval came in and introduced himself (it’s a large practice, and I hadn’t met him before). I nervously went pee a few times, holding my gown closed in the back, wheeling along my IV. I felt about 200 years old doing that. Finally, at 7:45 they told me to empty my bladder once more. Then they escorted me into the OR while Tammy went back to the waiting room. I had always pictured myself being rolled in on a stretcher, but alas, I walked. Not nearly as romantic.

The OR was kind of creepy, though. A little chair type thing, laid flat, and a million tubes and wires and utensils (shudder). Also a million people. An embryologist came in and asked for my ID wrist band. I thought she was trying to shake my hand, and she laughed at me and told me she WOULD shake my hand, but she needed to confirm my identity first. So we had this weird, limp wristed hand shake while she read my badge. As she asked me to recite my social security number, the anesthesiologist said in the background, “I’m just going to give you something in your IV. It’s not going to make you fall over, but it’s going to start the process.” I remember thinking to myself that maybe they should have me recite my social BEFORE they give me a sedative.

Then an OR nurse came over and fussed with my gown, pulling it open in the back. It’s probably an indication that the sedative was working that I cared not at all I was flashing my ass to the room. Then she helped me hoist my legs into these stirrup things. They weren’t the stirrups that you place your feet onto during a gynecologist exam, but rather you place the back of your legs (the knee-pit) INTO them, feet dangling down. The last thing I remember is thinking, “maybe I should lay down”.

Then I woke up the recover room, with Tammy holding my hand. I could feel the warm blanket they had placed over me and the heating pad on my abdomen. And then I felt both a sharp pain and a dull ache. I started to cry, not because of the pain (although it DID hurt) but because I was confused and scared. I don’t remember this, but apparently the nurse came in and asked why I was crying. I told her I didn’t know. She asked if I was having pain, and I told her yes so she gave me a shot of something in the IV. I distinctly remember the feeling of the painkiller flooding my body. It was like the pain melted away. Awesome. God bless painkillers. It was just after the pain melting experience that I told the nurse I loved her (apparently. I do not remember this). I drifted in and out of sleep for a while.

When I would wake up I’d ask Tammy the same questions over and over. How long was I out. What time is it. How many did they get. I also kept telling her I didn’t remember anything, and was quite distressed about that, apparently. My Tammy was an absolute star. I think I made far more fun of her when she was waking up from wisdom teeth surgery. Still tease her about some of the things she said. Bad wife! Bad!

The nurse checked on me a few times. I got another delicious shot of painkiller. Tammy filled a prescription of painkillers to take with us. I demonstrated that I could eat, drink and walk. And then we were allowed to go home.

I slept for a few hours once home, waking up occasionally to pee. I was warned I might spot, but so far there’s been nothing. The pain is better today, but it’s most definitely still there. I’m trying to stick to Tylen0l today, so I don’t slur on the phone with clients.

I’ve also been warned to eat lots of protein and drink lots of fluids as my ovaries were “quite large”. Hopefully this will help mitigate the risk of OHSS. Also, the large/swollen ovaries explain in part why I may be having more pain than average.

To sum up: needles in your vagina hurt, painkillers are awesome. If they suggest taking an OTC painkiller, give them a withering look and hold out for the good stuff. And take it easy the next day.