WUT?

So can we talk about this? Because WHOA:

I have peed on so many, many dollars over the last few years, but never has THIS happened. And let's be clear -- I am certainly not operating as though this means we'll actually be bringing a baby home come May. If this is indeed accurate and not just a chemical (first beta is Tuesday), I am at a mere 4w1d. There is still so very much time in which things could go wrong.

I am dangerously, wantonly hopeful, though; I just can't help myself. We did so much to get here and I think I was just expecting it would never actually work. I feel like hope is reckless at this stage, but alas, here we are. And fucking Pinterest, you guys. The siren song of its trove of nursery photos is irresistible; I mean, imaginary decorating is MY THING. I'm not pinning anything, of course, but ohh how I look and ponder themes and paint colors. I also had a conveniently timed shopping trip to pick up a baby shower gift and was promptly overwhelmed by Buy Buy Baby. There is so much CRAP; I could research from now until May just trying to figure out what is actually necessary. It makes reading about this stuff so easy to justify when I should really just back away and ignore the fact that our whole world has shifted.

I think imaginary decorating and reading about baby gear is just my method of distraction, because the limbo never really ends, does it? First I was anxious it wouldn't work, now I'm terrified something will go wrong. The really scary thing is that, if we're unbelievably lucky, it's only going to get worse. In the best case scenario, I'm going to spend my whole life, God willing, worrying about something happening to this little person. Right now, I'm just hoping I'll get that chance. 

I can't drink, so I'm soothing my nerves with pictures of Jenny Lind cribs and nautical stripes. It'll have to do for now.

Limbo

*Still rambling about reproductive matters. As always, feel free to avert your eyes.*

I'm horribly impatient, which makes the waiting for the first beta torturous. My sunny and optimistic husband just puts it out of his mind and goes about his day. My innards are still a bit jacked, so even in the rare moments I can forget, I'm reminded by the pain every time I have to pee. Or sit on my lumpy, PIO'd ass. If it didn't work, it didn't work; I JUST WANT TO KNOW. My test is scheduled for the 17th, but I am 100% a home test cheater, so maybe Thursday. We'll see -- I'm trying to hold out as long as possible. 

Did I tell you about the transfer? It was such a strange experience. They bring you into a dark exam room to wait for the doctor, then there is a lot of repetitive ID bracelet checking and name/birthdate/social recitation, first with the nurse, who also checks your photo ID before putting on the bracelet, then with the doctor, and finally again with the embryologist. We had to say why we were there and verbally consent to the single embryo transfer and sign the consent form. The embryologist went back to her bench and trained the camera on the embryo that had been voted Most Likely to Succeed, displaying the image on a tv in our procedure room. At this point, the doctor started describing what we were seeing and why they chose that embryo as she, um, set up shop. It was kind of weird because this was only the first time I had seen my doctor for an actual medical procedure. She works out of the main office, which is a hike for me to get to. I go there for consults with her, procedures requiring the ASC, and occasional monitoring appointments if I have to go outside of the satellite office monitoring hours. For my regular monitoring appointments, I go to the office that is on my way to work and I am a frequent flyer to the staff over there. My doctor coordinates my protocol, though, and has been wonderful to work with. She is super no-nonsense, yet still quite sure we will eventually have success, but in a very matter-of-fact way. I never, ever get the sense that she is blowing sunshine. We also went to the same small college. Although I was there about five years after she graduated, I feel like it makes her my people in a way. 

But I digress. (Ha, that should have been what I called this blog.) After setting up shop, the doctor looked around for free fluid, given my increased risk of developing OHSS. The ovaries were still swollen, of course, but I appeared to be fluid free otherwise, so she felt good about giving a thumbs up for transfer. She opened a door into the lab and requested the embryo by an ID number. The embryologist brought in the catheter, it was positioned by the doctor, and just like that, the transfer was done. The embryologist brought the catheter back to the microscope to make sure they had gotten the embryo out, and that was it. My doctor was lovely, taking a minute to chat afterward and thanking us for being so patient over a long road, saying how hopeful she is that this is the one and how confident she is that we would have a strong group left to freeze. (We did! Six!) She is super smart and very much a scientist, but she is also an excellent caregiver. This clinic sometimes gets a bad rap because it is so huge; people complain about feeling like a number. However, that has never once been my experience. Even visiting multiple offices, I still feel like they all know me and genuinely care about our experience and getting us to an eventual success. We're several cycles in, child-free, and I would still recommend these people without the slightest hesitation. 

Oh! The funniest part! (It's dark humor; bear with me.) So once the doctor leaves, they have you stay lying down on the table until one of the nurses comes in with your follow up instructions. As I was lying there, the embryologist came back with a card that had a picture of the embryo attached. It just struck me as morbidly hilarious, perhaps because detachment is an excellent defense mechanism. It was just like those cards you get when you take kids to see Santa or the Easter Bunny, except inside was a picture of our widdle blastocyst. What does one do with this? Hope for the best and save it to paste under "Baby's First Photo" in a future baby book? I couldn't help but think about what I was supposed to do when the clump of cells dies. Label it "Our First Little Crushing Defeat" and tuck it away to reminisce about those two weeks we spent hoping it would live and wondering who it would become? For now, I am going with hide in purse and try to forget it's there.

It totally has my inner cell mass. 

One hell of a weekend...

...with "hell" being the operative word there. 

*As always, here is your TMI warning to avert your eyes. Talk of the lady parts ahoy.*

Let me back up. When we last chatted, I was well into stims for this cycle and things were progressing nicely. It looked like there would be about 15 follicles, which is a nice number for ensuring success without venturing too deeply into risky Ovarian Hyperstimulation Syndrome (OHSS) waters. I was having daily monitoring appointments last week, and on Wednesday, they estimated another two days of stims before trigger. That was perfect timing-wise, as we had friends coming to spend the weekend, so a Monday retrieval was ideal. That would also bring us to a Saturday transfer, so minimal time out of work too. 

Enter Murphy's Law: At Thursday morning's appointment, we were up to about 18 follicles and the leaders had jumped into the 21-22 mm range. The sonographer had me talk to one of the nurses, because she was 99% sure I would trigger that night based on the looks of things. I got all of the instructions from the staff nurse, then awaited the post-bloodwork call from my regular nurse. It turned out that my estrogen levels had doubled overnight and were ridiculously high -- just over 5,000, so yeah. Time to trigger. Because of my PCOS diagnosis, the original plan was to use a dual trigger -- a lower dose of the traditional hCG trigger, plus Lupron. Where hCG is a driver of OHSS and it has a very, very long half-life, the traditional all-hCG trigger was a bad idea for me. However, with the discovery of the sky-high estrogen levels, the team decided that the dual trigger was also too risky and decided to go with Lupron only. Lupron can be dicey, as it causes a surge of LH from the pituitary to mature the eggs prior to retrieval, but in the rare case where there is no LH in reserve, the trigger failure could result in a cancellation. I was very worried about this potential, as the ovaries were suuuuper uncomfortable at this point. (It is very weird to be able to feel your internal organs bumping around in there.) 

Friday's bloodwork revealed that the Lupron trigger had done its thing, so we were good to go for the Saturday retrieval. I was both anxious to get it over with, but also frothed into a terrified lather over the possibility of OHSS, especially with the fast rising estrogen and my nurse's urging to start a high protein/sodium diet and switch to drinking Gatorade. (I may also have broken the 1st Commandment of The Internet: Thou shalt not google potential medical complications.) Anyway, I bought out the processed meat and fruit punch Gatorade sections at the supermarket and we immediately embarked on the high blood pressure express. Since Thursday, we have had cheeseburgers, kielbasa, hot dogs, a quattro carne pizza (pepperoni, sausage, meatball, AND bacon), a boatload of tater tots, and I have had two lunches of Baja Fresh. I'm also deep into my third barrel of Gatorade. It is surprisingly horrific (I would kill for a salad right now), but if it keeps me from developing issues? Bring it on. 

Saturday was pretty awful. I woke up starving, which I never do, likely because I knew I could neither eat nor drink. We had to be at the doctor's office by 11, at which point the anxiety began. I was straight up SCARED. I am a terrible patient to begin with, and not knowing what to expect was killing me. They got an IV started to rehydrate me after the pre-op fast, then we had a bunch of informed consent nonsense. I have loved almost all of the nurses at this place, but the one in charge of informed consent? OMG, awful. She was incapable of deviating from her script, even for questions. At least the others were all great. I was also put tremendously at ease by the doctor. Once they were ready to go, things went really quickly. They walked me into the procedure room, had me get situated on the table, then the anesthesiologist hit me with the versed. I remember laying down, then I have a vague recollection of scootching to the gurney when they were done. I think I apologized in case I had snored (such is life with effed up sinuses), then they brought Mark back. I kept telling him to sit, but he insisted on standing next to me and holding my hand. Things were getting painful the less groggy I got, so they shot some fentanyl into my IV. It didn't do much, but the Queen o' Bedside Manner had scared the bejesus out of me earlier, talking about women who refused pain meds and ended up in the ER from the pain. (THANKS, DONNA.) What has two thumbs and isn't a hero? THIS GIRL.  

Once I was back with the program, they brought me a giant diaper pad and said I could get dressed. My favorite nurse of the day walked me around to make sure I was steady enough to get to the car, then came in to tell us the egg count. Turns out they got TWENTY-EIGHT, HOLY CRAP. This is both awesome in that I could potentially not have to do another egg retrieval, but also ups the risk of OHSS (hola, Gatorade, old pal!) Apparently something about the number of eggs collected also caused them to switch me from the progesterone suppositories they originally prescribed to the dreaded PIO injections. They gave me a vial to bring home and drew helpful little targets on my ass for Mark. Unfortunately, they only had GIANT needles instead of the normal huge needles, but luckily I was able to draw on my stash at home. The shots really don't hurt in the moment (although Mark's needle phobia means he needs to steel himself with a scotch before stabbing me), but now I feel like I have big bruises on my butt. Lovely. 

Now for the ugly business:
-- Despite all I read, I was not quite prepared for the pain. You don't realize all of the small movements you use your lower abs for until that region is all aflame. For example, to sit in the recliner, I had to have Mark pop the chair open, slowly raise the footrest, and push down the back. I bounced back quickly, though. I've been proudly operating the recliner all by myself since mid-yesterday. 
-- I stayed on top of the pain meds, but was totally blindsided by the pain of --TMI-- a full bladder. Oh! And, embarrassingly enough, gas pain. With all of the swelling and inflammation in the area, there is just no room for anything else to move around without paaaaain. By the time I realized I had to pee, I was in such pain that Mark had to lift me out of the chair and walk me with little, shuffling steps to the bathroom. That? That was a low point.

Less ugly was the call from the office with the fertilization report -- 22/28 fertilized and were growing as of yesterday; we'll see what happens today. 

Other than overdoing a bit yesterday when the friends we had to cancel on came by to visit (their son ADORES Mark and talks about him all the time, and the feeling is totally mutual, so we were determined to see them before they went home), I have been taking it easy and trying to stretch out the intervals between pain meds. I am really grateful for the long weekend because there is no way I'd be up for going to work today. I am totally going to shower though. Way to aim high, overachiever. 

up