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. 


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