The Dog Days of Summer

I thought about using Time somewhere in this post’s title, but we’ve been there, done that.  Our last blog post, as written by Mike, was on April 1…it’s been an awfully long time since then, and I’ve had ideas for new posts here and there…I even have a drafted post in my email that I wrote after Mother’s Day (I’ll post that another day), but today’s post is inspired by yesterday’s #NationalDogDay.  So obviously, since April 1, I waited and waited…much like the story of our baby, he/she should be here in 10ish weeks, which seems like such a short time, but the 3.5 years of waiting does not!

Speaking of 10 weeks (more or less), Saturday we celebrated (? marked? noted? reached? ________insert word of choice here) 30 weeks.  30 weeks of pregnancy.  Holy moly.  I almost wouldn’t believe it, if it weren’t for the bad sleep, expanding belly, and constant trips to the bathroom.  Speaking of the bathroom… (a weird segue, I know, but stay with me), last week I said to Mike, “I haven’t been to the bathroom without Charlotte in 2 years”  (her choice, not my doing).  How did I know that?  Well last week was 2 years since I miscarried our only other pregnancy.  The days (because why would something so awful be done and over with quickly in one day?) were filled with emotions…sadness & wonder as I reflected and considered who that baby may have been and what life would be like with a 1.5 year old in the house, awe and hope as I watched my belly move and twitch while our baby practices karate chops and gets the hiccups.  The days were also filled with doggy snuggles with our goldendoodle, much like the days following the miscarriage.

Charlotte has never been a dog who chose only one of us to demonstrate fierce loyalty or protection.  She loves both me and Mike.  But, she accompanies me to the bathroom every time I go upstairs — even if she’s sleeping, she’ll jump up and greet me outside the bathroom door, an escort not provided to Mike.  And in all honesty, she has exhibited this behavior for 2 years now.  She found me miscarrying and crying in the bathroom 2 Augusts ago and hasn’t forgotten, and neither have I.

She’s a special dog and I’m glad that I’ve had this summer to spend with her.  It been so hot and SO humid, and Charlotte the dog and Melanie the pregnant woman have really enjoyed sitting (and sleeping) as close to the AC as possible!  Mike & I have enjoyed setting up for the baby and watching Charlotte explore, sniff, and acclimate to the stroller, bouncer, the crib, the nursery, etc…the 3 of us have been a family for almost 4 years now, and there isn’t a day that goes by that Mike and I don’t talk about how excited we are to see our family grow and to watch Charlotte with our baby.  He/She doesn’t even know what an amazing (albeit furry) big sister is waiting.  And I can’t wait to see all the places they’ll go together (hopefully not just escorting to and from the bathroom) & all the fun they’ll have!

The one about the future…

November 3, 2018 started off like any other normal Saturday in the Fall. At 6:54 am an overgrown and over enthusiastic Goldendoodle dropped a deflated football on my head.  This was my cue to roll out of bed, stumble downstairs without my contact lenses in, and open the back door so that the Doodle could roll around in piles of leaves and relieve herself.  While she was outside, I opened my fridge and took out a gallon of milk milk(expiration date November 1, 2018, phew it’s safe) to pour myself a bowl of cereal. If I’m being honest with myself, I also briefly considered opening a Sam Oktoberfest, but the clock on my microwave said 7:04 am, and this made me think twice about “starting too early.”  My inner guilt trip was quickly interrupted by BARK! BARK! at the back door. As any well-trained dog owner would do, I immediately responded to the commands of my dog and let her back inside so that she could sprint full speed up the staircase and jump back into bed with Melanie. Saturday November 3, 2018 had officially begun. charleyfootball

Rather than waking up Melanie, I laid on the couch in our living room and put on ESPN.  It was now 7:15 am and I had an hour and forty-five minutes of pre-College Gameday coverage to watch before the start of College GameDay at 9:00 am.  This week’s location for GameDay was Baton Rouge, LA for the Alabama @ LSU game. College Gameday is my and Melanie’s favorite show on TV. In fact, Melanie and I have been featured on the show twice over the last 5 years.  Once in Tuscaloosa and a second time in Atlanta. We are die-hard College Football fans, to say the least. As proof of this statement: Melanie and I got married on November 23, 2013, and each year for our anniversary we have road-tripped to a major college football game.  footballYear 1: Knoxville, TN for Alabama @ Tennessee. Year 2: Tuscaloosa, AL for Alabama vs. LSU. Year 3: South Bend, IN for Notre Dame vs. Virginia Tech. Year 4: Atlanta, GA for Alabama vs. Florida State. We even chose November 23, 2013 as the date of our wedding because it was week 11 of the College Football season, otherwise known as “cupcake weekend,” when there are no games worth watching. I’ll just end this paragraph with the obvious statement: I’m a lucky guy.

Like I said before, this Saturday morning was no different than most Saturdays in the Fall.  The one *small caveat was that this was the day that Melanie gave birth to our first child. The child that we endearingly referred to as “Emmy” (short for Embryo baby) for 9 months arrived just in time for a classic football game.

Dear Reader: If you have any eye for detail, then you’ve probably been asking yourself: How is this blog post about the future? (And no, I didn’t build a time machine out of a Delorean). To address your question, I would say that modern physics (and the late Stephen Hawking) believed that time travel into the future was absolutely possible if a person was able to travel at the speed of light (the theory being that time, as a relative concept, moves more slowly the faster someone travels).  For example, the “twin paradox” is a thought experiment where there are two identical twins and one twin travels into space on a high-speed rocket and returns back to earth while the other twin remains on earth. When the “rocket man” twin returns home, he or she will find their “terrestrial twin” to be older. Therefore, the “rocket man” twin who is technically younger than the “terrestrial twin” has returned to earth at a time in the future based on their relative ages. Interesting stuff! doc

But to get back to my point: When I found out that Melanie was pregnant (on February 27, 2018), all I could think of was travelling into the future to the day when she is due: November 3, 2018.  I want to travel to the future so that I can meet our “Emmy” and he or she can watch some great college football with us. I’m also happy that physics believes that it is impossible to travel back in time, because that means Melanie and I can officially put the past three years behind us and hopefully create a great future together as a family.

For anyone reading into this post and thinking that my “twin paradox” example was a hint that we are having twins: the answer to that question is “no.”  I gave that example just because I am a nerd! (Plus all this space-time continuum and time travel talk really freaks Melanie out!)

Specialists…and the time we almost burned a pharmacy to the ground.

[Picking up from the last post] …Again with no answers, some more trauma, and nothing to lose, we made an appointment to see one of their doctors.

This appointment was terrible! The doctor we met with was oddly abrasive and had no patience to answer any of our questions (a lawyer and a teacher…we had questions!).  His suggestion to us was something like this: “Do NOT try IUI, it will never work.  Just start IVF as soon as possible. Don’t worry about the cost. You’re a lawyer you can afford it. And you’re obviously not from Upstate NY, you seem like a Westchester type of guy.  Pay for what your wife needs.”  Our favorite part of the whole meeting was the very beginning though when he said: “Sorry guys, I didn’t get a chance to look at either one of your medical records prior to the appointment because the PDF was scanned upside down on my computer screen so I couldn’t read it.”  bookAdditionally, Melanie would like to note that he said she was healthy, and upon asking her weight (remember, he was unable to read the upside down records), told her, “Well, you carry it well.”  Yup.  Thanks for that.  Awesome.  Now, the financial pressure and snap judgment about who we are was offensive, to say the least.  But the medical record thing was ridiculous. We were looking at this guy and thinking, “if he doesn’t know that he can just print the records out, and turn them right-side up and read them or if he doesn’t know how to rotate a PDF document on his screen, how is he ever going to help us?”  We agreed to do nothing with the CNY facility and later in the week asked for them to transfer our medical records to Boston IVF, who luckily also has a satellite office in Albany, NY.  It took a real FIGHT just to get them to transfer our records.  What a joke some of these places can be!

By the time we had the miscarriage, restarted trying to get pregnant with Clomid and failed, had the bad appointment with CNY, and then got our medical records transferred to Boston IVF, it was March of 2017.  It had been more than 2 years since we first started trying for this elusive baby. stork-e1519606708408.png

We had our first meeting with the doctor at Boston IVF in April of 2017 (we think).  And right from the start we could tell she was wonderful.  Our initial interview was fantastic and very informative.  It had been a year since we last went through the basic fertility tests, so they asked that we re-do them.  So I had to go to a new masturbatorium (this one outfitted with a 60 inch flat-screen and a Roku of porn, pretty cool, I’d say) and Melanie went through her whole range of testing.  The results were in again……”UNEXPLAINED INFERTILITY.”  But we already knew this, so at this point the question we had for the doctor was, how do we come up with a medical plan that makes sense scientifically when we don’t have any data telling us what is wrong? And we both loved her response, because it was so freakin’ honest.  She said: “Look, this field is developing, it doesn’t have all the answers, I have two procedures that I can do for you guys, IUI or IVF.  After that, the medical field has nothing else to help you, and no other technology to measure what is wrong.”  So knowing that we still knew nothing, we were (at least) equipped with an honest answer and a doctor we personally loved.  So we just told her to tell us what she recommended and we would do it so long as we could afford it.

Her first recommendation was to do three rounds of IUI (covered in full by insurance), because, maybe whatever our un-observable problem was would be fixed by inserting the sperm higher in the uterus. So we did it.  Twice.  Coupled with Clomid 3 times.  2 & 3 aren’t the same number…and there are two stories here.  I’ll tell you about the Clomid first.  

Remember when our original OBGYN said he could prescribe up to 150mg?  Well, our RE (Reproductive Endocrinologist…or specialist, really), told us the same thing….however, being an RE, she could presecribe up to 250mg.  Let’s start with 100, though, since it worked the time we got pregnant.  I responded well to the Clomid.  The follicles looked good, the IUI was unsuccessful.  Second round: 100mg, because I’d responded so well the last round.  Unsuccessful.  Third & final round.  It’s only prudent here to mention, we had a consult with her after the 2nd round and she said most of my results were borderline, low, or just above average…I was constantly riding the wave with my blood levels, so IUI most likely wouldn’t be successful, but we could try a 3rd time and she would up the dosage.  Sure, why not.  I had already grown accustomed to sweating all day and night, so let’s increase the side effects (please read as, I would suffer any side effects if it meant carrying a pregnancy and delivering our baby).  150mg.  The prescription would be called in the next day (a Friday) and I was to start it Saturday night between 7 & 9 pm (everything is timed in Infertility Land).

We’re going to split this story up…1 Saturday afternoon.  150mg of Clomid.  2 perspectives:

This is where the infertility s**t (and rage) gets REAL

Melanie:  I got a call from CVS on my phone while I was driving, and because I don’t answer the phone while driving (mostly because my mother raised me well…thanks, Mom), I let it go to voicemail.  Plus, CVS automated messages aren’t worth answering.  Yeah, yeah, my prescription is ready for pickup.  So Mike and I are out and about and swing by our local CVS to pick up the Clomid.  We go to the drive-through window and buzz the pharmacist.  I tell her my name and date of birth, she leaves, and then she comes back to the window.  What happened next felt like an out of body experience. rx The pharmacist, whose name I know but am choosing not to type on the Internet…let’s just call her H…told us that she couldn’t distribute the medicine because it was a higher dosage than the last time.  We say, we know this, the 150 is the correct dosage.
She tells us, “While yes, that’s what the prescription is for, I tried calling the office to confirm it yesterday at 6pm.”  I (calmly, while death-gripping the steering wheel) tell her, the office closed at 4.  And it was sent over yesterday morning.  I then ask, “What were you hoping to achieve at 6pm?”  What I later thought of, was,
If this was such a concern, why didn’t you leave a message with their call answering service????  I then tell her, what anyone suffering through infertility, following a miscarriage, wants to tell a stranger in a small town.  “I’m infertile and the other doses haven’t worked.  I need this medicine and I need to take it tonight to try and have a baby.”  To which she tells us, “I don’t feel comfortable giving you this much.”  Mike, my hero, then leans across me and yells, “Listen.  My wife is a teacher.  I am a lawyer.  We are well-educated and in need of medicine to try and conceive a child.  Are you telling me you can’t or won’t give us this medicine?”  And she says, “I’m telling you, I’m making a professional decision not to give you this much Clomid.”  At some point I yelled at her, I’m not going to sell the extra Clomid on the streets! I need this amount to try and have a baby.  But no, she would not budge.  She was overriding a specialist, after NOT calling during business hours and NOT leaving a message for the on-call service after hours!!

OH NO YOU DIDN’T.  You’re overriding our specialist????  Who, once again, can prescribe up to 250mg….you’re making that decision, when we have a time-sensitive dosage to take?!?!?  

I drive away from the drive-through, park, and sob.  Why does even this have to be so damn hard?  As I google my dr’s office so I can call the answering service, Mike gets out of the car.  I get through to the answering service, leave my name and number, and am told I’ll receive a call within an hour.  I call my parents’ house phone at this point to tell my mom what’s happening, and my dad answers…my mom was out, what was going on?  He assured me everything would work out, not to get too upset, and that he was glad Mike was with me.  SO. WAS. I.  The pharmacist, however, probably was not.  Here’s where Mike can take over:

Mike: My memory of this incident is still clouded with rage…but here’s my recall of how this went down:  We pulled up to the drive-through window of the CVS, and I was reading an article on my phone about the college football playoff potential matchup.  As usual, I was not paying any attention to what was happening. Then at some point I hear the tone in Melanie’s voice change form pleasant to sad, and even though reading about potential CFP playoff scenarios is important, I put my phone down and listened into what was happening.  This is when I hear something like “I’m not able to dispense this amount of dosage to you Mrs. Carroll, because it’s above our normal dosage guidelines, and this dosage level can lead to severe side effects.”  At that point, I unbuckled my seat belt and leaned over Melanie and said, “are you not dispensing the medication because of CVS rules or in your professional discretion?” To which she responded, “it’s my professional opinion that this dosage is not appropriate because of the potential side effects, and because I haven’t had a second confirmation from your specialist, I can’t dispense.”  street sideTo which I said “Look, my wife and I are educated people, she is a teacher and I am a lawyer, we had a meeting with our specialist where she explained the risks associated with this dosage, and we understand the situation, and we’re not going to go be Clomid drug dealers on the streets of Saugerties.    To which she said something along the lines of “I understand sir, but I am not going to dispense this dosage amount.” To which I said “Do you consider yourself a doctor?  Because you’re not a doctor!  You’re pharmacist! And it sounds to me like you’re practicing medicine without a license!”  **Note: when we got home, we looked it up, and had she not dispensed our time-sensitive medication, we could have filed a suit against her under the ADA…know your rights and advocate for yourself, people!!** Then I got out of the car and stormed into CVS and starting screaming at another person who greeted me at the pharmacist front desk and told me “I had upset the entire staff and should calm down.”  To which I said “You have upset my wife who has been trying to get pregnant for over two years, and you are insulting our intelligence, and you cannot override the prescription of a reproductive specialist who has prescribed time sensitive medication because your staff wants to pretend to be doctors.”  rmThen all of my years of education climaxed into creating a super-douche bag who “requested to know his due process rights” and wanted to speak with the “regional manager”
and “to please provide me with the NYS Dept of Health complaint form for pharmacy disputes.”  Literally making all of that up on the fly in pure rage. In the middle of my tirade, the medicine was dispensed to me.  Not because of anything I did, but because the pharmacist finally got a hold of the nurse on-call after hours at our RE and they confirmed the medication was correct. Crisis averted! And screaming at people really made me feel pretty good about the whole thing. Now back to Melanie.

Meanwhile, a nurse practitioner called me back, told me she’d already called CVS and approved the dosage.  She said, “The pharmacist, H, or however you say her name, seems less than nice.” To which I said, “You’re telling me!”  She told me it was ok, get the medicine…and maybe consider a different pharmacy moving forward. Once again….You’re.Telling.Me.  This, I think, is what Mike looked like as he left CVS that day, Clomid in hand:

fire

Part B of this story is that our schedule seemed to be on track, I was going for monitoring, thought I had a couple more days, and was told (shockingly), my body was moving faster than expected and I could trigger, and plan on a 10:30 IUI in 2 days time.  Um, that couldn’t work.  Why?  Oh, 11 months prior, I bought tickets for Hamilton for me and Mike, and it was the only thing that I was looking forward to.  No, really.  The only thing.  Since the doctor was pretty sure the 3rd IUI wouldn’t work, we triggered and had the green light for timed intercourse, rather than a mid-morning appointment that wouldn’t get us to the matinee show on time.  I hemmed and hawed over so many things during our battle against infertility (because really, a journey most people head out on willingly…and we are constantly fighting against this invisible beast), but I knew if we missed Hamilton for another failed IUI, it could destroy the joy and spirit within me.  I know this seems dramatic.  I KNOW it does.  But Mike and I felt confident with our decision, and we loved our day in the city to see Hamilton together.  In a way, I think it’s what we needed.  It reminded us of life beyond (and really, amidst) infertility.  For those of you who think this was stupid, you’re probably (not) thinking of this line from the show: awesome.jpg


After our third failed test we met with our doctor again, and she was able to shed some light on what we were experiencing.  She was able to observe through our 3 Clomid cycles that Melanie’s AMH levels were just below or JUST at/above average on each of her cycles, and as the doctor explained, this meant that she believed Melanie had a “low ovarian reserve,” and that as a result, it was unlikely that we would ever get pregnant on our own.  She said that the one time we did get pregnant was more of a fluke than an indicator of a future possibility.  She recommended that we move onto IVF.  At this point, we felt a bit relieved, in the sense that we finally had an idea WTF was happening!  We said to ourselves: “OK, so Melanie’s eggs need a boost, and maybe the IVF stimming process is what we need!”  So we thought we’d consider IVF, if we could do pick the right time to do it, and we could figure out how much it would cost.   

angry cat
First we looked into cost: At our facility $12,500 for IVF medicine and procedure. $1,000 for freezing, $2,500 for a frozen transfer.  Now for two people who are trying to get out from under their student loans, save some money, and want to move sometime in the next year or two, we felt like, SHIT! But at the same time, we couldn’t let that dictate our chances of trying to have a family.  So we checked our insurance plans to see if there was any chance of coverage. We found out no chance to cover the surgical procedures ($6,500) but a slight chance that the medication would be covered ($6,000), because as our nurse told us, “More often than not,  your insurance will cover the IVF injections.”   Now this seemed crazy to us, but we decided, we’d cross our fingers and hope this was the case.  Also, we have this amazing health insurance plan through Melanie’s school, where they pay our entire deductible and we only owe for co-pays after the deductible has been used up, until reaching out of pocket max (Melanie is $40 away from her max…and it’s February.)  So we agreed to pay $6,500 for the procedure and hoped the medicine was covered.  And to our pleasant surprise, IT WAS!  So while we paid a good amount of money, it’s not as bad as it could be.   After we crossed this financial hurdle, it was around November of 2017.  We decided we’d wait until after the holidays (Melanie’s favorite time of year…our anniversary, her birthday, Christmas, saying one hell of a good bye to the sh** storm that was 2017, etc.) were over to start IVF.  Mike’s usually not very busy in February and Melanie could do IVF around her February break time, so we decided we’d start the stimming process at the end of Jan/beginning of February.  

So that is where we find ourselves now.  Waiting, once again, for results.  Hoping for positive news on Tuesday.  And although Melanie has said she won’t POAS (pee on a stick) before then, if the Beta level is good (please let it be good), she’ll definitely POAS to see those two pink lines again.waiting still


Thanks for reading this far, if you are, still, in fact reading.  Mike told me today he didn’t realize people could leave comments on the blog, so if the spirit moves you, please don’t hesitate to reach out with a reaction or a question.  If you’re going through infertility, I hope it helps knowing that there are good and bad times for everyone on this rollercoaster ride.  That, and feel free to drop a line to talk about what you’re going through, too!  And if you’re on the other side of infertility, I leave you with the origin story of The Infertile Turtle, as told by Mike:

We were telling our friends about all of the stupid shit people say to couples who don’t have children/are struggling with infertility, and I mentioned to Melanie that she should carry around a small turtle hand puppet, and when someone says something stupid you should take out the hand puppet and say “the infertile turtle says you’re an idiot.”  We all had a good drunken laugh about it…but it has become a nice way to vent and a cathartic experience.  [Plus, some day our child(ren) will know how much we wanted this.]

cropped-img_4415.jpg

Pulling the goalie

We have 2 more days until our Beta test, which will determine just how PUPO I am.  Hopefully I won’t be (U)PO.  With any luck, I’ll just be P.  And hopefully Mike and I won’t go crazy by then, waiting for the blood test and the subsequent results.  

How to pass our time, then?  Well, I thought we could blog about what got us here?  What brought us, day by day — kidding, not that specific — major piece by major piece, to less than 48 hours until we have pregnancy test results from our first round of IVF.  This blog post is just like our embaby, a little bit of Mike and a little bit of Melly.  Mike wrote our friend an email (actually, a Facebook message), and Melly went back through it, adding some details along the way.  We work pretty well in tandem…anywho, without further delay…

We starting “not defending” against pregnancy back in February 2015 (looking back, we are shocked by the $$ we preventing pregnancy through the years for no reason!).  Mike was in the beginning stages of looking for a new job, and because he’d be quitting his job at the law firm he was working at in Poughkeepsie, in order to claim his life back (no more billable hours), February seemed like the right time.  Plus, he was going to work as an in-house attorney at a company that provided paid paternity leave.  The timing made so much sense, and we figured we’d be pregnant in 3-6 months, and we’d have our first baby before the end of 2015.  LOL!

Mike:  We tried to get pregnant naturally for about a year.  We did all the timing, and temping, etc., but nothing worked. Never a positive pregnancy test from February 2015 – March 2016.  Sometimes I look back on that period and think it was the most painful part of the whole process.  We were so hopeful (and really naive) at the beginning. I think that every month when Melanie either got her period or we had a negative pregnancy test, it hurt pretty badly.  Around April of 2016 we decided to go for infertility testing.  So I entered the masturbatorium (which is both a real and amazing word) and Melanie went through the invasive poking and prodding that is required to gauge a woman’s fertility.  Our results were, to us, crushing: “UNEXPLAINED INFERTILITY.”  I had plenty of swimmers and Melanie ovulated on schedule and her tubes were clear, and her urerus without polyps or issues.  Plus, she HAD a uterus, so things were looking good!  How confusing for us.  So after a year of disappointment, and a slew of testing, it felt like we were just not meant to have children on our own, and we had no idea why. Melanie’s gynecologist, a sweet Asian man, who I often joked was providing us with his Eastern magic,  suggested that we continue trying to get pregnant the old fashioned way, while also using the fertility drug Clomid.  So feeling like we had nothing to lose, we started what was supposed to be a 3 month cycle of Clomid pills and timed natural conception….but as you know, with infertility, nothing ever goes as originally planned.

We decided to start the sex/Clomid combination in June of 2016 when school ended for Melanie (Melanie is a teacher).  The first month, Melanie took 50mg of Clomid.  Her doctor told us that he, as an OBGYN, could prescribe up to 150 mg, but for anything higher, we’d need to be working with a specialist.  The Clomid, he hoped, would rev up the follicles to produce a heartier egg.  What actually happened, was what the label warns you about.  The side effects of Clomid were pretty bad for her.  Terrible hot flashes (when he says terrible, he means, TERRIBLE!!!  I was drenched, slept as close to the AC on max as possible, and couldn’t have Mike or our goldendoodle, Charlotte, anywhere near me at night…it was super pleasant, and I felt really well-rested), nausea, and irritability (of which I tried to steer clear).  The results in June were more of the same, negative pregnancy test.  But then in July, on our second round of Clomid (this time 100mg), Melanie had a positive test.  It was the best thing ever. We were over-the-moon about it, given how long we’d been trying.  Melanie put our 2 Mets hats (year, yeametshath, we know…) on the dining room table with an infant Mets hat she bought that day to tell Mike.  It was sweet.  And now, seeing it isn’t as sweet.  But we kept it, because we want our baby to wear it someday.

 

About 3 or 4 weeks later (7 ½ weeks pregnant), friends from NYC were planning to visit us (a summer and fall getaway for many a friend who enjoys the Catskills).  Friday morning, Melly woke up with some spotting.  The doctors were not concerned.  It was brown blood, and without back or shoulder pain, they thought it was just old blood, but offered to do an ultrasound, if we’d like…we liked that option.  So we went in, for what we were told was an early ultrasound…we were, in fact, told not to expect much, as it was so early.  But the ultrasound tech showed us a black sac and said we had nothing to worry about.  Take it easy that weekend, but no need for bed rest or concern.  Great.  Old blood.  No need for concern.  

Still pregnant…so, we’d tell our friends that we were pregnant.  Even though it was early, we decided it made no sense to hide the news, since it would be uncharacteristic of Melanie not having a few glasses (or a bottle) of wine with everyone.  So we told them.  Later that night, around 11:30 pm, Melanie went to sleep.  She was feeling tired, so Mike stayed up, played beer pong on the back porch with a good friend, and together, they told his wife old stupid high school stories until she chose sleep over high school memories (Good choice! Smart choice!).  

Mike: Then about 2 hours passed by, and my dog ran onto the back porch, and she started barking and jumping and howling at us.  She typically doesn’t leave Melanie’s side, so I knew something was up, and I followed Charlotte (that’s the dog) upstairs where I found Melanie in the bathroom having a miscarriage.  All four of us (thank god my friend’s wife was sober) (what a kick in the gut when your DD can’t drive) drove to the hospital in Rhinebeck per her doctor’s advice, due to fever and vomiting and pain level, and we spent the night at the hospital while Melanie got painkillers and dealt with the effects of the miscarriage.  I think we got back home that morning at 5:30 am. Crazy night, to say the least.  

twolines
A day or two later we were at the doctor’s office, to have another blood draw, confirming that her levels were lowering on their own — in hopes of avoiding a D&C.  Her 3rd blood draw was stagnant, and Melanie was worried to say the least, but then her repeat test bottomed out.  The miscarriage (physically) was over.  The emotional toll it took still isn’t over (says Melanie).  Adding insult to injury, a day or two after the miscarriage started, Melanie received a phone call from her OBGYN’s office, confirming her 8 week ultrasound the next day.  Oof.  Talk about pain.  

A few months later, when Melanie’s doctor thought it was OK for us to start trying to get pregnant again (and after he told Melanie for the 10th time that mowing the lawn that week had not caused the miscarriage…in fact, he told her that short of going to Chernobyl, there was nothing she did to cause it…and seeing as she had not traveled to Chernobyl recently… we started sex/Clomid again.  He prescribed the 100mg again, as it had worked the last time.  And I think we were both hopeful it would work again.  The 2nd time we’d cycled with Clomid, we got pregnant, so it should work again quickly!  Ha ha ha.  So foolish.  We tried that for 2 more months. No success.  At that point, we were referred to the CNY Fertility Specialists in Albany.  Again with no answers, some more trauma, and nothing to lose, we made an appointment to see one of their doctors.

The other shoe…has dropped

Given how hard and trying the last 3 year have been, we should have known that IVF was treating us too well.  I felt great stimming, especially emotionally.  Hormones weren’t crazy.  I didn’t feel or act crazy.  In fact, I felt even-keeled and empowered.  Then, retrieval was a breeze with a great yield.  14 eggs retrieved, 9 fertilized!  Statistically, half would make it to transfer day.  So 4 or 5 embryos.  But Friday came with different news.  Infertility had reared its ugly head…again.

We got to the office, checked in, and were quickly ushered back to the IVF Suite by a very spunky nurse’s assistant, Tara.  Mike and I were both in good moods and we were happy to hear “Complicated” and then “I Want it That Way” playing when we first walked in and got settled in Area #1.  Unlike the retrieval, which had a very busy suite, we were the only couple there for a few minutes, and only one other couple was there when we left.  We were ready quickly and had to wait for our doctor to come and chat with us.  I’d filled my bladder, as instructed, for the transfer, so the longer we waited for the doctor, the harder it was not to focus on needing to empty my bladder.  About 15 minutes later, she came and brought us to an adjoining meeting room.  She was pleasant, per usual, and asked me all about recovering from egg retrieval.  Then she said how pleased she was that I had 14 eggs and she took out a piece of paper with a big chart/spreadsheet on it.  The spreadsheet tracked retrieval day, fertilization report, 3 day update, and transfer day.  The report tapered from wide to narrow, which is because we lost so many embryos along the way.

She explained to us that not only did she retrieve 14 eggs, but all 14 were mature!  She reiterated that she would have been happy with 10, so 14 was really great.  And, while we were told that 9 fertilized, in reality, 12 did.  However, 3 of them fertilized too much.  What does that mean, Melanie?  Well, as she explained to us, 2 sperm may have gotten to the egg before it hardened/closed off, of the sperm may have been double headed/coded.  Either way, too much DNA for one egg, so they weren’t counted in our fert report.  Then she showed us that on Day 3, we had 7 eggs with enough cells, but a few of them received an initial grade of C.  By Friday, we were down to three.  I’m not going to explain grading, but we had a 3AB and two 2EB embryos.  The 3AB was the best embryo, and she was happy with its quality for transfer.  The remaining 2 needed another day to see if they popped and could be frozen, we’d receive an email on Saturday, to let us know how they turned out and how many were frozen.  

We were gutted.  9…and then 1.  Maybe 3.  Hopefully 3.  But, 1, for sure.  What happened to those other embryos?  Why did they arrest?  Why were they receiving C grades?  Gosh.  Even if 2 others had been a little bit better a received grades of B, we would have been happy.  But 1?  After all of that?  …and yet, there was still a transfer.  So, Tara brought me to the IVF procedure room, which is attached to the embryologists’ den, and then the doctor came in.  Using an external ultrasound, she showed me my full bladder and the space below, which is the uterus, turns out.  Then, using the ultrasound, she placed a “practice” catheter in my uterus, but it went in so smoothly she didn’t need to change to another catheter.  She told the embryologist she was using “a wallace” …whatever that is.  She showed me where to watch as she transferred the embryo…and then there it was.  A little white bubble in my uterus, which she printed a picture of for Mike to see.  Our little embaby.  The only time in 3 years we’ve had an ultrasound photo showing us anything…and, we’re hoping we’ll have many more ultrasounds of this little embaby, maybe this is our miracle.  

miraclas

It’s been such a long and trying 3 years, and we both feel like…of course this ended up being trying and difficult, too.  Adding another layer of insult, an email at 7:28 am on Saturday: there were no embryos to freeze.  We don’t know why.  We won’t know until we have another consultation with our doctor, which will hopefully be amidst prenatal visits and care.  She also said we’d have a chance to talk more in depth about our embryo report and what happened to them at a follow-up.  

Hope_ImageI haven’t talked much about what brought us to IVF, yet, and I think this winter vacation from school will be a good chance to blog more about our back story, but one thing makes more sense to us now.  When we stopped trying not to be pregnant, my cycle went from totally normal and 28 days to sometimes 28 days, sometimes 32, one time 37 days, but just one positive pregnancy test, during our second round of Clomid.  And we didn’t have any answers why.  I wondered if I was having an implantation problem?  A nurse practitioner thought it might be a Progesterone issue.  Were we doing something wrong??  But, if it’s anything like our embryo report, which Mike and I suspect, I’m releasing eggs, they’re fertilizing, but for some reason, they’re breaking down…as have we from time to time this weekend.  Don’t get me wrong, it’s wonderful knowing that we have a healthy embryo on board…hopefully the little embaby is making itself at home and plans to stay awhile, but we sure would have loved a better report that gave us a little more hope.


Going from 9 to 1 was so dramatic and there’s some loss there, as early as it is.  We should have known better, than to be excited for 14 and 9.  We should have.  Science and statistics have not been on our side as we’ve tried to start our family.  But, we
finally received good, promising news.  And now that hope and joy are most certainly deflated…but at least they’re not gone.  Because for now, I’m PUPO, Pregnant Until Proven Otherwise.  pupoAnd for only the second time in 3 years, have I been any form of pregnant…and that’s pretty great.  I know a few people who have gone through IVF and I reached out to them once I got home and had processed things a bit.  I’m so thankful for these women, all of whom had successful IVF stories and have shared so openly with me, sharing their strength and grace, when I’ve needed it most.  And when I told them my news about the embryos lost along the way, all 3 said the same exact thing to me: It only takes one.  

justtakesOne-536x149

And when I start to feel sad or weepy that our results weren’t better, what we expected, or what we wanted, I tell myself that.  It only takes one.  One egg.  One embryo.   And we’ve got one.  And IV’F Got This.  

 

 

Retrieval & Fert Report

Yesterday morning Mike and I needed to be at our RE’s office by 8:30.  We arrived at 8:22, so for anyone who knows us (or just Mike), this was a big deal!  We were early!  I felt pretty good.  On the drive up, we listened to the Beach Boys: Endless Summer, which was the first cassette I ever bought…and I sang most (all) of the songs to Mike as he drove.  After arriving, we signed in and sat in the waiting room for less than a minute before a nurse, Grace, called us back to the IVF Suite.  It sounds very fancy, doesn’t it?  

The IVF Suite was in a totally different part of the building than we’d been to before.  A nurse showed us to our space, area 4, and I was handed a Rubbermaid box with a gown, booties, blue hair cover, and a blanket.  I emptied my bladder, which I had (nervously) tried to empty at least 4 times before we left the house.  Then we completed the intake paperwork before my IV.  

Getting my IV was, in all honesty, the hardest part of yesterday.  Jennifer, the nurse who was doing my intake was struggling to find a vein on my left hand/forearm.  I told her that the phlebotomist has a hard time finding a vein on my left arm, but my right arm is usually pretty good.  She explained that the anesthesia team prefers the IV on my left side, if possible.  After Jennifer tried 3 times, she called another nurse over to help.  Kristin, nurse #2, said that the vein felt good, “it’s a pipe” was the actual quote…whatever that means.  But Kristin couldn’t get the IV in, either.  So she called in the nurse anesthetist, Rachel, who tried the left hand, and she, too, failed.  So she switched sides and after some poking and moving around, success!  She apologized in advance for the bruises I’d probably have when all was said and done.  No worries, I told her.  No need to apologize.  Do whatever it takes to get the IV, put me in twilight, and retrieve those eggs!

Then Mike had to leave to give his sample.  So he kissed me goodbye and I waited alone in area 4.  Our RE came in about 10 or 15 minutes later to talk with me…asked how I was doing, how’s Mike, are we ready, excited, etc?  She said I looked good and she was excited for me.  As she exited my area, two nurses swooped right in, started my anesthesia, and escorted me to the operating room.  It was quick!  It was a well oiled machine.  I had no doubts about the care I was receiving.  

Jessica and Michelle, two nurses with whom I talk a bunch about scheduling and updates, were in the OR with me.  Jessica helped me scooch onto the table and as I was getting in place, Rachel said, “Take two deep breaths and think about your favorite vacation.”  Next thing I knew, I was waking up back in area 4.  

This is the funny part of yesterday’s story:  I woke up and asked where Mike was, to which a nurse told me he’d be in to see me soon.  I fell back asleep (for 30 seconds? 4 minutes? An hour?) and when I woke up, I head a nurse saying to someone else (in passing) “Oh, it was bad.”  So, in my drugged state, I decided that my retrieval had been bad and Mike was somewhere else finding out first.  And I started to cry a little.  Then I saw Kristin and asked her if she knew where Mike was…she said she’d go get him and asked if I was ok, to which I said, “I just miss him”.  ❤

The nurses thought this was pretty sweet and Grace came in to check on me and offered me a mini can of ginger ale.  I had a couple of sips, fell asleep again (I think) and then Mike came in area 4.  (Reunited & it feels so good!)  In reality, he found me crying and explaining that I missed him…then I told him my fear about “it was bad” and he assured me no one had said anything yet.  Then the doctor came in and handed us a small card that said “14 eggs retrieved”.  FOURTEEN.  14

When we met with our RE for our initial IVf consultation, she told us she hopes, on average, to retrieve 10 eggs.  And on Friday, Michelle told me the ultrasound made it look like 6 or 7 mature follicles/eggs.  But, Dr. Elguero retrieved 14 eggs and we were so excited.  It was well beyond what we expected, and even more than we hoped for, I think.  We have been beaten down by infertility and years of negative pregnancy tests, and a miscarriage following our one (and only) positive test.   So imagine our surprise to hear better than expected results!

After we talked with our doctor a bit (Mike remembers more of this than I do), we were told we’d hear the Fert (Fertilization) Report midday today.  Then I finished my mini ginger ale, emptied my bladder one last time, got my IV removed, and was allowed to change and go home.  As I shuffled out the door holding Mike’s hand (there’s an exit right from the IVF Suite!), the nurses waved and smiled and someone said, “Now you won’t have to miss him because you’ll be together all day!”  It was so cute.  We made some calls, Mike drove home, got us some lunch, and then there was much napping on the couch with the heating pad.  

Midday came early today!  Michelle called at 9am this morning to check in on me…and to tell us that 9 of our eggs fertilized!  NINE!  nine  A second day of great news!  We are ahead of the curve we expected to be following, or that we hoped and aspired to be somewhere near!  Mike and I talked a bunch today and we both expected/prepped ourselves for low numbers without sharing that concern with the other.  Results have been borderline-to-low with all testing and moreover, Dr. Elguero suspected there might be an egg quantity and/or quality issue.  Now we’re (cautiously) hopeful that my eggs are good, they just needed some help!  Michelle scheduled our 5 day transfer for Friday, and my acupuncture will immediately follow the transfer.  

So now we’re back in limbo, back in the waiting abyss.  But, at least we’re in limbo with some positivity, The Office on Netflix, IMG_4999.JPGa heating pad, Gatorade, and unexpected joy in our hearts.  Right now, we could field a baseball team with our 9 embryos.  Statistically, half will make it to Friday…we would be lucky and blessed to have 4 or 5 embryos when all is said and done.  And until our transfer on Friday, we’ll continue to hope and pray that our little embryos strengthen and grow!  Little embryos…let’s grow!

Weekend Update

Friday I had my earliest appointment yet: 6:45 am.  It was really quick, unlike waiting for the phone call from my nurse about what was next.  The call came around 2pm (not bad, but time was ticking backward at one point, I think) and Michelle (the IVF coordinating nurse) told me the doctor liked what she saw and that I was ready to trigger.  To which I replied, “Really?  Are you sure?”

I felt like I could have stimmed indefinitely.  Yes, there were mild side effects, but I was so involved!  And now, after the trigger, I go back to being a spectator of sorts.  I mean, I’m obviously involved, but, I’m also along for the ride.  Speaking of being along for the ride, after going over the trigger shot, Michelle told me to be at the doctor’s office at 8:30 Sunday morning and make sure that Mike brings his license, because he’ll need to prove he can drive me home afterward.

I triggered Friday night.  It may have been the most painless of all the shots I administered the last 2 weeks.  And tonight, there were no shots.  Mike took me to dinner to celebrate that we got to this point.  We toasted (I had seltzer and Mike had a Sloop Juice Bomb) to luck ahead and to our future baby(ies).  Mike shared a picture on Facebook from dinner and said that we were out to celebrate our IV FU to infertility.  (A la Argo‘s famous, “Ar-go-f**k-yourself.)  It was perfect.

Fingers and toes (but not ovaries) crossed that we have good,quality eggs, later-this-week embryos, and someday-babies that are retrieved tomorrow.  It’s only a day away.

eggs

RELAX!

“If you want, I can give you Valium.  It helps me relax when the ride gets bumpy.”  “No thanks,” I said to the middle-aged soccer mom drug-pusher who sensed my fear when our Captain announced “sorry for the delay folks, we are taking on more fuel to add weight to the aircraft because we have rough skies ahead.” Rough skies, you can say that again…

Let me back up: I have two great fears in life: (1) Air travel and (2) Sharks.  The only thing worse than feeling turbulence in the sky is the terrifying experience of having to partake in the sandy summer ritual of swimming alongside blood-thirsty man-eating monsters while pre-teens play paddle ball without a care in the world.  But back to the story…

jaws

How did I find myself sitting in an airplane on a runway in Orlando next to a drug-dealing housewife? Twenty-six hours earlier, I landed in Orlando for the purpose of attending a work conference, and 15 hours after landing, I learned that my father required emergency quadruple bypass open heart surgery.  After acting like a deer-in -headlights for a few brief moments, I got to work securing a flight back to New York and checking out of my hotel.  While standing on the sidewalk outside the hotel lobby, I ordered an Uber, and as fate would have it, Carlos, a man with a scorpion tattooed on his neck, and a jet-black old-school Florida Marlins hat (flat brim, huge teal Marlin) who graduated from the Dale Earnhardt, Sr. school of driving picked me up for my eventful ride of cutting people off and flipping people off until we reached our destination: the Southwest terminal.  Eventually my flight did get off the ground, and while it was rough, I resisted the urge to pop pills.  After arriving back at the Albany airport, I picked up my car and headed out to Bridgeport Hospital to be with my family.

nascar

My father’s surgery took place roughly 5 hours after I arrived at the hospital and it lasted for 6 1/2 hours.  I personally, and my family in general, deal with stress through humor. But for some reason we couldn’t find much humor in the situation and spent much of the surgery stress eating and staring at our smart phones.  Thankfully the surgery was a success, and after 5 days in the ICU my father was moved to a general recovery room, and shortly thereafter, back home.  This was my cue to head back to New York, so that I could get ready for my week and return to my life/wife & dog/job/normalcy….until Monday morning when my boss quit.

Now, I had recently (about 5 weeks earlier) been “promoted” at work.  Which is actually less of a promotion and more given a job that I had the skills to do, but no one else wanted to do it.  My boss was supposed to be “teaching me the ropes” so that I could become familiar with my new role, but the “best laid plans of mice and men often go awry.”

In sum, in a short 2 week span, I traveled to Orlando for a grand total of twenty-six hours, spent 5 days in and out of the ICU after my father’s emergency open heart surgery, and then returned to work to find out that my boss had quit and I was now responsible for much more work than I originally expected.

Talk about burying the lead here, but everything described above has happened during the last two weeks when my wife and I started the “stimming” process for IVF.  The experience of infertility has brought us many downs and very few ups over the past three plus years.  There are few constants in this process other than the negative pregnancy tests.  The medical situation is fluid, our expectations are constantly shifting, and our hopes, determination, and tolerance have grown thinner throughout these years.  However, the one somewhat funny constant that we have experienced in this whole process is people telling us to “relax.” Now I know I’m getting old when I say this, but if I had a dollar for every time someone said to me, “look you and your wife will get pregnant, you are just overthinking it, just relax and you’ll be fine” then I’d be a millionaire, or at least suspected to be a male-stripper on the side.

relax

People telling us to relax is something that is said with good faith, and I don’t begrudge anyone who says it.  But life is just too complicated to be relaxed.  Things happen you don’t expect.  The best plans sometimes don’t work out. Shit happens. My wife and I actually tried to plan our IVF cycle around when we would be most relaxed.  This month is typically a slow time for both of us at work, and the weather is usually miserably cold so being able to get to the doctor’s office every other day is not an issue that conflicts with any nighttime or weekend plans.  But alas, the time that we decided to have IVF has been arguably the most stressful period of any time of my life (and I think this certainly rubs off on my wife unfortunately).

infertileslap

Next week we are going to be having our egg retrieval process and hopefully, if all goes well, our embryo transfer.  At this point, I hope that relaxation is not a prerequisite for success next week, and that the rough skies that we’ve navigated will prepare us for what lies ahead.

And Ganirelix Makes Three

Sunday morning was spent like most other Sundays…a drive up the Thruway to the doctor’s office for blood work and an ultrasound at 8am.  Just like the other appointments, it was easy.  After my ultrasound (during which no ovaries were hiding), I walked down the notably empty hall to the acupuncture room.  That’s right!  On Sunday I tried acupuncture…and it. Was. GLORIOUS.  

I didn’t feel nervous about acupuncture.  I’ve been busy stimming with needles every night, so the acupuncture needles didn’t worry me.  I had about 25 needles in my head, ears, hands, belly, legs, and feet.  After the needles were in, Caitlin, my acupuncturist, put a warming lamp near my feet, turned on a white noise machine, and left the room for about half an hour.  I feel relaxed just talking about it.  I dozed in and out, focused on my breathing, and savored the quiet that I heard and felt.  I will go back the day of my embryo transfer, before and after the transfer, as well as 4 days later, to help with blood flow and to support possible implantation.  I can’t wait.  

acupuncture

After my acupuncture was done, I grabbed a coffee (half decaf) and drove back home.  As I got home, I got a call from my doctor’s office.  The time had come to add the Ganirelix shot to my evening lineup.  Holding steady with my Follistim at 300 and Menopur at 150.  Repeat 3 times and return for blood and ultrasound on Wednesday.  

Sunday night, after lounging about it all of my post-acupuncture glory, watched the Super Bowl and then I took shots, just like so many football-loving, Super Bowl-partying,  red-blooded Americans.  BUT.  No alcohol shots, just the new norm: fertility shots.  Side bar: Friday or Saturday night I had a dream that I had a glass of wine and I woke up feeling SO guilty.  I immediately thought, “It wasn’t worth it!”  …for the record: it wouldn’t have been worth it…but it didn’t even happen.   So weird.

shots
Anyway, we administered the Follistim and Menopur as usual and opened the box with the ready-to-go Ganirelix.  The syringe comes pre-filled and once you remove the needle cover & tap the air bubble to the top, you’re ready.  What I didn’t expect (and neither did Mike) was that the Ganirelix needle is thicker than the Follistim and Menopur needles and was much tougher to get in!  My first attempt was weak, I suppose, and the needle just kind of bounced off my skin…I mean, it pushed the skin in, but didn’t pierce it.  So I pulled the needle back and after Mike and I both talked about how weird it was to see that, I used a little more force and got the needle in.  The Ganirelix burned as it went in and I had a small reaction immediately after.  The skin around the injection site was red, probably a couple of inches long, and it was hot.  It passed within 15-20 minutes, and I continued to watch the Super Bowl without issue.  

At my appointment on Sunday, a woman in the waiting room remarked, “Ready to be done?”  And I smiled politely and think I said something like, “You bet.”  But my follicles aren’t ready…and in all honesty, I’ve kind of enjoyed this process.  I have felt relatively well, aside from some tiredness (I’d say exhaustion is too strong a word, but an afternoon nap is basically necessary to survive), bloating, and headaches last week.  It’s not that I’ve enjoyed the injections or the probing.  I have, however, enjoyed playing an active role and feeling like we have some sort of (albeit very limited) control of our struggle with infertility.  

Today we have another box of Menopur and one more cartridge of Follistim coming.  My doctor’s office did a great job ordering enough for my predicted calendar: my original retrieval date was slated to be tomorrow, February 8th.  But my follicles aren’t done growing yet.  Slow and steady, but on track and looking good, or so I’ve been told.  Given we’re snowed/iced in right now, I’m glad we didn’t have to navigate a winter storm today or tomorrow for egg retrieval.  It would probably be another layer of stress that we don’t need to add right now.  I suspected that school might be closed today because of all the snow that was on its way, so I actually stayed with my parents last night, so this morning I could just drive 10 minutes to my appointment and then head home, rather than driving the hour north to the doctor’s office, have a quick appointment, and then drive back home.  Getting the extra sleep and only driving the thruway once today was a nice treat.  Although, I must have triple checked (or more) that I had all of my meds, syringes, needles, alcohol swabs, etc packed up yesterday morning before heading to work.  And then I needed to store my Follistim in a coworker’s fridge during the school day.  All in all, it was no big deal, I was just worried I was going to forget my Menopur, or not bring a needle, or who knows what!  I made it up and back home with everything I needed, and now we’re just waiting for our new boxes of meds to arrive. 

After 2 more nights of stimming and Ganirelix, I’m scheduled to go back Friday morning for another set of blood work and an ultrasound and then Friday afternoon we’ll have a better idea of what’s to come.  Until then, we’ll lay low some more…we’ve (re)watched a LOT of episodes of The Office today, I’ll probably nap, Mike is drafting a blog post to share sometime soon, and we’ll enjoy the last couple days of control that we have during this whole struggle that is the life of the infertile turtle.

turtle