I'm Pregnant!?

Prior to the good news Thursday, it had been a rough week, to say the least.

You haven't really lived until you've stood in line at CVS for a prescription and just started bawling. As I was called up to the counter to get a refil of Mom's anti-nausea pills, I still wasn't able to compose myself and had to respond to their cheery "CVS number?" inquiry through tears. While I feel like I am able to hold it together 99% of the time, and actually find work a welcome distraction, I can't be strong all of the time. No one can. Three nights ago, I actually woke up crying, still very much "in" the dream I was having about Mom dying.

Mom now needs someone with her 24 hours a day. My Dad is with her all day long while we are at work. For 45 years, she has waited on him hand and foot and now he is the one helping her use the bedside commode, fixing her tea, coaxing her to eat. When I get home, I relieve Dad, who has some time to read or watch his Fox News. We encourage him to leave on the weekends, and he usually spends time with my brother. When he's gone, Nate sets his alarm every 4-5 hours through the night to lift her onto the commode. She is spending more and more time sleeping, and cannot sit up by herself or position herself in bed. It is the hardest thing to bear witness to, and it breaks my heart every second of the day.

We placed her on hospice this week. I thought this was our choice, but it wasn't really because home health care was going to run out anyway on the at the end of the month. We need additional help and support for her, probably beyond even what hospice will provide, so we are also looking into hiring someone to come to relieve Dad, especially while we're in DC next weekend for Nathan's brother's wedding.

Her short term memory is not there, and it is hard to even have a conversation with her because she is so weak and tired. I mostly just lay next to her and read, craft or facebook. But there's one thing that she hasn't forgotten about. On Monday she asked me "Did you get...the ... circle?" Realizing that circle was not the word she intended, she said "Ooh!...did you get the..." And I asked "Pregnancy test, Ma?" Yes! That was what she wanted to know. "Not yet, on Friday" I had to tell her. How I hoped we have good news, but feared we would not.

Thursday, I met with a fellow middle school counselor who is also at a 7-12 school for collaboration and to share resources. We decided to meet at Starbucks instead of either of our sites, because uninterrupted meetings are nearly impossible when people know where to find you. Completely off coffee for four days now, I ordered my venti passion fruit ice tea with light ice and no sweetener and the hour flew by.

After our meeting, I went over to CVS and bought a test, to have on hand for morning. But as I was walking back to my Jeep, all that tea was getting to me and I needed to use the restroom. Being in the Starbucks restroom with my test proved to be too tempting. Even though you're supposed to test in the morning when levels are likely to be higher, I could not resist. I set the test down and tried not to look at it for the suggested 2 minutes. I lasted about 5 seconds before I took a peak.

Positive!? There was already a plus sign, and it wasn't faint. I honestly could not believe it. Frantically, I checked the key on the test, afraid a plus sign actually meant the opposite. I sat there and stared at it, smiling like crazy. And then I started taking pictures of it because I was afraid my proof would disappear. I checked the key several more times, to make sure I wasn't misreading it, and walked out of the bathroom, beaming.

Elated, I got in the car and thought of how I was going to tell Nathan. Even though I was already on the drive home, I knew I wouldn't be able to wait until then. I called him right away. "I'm pregnant!" I announced, and he told me not to mess with him. I have been known to, he pointed out, as I had hidden his Mustang on April fool's, leading him to believe it had been stolen. "Nope, I just took a test and it's positive!" He couldn't hide his excitement.

When I got home, I went straight to Mom's bedside. Gently waking her, I waited until Nathan got home, a few minutes after me, so that he could film me telling her the news. It was a much more muted reaction than she normally would have had, but an enthusiastic one nonetheless. After spending some time with her, I had to head back to work for Open House. It was great to see everyone and get the hard-earned congratulations.

Its early days still, and of course I won't be in the clear for another 10 weeks. One in four women miscarry in the first trimester. But even if that were to happen, it is still good that I can get pregnant. I'm soaking all of this up and could not be happier. For now, it's at least a break in the clouds.

Our 2nd Embryo Transfer

Yesterday was a big day for us: embryo transfer day! After one failed IVF, I have to say that my heart is even more set on this one working. I'm not sure how that's possible, since I wanted it an awful lot the first time around (read about our first transfer here).

I guess I want this to work more than I did last time because it didn't work last time. Our failed attempts have intensified my desire to be pregnant and become a Mom. We've all heard stories about someone who was given a material possession, a car maybe, that they took for granted because they never had to work for it. Even budding relationships work this way, leaving us worried that someone who is readily available has something wrong with them, pursuing instead the one that isn't really interested in us. Within each of us seems to be an innate tendency to appreciate more, and rejoice in, the things that are tough to obtain. When you really work for something, you appreciate it more and conceiving is no different.

This is certainly not to say that if a baby were to drop out the sky the second we wanted one, we wouldn't love it just as much - we certainly would - but, I wouldn't appreciate it, or the struggle, nearly as much as I know I will now. This process has led me to put an increased value on being pregnant and the opportunity to become a Mom. If this works, I will be so much more elated than I would have been if it happened on our honeymoon.

We woke up and got ready for an appointment with Mom's neuro-oncologist, not knowing how many embryos we would have to transfer. Our last update had been the day after they were fertilized, and only two were developing normally. What if we only had one? What if we had...none? The four of us sat in the room discussing taking a break from her intrathecal chemo with Dr. Carrillo, and some concerning new symptoms/confusion. The night before, I was sitting at the kitchen table with Mom when she called out "Megan!" I touched her arm and said "I'm right here, Ma." And she looked at me and called "Megan!" two more times before telling me "She's not listening." It was, and is, absolutely heartbreaking.

Before we knew it, it was time for us to leave for our appointment. We've built a relationship with Dr. Carrillo, and he knew we had made into the trial. I stood up, and explained that Nathan and I needed to leave while Mom and Dad finished the appointment because "We have embryos to transfer!" He was excited for us, and stood up too, thanking me for the blog posting about Sunida that he was mentioned in. Very humbly, he said "Everyone's talking about it" and that it was seen by some really important people, including the CFO of the hospital. Hearing that his boss, and bosses' boss read my posting made me feel so good, because I owe them so much, yet have little I can do to express that gratitude. The time, care and comfort he gives us is invaluable.

Nathan and I set out on the drive to Encino. A little traffic, but not too bad because it was the middle of the day. I was drinking a lot of water to ensure a smooth transfer, and took the Valium they prescribed to make sure I would be relaxed. It was a very small dose and didn't last long but it certainly helped. We checked in, and didn't know how many we had. I had my blood drawn, not knowing how many we had. We sat in the waiting room and the doctor waved hello to us from behind the counter as I tried to decipher what his wave and smile meant. Was it sympathy?

We were called back into the room and sat there in the dim light, still not knowing how many we had when Dr Tourgeman waltzed in. "How are you doing?!" he energetically asked. "I don't know." was my very truthful response. "It all depends on how many we have." He flashed a huge grin and told us that we two healthy embryos that look perfect and are ready to transfer. The other three will be watched over the next few days, and if they do what they're supposed to, they will be frozen. Two aren't dividing, and one is asymmetrical.

We transferred the two on the left, than the three on the right will be watched.

It was so amazing to watch the transfer. You can actually see the little embryos (or embies, as I like to call them) go in. Although it's hard to pick up on the video, they look like little orbs of light. Light that contains all of our hopes and wishes and dreams. If they're going to implant, it will be withing the next five days, but a test won't pick up anything for an agonizing two weeks. And so I enter the dreaded two week wait. Spending the first day off work, on bed rest with Mom and with Trevi.

Egg Retrieval #2

My egg retrieval went well on Monday. I like going under anesthesia because its effortless and painless and when you wake up, its magically all over. But I guess I do get nervous about going under, and even more nervous about the results of the retrieval. I asked them to give me something in my IV to help, like they did last time. They chose versed and gave me the lowest dose. I felt the same, and so they gave me more. I still didn't really feel much different when they wheeled me into the operating room and transferred me to the table. The doctor was running late, and the last thing I remember doing was checking my watch and tapping my fingers on the stainless steel table.

I must have still been nervous, because when I saw him after I woke up in recovery, the first thing that he mentioned was how anxious I was when he came in into the room. I don't know what I said, because I don't remember even seeing him.

I was surprised to learn that he was able to retrieve 10. We knew not all of those would be mature, but were still quite pleased with the number because last time, a different doctor retrieved only 7. I went to bed that night excited and hopeful.

And then the next day, yesterday, that hope was deflated. The call came that only two were developing normally. All 8 that were mature (2 were not) fertilized, but three weren't doing anything just yet (the DNA wasn't unwinding) and 3 had two polar bodies. There's a chance that the three slow ones could catch up, but no chance that the others will develop. Then he said something pretty unnerving: "This is likely an egg issue." I don't know what that means, and have more questions than answers right now. But I am holding on to the hope that comes with knowing some women have been in a similar situation egg-wise, and are now mothers. One girl I know had 19 eggs retrieved, and only three fertilized normally. And one of those three is a beautiful 3 month old girl.

They told me that they would not check them again until it was time for transfer day, tomorrow. I keep picturing them, all snug in their little petri dish and wonder how they're doing. Will we have only one? Will there be three?

We will transfer one or two, but if there happens to be three, the extra one will be frozen.

There's so much riding on this, and not a darn thing I can control other than my outlook, what I eat, and how strict I am with my bed rest orders (very!). My instructions for tomorrow include drinking a lot of water and taking a Valium one hour before to make sure I'm relaxed during the transfer, which should take place around 1pm.

Faith, Hope, Gratitude

After three visits to Encino last week (3-4 hours each time), my doctor told me he needed to see me again this morning. I didn't get home from my appointment last night until after 7pm, and since today is Saturday, I was so looking forward to chipping away at my sleep debt. School started Tuesday and under ideal conditions, I would be swamped with schedule changes. But I had to either come in late or leave early three different times, which put me behind. I also caught a horrible cold that I'm still recovering from. Add to that the fact that Mom was still in the hospital up until last night, so each day also included a few hours at her bedside. Of course I wanted to see her, but I also needed to relieve my Dad. Thankfully, my brother came and spent the night with her earlier in the week, allowing Dad to spend one night in a comfortable bed without nurses coming in every few hours. 

Dad has been with her 'round the clock since she was admitted almost three weeks ago. His devotion to her is really shinning through during this time, even though every day is challenging. It is unbelievably hard to see someone you love so dearly need help with ... everything. It absolutely breaks your heart. Helping them isn't the hard part. The hard part is seeing them wanting and trying to do something own their own, but unable to.

Mom's situation has been trying on all of us. While it does help to have the prospect of a baby to focus on, I recently came to terms with the fact that it may not work this time either. At this stage in the game on our first round of IVF, we had 12 follicles (7 were retrieved, and 3 made it to day 3). Right now, we have half as many. 

My doctor counted 8 yesterday, and bumped up my retrieval from Wednesday to Monday because they were growing faster than expected. But today, a different doctor counted only 6. My husband and I were confused about the discrepancy, until he explained that the other two are still there, they're just not large enough. There's a small chance they could catch up by Monday, but it's unlikely.

So how does one come to terms with the prospect of not getting what they desperately want, when they want it? How have I "accepted" that I may get another BFN? That I may not be a Mom this time around?

1. Hope. For the future, for next time. Hope that it will eventually work. I know that if it doesn't work this time, we will try again. Hopefully, we will be able to do the Ivy Study a second or even a third time. I know people who have a child though IVF even though it didn't work the first, second, third,  even fourth times. And, if worse came to worse, we would consider surrogate eggs or adoption. Adoption is something we hope to do someday regardless. So, I have hope that I will be a Mom, its just a question of when and how.
2. Gratitude. I am so thankful for what I have, right here and now. I realized earlier this week that I spent so very long wishing I had a husband. And now, I don't just have any ol' one. Somehow, I managed to wind up with one better than any I could ever dream up! Dear future child reading this: Never settle! Hold out for exactly what you're looking for, and then some. He's really all I need to be happy. Everything else is just icing on the cake.
3. Faith. I don't have as much as I would like, but I have more than I've had in the past. It would be easy to turn away from that right now. But I have been actively trying to cultivate it by reading, praying and going to mass. I realized last week that I had gained some ground when instead of intelligent design seeming unlikely, the idea that all the beauty and pain in life is just random seemed more improbable.  

Even though I'm prepared for it not to work, I am still hopeful it will. I'll update before our embryo transfer on Thursday with how many we retrieved and how the little fellas are developing.

Now, setting my alarm set for 2 am so I can take my trigger shot!

Grow follies, grow!

If you follow me on my instagram or facebook, you know I am officially in The Ivy Study and just finished up my first 7 days of stimulation medication. Last week, I was so nervous about the final 'hoop' that I had to jump through (having an estradiol level under 25) that I could hardly contain myself. I blogged about it for Fertility Authority:

Home » Fertility Treatments » IVF » Hope, in a Jar

Hope, in a Jar

 

By Megan Swanek

A blog by Megan Swanek, August 31, 2014

Remember as a child just how excited you were on Christmas morning, hoping that one of those presents under the tree was the one you really wanted? And how disappointed you knew you would be if you didn’t get what you had been hoping and wishing for over the last few months? That feeling pales in comparison to just how nervous and excited I was the other day waiting on the results of my blood test and estradiol level. Read more...

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My levels turned out fine, and after 12 days of giving myself Lupron injections, I was given the green light and drove home with my follicle stimulating medication on ice. I have been given the study drug, AFOLIA, which is being tested as a generic equivalent to Gonal-f. Garnering FDA approval for this will ultimately help bring down the cost of IVF medication for women across the country, a cause I am all for. After-all, if it weren't for the reduced cost of this clinical trial, we would not be doing IVF right now.

Tuesday was day five of my stimulation medication, and I had an appointment for a scan, blood work and to receive more medication.  My scan showed 8 follicles, which was a bit disappointing. At this point in the process the first time, I had 12. He increased my dosage of AFOLIA from 225 IU to 300 IU to ensure they all kept growing. Stimulation medication never affects how many follicles you have. It only helps those you do have reach maturity.

Sure, it could be better. But as with all things in life, it could also be much worse. What if I wasn't responding to the meds? At least my 8 follicles are all growing, and I'm still in the study! I had them checked again today and everything looks good. My doctor needs to see me again tomorrow afternoon to decide exactly when I need to give myself the HCG trigger shot. I'm still on the 10 IU of Lupron each morning which is preventing ovulation, and this trigger shot will ensure that ovulation occurs 36 hours after its given. 

Then, it will be time for retrieval! Right now, retrieval looks like it will be on Wednesday, with a possible transfer on Saturday. The study specifies that we have to transfer two on day three, but I don't know if we will have that many. I was worried about what this would mean if we have less, but I double checked today, and they will still transfer one if that's all we have. 

And, one is all we need.