All But Over...

Trina's temp has been virtual roller coaster this cycle. The last few days has made it painfully obvious that the hills are getting shorter and the valleys are getting lower. This morning's temp was a mere .1 over the cover line. Thur's blood work will make this BFN official. 

What do you mean what did I mean by that??

Oh pr0gester0ne vaginal suppositories, how I loathe thee. You have hijacked my wife and replaced her with a quick tempered devil woman. If you weren't so strongly equated with "baby superglue" I'd drop the whole lot of you in the trash. 

IUI Cycle #11

Driving to our RE appointment Monday morning we made guesses about how many follicles we would see and joked about having twins and triplets. The one good thing about our having to use fertility meds was the higher instance of multiples. We would LOVE to have twins. Triplets are scary, but even still, I'd be thrilled. Much to our disappointment, the ultrasound showed she still had only one responding follicle on the right side. I know it only takes one, but I sure would feel more confident if we had a few to work with. It was 15.7mm and her estradiol was 248.We were told to come back at 8 the next morning for a recheck.

Tuesday morning's ultrasound showed our solo follicle had grown to 17.14mm and labs revealed her estradiol was up to 380. She was to trigger at 9pm and be back in the office for IUI#1 at 9am the next morning. We left the office with mixed feelings of excitement and anxiety. I was scheduled for hip surgery in an hour and I had no idea what shape I'd be in the next morning. What I DID know was that I would be there for the IUI even if I had to crawl on my hands and knees.

Wednesday morning came and I was not exactly happy to be conscious. I had been asleep for the better part of the last 20hrs. My wife, the rock star, had given herself the trigger shot the night before. I can't imagine how she made herself stick that 1.5" needle in her rump. I slowly got to my feet and with Trina's help slowly dressed myself in the baggiest clothes I own. She frowned at me when I refused to take my pain meds, opting for Motr1n instead. I was barely holding on and I wanted to at least remember the day we made our child. I slept the whole way to the Dr's office and stared into space while we waited in the lobby. A nurse came out and called Trina's name. It was our turn. Trina was so nervous since she had had a horrible time with her 3 IUI experiences. Her last IUI had gone so badly that we chose to do at-home ICI's for the last 7 cycles.

We didn't have much time to worry because, as usual, our doc didn't keep us waiting. He came in with a beaming smile and as he got his tools ready, he told us we had a whopping 56million swimmers! We were stunned and even he seemed impressed. We were used to counts in the high teens and low 20's. The IUI was, much like our Dr, fast, gentle and efficient. There was no sharp pain like when our old Dr bumped the top of her uterus with the catheter. Afterwards, he shook our hands, told Trina to lie still for 15min and said he'd see us the same time the next morning. Then he left with the smile he came in with. We sat there half waiting for the pain to start, for the cramps to double her over or for the nausea to come. 5 min passed, then 10. Nothing happened. She was so relieved that she teared up. Was this how everyone else experienced IUI's? No wonder no one thought they were a big deal. Amazing. Other than a few passing cramps and light spotting throughout the day, all was well.

The next morning we repeated our routine and ended up back in the same exam room as the day before. This time we had grins to match our Dr's. How could this not work? The previous day's sperm count was double what we were used to and here we were doing it again. Add in the nearly painless IUI and we were on cloud 9. Again, he came in and got right to work. He said "Today we have 63 million! Your donor is a champ!" This IUI was a little more painful, causing some small cramps during the procedure, but still nothing like before. He told Trina to start the pr0gester0ne suppositories on Sun, shook our hands and wished us luck. Our 15min was soon up and we were out the door. Our TWW has officially begun and our next appointment is for a beta on OCT 1.

Our swimmers waiting to be deployed.

Marveling in the pain free 15 min wait.

Rockstar

My wife is a total infertility-treatment rockstar. This is the same woman who refused a steroid shot while she was having an allergic reaction that caused vertigo, hot flashes and itchy red welts to cover her entire body making her every waking moment miserable. She opted for the pills that would take up to 24 hours to kick in instead of having nearly instant relief just to avoid that needle. She's chosen to have dental work done with no Novaca1ne because having her cavity filled with full sensation caused less mental anguish than a simple local anesthetic. The fact that she is willing to be in the same room as a needle, let alone stick it into her own muscle is a testament as to how badly she wants to be pregnant. She is amazing and I couldn't be more proud of her. :)

Pincushions

Wed Trina had her first u/s and blood work to see how she's responding to the meds. The u/s showed several follicles on both sides in the 7-8mm range. Later when the nurse called with the blood results they said her estrogen wasn't where they wanted it (not sure of the exact number) but that the dr was hesitant to up her meds. She has so many reserve follicles that he's worried too many would grow and we'd have to cancel this cycle. Instead, he recommended that she keep the same dose, but switch to IM instead of SQ. Trina did amazing with her first 3 injections and was really disappointed to hear that she had to change her routine. The mere thought of IM injections make her dizzy and panicky. She wasn't sure she'd be able to make herself put that needle into muscle, but she wasn't ready to give up control of the syringe either. When the time came, I gave her an icepack for her arm and she left it on until the skin was good and numb. With only a little hesitation, she was able to inject herself. Afterwards she was really lightheaded and a little nauseous, but the deed was done. Today, CD-8, she had her 2nd monitoring appointment. The u/s showed she had several small (less than 10mm) follicles on both sides and one 13mm front runner on the right. We were both really surprised to see only one follicle breaking from the pack, but we were assured us that anything can happen between now and triggering. Her estrogen was up to 138 so he said to continue with the IM injections at the same dose. We go for another check up on Monday. That makes 3 blood draws, 3 SQ injections and 3 IM injections so far this cycle...

Wed I had an arthrogram and an MRI. I wasn't sure exactly what to expect because I had never had either procedure. I did a little research and was not impressed by what I learned. They were going to lay me on a table, numb the area with lidocaine, guide a 4" needle into the joint capsule by means of live action xrays, inject 10-12cc's of contrast dye then slide me into an MRI tube for about 40mins. This did NOT sound like a good time. It wasn't. First of all, local anesthetics never work right on me. It takes an elephant dose to numb me up and it always wears off very quickly. Sure enough, the radiologist starts in with his "bee sting" speech. Why can't they be more honest about these things and say "It's going to feel like I'm ramming a dull hot sword through your leg and out the other side. Please don't scream as it upset the other patients, but feel free to weep quietly  to yourself". After the radiology tech had to go track down more lidocaine, I was somewhat numb. Even though he assured me I'd only feel "pressure" as the coffee straw sized needle went in, I prepared for the worst. I can't explain the sensations I felt. It was like painful cramping and pulling punctuated by sharp jabs each time he hit the bone. He was having a hard time "finding the right spot" so he would push in, hit the bone, back out a little and inject a bit of dye over and over. Finally he was "pretty sure" he had the right position but wanted a 2nd opinion since the dye wasn't dissipating the way he wanted it to. I lay there on that table with a huge needle stuck in my hip for what felt like hours as my anesthetic quickly faded away. The sensations were getting sharper and I was starting to get nauseous. My mouth was watering and I kept myself from vomiting by shear will as he came back with the other radiologist who said his position was fine. As he slowly injected the dye, the pain in my hip grew and grew. It felt like something was going to rip. Finally he was done and the needle was removed. Now all I had to do was walk the 50 yards to the MRI suite with a half numb, painfully distended hip capsule so the dye would move around in the joint. Swell..

I made it and they got me situated on the table and slid  me into position. I'm not overly claustrophobic, but I was glad I was out of the tube from my eyebrows up. It's a wonder what a few inches can do for you. Just being able to look up and see the room was comforting. Unfortunately about 20 minutes into the scan they pulled me back out of the tube, resituated me and slid me back in past the top of my head. My feet were taped together, an MRI coil kept me strapped to the table from mid chest to mid thigh and my arms were crossed over my upper chest. Both elbows pressed against the sides of that damn tube and my nose was only about 6 inches from the top. I had to remind myself that I could breathe. They had given me headphones, but half the time I couldn't hear the music over the thumps and AK-47 like bursts coming from the machine. Every time a series of clanging would stop, I'd think "oh good, it's almost over", but then it'd start back up. It seemed to go on and on. At last the machine was quiet and my table slid out of the tube. I waited patiently while a woman untaped my feet and unstrapped me from the "coil" I asked how long I'd been in there and she replied over an hour! She said they were having trouble getting clear images because I'm "so skinny". When I finally hobbled back out to the waiting room to see Trina, I had been gone for 2 1/2 hours. I have had more pain in my hip since that arthrogram than I've had in weeks. Monday I should get a call from the orthopedic office to schedule my surgery. Hopefully then I can finish healing and put this all behind me for good.

Injectable Cycle & a Needlephobe

This cycle will include 9-12 daily Brave11e injections in the lower abdomen, 1 Novare1 injection in the hip and 2 IUI's followed by progester0ne suppositories. Trina is a hardcore needlephobe so this is going to be a challenge. She wants to do all of the Brave11e injections herself. Being in control of the needle helps her deal. She's already obsessing and panicking about the Novare1 injection, because she knows she can't shoot herself in the muscle. Every time she talks about it, she gets light headed. The things we're willing to put ourselves through to make families...

Round 1:

Intently pulling up the first dose & tapping out the bubbles.

Administering the first of many injections.

Trying not to pass out and starting to feel the medication pain.

Laughing at herself for getting so dizzy but proud she was able to get it accomplished.

Glaring & telling me I better not make her look stupid on the blog. :)

Injectables, Here we Come!

Unfortunately on top of everything else going on right now, we had BFN #10. I am completely done with our OB and have been for some time now. I did some research on REs in our area and emailed one with a few questions. They got back to me immediately so I set up a consultation appointment. We went in on Wed and he briefly went over what we had tried so far. He wasn't impressed and asked who our OB was with a sour look on his face. He brought up some of the exact concerns I had expressed to Trina and had brought up with our last OB. He wanted to do an HSG, blood work and ultrasound then to move onto injectables if all came back normal. He asked us when she was due to start her period. We said Friday. He looked up and casually said "Oh, well these tests need to be done before her period. We don't want to waste a cycle testing, so how about I just fit you in for everything tomorrow morning. How's 8 or 8:30?" We were in shock! We went in for a consult a mere 2 days before her period fully expecting to have to take a cycle off to do testing and paperwork and such. He walked us out to the check out desk and told the girl to schedule us for all 3 procedures for the next morning. We walked out of there with our heads spinning. 

The next morning we arrived at the office as glorified walk-ins and expected to be there for hours. Surprisingly, we were taken back within 15mins. Trina had her vitals taken and was given a gown to change into. I was told I'd have to wait in the room while she had her HSG done in a surgery suite. She was SO nervous because of the violent reactions she had to the 3 IUI's we had done. I hated that she had to go alone. I opened my book and was only 3 pages in when she was back and smiling! I couldn't believe it! I had read that an HSG takes 15-30mins and if she was gone for 15min, it sure didn't feel like it. She handed me a printout of her xrays and showed me her two open tubes. We were ecstatic as we walked back to the lobby to wait for our 2 other "procedures". We barely even sat down before another nurse called her back. We were taken into a room and told that it was time to draw blood. I told the nurse that Trina was a needlephobe and would have to lay down. She didn't seem bothered at all. She hit the vein on the first try and was done in a flash. Trina was amazed at how quick and painless it was. The nurse told us when were ready, we could go into the next room to get the ultrasound. We headed over and once again there was no wait. A nurse came in and told Trina to strip from the waist down and hop on the table. A moment later our RE came in and started the u/s. He explained everything he saw and said Trina has super ovaries with a great egg reserve. We were walking to our car at 8:54. Less than one hour to do 3 procedures as walk-ins. I've never heard of such a thing. We were giddy.

A few hours later his nurse called to see how the appointment went and to remind Trina to call her when she started her period. She said she had ordered our meds based on the test results from that day. Less than 5 min later the pharmacy called to say that our meds would be on our doorstep before 3 the next afternoon. These people do not play around. Never in my life have I seen a medical establishment work so efficiently or politely. Now I know how rock stars must feel. This is definitely our cycle. I just know it. :)

St@rFlight & BFN #9, Part 2: The Hospital

Upon arriving at the hospital, I was whisked into the trauma center. My gurney was surrounded by faces. I listened as my rescuers gave the ER staff a run down of what happened, my injuries and the treatment they had provided so far. Several people started looking me over all at once. There were questions or directions to follow from every angle. "Squeeze my hand" "What's your name" "Move your feet" "Does this hurt, or this or this?" One of the nurses put her hand on my forearm and asked me if I was cold. Her hand felt hot. I was cold, wet and shaking, I just hadn't realized it. They cut off my clothes. Someone offered an apology and said they'd keep me as modest as possible. The nurse who asked if I was cold reappeared with warm blankets. They felt amazing. After the initial assessment, they decided I was safe to move off of the helicopter's gurney and onto one of their beds. I was assured they'd be careful, but as 6 of them got into position and went over what they each would do, my stomach dropped. I was terrified of the pain it would cause. I had good reason. Even though they were as gentle as possible, my chest went into spasm and I was left gasping for air. I didn't know how much more I could take. One of the doctors came over to examine me.  He lifted my injured leg and as he brought my knee towards my chest my hip popped SO loud and thunked back into place. I screamed. A few minutes later I heard him talking to the nurse. He told her where he wanted Xrayed and that he wanted a CT scan of my chest, abdomen & pelvis. She said "You know Dr. X is in charge  tonight, there's no way she'll approve all that." Sure enough, in no time Dr. X was at my bedside explaining to me that although my injuries were painful, they didn't seem overly severe and that she believes a few xrays will tell "us" what we need to know.

A portable xray machine was brought to me and they started taking films of my neck, chest and leg. I heard someone say, "there, at the top of the femur shot, see that? We need a better shot" I thought "Oh shit, I broke my femur!" They took a few more xrays. Dr. X came over to a little while later and told me that I had displaced fracture of the iliac crest, but my ribs and everything else were fine. I couldn't believe it. I would have put good money on a broken rib or two. The pain was so much worse in my chest than in my hip. Every breath was excruciating. Trina arrived at the hospital and I was SO relieved to see that she was safe. In short sentences punctuated by gasps for air, I told her about my hip being broken and how my Dr wanted more tests, but that he was vetoed. She asked me if I needed more pain meds and I told her no, that they'd already given me several shots and nothing helped. I felt worse now than before so what was the point? She called a nurse and told her my pain was getting worse, not better. She said she's find something stronger. I'm not sure what she gave me, but I started losing time after that. Mr. Swimmer showed up at my bedside and asked if I remembered him. I said yes. He asked if I was feeling better. I told him no, the pain was so much worse and I couldn't breathe. He looked worried and told me I didn't look good. He said he'd find my doctor. I'm not sure how long it was, but my Dr came and said that I was going to CT scan. 

Two people I hadn't seen before came to wheel me away. Trina wasn't allowed to come so she went to the waiting room to give the rest of my family an update. By this time I was fading in and out. When my bed stopped I briefly opened my eyes, but my eyelids were so heavy. A man went to lower the rail on my bed but my foot was in the way. He just pushed harder. I kept whispering, "myfoot*gasp*myfoot" but he didn't listen. Finally he realized I was talking to him and moved my foot. He didn't even apologize! The two of them used my sheet as a hammock and just swung me over onto the CT scan table. My chest seized up and my hip was on fire. I couldn't breathe at all and was writhing in pain. As the pain subsided I was able to pant. The woman told me I needed to be more still. I was so angry, but couldn't even form words, I was very close to blacking out. When they were done they came over and the woman told me softly, we're going to move you back now. I told her to just give me a minute, but then faded out again. The pain brought me back, but they must have been a little more careful because it wasn't as intense. 

When I arrived back in the ER, my dad was there. He told me how much I had scared him and that my mom was driving in from Dallas. I said "already?" I didn't realize how much time had passed. The next thing I remember is that the Dr came to give me my CT results. I had 5 broken ribs, my spleen was lacerated and I had two hematomas, one at my broken pelvis and one around my bleeding spleen. He told me I was being moved to ICU and that they would keep an eye on my spleen. He said there was a chance I'd need a blood transfusion or to have my spleen removed if it kept bleeding. Apparently all of my injuries were super painful, but none of them required surgery at that time. 

I must've passed out again, because Trina was with me when I opened my eyes instead of my father. Two nurses from the ICU came to transfer me. They were both so nice. The next 2 days were a blur. I came around occasionally when the nurses would take blood or vitals or when radiology would take my daily chest films. Trina almost never left my side. The ICU nurses never told her to leave when visiting hours were over. If she had to leave to use the restroom she couldn't get back in, but they never actually kicked her out. I thought that was so sweet. I had a parade of visitors come see me and I remember almost none of it. Just little flashes here and there. The 3rd day, my nurse came to tell me that I was now allowed to have liquids. Until then I could only have tiny amounts of water from a sponge on a stick to help with the morphine induced dry mouth. She said she'd have them send up juice and chicken broth. I told her I didn't eat meat. She said "Oh, there's no meat, just broth". I blinked alot... They ended up sending a bowl of what tasted like water that broccoli was boiled in. I couldn't take in much, just a few sips of that and some juice. Unfortunately it didn't stay down for long. Vomitting was SO painful. Everytime my muscles tightened to heave, my chest and hip screamed with pain. It was awful. Later that day a physical therapist came by. She said I needed to start getting out of bed. I thought she was insane. I couldn't even sit up. With her help, I finally made it to the sitting position on the side of the bed. Tears were streaming down my face. It was the first time I'd cried from the pain. She said I didn't have to go any farther, but I hate giving up. With some work and assistance, I got to my feet and shuffled to a chair. She told me to call a nurse in no more that 30min to put me back in bed. Who would've thought that sitting up would be so exhausting? That small feat was my first accomplishment on my road to recovery. That afternoon my lunch of chicken broth and jello arrived. I tried explaining the concept of vegetarian again... Later that day I was transfered to a regular hospital floor.

When I got to my new room, it was dinner time. My nurse asked if I'd eaten. I told her I hadn't and that I was a vegetarian. She said no problem and that I was allowed solid food now. When my tray arrived, I was only mildly surprised to find pepperoni pizza and jello. Apparently "vegetarian" was too hard a concept to grasp even though the ticket on the tray had my name and said the word vegetarian in all caps AND was highlighted. I can see how that would be confusing... We called the nurse to inform her of the mix up and take the tray. She said she'd send down for new food but I told her not to bother. Trina went to the cafeteria to try and find something edible for us. The next day I felt better and stronger than I had since arriving. The physical therapist came and said it was time to walk. It was a pretty frightening thought since the day before sitting up made me cry. I actually did pretty well. Sure I was moving with the speed and grace of an arthritic 85yr old, but I made a half lap around the whole floor. I was quite a sight with my IV pole in tow, crouched over my walker, taking 6 inch halted steps and breathing open mouthed like I was running a marathon. :) I felt so accomplished I even had them set up a shower chair so I could wash the 4 days of funk off my nasty self. Later that night my dad brought me some delicious pizza (sans meat) and I took an after dinner stroll with him. I was on top of the world...for a VERY short time. 

I woke up so nauseous I couldn't see straight. I called the nurse's station to see if I could get some nausea medication. She never came. When I vomited I was really surprised to see the pizza I had eaten 13hrs before. Trina walked out to the nurse's station to tell them that I had never received my meds and that I was vomiting. The nurse didn't seem alarmed that food had stayed in my stomach half a day and was still recognizable. I was sick and cranky all day. To top it off the Dr came in and told me my hemoglobin had been dropping for 5 days straight and if it went down one more point, I would have to have a blood transfusion. He said they'd have to see my numbers "trend up" for several days before releasing me. I ate next to nothing all day. Even drinking water was a chore. That evening Trina finally convinced me to eat some almonds so I could get a little protein. Nearly 9hrs later I threw up almonds and acid. Again I voiced my concern to a nurse about how long food was staying in my stomach before I threw it up. Again I was blown off. For breakfast they brought me eggs and hashed browns with a big slab of fried ham across the top. Trina was furious. She took the tray out to the nurse's station and told them not to bring me any more food, that she'd take care of me herself. A few hours later a nurse came in to tell me my hemoglobin had gone up 4 tenths of a point so I was being discharged. 

I had the worst heartburn of my life. I felt as if every sip of water or nibble of food just displaced that amount of acid out of my stomach and into my throat. I felt worse than the day I arrived. I was sick to my stomach, weak from anemia and low blood sugar and in more pain than ever and they were releasing me. Less than 24hrs earlier a Dr had told me I would have to improve for several days before I was allowed to leave. Even so, I wanted out of there. Trina was taking better care of me than anyone there. She'd had to practically beg for my medication on several occasions, she was the only one making sure I had food that I could eat, she was there night and day keeping me comfortable, helping me to the restroom and being my advocate. 

The 3 hour drive home was awful. My broken bones and sick belly amplified every bump in the road. The turns made my stomach churn and my chest spasm. Going over railroad tracks was murder on my pelvis. On the way home we stopped at a pharmacy. She bought me antacid and stool softeners. The way we saw it, my digestive system had shut down. It had been 6 days since my last bowel movement and nothing I ate stayed down, even the acid was backing up. I cut my pain medication dose down to the bare minimum. I just needed to take the edge off so I could breath. That's no easy feat with 5 broken ribs that click with every inhalation. By the next day I was back on the road to recovery. Food and water going in, waste coming out. It was a beautiful thing. 

My poor wife had to do everything for me in the beginning. I couldn't lay down by myself or get myself out of bed. I could barely walk down the hall without being winded. Getting me in and out of the shower was such a big production that I was only bathing every few days. I had Trina shave my head since I couldn't even lift my arms high enough to touch my head, let alone brush or fix my hair. I'd rather be shorn than limp around with greasy bedhead. She said I was being vane, I just thought I was being logical. I made quick progress those first few weeks. My 3rd day home I was able to completely dress myself, even tying my own shoes. By the 2nd week I was off the walker and only using a cane. I could almost always get myself out of bed in week 3. Week 4 I was able to turn over and sleep on my right side for small amounts of time. I felt a little more independent everyday.

I wish I could say that all was well now, but that's not quite true. My progress has slowed and I've hit a plateau. As my spleen, ribs and pelvis have healed, the pain in my hip joint has gotten worse and worse. I made an appointment with my orthopedic doc and he thinks I may have torn the cartilage in my hip. I have an MRI scheduled for Wed and I'll find out Fri if I need surgery. I guess I have a few more hurdles before this little journey is done. Wish me luck.