My Cautious RE

October 2, 2010

I can’t imagine having to go through all this with a sub par doctor. My RE is absolutely WONDERFUL. She’s made herself completely available to me. She has a great bedside manner. And she’s super smart and good at what she does.

But.

She’s so overly cautious that she’s starting to remind me of my mother when she was teaching me to swim when I was little. OK, just take two strokes and swim to me here. And then she would back up thinking I wouldn’t notice. All you have to do is make it to where I am. And then she’d back up some more. Until finally, I had swum half the length of the pool at age 4 when she had made it look like just a couple of feet. It infuriated me then, and it infuriates me now.

This is what my RE is doing now. We’ll let you go home as soon as your beta starts to drop. It drops. And not just a little. Well…. let’s wait to make sure it continues to drop. It drops for four consecutive days by more than the amount they are looking for – they wanted to see a 15% decrease every 48 hours and I was dropping about 15% DAILY. Well… let’s give it a few more days. We’d like it to be less than 10k. And that was when I insisted on going home. There was no way I was staying in the hospital until my beta dropped below 10k. It was at 34k the day I came home.

Upon release the plan was to monitor my beta twice a week. We were all thinking roughly a Tue/Fri schedule. I came home Wednesday. I went in Friday for a beta. I thought I was free until Tuesday. Yesterday’s beta decreased by 35% (down to 22k)! And yet I still have to go in tomorrow, bright and early on a Sunday, for yet another beta.

I know I shouldn’t complain. She’s just being super cautious – and that’s not a bad quality in a doctor. She called to check on me the day after I came home. She wanted to make sure I was still OK with my decision to come home. She said she would gladly put me back in the hospital if I wanted to go back. Technically there is still a risk of rupture. If my beta HCG should suddenly stop dropping and/or start rising bad things could happen. But I’m tired. I know this is going to be a long drawn out process but it feels like she keeps making it longer/harder by introducing more hoops to jump through. I’d rather just know up front what’s required of me so I can mentally prepare for it. This constant “just a little bit farther” business is mentally exhausting. And I don’t have energy to spare right now.

I still think she’s awesome. But my veins are tired. It takes two tries for any nurse to get my blood. I need a break. My veins need a break. I want to sleep in.

Clearly I’m whiny. Again. Sigh.

The pain is not helping the whiny. So I sort of have an excuse. But I still hate being whiny. Double sigh.

Still here in the hospital…

September 23, 2010

My beta HCG came back this morning (Thurs) at 66k. Up from 42k on Sunday. So I’m stuck here. I think they want to see it <30k before they even think about letting me go home. My RE didn't seem particularly worried that it had gone up – apparently it often goes up before it goes down. And it hadn't doubled so she was happy about that. But she told me to mentally prepare myself to stay through the weekend. Ugh. And if I'm still here Monday, she is sending the clinic's psychologist/counselor to me. Double ugh.

They will check my beta again in the morning before they give me a 3rd methotrexate shot. I don't think hopes are high that it will be low enough to cancel said shot but they just want to check it again. They'll do the same on Sunday.

I didn't have much reaction to the first shot so I was surprised yesterday when, after the second shot, I felt like I had been run over by a bus. At least now I know that I can probably expect the same tomorrow. And after my surprise vomiting today, I think I'll go ahead and ask for the anti-nausea meds up front. It is very easy to forget that methotrexate is chemotherapy. But it is. And like most chemo drugs it can cause extreme fatigue and nausea. So I'm still happy to be here in the oncology ward where they know exactly how to deal with vomiting. I'm really starting to fit in here. Except for that whole not having cancer thing.

So anyway… here I am. Still in the hospital. Sleeping a lot. Not eating much. Wanting to go home and curl up with my kittehs. Still waiting for the inevitable tidal wave of depression and emotional breakdown. But I have to get through this physical stuff first. The support is overwhelming – more on that later.

Conservative Clinic

September 10, 2010

Going through IVF last month has really made me realize that my Fertility Clinic is rather conservative. But I’m OK with that. It can be infuriating sometimes but I understand why they do it.

They rarely do 5 day embryo transfers despite what I’ve read about the increased success rates. Their reason? The embryos do not like being outside of the mother’s body. Although it’s easier to identify on Day 5 (as opposed to Day 3) which embryos will turn in to a baby, it’s apparently much more difficult to keep them alive those 2 extra days. So my clinic chooses to put them back in their natural environment as soon as possible instead of risking losing them all together.

My original beta HCG test was scheduled for 14 days past transfer day – not 14 days past retrieval. That seemed awfully late to me. But since I got a positive home test much earlier, I ended up going in for my first beta 3 days early. In my case, an earlier test worked out fine. But my Cycle Buddy, @IVFQueen, was not so lucky. Her clinic had her come in at 14 days past retrieval (I think). It turns out she had a chemical pregnancy and that beta came back at 12. But she couldn’t know if that number was on it’s way up or on its way down. So she spent two days waiting in agony to find out. I suspect this is one reason why my clinic prefers to test later. And why they had me come in for a 3rd number. They want to see it go over 300 to be safe.

My first ultrasound is scheduled at 7 wks. I’ve heard of others who go in during their 5th or 6th week of pregnancy. Some of them hear a heartbeat that early. Some of them don’t. The ones who don’t are left waiting in agony. Again, they are left wondering if it was simply too early or if there’s a problem. Another two week wait for my ultrasound is going to be PAINFUL. But I feel confident that the outcome will be definitive on that day. Or as definitive as it can be.

My RE once told me that she is open to trying anything and everything that her patients want to try. But she will only suggest treatments that are based on empirical evidence – treatments that have been thoroughly tested and proven to be effective. I think I like that attitude. Not afraid to try new things, but also not quick on the draw to try the latest, unproven, possibly fad, treatment. One example was DHEA. She discussed that with me. She said they don’t routinely use it because the evidence of its efficacy is controversial. She also said it causes severe acne. But she was willing to try it if I wanted to. Fortunately we didn’t have to.

So anyway, while I go crazy waiting for this ultrasound I just have to keep telling myself that it’s worth the wait. They’ve done right by me so far so I have to keep trusting their judgment.

Beta #3

September 3, 2010

Beta #3 has come in at 355 so all is still well. My levels are doubling every 48 hours.
90
172
355

I’m not out of the woods yet by any means but now I’ll finally post the pic of the embies. I didn’t do it on Transfer Day – felt too much like jinxing it.

embryos
Here they are. One, or possibly both, of these little guys has decided to set up camp and hang out for awhile – hopefully for 9 months. Beta numbers would seem to indicate that it’s just one. But you never know. We’ll just have to wait for the ultrasound in two and a half weeks. Hopefully it will be good new for Right Guy’s birthday (the u/s will be the day after his bday).

Beta #2 Results Are In

September 1, 2010

And… the results are in. 172. Not quite doubled from 90 but really really close (and technically not a full 48 hours between the two). They want me to go in for a 3rd test on Friday just to be safe.

I was so optimistic yesterday since I think my levels have been doubling properly up until now. So I figured they would continue to do so. And then last night I had a dream that I was bleeding. The dream never got to the point that I was definitively miscarrying – just bleeding. Or at least that’s all I remembered this morning. But since I had a dream about a BFP last week and it came true I guess I’ve developed a little pregnancy superstition. I awoke this morning checking for nausea, sore boobs and exhaustion. And itchiness (no one ever mentioned that one to me before but Dr. Google has confirmed it). All still there but somewhat lessened. But most of those symptoms could also be caused by the Estrogen patches and Progesterone in oil shots I’m still on. On the other hand I didn’t make it through a whole day of work yesterday either – I left early again for a nap. So how bad could it be?

I started to feel a little more confident after I walked 2 blocks to Whole Foods to get a sandwich for lunch today. On the way back I was really woozy. Clearly I didn’t eat enough breakfast. And clearly I’m still pregnant.

I have no idea if it’s pregnancy or just some fluke but apparently my veins now roll. I used to be the easiest stick. I was a phlebotomist’s dream. Somehow, practically overnight, I’ve turned into a phlebotomist’s nightmare. That prominent vein that they love so much is still there, beckoning them, “Choose me. I’m Easy.” But then they have to dig around for a minute or two to actually get the needle in. On Monday she gave up and drew blood from my other arm. I had a different nurse today and she had the same problem but managed to make it work.

Again Right Guy will not have a phone or be on email most of today. So I’ll have to text page him the results. But this time I’ll spell it out: one hundred seventy-two. And he told me to include a 🙂 or a 😦 so he could get the gist if the number didn’t come through properly.

Official BFP

August 31, 2010

It’s official. My bloodwork shows a beta HCG level of 90. That’s a solid number for a singleton (although it doesn’t rule out twins) at 14dpo / 11dpt3dt. Now we just have to wait and see if it increases appropriately. I think it will. Based on when I got the first faint positive and the sensitivity of that test I thought my beta would be at around 80 yesterday – and I was thankfully right.

Let the waiting continue!

I have so many cliches swimming around in my head right now. “Take one day at a time.” And in the immortal words of Renee Zellweger (a.k.a. Gina) in Empire Records, “Don’t screw it up.”

And I’ve already had one minor screw up. Unfortunately I think I gave Right Guy a mini heart attack yesterday when I shared the news. He’s difficult to get a hold of – I can’t really just pick up the phone and call him – so after I sent him an email with all the details I also sent him a quick text page that just said “beta HCG = 90”. What he received was “beta HCG 0”. Being a Dude he only admitted to being confused by it and not upset. But I’m sure he was upset. Hopefully I can avoid that with tomorrow’s number.