Wednesday 28 October 2009

Gaining the IVF drugs and losing my furry friend

Holy sweet smoking shit at sunset.

My mum collected my IVF drugs today. The two SACKS thereof. I came home, saw said sacks sitting on my coffee table, with a note to say there was more in the fridge. I unpacked them and set the assembled goods before me in growing disbelief. It was like Christmas morning in the mad scientist's house. I then hastily repacked the sacks and forced down the ratatouille hubby had whipped up before I lost my appetite.

Hubby and I just spent half an hour in the spare room - the coolest, darkest room in the house, being as it is a forlorn place where a baby should reside - with the drugs and assorted paraphernalia spread before us.

It's just overwhelming. It's overwhelming. There are:

- two boxes of nasal spray
- five boxes of crazy glass vials with some kind of liquid-and-powder combo
- fifteen small needles in orange packets
- fifteen scary ass huge motherfucking needles in green packets
- about 250 (looks like) syringes
- a "sharps box" which looks and sounds like it should feature in Saw VI
- a packet of pessaries made of VEGETABLE FAT
- a partridge in a pear tree

I have so much to say right now and yet the terrifying nature of having these drugs ACTUALLY in front of me has rendered me virtually inarticulate.

The biggest news - and the reason I've been away for awhile even with IVF plans proceeding apace - is that my cat died.

I'm still not ready to talk about it in detail. Regular followers might remember I nursed him through cancer 18 months ago. We knew his time with us was limited as he had been diagnosed with kidney failure, but I was hoping he'd see me through my first cycle of this hell.

However, fate moved against us and he started having daily seizures ten days ago. Hubby had taken me away for the weekend as a sort of last ditch romantic break before IVF, but we had to cut our trip short and rush home so my mum and I could jointly make the decision that it was time to let him go.

The vet came to the house last Monday and my darling furby died in my arms on his favourite chair. It was the worst thing I've gone through to date. We buried him in the garden and since that awful day not a second has passed when I don't miss my best boy. Not having a furry companion has made the loneliness of infertility bite even harder, but any notion of getting another cat makes me feel unfaithful. I guess right now the pain of losing him is still too raw.

That said, I have written all of this so far without crying. It's all about crying less each day and I'm impressed I've managed to tell the story - badly, but I've got the words out - without dissolving. I think the fact I am still bug-eyed with horror about the sacks of drugs lurking next door may have something to do with it, mind you.

So that happened. Then my relative who'd just had two embryos transferred had her pregnancy test, and it came back negative. She started bleeding the next day. I know I said last time that I was jealous - and I was, fuck me, I was green - but I never, ever wanted her cycle to fail. She is hurting so much right now and my challenge is to be there for her as best I can while making my own final preparations.

So on day two, a fortnight ago, I visited the clinic for my bloodwork. Turned out my FSH is 11.7, which is a little higher than they'd like for IVF (though not off the map) but a lot higher than it should be for a 30-year-old. I'm told stress can play a part, and with my cat and various other factors I suspect that's had a significant effect, but the clinic did say it may also mean my ovaries are struggling and that in turn may mean a higher chance of a cancelled IVF cycle or indeed a total failure of my body to respond to the drugs. They've prescribed me a higher dosage of Menopur - four ampoules rather than three. Whatever the fuck an ampoule is. Up until this month I thought it was something to do with plugs. I guess I was off sick the day we covered this shit in school.

So I got my treatment schedule, and they want me to start the nasal spray a week on Sunday. I get to attend the clinic on Friday for a "teaching appointment" to tell me how to take it. I'm not sure exactly what kind of imbecile doesn't know how to take a nasal spray - I mean, what, am I going to stick the bottle in my ear? - but there we go.

I'm not squeamish about needles but some of those motherfuckers are big. My relative tells me the last one - the one with the HcG in it - is the worst, because that's been kept in the fridge and is icy cold right about when you start flooding it into your thigh. If my hormones fuck up we may not even get that far. Right now, this autumn just looks like one long track of increasingly steeper hurdles, each one of which may constitute the end of the road.

I also may jest about being intellectually evolved enough to figure out a nasal spray, but I'm clumsy, bad-tempered, impatient and liable to hurl small, fiddly things that don't comply with my wishes at the wall. How in the world I'm going to manage with the selection of Sylvanian Family-sized glass bottles, dinky vials and stabbing instruments currently shoved hastily in a chemist's carrier bag on my spare bed is anyone's guess.

The side effects freaked me out, too. I mean, obviously chest pain, decrease in breast size, vaginal bleeding, migraine, shortness of breath, vaginal dryness, hot flushes, night sweats, muscular pain and abdominal swelling are every girl's dream, but we've all read about the scary stuff associated with IVF. By which I mean the cancer. That's a c-word that puts all my fears about what's going to happen to and in and around my other c-word into perspective.

I'm particularly looking forward to the pessaries because I've always imagined what it would be like to shove a lozenge of vegetable fat up myself and wait for it to ooze stickily into my pants. Every night for fourteen nights.

My timings are such that the egg collection will happen shortly before Christmas, which works well in terms of holiday from work and rest potential. What potentially sucks is that if things go well and we get eggs, then embryos, my pregnancy test will take place New Year's Eve. Kind of a bum start to 2010 if it fails, no?

I have the word DAUNTED in block red capitals in my head, but it doesn't do justice to how I feel right now. I think a more accurate summary is that I feel a level of terror and anxiety sufficient to almost - but not quite - anaesthetise the pain of losing a 19-year furry friend. I so hoped my little kitty would see me through this.

And here are the tears.

Tuesday 13 October 2009

A Daniel Powter of a period day

God, I just feel awful this evening. I had a broken night's sleep, one of those awful pre-period nights where you're too hot and wake up hourly, bathed in sour sweat and just waiting to feel the telltale trickle between your legs.

Why do I persist in continuing to hope in the face of compelling evidence that my period is imminent? I have been in this nightmare for nigh on four years and yet not a cycle goes by without me trying to talk myself into the brown stuff being implantation bleeding, the swollen gut being the start of a bump and the sore boobs being caused by pregnancy hormones.

I think the dangerous hope fairy was spurred on this month by my scan at the clinic, which clearly revealed a follicle out of which an egg had recently popped. How can you not hope when you see that with your own two eyes?

But oh, god, it was hideous this morning when that dastardly trickle did start up, accompanied almost immediately by wracking cramps. I was at work, as I usually am when this happens to me - of course my body wouldn't be so considerate as to commence menses on a weekend when I'm free to hide under the duvet and howl to my heart's content.

No, I bottled it up as best I could - a feat made more difficult by a colleague bringing her new baby in for a visit (bad timing obviously not her fault, but I hid anyway).

I also had no Tampax in either my desk drawer or my bag - I only had one crappy Asda tampon from a packet which hubby once bought me because he "thought the box looked the same". They're bigger and somehow unwieldier than the plastic-coated Tampax Compaq that I favour (although you'd wonder why I have an issue with large tampons given the vast array of bulbous implements that have probed my nether regions in recent years). So I had to do the horrid drippy walk to the ladies' knowing I had a shitty tampon situation going on as well as being horribly devastated at our last-chance disintegrating into dust.

So after all that, I kind of expected I'd start crying as soon as I left for home but by that stage in the afternoon it was all buried too deep. It has taken a bottle of beer, a bath and a lot of thinking on the couch before it all splurged snottily out just now in a very weepy phone conversation with my mum. It just hurts so bad to fail, and fail, and fail, every month, despite trying so very hard.

I'm clinic-bound in the morning for my final day two bloodwork before IVF. Hopefully they will have the results of hubby's latest sperm sample, which he produced last week, and I can finally talk dates and get some concrete understanding of how things will progress from here on in.

A family member has just had two good embryos transferred following her first cycle, and god help me, I'm jealous. I know how hideous that makes me - she has tried just as hard as I have and for nearly as long, and I honestly thought I'd be a better person and find it in my heart to be happy for her if she had a good outcome.

Please don't think I'm saying I wanted - or indeed want - her to fail. I don't mean that. I just guess I underestimated how hard it would be to be bombarded with texts from her describing her emotions about her two living embryos, about which she tells me she already feels maternal, when we are still in limbo.

I think I also overestimated my own decency. Sometimes I worry I don't deserve a baby.

Nothing for today but to write it off as a reeeeeally bad job. I need, in no particular order, a hot water bottle. A cuddle. A glass of wine. My mum. My kitty. Bed. A bit more of a cry.

I also need hubby to stop irritating me. I am weepy right now, so most of the impotent fury has leaked out of my tear ducts, but I am also really angry with our situation, and there's nowhere to direct it other than at him. He has done absolutely nothing to comfort me this evening - he sat and fucked around with his iphone while I was crying on the phone to my mum right next to him on the sofa - and right now he is making an infernal racket searching for a bulb for my bedside lamp - it fused this morning as part of what has generally been a shitfest of a day.

At times like this I just wish he'd get out of my sight until I've done my monthly grieving and can interact with other humans again. Because right now even the sight of his socked feet is enough to enrage me.

In addition to my list of needs cited above, it goes without saying that I need to feel I am making some kind of progress through this hell. I'm losing my mind here. Guess I'll have to wait and see what tomorrow morning brings.

Monday 12 October 2009

Awards galore (good on a period day)

Aw, you guys! I can't believe I've been nominated for two awards by fellow readers battling their way through the unending nightmare that is infertility.

I really am touched and a wee bit teary - in a good way - at all the amazing comments I've had recently. I wasn't going to blog tonight - after spending the day in a trying-not-to-be-but-fuck-it-I-am-anyway spiral of hope because of it being day 29 with no bee-yatch in my pants, I got home and promptly exuded several millilitres of brown sludge. So it's coming. The fact my stomach resembles a beach ball and I want to knife everyone I meet should really have alerted me to this fact. Perhaps one of these relentlessly marching months I'll learn.

But when I checked in and saw the comments and awards mentions I just had to say thanks.



Really, honestly, heartfelt thanks to Hope Springs over at Moving On To The Next Plan for this:

And to Illanare at My Words Fly Up, My Thoughts Remain Below for this:



Now for the revelations - my OTT award first up, for which I have to answer a series of questions using just one word:

1. Where is your cell phone? Bed
2. Your hair? Red
3. Your mother? Lifeline
4. Your father? Difficult
5. Your favorite food? Curry
6. Your dream last night? Unmemorable
7. Your favorite drink? Wine (I know, I know)
8. Your dream/goal? Motherhood
9. What room are you in? Study
10. Your hobby? Comedy
11. Your fear? Arachnids
12. Where do you want to be in 6 years? Fertile
13. Where were you last night? Sofa
14. Something that you aren’t? Patient
15. Muffins? Waitrose
16. Wish list item? Daughter
17. Where did you grow up? England
18. Last thing you did? Bathed
19. What are you wearing? PJs
20. Your TV? Downstairs
21. Your pets? Cat
22. Friends? Essential
23. Your life? Unfulfilled
24. Your mood? Lousy
25. Missing someone? Cousin
26. Vehicle? German
27. Something you’re not wearing? Contacts
28. Your favorite store? Shoe
29. Your favorite color? Green
30. When was the last time you laughed? Today
31. Last time you cried? Today
32. Your best friend? Legendary
33. One place that I go to over and over? Clinic
34. One person who emails me regularly? Dad
35. Favorite place to eat? Curryhouse

And for my Honest Scrap award, here are ten things you didn't know about me:

1. I hate cheese. I mean, I REALLY fucking hate it. Can't be in the same room with the stuff when it's melted. I make hubby keep his (inevitably, he loves it, especially the blue mouldy veiny shit) in a sealed box in the fridge.

2. I think laughing really, really hard is better than any sexual move any man or machine could ever perform on me. I always have thought this, and I always will.

3. If there was a really big spider in my home and hubby wasn't around to deal with it, I'd have to call the police once I'd exhausted the options of male friends and relatives.

4. I'm such a big pain-wimp that I've never had my legs, eyebrows or anything else waxed and blanch at the thought. Yet I have handled an HSG with only a smidgen of braying hysteria.

5. I am the most irritable person I have ever met, except for perhaps my father. Hubby sniffling is enough to make me bark out insults with feeling.

6. I'm an unusually good cook for a woman who's quite slim (I flirted with bulimia aged 19). I make a lentil curry that hubby goes wild for and which I believe is restaurant-quality.

7. When I arrive at a pedestrian crossing to find someone already waiting who has failed to press the button, I mutter "Works better when you fucking press it", increasingly audibly. Ditto lifts.

8. It is only a matter of time before I make an error of judgement and end up in hospital as a result of the above action.

9. There is a place in Canada, on the water, where I feel truly at peace.

10. Right now I am looking at a framed photograph of Bruce Springsteen, who I have loved since I was 13 years old.

Recipients

1. MK at An Infertile Blog, who's about as pissed off with this whole shitty process as I am, and who got a laugh out of me the first time I saw her brilliant use of a pregnancy test image.

2. Melissa over at Stirrup Queens, who has awards galore but who provides an absolutely amazing and essential service to those of us facing this battle (and who gave me a big boost with her welcome back after my long summer absence this week).

3. Rambler, at My World, My Ramblings, for her recent post that puts very eloquently what I didn't know then and wish I didn't know now.

Tuesday 6 October 2009

The barren woman's hate list: item #9 - Pregnancy vitamins

It amazes me that I have not yet mentioned how much these little puppies vex me.

Let me first say that I believe they are extremely valid and important. I would advise any woman trying to conceive to make sure she at least takes her 400 micrograms of folic acid every day, even if she doesn't want to go the whole hog with the Omega-3 oils, because the advantages proper folic acid consumption give a growing baby are immense and proven.

But hell. My problems with pregnancy vitamins are manifold.

For a start, it's the marketing. Every brand is the same: a smug, beaming woman grinning beatifically and yet with some measure of surprise at her bump, as if mildly astonished to see it there. I start every day by waking and wishing I had a child. To then trudge downstairs and be confronted with said woman's joyous countenance before I've even ingested orange juice is sometimes more than I can stomach.

Secondly, the price. These vitamins are at least a third more expensive than regular daily multivits. If you go for one of the super-duper Omega-3 brands - "for brain and eye development!" sings the packaging, as if any wannabe mother plans on having a brainless, blind child - you're talking £10 to £12 for a 30-day supply.

Fair enough if you're one of the blessed souls that produces offspring using the following maths: select preferred month of birth (hmm, spring baby or autumn baby?), count back nine months, mount husband on appropriate day.

However, that's a lot of money every pay packet when you've been trying three years or more.

Yet still, doggedly, one almost feels pointlessly, I take them. Every day. Religiously, with my cornflakes and OJ. It actually bothers me if I'm away from home and forget to bring my vitamins with me. "What about the brain and eye development of the big fat fucking nothing that's growing inside you?" my inner voice yells.

I'm on Pregnacare at the moment. It's always either those or Sanatogen Pro-Natal, depending which are on special offer. (Both fulfil the brain and eye criteria, so it's an even toss.) I hate Pregnacare especially because they come in truly inconvenient blister packs, with a purple oblong folic acid tablet in one and a bulbous oil-filled brain-and-eye capsule in the other. The blister packs don't quite fit in the box with the instructions, which tend to get crumpled at the bottom and take more room than they ought, meaning you end up ramming and cramming the blister packs back in the box while pounding the whole lot off the kitchen counter (smug pregnant lady facedown, obviously) for good measure.

And this is how I start my days. Is it any wonder I'm losing my mind?

Monday 5 October 2009

First IVF consultation

So it has come to this.

Last Wednesday hubby and I attended our first IVF consultation, thus formally acknowledging on our medical history that infertility has beaten us and we have reached this juncture.

We met a lady who I hope will be our doctor from now on, though you can never tell who you're going to get at the clinic (in which respect it's a little like Forrest Gump's chocolates). I'd not met her before but I liked her manner instantly and by the end of the appointment she'd stared into my innermost recess with interest so I felt we'd bonded.

The session took way over an hour in total and, as is typical of visits to the clinic, wasn't what I'd expected. We first reviewed our progress, or lack thereof, to date and then discussed the fact that despite my cycles having righted themselves post-clomid, we're still not pregnant. I've tested for ovulation these past three months using home predictor kits and have had a positive each time. We've had sex bang - if you'll pardon the pun - on the right days. And yet we're still not pregnant.

Our doctor said that in an average month, consisting of average sex (is there any other kind? I nearly quipped but thought better of it) between an average couple with nothing much wrong with their average bodies, there is a 20-30% chance of a pregnancy. However, once said couple have been trying for more than three years, as we have, this probability drops to just 3% due to the likelihood of there being an as yet undetermined problem. Happy thought, isn't it?

Anyway we agreed that while we could wait interminably for a couple more years, this is not an option for us emotionally and that we need to move on. That leaves us with the option of IVF.

I knew all this from the previous discussion with the clinic's professor, of course, but the purpose of this meeting was to go through it all in glorious technicolour. And inevitably to stare up my bits once more. It'd be rude not to.

Yes, I had another scan with my old buddy the Renault Espace. This was because it has been nearly two years - which is appalling, in a passage-of-time sense - since our first consultation and my first triple-S session of Swabs, Smear and Scan. Quadruple-S if you then add in Sore. Or Shitty. Or...I'll stop now.

I forced hubby to come in with me as I think it's about time he started confronting some of the realities of this process rather than sitting in blissful ignorance thinking that the most traumatic thing any infertile person ever has to do is wank in a cup on demand. He wasn't happy but he acceded to my request and hovered uncomfortably at the edge of the room looking dubious while the doctor rummaged around looking for my ovaries.

I had a moment of vindication - all summer hubby has doubted my claims to be ovulating independently - when she identified a recently burst follicle out of which an egg would have popped about six days previously - on the day I thought I'd ovulated, and on my right ovary where I'd felt the telltale jabbing pain.

I very nearly shouted "Hah!" in hubby's face but revised my decision at the last second in case it cast aspersions on the robustness of our relationship. I had to content myself with looking smugly triumphant - or at least, as triumphant as it's possible to look with a remote-control-sized doppler hanging out of your undercarriage.

The scan checked out - both ovaries looked good, I'd clearly recently ovulated and was starting to form small follicles for next month, and neither looked polycystic, firmly placing the opinion of the very first doctor I saw at that clinic in the category of utter bollocks. My womb looked fine also, and was half-filled with normal-looking endometrium consistent with that stage in my cycle.

BUT WHERE IS THE FUCKING BABY, I hear you cry. Or at least I hear myself cry, on a daily basis. I have no idea what is preventing us from conceiving, and not knowing is frustrating beyond words.

I got dressed and we returned to the consulting room where the doctor took us through the seven weeks of the IVF process in elaborate, terrifying detail.

Three weeks of nasal spray to "control" - for which, read "shut down" - my natural system.

Two weeks of daily injections, self-administered in thigh or tummy, to pump me full of eggs.

Scans to look at said eggs. Lots of scans. (The local authority where I live is building a new road tunnel beneath the river to ease traffic congestion. Said tunnel will be able to be closely modelled on my vagina by the end of this process.)

The dreaded egg collection, or "harvesting". (And on that, why so many fertility terms are quasi-religious is beyond me. This word always puts me in mind of a choir of small children singing "We plough the fields and scatter the good seed on the land".)

This involves being sedated, strapped up and plumbed with the Espace, which this time will be accompanied on its journey by a needle which will pierce - and there's a word you don't want associated with your bits, unless you're a body art fan - my vaginal wall and pop into my ovary to extract the baker's dozen eggs I will be filled with.

At this point in proceedings, hubby has to have his wank. In, like, the CLINIC. In some shitty private room with no, like, windows or anything. Into a POT. I mean, the trauma of it.

They look at the outcome of said wank and if the sperm are decent sorts, mix them with my eggs and put what you have to imagine is the resulting gelatinous mess in an incubator overnight, the idea being that by morning several sprightly embryos will be jostling the sides of the petri dish in their eagerness to become kids.

But here's the rub: you might have fuck all embryos. You might - and by you, of course, I mean ME, the poor, beleaguered woman - go through all of that only to discover that for some unknown reason, your eggs and hubby's sperm just don't like each other (much like you and hubby on bleaker days). You might also have crappy embryos which would never, could never become successful pregnancies and just have to be binned.

If all goes well and you have at least one good-quality embryo, you go in the day after to have it transferred back into your womb via my old chum the balloon-toting catheter. I already have all the literature from the clinic about these procedures and weirdly on the day of the embryo transfer you're not allowed to wear perfume, body lotion or strong deodorant as "strong smells can be detrimental to your embryos". Who knew that?

You then basically cross your fingers, toes and legs and wait for a fortnight to see if the embryo(s) implant. If you haven't bled by the two-week mark, you go for a pregnancy test, and if it's positive, you presumably bellow with joy all the way home and then return in three further weeks for a scan. If all's well with THAT, you're turned over to the care of your local GP who will arrange a midwife for you. I cannot imagine the word "midwife" ever applying to me at this point.

If things fail at any of the stages mentioned above, you presumably cry until your lungs fall out your nose and then the clinic give you six weeks or so to "heal" physically and emotionally before you have a review consultation to discuss where it all went wrong, and next steps if any are available to you.

It's huge, scary as shit, deeply traumatic and life-changing. Where I am right now is terror - not of the process itself; I think I can handle that after everything I've been through already - but of it not working. I know I can drag my body through all the physical trauma and survive, but I can only do that because of the shred of hope that it will work and that this is just what I personally have to go through in order to become a mother. What I can't countenance is putting myself through all of that and failing.

The clinic want more early-cycle bloodwork from me - fuck knows why, they've taken blood at least 1,100 times; I swear to you, they're vampires - and more sperm from hubby, which as you might imagine he is overjoyed about. He goes on Thursday, actually - he's going to have a dry run, as it were, of doing his sample in the clinic to prepare him for what he genuinely referred to as "the trauma of the day". I told him I'd share his pain and that he could share mine by allowing me to inflate a cocktail umbrella inside his shaft when we arrived home.

Once the results of this final batch of tests are in, we can start. Nasal spray is likely to be November - I have no confirmed dates yet, which makes me feel a bit like I'm in limbo - so the egg collection/embryo transfer process is likely to be just before Christmas. This is bittersweet - I hate Christmas anyway so the prospect of spending it with sore bits doesn't really bother me - but equally it's an emotive time of year and I'm likely to be in pieces. On the other hand it will coincide with holiday from work so I'll have plenty of time to rest up and recover from the op - which, by all accounts, only takes a few days.

It's so weird. I suppose a tiny part of me - a part that's nowhere near my vagina, I can tell you - is excited because this might actually be it, after all this time. But a much bigger part is want-my-mum petrified.

All I know is that it's autumn now. Cold, crisp weather descended the minute the calendar flipped last week. This has been the most difficult year of my life.

There are days when I'm not doing so good, and days when I cope OK. The balance would be very much in favour of the former were it not for certain key things and people - encouragement from those who comment on my blog; the candid and frank relationship I have with my wonderfully supportive mother; an interesting and challenging job; a cosy home and a husband who knows how to do comfort food; my darling cat, who is on his very last legs but keeps plodding on for my sake; and most of all, the distraction, silly times, late nights, shoulder-cries and belly laughs provided by my dear best friend, who knows who she is and to whom I am eternally grateful for helping me pick my way through this mess.

And amid all the terror, this glimmer: I may end this year with a tiny embryo in my womb. That's a pretty amazing thought, and getting there justifies all kinds of nightmares en route.

It seems extremely lofty and pompous to use a quote from Paradise Lost to describe my ordeal, but fuck it, I watched Seven the other night and it's in my head, and I don't imagine I'm the first person to feel this line has a resonance with the battle of infertility:

"Long is the way, and hard, that out of Hell leads up to light."