herveryown

I Am Delicate

My mother raised me to say please and thank you and to always use my pleasant social voice on the phone and with any and all people I interact with on a professional level.  I'm sure she would be very proud of the way I received my second beta number: I very politely yelled "Holy crap!" into the nurse's ear.

My second beta (ten days past a five day transfer) was 302. 

I assume those of you playing along on the home version of this game have already yelled "Holy crap!" as well, but for those of you unfamiliar with the mathematics of hCG levels in early pregnancy, one expects the numbers to double every 48-72 hours.  Adjusting for date, time of draw, windage and the airspeed velocity of an unladen swallow, my beta doubled in 34.12 hours. 

This is good news.

In terms of OHSS, I am still huge.  This morning I seriously considered buying maternity pants, because hi, huge.  I am currently eschewing tight shirts and anything form fitting for fear that a stranger on the street will attempt to rub my belly.  Two things kept me out of an elastic waist this morning: The fear of Jinxy McJinxerson and the certainty that buying maternity pants at all of four weeks gestation would turn me into one of those assholes who pees on a stick and buys a crib.

One thing I did do was scurry over to Evil Insurance Company, Inc. with a hard copy of my betas and say "Hi, y'all didn't believe that I was pregnant the last two times until I was already miscarrying, and on one memorable occasion your people argued with me about whether or not I'd ever been pregnant while I was busy miscarrying, so...here.  See that right there?  That number means I need to get some sort of pre-natal appointment before the earth crashes into the sun."  It is my impression that in order to wrangle an OB/GYN appointment out of Evil Insurance Company, Inc. during the first trimester and in time for any kind of meaningful screening cutoffs, you have to call for the appointment while you're still in puberty.  Since I had carelessly failed to do so, I figured I shouldn't waste any more time. 

Don't worry, Mom, I was actually very polite and pleasant about the whole thing.  I even used your insanely perky 'Thou shalt not fuck with me, for I am not in the mood' voice.  Smiles were exchanged all around, appointments were made, forms were filled out, and then I went home and had a good laugh.

Apparently, I am pregnant.  Again.

It would still be nice if this worked out.

One Week Wait

Yesterday's beta was 79. 

At seven days past a five day transfer, the clinic considers anything over 50 to be good.

We finally smiled at eachother after the phone call, just for a moment.

Late Bloomer

I think I just discovered a new symptom of OHSS: If it comes on fast enough, it will make your pubic hair just up and disappear.

Well, okay, to be fair, it didn't entirely disappear, it just decided to seek shelter under my rapidly expanding abdomen and became temporarily invisible from all northern vantage points.  Sam had actually noticed my expansion last night, but had wisely declined to mention it under the theory that it is incredibly stupid to point out to your wife that she appears to be rapidly gaining weight.

My waist measurement increased by four inches between the weekend and this morning.  I found this kind of disturbing, so I called Nurse Sweetie, who said that it might just be bloating related to the raging hormones, but suggested that I drop by for a little wand-related slap and tickle, just to be on the safe side.

Dr. N00b measured my ovaries at sevenish and eightish centimeters.  This is bigger than they were just prior to trigger but still way smaller than they were following last year's fresh cycle.  I was weighed and poked and thoroughly checked over, and then Dr. N00b flipped to a fancy color screen to verify a healthy blood flow to each ovary.  We discussed risks of torsion and projected duration of my recent enormity.  A small pocket of free fluid behind one of my ovaries was discovered and measured, neatly sealing the deal.

I have moderate late onset OHSS,* a condition usually either caused or exacerbated by pregnancy. It is my understanding that having a bad outcome so closely linked to a good outcome is classified in medical circles as 'a huge pain in the ass'.  One website helpfully pointed out that since there are no great treatments for OHSS other than supportive care, the best thing to do is avoid getting it in the first place.  Gee, thanks, Internet.  What's next, sagely suggesting people avoid getting hit by beer trucks?

Since Dr. N00b and company are nothing if not thorough, they ran a CBC, complete thyroid panel, and threw in an early beta for fun.  I get to go back for another checkup later this week, although Dr. N00b encouraged me to call or come back if I was concerned for any reason, stressing that she would be on call around the clock if anything untoward happened to my Vicuna.

Well, you know, more untoward than late onset OHSS, I guess.

*I had early onset OHSS before, meaning I have now had the distinct pleasure of having both types.  Do you think you get some sort of badge or patch to sew on your underpants, or is it more like playing Monopoly?  Now that I've collected the full set, can I stuff little plastic hotels up my cooch and raise the rent?

(Not) All About The Benjamin(s)

At six days past a five day transfer, the line is bright enough that even Sam can see it.  Even a perfectly fertile woman (one who has never scrutinized a pregnancy test under every light bulb in the house and then impatiently waited for the sun to come up in order to check it under natural light) would agree that yes, there is a line and it is darker than yesterday.

Of course, a perfectly fertile woman would probably be squealing and announcing the news to her infertile sister in law and buying a crib right about now, and we're definitely not doing that.  We are both quietly thrilled, but the thrill is actually so quiet that we haven't even cracked a full fledged smile at eachother over it.  The closest we've come to discussing it is when I leaned on Sam's chest and said "Boy, I hope this works out."  "It would be nice," he agreed.  That was about the extent of our elation.

Just to put it in perspective, this is the third time I've been pregnant in the last fourteen months, so it's a little hard to get excited.  Even the idea of getting excited is quite terrifying.  Getting excited reminds me of how deliriously happy I was when I was pregnant with Good Embryo and how soft and regretful Dr. BrightEyes' voice was when he said he could no longer find a heartbeat.

In the commercials, women pee on two line sticks and smugly say "It's how I knew Benjamin was coming."  There are no gleeful Benjamin moments in the Buttmansion abode.  Instead, we are sitting over here wondering how this will turn out.  Baby?  Chemical?  Miscarriage?  Something worse?  It's anybody's guess.

Are we happy that I am, for the time being, pregnant?  Yes!  Absolutely!  We are also scared.  For us, getting me pregnant isn't half the battle, it's an engraved invitation to the battlefield.

Boy, I hope this works out.

Hmm

At 5dp5dt, it looks kind of positive-ish.

Thirty Helens Agree

Thirty Helens agree, but three pee sticks do not.

Stick Number One: "La la la la, duuuuude, check out this white line!"
Akeeyu: "Excuse me, what the fuck is a white line?  It's pink or nothing, asshole."
Stick Number One: "Well, we're all out of pink today."
Akeeyu: "You suck.  I'm getting a different box."
Stick Number One: "I would like to change my vote from 'white line' to 'negative'."
Akeeyu: "I'm not listening."

Stick Number Two: "Come to me, baby.  Let me take you into the comforting embrace of my different lot number and much later expiration date."
Akeeyu: "Hey!"
Stick Number Two: "What?"
Akeeyu: "Is that a white line?  Motherfucker!"
Stick Number Two: "No, that's a pink line.  See?  Very faintly pink.  Or maybe negative.  No, no, it's pink."
Akeeyu: "Huh."

Stick Number One: "He's lying."
Akeeyu: "You and your white line!  Like you would know!"
Stick Number One: "I'm just saying.  He says positive, I say negative."
Akeeyu: "I still say you suck."
Stick Number One: "But you don't know for sure, do you?"
Akeeyu: "I hate you."

Stick Number Three: "Boy, it's early."
Akeeyu: "And thank you for not having a white line."
Stick Number Three: "If you don't stop turning me over and squinting like that, either I'm going to barf or you're going to go blind."
Akeeyu: "Squinting doesn't make you go blind.  You're thinking about masturbation."
Stick Number Three: "Whatever.  Your face is going to freeze like that."
Akeeyu: "Old wive's tale."

Stick Number One: "You are wasting your time."
Stick Number Two: "It's positive, isn't it?"
Stick Number Three: "There, are you happy?  That is absolutely definitely kind of a line right there.  Maybe.  Now put me down, for fuck's sake."

Akeeyu: "Okay, but is that still trigger or what?"

(crickets)

Stick Number Three: "Wait, no, it's gone again."
Stick Number One: "I told you so."
Stick Number Three: "Hang on, there it is."
Stick Number Two: "I told you so."

Akeeyu: "Oh, for fuck's sake.  Why do I even bother?"

Glaring Symbolism and Cat

Last night I dreamed I put a newborn to bed (complete with vivid baby smell-o-dream-o-matic goodness/agony) and then discovered that a man had drowned in milk in my basement.  As if that's not odd enough, I think extra weirdness points are in order for the following:

1. I wasn't entirely sure if it was breast milk or cow's milk.
2. I wasn't really sure who the hell the man was.
3. Or what he was doing in my basement.
4. We don't have a basement.
5. When we opened the door to let the milk out, it flooded the streets and closed down a nearby freeway onramp.
6. Upon hearing that, my first thought was "Hey, I wonder if I'll end up on the Department of Transportation's website again.  Because that was pretty cool."

This morning's peestick was negative.  As white as the driven Snowy, or Struppi, if that's more your thing.

For extra entertainment value, this morning the cat came sauntering over immediately after I peed in a cup, inspected the cup carefully* and then said "Oh my God, I can't believe you're doing that thing again.  You completely flip your shit if I so much as overshoot the box by an inch, and you're carrying piss around in a cup?  You are such an asshole," and stalked off.

T'lgo's pretty smart, so I may in fact be an asshole.

I'm definitely an idiot.  Yesterday I wrote that I was seven days past trigger when in fact I was seven days past retrieval, making me simultaneously nine days past trigger and really sloppy about math.

That would make today ten days past trigger and three days past a five day transfer, making today's negative** pee stick completely reasonable.

*I would have just shooed T'lgo away before she completed her cup check and got all judgementy, but when I tried to do that the other day I ended up knocking over the cup, broadcasting pee all over the bathroom floor.  I'm pretty sure that peeing all over the bathroom floor at my age (even indirectly and cup-related) is much more embarrassing than the scorn of an animal that eats bugs, so I've decided not to repeat that experience.  I've also decided not to tell anyone about that except you.  It's our secret, right?

**Upon further reflection (the sun came up, making natural light available for stick scrutiny), today's stick is not actually negative, meaning that the trigger is not dead yet, is in fact feeling better, and thinks it will go for a walk.

Chemistry Lesson

I would like to preface this by saying "Dude, I know that two days past a Five Day transfer (or 2dp5dt) is way too early to test."  I know.  Veteran infertiles probably know why I'm watering a stick every morning, and it's not my usual reason.

Veteran infertiles also know why the sticks are currently coming up positive.  Hint: It's not because I'm pregnant or not pregnant.  Like I said, it's way too early to test.  The reason the sticks are positive is because the trigger shot that is used to ripen the eggs before retrieval is hcg, or Human Chorionic Gonadotropin, or The Same Thing Home Pregnancy Tests Test For.

There are many reasons to pee on a stick even when you know it's the trigger, or Test Out The Trigger. 

Maybe you want to make sure the trigger injection actually got in there.  This may seem silly (Because after your husband jams that shot 1.5 inches deep in your gluteus maximus, where the hell else is the stuff going to go?  France?), and it probably is.  Sam, however, felt infinitely better when I peed on a (chemically) positive stick the day after trigger.  He was just sure he'd screwed up the injection, despite being a pro at sticking things into my butt.  Needles, I mean.  Into the upper outer quadrant of my buttock. Perverts.  Sam's reason for believing this was that during this trigger, I failed to bleed like a stuck pig, which I did last time, and Sam took this as a bad sign.  Sam is odd in this way.

Maybe you test after trigger because you just want to finally see a goddamned pregnancy test turn colors.  I hear this opton is very popular, and not just among nutbars like me.

Maybe you want to be able to determine when the trigger has left your body, to eliminate the possibility of confusing the lingering effects of an injection with an actual positive result.  Let's face it, negative results suck ass, but positive "OMG, yay, I'm preg...oh shit, nevermind" results are way worse.

I'm currently Testing Out The Trigger for the third reason, and I am very impressed (read: slightly annoyed) with both the tenacity of the trigger shot and the sensitivity of these tests.  I use ridiculously cheap tests that read at 25iu of hcg, something that I apparently spent about $4000 to verify last year by doing a Frozen Embryo Transfer and ending up with a shitty chemical pregnancy with a beta of 26.5. I peed on a positive stick the very morning of that beta.  Ah, good times.

The tests are still popping positive at seven days past trigger.  I have no idea how long it's supposed to take for a trigger shot to vanish, because I've never had to worry about this before.  I didn't bother to test out the trigger after the last fresh cycle because the transfer was canceled (and you don't have to worry about triggers for FETs), so this is all new to me.

Well.  Not all of it.

There is something particularly aggravating about experiencing all the symptoms of the thing you want more than anything, and yet knowing that those symptoms are unquestionably synthetic.

Between the trigger shot and the progesterone in oil shots, this very much reminds me of my brief and unsuccessful pregnancy with Good Embryo.  I can smell everything.  Tonight Sam's hands reeked inexplicably of metal, but only to me.  Crap, my hands smelled pretty weird.  My mouth tasted weird.  Since when can you actually taste your own mouth?

After dinner, I couldn't stand the smells anymore.  I stood up, on the verge of beating my chest and rending my hair and yelled "I THINK I'M GOING TO THROW UP!  I NEED A FUCKING MINT!"  Sam, who is used to troubleshooting such outbursts, suggested the ginger mints he'd bought earlier, as they might address both the nausea and the urgent need for freshness.  For some reason, this made me cry, although I was a damned sight mintier while blubbering. 

"If Fitz-Hume and/or Millbarge stay, I wouldn't mind this," I said snuffled moistly.  "I would do this for the rest of my life if it was for a reason, but I am so fucking afraid that it's for nothing."

"Yup," Sam said, seeming for all the world like a man cheerfully holding a paper cocktail umbrella against the monsoon of my tears.  "Say, how are those hormones working for you?"

"Great, honey.  Just fucking great."

I Think My Vicuna's Ears Are Burning

Dr. N00b called to give me the status report on the third blast which shall in future be known as The Little Blastocyst That Couldn't And Therefore Did Not Get Frozen.  It looks like Fitz-Hume and Millbarge are the entire result of this cycle, so um, no pressure down there.  Seriously.

I was surprised that a real live doctor called, but not remotely surprised by the news.  We kind of expected that result.  Even if TLBTCATDNGF hadn't arrested, it probably wouldn't have been good enough to meet the clinic's stringent freezing qualifications, which are as follows: They only freeze embryos that they have a good faith belief will survive thaw and have any kind of chance of continuing to develop.  This may not seem like a big deal, but from what I understand, some clinics aren't all that picky and will freeze any old damned thing, including utter crap that is about to arrest.  This also may not seem like a big deal, but it can lead to abysmally low thaw survival rates, needless frozen embryo storage fees and (perhaps worst of all) false hope for future FETs.

Dr. N00b was, like Dr. DuJour before her, very curious about my health.  I know she's a doctor and that's her job, but her concern seemed so peculiarly...genuine.  Was she expecting something?  Had they secretly replaced Fitz-Hume and Millbarge with delayed-fuse party poppers?  Did they really think I'd be feeling anything one day after transfer?  I was perplexed.

"Oh, I'm fine," I said for the second (or possibly third) time, then paused.  "Well, they said to call if I had any vomiting.  I was vomiting a couple of days ago and I've been really nauseated, but I just assumed that was from trigger, so I wasn't worried."

Dr. N00b pounced.  "Oh!  Are you bloated?"

"No, not at all."

She sounded fretful.  "And you're still able to keep some food down?  And you're producing urine?"

A little light went on.  "I don't have OHSS.  It's nothing like last time."

"Ohhh...okay," Dr. N00b said, actually laughing and sighing in relief.  "Because we want to watch you closely.  We worry about you, you know, because of what happened last time."

I'm torn between finding that incredibly sweet and incredibly funny.  Also, I wonder if the doctors sit around during my cycles playing Canasta and laying odds as to whether or not I'll blow up like a Macy's parade float, and if so, when and exactly how big will I get?

I used to have an amazingly jerky cat, and every time I took her to the vet, I couldn't help but notice that somebody on staff had helpfully written !!!CAUTION!!! across her file in bright red marker.  No kidding.  That cat would have your arm off if she didn't like you.

Sam has started to wonder what kind of !!!CAUTION!!! they've stamped across my file.  He had several suggestions:

• !!!CAUTION!!!  Had superbad OHSS!
• !!!CAUTION!!!  Patient's ovaries are full of explody goodness!
• !!!CAUTION!!! May bite & scratch. Also, had OHSS last time!
• !!!CAUTION!!! Compliment socks or face wrath!
• !!!CAUTION!!! Fat husband has zero tact and is very protective of wife!
• !!!CAUTION!!! Fat husband kicked her in the face, and he doesn't even LIKE you!

I'm voting for something simple and eloquent, like "Oh my God, she's gonna blow!"

Your turn: What would the !!!CAUTION!!! on your medical file say?

Now With 200% More Embryo

My only excuse for this morning is "Because I'm an idiot, that's why."  I'm not talking about the transfer; we'll get to that in a minute.  I'm talking about getting kicked in the face.

I am about to make Sam a very happy man: Yeah, okay, fine, that was all my fault, honey.  There were lame excuses on my part extenuating circumstances, however.

• Exhibit A: Sam is really ticklish.
• Exhibit B: Sam makes really funny noises when he is tickled.
• Exhibit C: When tickled, Sam loses all bodily autonomy and jerks around like one of those mechanical bulls, which I find endlessly hilarious.
• Exhibit D: One of my hobbies is sneaking up on Sam, pouncing, tickling furiously and then seeing if I can hang on for eight seconds.  It's kind of like my own personal Big Fat Guy Rodeo.  It's a peck of fun.

Well, if you mess with the (big fat) bull, sometimes you get the (big fat) horns, or in my case, the (big fat) knee in the (rapidly swelling) nose.  And then you cry and the bull just feels terrible about the whole thing and you run to the mirror and scream "Oh my God, my nose is crooked!  Does my nose look crooked to...oh, wait, it always looks like that.  Nevermind." and hope against hope that you don't develop two black eyes by transfer time because, um, awkward.

No black eyes materialized, but my nose still kind of smarts.

Dr. DuJour did the transfer and surprised us both by being quite charming, personable, and above all, exceedingly gentle.  I'm not sure if this was a fluke, if our previous experiences were, or if she has turned over a new flippyflap, but whatever the cause, she was just wonderful. 

The numbers shook out like this: Fifty five antrals, twentyish appropriately sized follicles, eighteen eggs retrieved, twelve mature, seven fertilized with ISCI, seven embryos on Day Three, two blasts on Day Five.

Well, kind of two and a half.  There's still one blast at the lab right now that was kind of weird and behind and currently qualifies as Unsuitable for Transfer but Not Dead Yet.  If it catches up by tomorrow, they freeze it.  If it doesn't, they don't.

One of the blasts looked like those pictures they put up on websites as shining examples of "High Quality Blastocysts," with all the accompanying structures and layers and fancy whatnot.  The other one...kind of looked like a meatball.  We decided to transfer both of them, and by 'we' I mean 'me'.  Sam has always been a big fan of elective single embryo transfers and (both in theory and in practice) I am too, but since our previous SETs didn't really work out, I felt ready to transfer two.  Two doctors also recommended transferring two, although neither of them are married to either of us, so their votes didn't count in the all important tiebreaker round.  What did count is the fact that I am still the primary owner of the only uterus in the relationship, and as such, I kind of get an extra vote in all matters uterine.

This is not to say that I do not respect or value Sam's opinion on this or that he is just a hapless bystander.  If he so desired, he could have withdrawn his consent at any point prior to transfer and the catheter would have come grinding to a halt.  We've talked about this before.  A lot.  What it boils down to is that in a typical IVF cycle, one partner usually takes on a greater physical burden and therefore qualifies as the tiebreaker. 

So, here I am on (frivolous and scientifically questionable) bedrest.  Again.  Sam is waiting on me hand and uterus.  Again.

Since a strong factor in our (my) decision to transfer two was what I call Dr. BrightEyes' Spies Like Us Theory, I have decided to call the current pair of blastocysts Fitz-Hume and Millbarge. 

Dear Fitz-Hume and Millbarge,

I promise that if either or both of you decide to stick around for any extended period of time, we will not name you anything embarrassing.  You know, like Fitz-Hume and/or Millbarge.

Sincerely,
    The Management

PS. Please stay.