A Date with the Dildo Cam

I went to the local RE's office today to have an ultrasound and to discuss my blood work results from the tests done last cycle.

I came out of there with a smile so broad, I'm sure I looked ridiculous. In the car, I even let out a little "Wooo!" of glee.

It's been awhile since I had the pleasure of an external ultrasound as well as the good ol' dildo cam. Oh joy. It wasn't anything that I wasn't prepared for; I guess having gone through so many tests and so many years of IF, it's not a shock for me. I hear that some women are terribly traumatized by the dildo cam. I can understand that; certainly if you're not ready for it or you feel violated or invaded. I never really did, and I've learned to guide technicians to the right spots to best view the ovaries. (You know you've done this too much when...)

Anyway, the tests were finished, and I went from the ultrasound room on the main floor to the offices upstairs for my appointment with the RE.

He opened my file and blinked. And I quote:

"Wow. Gil. This is great. You have the LH and the FSH of a teenager."

I'm so lucky. In the same breath he told me he'd seen a 36-year old earlier this week who is in early menopause. My heart sank for her, and her hopes of having a family with her own eggs. I don't know what that's like but I do realize that so many of us do.

Anyway, I suspected that my results were good, as I had obtained a copy of them from my GP a couple of weeks ago. But I didn't think he'd consider them quite that good. So I'm really pleased with his reaction.

And better yet, I have TEN (count 'em!), TEN antral follicles! I am super pleased with that bit of news! I still have that functional cyst on the right but at the moment my estradiol is not reflecting elevated numbers so it's not affecting the hormone levels. That bodes well for aspiration of that cyst prior to starting a cycle, sort of like we did the last time around.

Would you believe he shook my hand and said, "Good luck. We know you're fertile so I really hope the second time around works as well as the first."

Fertile. Oh my. I've been called a number of things... some good, some rather derogatory, but "fertile" is not a term that I'd apply to myself. That's for sure. In fact, we are definitely infertile; we NEED IVF to create our family. That's never easy. But it's something we can do. So we'll look at pursuing it.

Again.

We've cleared the first hurdle.

Good thing. Because regardless what opinion the local RE has, I guarantee you, I'm no teenager.

Bursting Cysts for Mother's Day... anyone? Anyone? Such Fun!

We've had a lot going on in our world in recent days. More about that to come in future posts.

Yesterday however, being Mother's Day, (aka, the day that infertiles around the world probably dread the most), I had some things of my own to do and focus on.

As usual, I went to church yesterday morning; the choir had a lovely anthem to sing and it went off beautifully. We even got a loud round of applause (which is acceptable at our church, but doesn't always occur) for our efforts. It was really nice and I think our director did a beautiful job with it.

For my own mom, a couple of weeks ago, I went online and ordered a 50-page photo book of pictures of (mostly) her and Petite. There were some extra shots thrown in for good measure; Petite's first photos with family members on Mom's side of the family in particular. Anyway, the book came back this week and I wrapped it and gave it to her for Mother's Day. "To Nana, with love," was the title. I think Nana liked it!

Yesterday afternoon, Mom and I went shopping. We had planned to spend our day chillin' on our back patio, but it was a little too cool for that. Oh well. We went shopping instead and Mom spent some money on me (and Petite), for which I was grateful.

But late in the afternoon, we were getting things together for dinner and all of a sudden, the pain in my right ovary became unbearable. I thought for a moment I was going to pass out! It was just excruciating. I doubled over in pain and just tried to breathe through it. Terrible stuff. The pain went on like that in waves for about 20 or 30 minutes. I haven't had pain like that in years!

But I am keeping my fingers crossed that my suspicions are right: if it was what I think, then that pain would have meant that my ovarian cyst has burst and (with a little luck) we won't have to deal with it in the upcoming IVF. And THAT would be amazing. We'll know more in the coming month or two when we start up a cycle and I get wanded to check the status of the cyst. But if my hunch is correct, there's no longer a cyst there to worry about. :) I have to find a sliver of hope somewhere!

Whether you focus on your own mother, a mother-in-law, a stepmother, an aunt, a great-aunt, sisters, friends, etc.; whether you are a mother and have a baby at home, a mother of a baby-waiting-in-heaven, a mother in your hopes and dreams, a motherly figure to children (or adults) in your life, or whether you try not to focus on the day at all, I hope that Sunday, May 8 was a beautiful day for you and that you spent it in the company of people that you love and that love you.

The Plan has Changed

Last night, as we were eating dinner, our phone rang. Usually, we ignore it because telemarketers are prone to interrupting our evening meal, and frankly, at that hour, I refuse to speak to them. But something told me to grab the call. When I picked up the handset, I saw on the screen that it was my local RE's office calling.

Lo and behold, it was the RE himself. He had just recently received a fax from my OB's office. The OB doesn't think he can work with a cyst as small as mine (about 4 x 5 cms). To be fair, the OB isn't usually required to do that sort of thing. I mean, aspiration of a cyst is pretty much the same technique as egg retrieval during an IVF cycle and it certainly isn't the OB that does that. The last time I had a cyst like this, I had it aspirated in Montreal at our clinic there. The time before that, it was the OB who did a laparoscopy to remove it. He's comfortable with doing the lap, but not with aspiration. Not really his area of specialty. I can understand that.

But the question remains: who can do the aspiration? There's the local fertility centre who, technically, COULD do it for me. But wouldn't they be pissed at doing that when I'm not even cycling there? I certainly wouldn't be a priority for them. The folks in Montreal can do it. Sure. But it means travel time, etc. And Lord knows when they can work me in. I asked my local RE if he could possibly contact Montreal and ask if perhaps that procedure can be squeezed into our appointment day in mid-December.

The local RE said that they'd ponder possible options and they'd contact me soon with something. I hope they come up with an idea soon though. The pain was so bad last night, it woke me from my sleep. That's not fun. I've said it before and I'll say it again; you can be damn sure that if it was a man suffering from a 4 x 5 cm growth in his abdomen that could easily be rectified, it would be fixed in the blink of an eye. Why do women have to suffer so? It's terrible. It's just not acceptable in my view.

On another note, I was home unexpectedly yesterday. Petite is ill and while she could have probably gone to daycare, I got a phone call just after 7 a.m. yesterday from our caregiver to let us know that her own son was violently ill so she was going to have to cancel care for the day. C'est la vie. I stayed home and cuddled Petite, trying to relieve her symptoms as much as possible. Poor girl. She is having a tough time breathing. That continued into last night. Every time she stirred, her breathing difficulties woke her and she'd cry. Sitting in her crib, just feeling miserable; she looked terribly forlorn. My poor baby girl. It's hard to know I can't do much for her. I must look into some natural remedies that come highly recommended, at least to relieve her symptoms a little. We've tried a few things already: saline in her nose, suctioning out the junk, raising her mattress on one end, keeping a running humidifier with liquid Vicks going, having a steaming hot bathroom when she takes her bath, etc. I hope this cold runs its course soon. I hate to see her ill. She was so uncomfortable last night, I was up until almost 2 a.m. trying to rock her to sleep on my chest, semi-upright so she could breathe. She was miserable though.

Something that's amazing to me though, is Petite's absolute LOVE of books. At not quite 15 months, she spent all day yesterday running back and forth to me with book after book after book. At last count last night, I'd read "Guess Who?" (one of her Halloween, lift-the-flap books) a total of 18 times. EIGHTEEN, folks. And that's just one of her books! She has about a dozen or so piled in the living room and she loves to have us read them to her. I am very, very happy about that. She is beginning to recognize her books too. I've read "Goodnight Moon" so many times, I've memorized it. The other evening, I started to recite it from memory when it was bedtime and we wanted her to settle down a little and have quiet time. As I was reciting it, she stopped her frenetic spinning, and immediately went to her stack of books, plucked out "Goodnight Moon" and brought it to me, climbing into my lap. We read it cover to cover three times before she was satisfied.

I am so glad she loves books. It's important to me that I read to her every day and instill a love of the written word and show her that books are wonderful. It will serve her in good stead as she gets older. That's for certain. But oh dear heavens, how many times do I have to read them over and over and over? It makes me laugh, but I cannot despair. It's a wonderful thing and I am deliriously thrilled that she enjoys books as much as she does.

Sending out lots of love to my fellow bloggers. And wishing all Americans (and my sister who lives in the States, along with her husband and his family) a wonderful Thanksgiving holiday. Enjoy.

A Plan of Sorts

Again, a warning for those gentlemen and ladies who are sensitive to bodily fluids and functions. This post deals with how my doctors plan to treat extremely severe bleeding during my periods. Click away now if you'd prefer not to read or know this information.






So I thought I'd write a quick update for those who have been wondering what I've done to address the whole "bleeding like a stuck pig" issue.

Plan A.

Monday and Tuesday saw me trying to get appointments at my GP's office. My GP is out of town, but any of the others at the office could have seen me... if their 'emergency' appointment slots hadn't been taken. But they were, so I struck out there.

On to Plan B.

Tuesday night, enough was enough. I went to an urgent care clinic near our house. The nurse was amazed that I was still standing and able to function! She took the details down, and then took my BP which was pretty decent at 140/80. After that, I saw the doctor. He too was amazed. And somewhat perplexed. He ordered some bloodwork to be done to check hemoglobin levels and CBC details. He indicated that if the hemoglobin was low, he was going to send me to emergency to be assessed and treated.

About 45 minutes later, we learned that hemoglobin levels (and everything else they tested) was completely normal. So the doctor was at a loss as to what to do. He suggested that I contact my RE first thing Wednesday morning to get an appointment. That lead to...

Plan C

Wednesday morning, it looked like the bleeding was subsiding. It wasn't as copious as it had been and seemed to be tapering off. I figured I'd let it sit.

Overnight Wednesday into Thursday, almost nothing! WOW! First time in weeks! Alas, it was short-lived; as soon as I was done my morning shower, the bleeding returned. Not fast and furious, but it certainly did return.

So from my office this morning, I called my RE, who immediately booked me for a 10:30 appointment today. I left my office and headed there. They took my details and a copy of the blood work that was done on Tuesday night at the urgent care clinic. Next, my RE ordered a high level ultrasound elsewhere, which was booked for noon today (man, they were on the ball!). After that, I sat with my RE and chatted a bit about the whole situation. Here's his take on it:

The cyst is likely still there (I can feel it, I KNOW it's still there!) and is producing estrogen. That's throwing off my hormone levels. My progesterone is way down, and my estrogen is way up. So if he prescribed me some progesterone, in the hopes that hormones may level off a bit. And the progesterone may help alleviate the pain and aching that I'm getting from the cyst. He prescribed 20 mg per day, to reduce if I feel depressed. I'll get that prescription filled later today.

Secondly, assuming the cyst is still there, and it hasn't shrunk at all, that means the b/c pills for the past month aren't having any noticeable effect. I figured this much; we've done this before with no noticeable results on my cysts. And according to my RE, the cyst is likely causing a lot of this bleeding so it really needs to be removed.

He quickly put in a call to my OB. If you recall, my OB during my pregnancy is the same doctor who did a lap for me way back when to remove yet another cyst. However, this time, my RE asked the OB if I can be worked into the schedule in the coming few days to have the cyst aspirated. Aspiration is the same procedure I had done in Montreal right before our IVF cycle in the fall of 2008. Basically they use the same type of needle that's used in egg collection during IVF and using ultrasound, they locate the cyst, go in through the vaginal wall, and aspirate it. Poof, gone. Painful, sure. No doubt about that; there's no meds given for the procedure. But boy, it sure works like a charm!

So right now I'm waiting on a call from the RE or the OB's office to tell me when I'm scheduled. They figured by Monday or Tuesday, they can work me in for the aspiration.

At the moment, I'm just keeping fingers crossed that I don't start bleeding profusely between now and then. I'm getting tired of it all at this point. Time to just get it over and done with. Ugh. Wish me luck.

CD 4; OMG, I'm counting again?! REALLY?!

And just like that, we're back on the infertility-go-round. There's NOTHING 'merry' about it, that's for darn sure!

We have an appointment booked in Montreal in mid-December for an initial consultation with our RE there. He's ordered a plethora of tests prior to that consultation, as is usual for IVF protcol.

(A note for the men reading: TMI may be incoming. You've been duly warned. After all, this is a blog about infertility and making babies who are our little medical miracles.)

First up: CD3 bloodwork and an ultrasound. (Well, anytime between CD2 and CD5.)

Oh joy.

I had semi-forgotten the dildo cam and its invasive prodding. Nothing like an early morning poke to remind me, now is there? I confess, I can think of much better ways to start my day.

This morning, we began with the dildo cam. And just as I suspected, a huge cyst on the right side. I've been feeling it for months; sometimes it's harsh and I double over, but life goes on, yanno? My RE immediately prescribed b/c pills in the hopes that they'll get rid of the cyst. Forgive me but: Ha ha ha ha ha!!! Now that's funny! We've gone that route three times before, to no avail. I ended up with a laparoscopy on one occasion to remove it, another one burst (ouch!), and yet another was aspirated right in the middle of our successful IVF cycle. Regardless, I'll take the pills and see if anything happens. We have a number of months to play with so something ought to work between now and then. If needs be, we'll aspirate it again before the IVF proceeds.

We saw lots of little follicles on both sides. A very heavy period, which was evident on the monitor, too. My doc wondered if it might be the cyst doing that. I suspected it might be because of the low iron levels at the moment, but I'm taking iron supplements so that would probably have fixed the low levels. Dunno. What are your thoughts? It's been like that since since I had Petite, in fact. Very heavy. Crampy. Clotty. Icky. Like changing protection every two hours for five days straight. Terrible. Just terrible. Not fun at all.

The doc also prescribed metformin again for the PCOS. I've been off it since Petite arrived because I haven't 'needed' it per se (I'm not diabetic, my sugar levels are fine), but it will help with the cysts and other PCOS symptoms. I know the metformin will wreak havoc with my system, but I'm going to need it again for the IVF so I may as well begin now.

After all that was done, I went downstairs to the lab. Trembling.

For my longtime readers, you all know that for me, the blood draws are the WORST part of IVF. Even giving birth to Petite wasn't as bad as having needles shoved in my arms! SERIOUSLY!!! I bruise terribly. Usually bruising lasts 1-2 weeks. My veins are hard to find. They're deep and narrow. They frequently collapse. Techs have told me that my veins are worse than a 3-day old infant. Others have had training to get blood from drug addicts, and they tell me that my veins are worse than those people's as well. How freakin' lovely is that? Fun fun! Oh how I've missed thee, prodding and poking!

Anyway, I managed. I've lost track of where my old phlebotomist ended up, but this morning, a sweet woman by the name of Karen got a good vein on the first try! (YAY Karen! And thank you!) A bunch of vials were taken and with those, the following tests were ordered:

(Updated on November 8, 2010 to include results)
Fasting Glucose -- 5.5 (3.6-6.0)
TSH -- 1.19 (needs to be under 2.5)
Free T3 -- 4.4 (2.6-5.7)
Free T4 -- 16 (12-22)
Iron (Ferritin) -- 29 (LOW: 12-30 = depleted iron stores; currently taking iron supplements but anemia is still present)
FSH (may be affected by the cyst) --4.0 (4-13)
LH -- 1.0 (LOW for Follicular phase; 2-13 = normal)
Estradiol (aka E2) -- 489 (aka 113 in US measures) (46-607, somewhat high for follicular; could be the presence of the functional cyst that is causing the high E2 levels)
Prolactin -- 7.0 (less than 24)
Progesterone -- 1.1 (0.6 - 4.7)
Free Testosterone -- 2.1 ((ND - 7.0)
Testosterone -- 0.6 (less than 2.0)
Blood Group (I know I'm blood type A)
RH Factor (I know I'm positive)
DHEAS -- 4.1 (1.65-9.15)
HIV -- negative
Hemoglobin -- 137 (115-155)
Hematocrit -- 0.4 (0.3-0.45)
RBC -- 4.64 (3.6-5.01)
RBC indices MCV -- 87 (80-99)
RBC indices MCH -- 30 (27-32)
RBC indices MCHC -- 339 (320-360)
RDW -- 12.9 (11.5-15.5)
WBC -- 8.9 (4.0-11.0)
Platelets -- 223 (145-400)
MPV -- 8.3 (7.4-11.3)
Differential WBC's Neutrophils -- 5.79 (1.8-7.0)
Differential WBC's Lymphocytes -- 2.31 (1.0-3.2)
Differential WBC's Monocytes -- 0.53 (0.0-0.8)
Differential WBC's Basophils -- 0.09 (0.0-0.2)
Blood group and RH Factor -- A positive
Rheumatoid Factor -- less than 20 (less than 20)
HIV1/HIV2 screen -- Negative (non-reactive)
HIV Final Interpretation -- No HIV1/HIV2 antibodies detected
Hep B Surface Antigen -- Non-reactive
Hep B Surface Antibody -- Non-reactive
Hep B Core Total (IgG+IgM) Antibody -- Non-reactive
Hep B Virus interpretation -- No evidence of Hep B infection; No evidence of immunity to Hep B Infection
Hep C Antibody -- Non-reactive
Hep C Virus Interpretation -- No evidence of antibody
Rubella IgG -- Reactive
Rubella Interpretation -- Evidence of past infection/vaccination; evidence of immunity.
Rubella (immunity) -- Reactive; evidence of immunity

NOTE: Current meds are 1.0 mcg Synthroid and +/- 150 mg iron supplements.

I think it was five or six vials. I lost track. I was in my happy place and trying hard to keep focussing on other, nicer things.

Anyway, I got the bloodwork done, picked up the prescriptions, and then I made a beeline for the nearest Tim Horton's for some breakfast. I had been fasting since about 11 p.m. last night, so I was getting kinda hungry. I treated myself to an English Toffee flavoured cappucino (yum!) and a cinnamon raisin bagel with cream cheese. How sinful is that? Pretty sad when I consider that an indulgence, isn't it?

With luck, we'll have some results in a few days. I'll update as required. Next up: CD21 testing for progesterone and Hubby's bloodwork.

Excuse me. I'm going to go rip off a band-aid and finish my breakfast.

Shout out to:
Mo and Will at Life and Love in the Petri Dish. We're all pulling for you guys. Hang in there. Have faith.

And to you, my dear readers. I need to come comment on a few blogs and I need to get in touch with a few of you for your snail mail addresses. I have NOT forgotten. Bear with me.

Love to all in blogland!

Cyst Be Gone!

I'm back from MTL and I am glad to report that the cyst aspiration went without a hitch.

My hubby was able to be in the room with me and he watched the cyst on the ultrasound as it shrunk in size and disappeared from the screen, all while holding my hand and letting me dig in a nail or two when I felt the pain of the needle poking through. It felt like a lot of pressure in my abdomen, like a stitch in your side that doesn't go away, and it sorta took my breath away a little but nothing drastic. Mind you, I know my pain threshhold is rather high, so I expect some women might feel it much more intensely. At least now I know what to expect for the retrieval in early December.

The actual procedure took less than five minutes so it wasn't bad at all. And I have to say, those are the most comfortable 'stirrups' that I've ever had the pleasure to be in: padded, nice and long up your calf, and cozy in fact... actually WARM. Odd to describe stirrups that way isn't it? Would that all doctors had that style of stirrups!

When we were done, I asked the doctor to tell me how many follicles were on the right side (my monitoring ultrasound couldn't see them all because the cyst was in the way). He started counting...
SEVEN.

I have seven follicles (at least) on the right, and at last count, five on the left. For a grand total of about 12. Not bad. I hope that continues and that I get a bunch of them to mature in the next week or so with the Gonal-F and the Luveris.

So we returned to our home last night and at about 10 p.m. we started laying out all the injections. I'm currently taking the following meds:

• Metformin (500 x 3 times per day) for PCOS
• Levothyroxine (0.5) for Hypothyroidism
• Pre-natal vitamin
• Buserelin (20) sub-cue injection
• Luveris (75 IU) sub-cue injection
• Gonal-F (225 IU) sub-cue injection
• And hubby started his doxycycline (oral antibiotics) last night too.

MTL would like me to have a monitoring appointment on Wednesday the 26th as well. And next Friday, I'm back in MTL for an appointment so they can see me themselves.

So this cycle is still on track. At least, for now.

Next week, I have a distraction. my best friend MH and his wife and kids will be arriving on Thursday for the long Thanksgiving weekend in the States. I cannot wait to see them, and it'll be the first time I get to meet their kids. It'll be wonderful. We're ALL going to MTL next Friday; me for my appointment and with luck, we can take their kids (boy-girl twins, almost 6 years old) to the Biodome or something. Does anyone have any suggestions as to what to do to entertain children in MTL? Advice most welcome.

Oh and Mel? Thank you for putting a link to my blog on Friday's L&F. I really appreciate it. Support is a great thing and I know the women (and men) here 'get it' and can offer their good thoughts. Sending hugs your way for the kindness.

Impromptu Trip to Montréal

In about an hour, hubby and I are heading out the door for a previously unscheduled and certainly impromptu trip to the hospital in MTL. They got the results of my ultrasound and my bloodwork from yesterday, and I arrived home late yesterday afternoon to find a message on my phone:

"If you can be in MTL tomorrow, we can aspirate the cyst using the same procedure as we do for a collection (retrieval) and you can continue with your cycle, starting stims tomorrow instead of today."

WTF? You're kidding me?

I called them back and after a bit of phone tag, around 5:45 p.m. I had the details. So with luck, this cycle won't be scrapped after all AND I won't need a full laparoscopy to eliminate the ovarian cyst.

I'm not going to count on this though; I'm fully expecting something else to crop up and cause a problem. But we'll see what the day holds; keep your fingers crossed.