Big big week!!!


Well, I’m writing this the day after surviving the big egg retrieval! I made it, things went well, and it was a big moment for us. Here’s the recap….

Thursday evening we met my dad and Brooklyn went home with him. She was going to have a fun sleepover with Aunt Abby…complete with pizza, caramel apples, pine nuts, movies, hut building, and all the fun stuff.  Grandma was out of town tending to the other Staples children in Texas, so it was up to Grandpa, Abby, and Brooklyn to keep each other in line J  I’m sure they had a good time. Jerry and I then had time to grab a quick dinner and a movie….wow, an actual date! It was nice to spend time together before such a big, early day in the morning.  I started my round of antibiotics that night and then had nothing else to eat or drink until after the procedure.  I received a blessing from Jerry and was able to sleep pretty well, actually.  That is, until about 5:00 when our cat Milkey somehow got into the house (through an open back door we later discovered) and jumped up on Jerry while he was sleeping.  It was actually a funny moment. It was also the end of sleeping for me. I tossed and turned until 6:30, then finally got up to get ready.

Jerry and I drove to the clinic to be there for our 9:00 appointment. We were about 10 minutes early and they were ready to take us back just before 9:00.  They took us to a treatment room where I changed into a lovely hospital gown with booties to match. It was very becoming. I sat in the big, green chair that looked like the electric chair at the jail. It was big and tall and not very comfortable.  The room was dim and cold. They also had some lovely music playing. Jerry sat in the chair they provided for the husbands…which was behind my big chair, so it was hard to turn around and look at him. He just kept telling me to relax and that it will all be fine. I think he was a little nervous too, though.  The medical assistant came in to take my blood pressure and vital signs. Naturally, my blood pressure was higher than it’s ever been. Then a nurse came in to place an IV. I forgot how much those sting going in. She did a pretty good job after reassuring me that she’s been doing this for 21 years, and so she didn’t need the lights on or gloves…she just does it by feel.  Whatever lady…! She did get it in on the first poke, though. She then gave me a paper explaining all the steps for the next few days and weeks including signs of problems, when to start the other meds, when the embryologist will call to schedule the transfer day, etc.  There were some activity restrictions as well.   She left and said the doctor would be in to sign the consent with me in a minute. While waiting, another nurse hurried into the room to get an oxygen tank…not a very comforting sign.  We waited a little more and then Dr Hammoud came into the room with my chart. He sat down on his little roller chair right in from of me—sitting in the big chair—and proceeded to explain the risks of this procedure. He told me the medicine would put me into a ‘twilight zone’ where I will hear things but not understand them, and feel pressure but not pain. The list of risks included things like bleeding, infection, damage to all the eggs, and or damage to internal organs that would require surgery. Again, not very comforting.  But, we didn’t come all this way to back out now, right!? He assured me that never once has anyone from this clinic required any surgery or extensive follow-up care. He signed the consent and then I signed.  They shortly came into the room to get me and take Jerry to where he would wait.  I kind of thought and hoped that he could stay with me, but from a medical point of view, I understand why they have family go out of the room. It was a little weird to say bye to him.

I looked into the retrieval room. It was a little scary looking. It also had a big green “electric” chair. This time it was all covered in surgical towels. The room was dim with a few bright spotlights, an ultrasound machine, and a couple of instrument tables. One girl in the corner was in a green surgical gown putting together some kind of tubing and other items. My nurse for the procedure was Jannine. She told me where to put my feet and arms, put an oxygen monitor on my finger and a blood pressure cuff on my arm. She covered me with a ton of blankets and then started putting medicine into my IV. She said “This works pretty quickly, so just close your eyes and relax.”  What!  Me, close my eyes and relax!?  Impossible. She then said, “I’m going to tip this chair back like at the dentist.”  And that was it…I was starting to feel fuzzy and heavy. I guess the medicine was working.  I don’t remember the doctor coming in or a whole lot after that. The things I remember are feeling like the blankets were really heavy, pressure and cold water (have no idea what water would have been doing there, but that’s what it felt like), the blood pressure cuff going off every few minutes, and hearing people talk. At the moment, I thought I understood what they were talking about, but I’m not really sure I did. I peeked though my eyes one time and remember seeing a bright light by the doctor and people wearing green surgical gowns, surgical hats, and masks. That’s the only visual picture I remember of the procedure. I do remember feeling some intense pressure, but no pain. For a moment I though that maybe I should tell Jannine I need more meds, but I couldn’t figure out how to do that.  It was like I was separated from the world around me…totally the ‘twilight zone.’  I also remember Jannine putting her arms on my back and helping me to stand and transfer into the recliner chair for recovery. I don’t remember the procedure chair tilting back up or them wheeling me into the recovery room. All I can use to describe it is that it’s literally like a dream.  When you are having the dream, you think you are totally in control and coherent. You may even know you are having a dream. But, when you wake up, all you remember is that you had a dream. You might be able to remember that it was generally about puppies or something, but the details are way too fuzzy to piece together. At some moments during the procedure, I remember thinking I totally knew what was going on and that I was listening to the conversations around me.  But, like I said, it felt like a disconnection with anything outside of what was going on in my head.  It was definitely the ‘twilight zone.’

I don’t remember the transfer to the other room. But, apparently my Aunt Jennifer was there…surprise! She actually works at a clinic in South Jordan and was doing some training at this clinic for a few days. She had seen Jerry and then I wheeled out of the room. I know I was still fuzzy in the head, so I have no idea what I said to her or if I even acknowledged her, but I do remember her stopping into the recovery room and saying ‘hi.’  The assistant hooked me up to the blood pressure cuff and O2 sat monitor again, and I was still covered in blankets.  After about 15 minutes they brought Jerry into the room. It was nice to have him back with me.  Of course, I thought I was totally with it, but he kept laughing and thinking I was a little snowed. He texted my parents and let them know things went well and that I was resting.  I was just glad that I didn’t feel nauseated or painful. I probably could have handled the pain, but I had been terrified that the meds would make me sick. Good news…no sign of that...and I was sure thankful!  In fact, after a while the assistant brought me some delicious cranberry juice and crackers and I ate them like I was starving. I then told Jerry I wanted Café Rio.  I did have a pretty good headache, though, and they gave me some Tylenol.  After a little more than an hour in the recovery room, they let me get dressed. My legs felt a little bit like Jell-o, and my head was a little foggy, but I felt pretty good. I got to ride in a wheelchair to the car. J  Some young guy and Jennifer helped walk me out.  It was kind of nice to have a familiar face around. I remember trying to explain to her where Brooklyn was and how the family was doing, but who knows what I actually said. I remember her saying that she would be there again on Wednesday, hopefully the day they do the embryo transfer.

We picked up Brooklyn and some Café Rio, and headed home. By the time we got home I was pretty tired. Jerry went back to work and I fed Brooklyn some lunch then turned on the TV for her. She was such a good girl and let me sleep on the couch for a while. She’d come give me hugs and drinks and love. I was kind of sore through out the day, but was allowed to take Tylenol for the pain and headaches.  When Jerry got home we went to pizza and Toads to let Brooklyn have a little fun. By the time we got back, I was ready for bed again.

Today I feel just fine and am back to my normal self. I’m still a little tender, but nothing worth even a Tylenol. Things went so well, and I am so pleased. I always worry for no reason, but that’s just me. Like I told one nurse, it’s easier to be the nurse and not the patient. However, I have been blessed to have things go so well and be able to feel pretty healthy. Now, I take progesterone shots in my hip every day and an antibiotic twice a day for a few days. I’ll take the progesterone for about a month, then six more weeks after that if my pregnancy test comes back positive. So, me and that needle are about to become good friends. Jerry’s given me a few shots and he’s done a good job. On Sunday the embryologist will call us to update us on the little growing embryos. As my brother put it, ‘We have little children growing in a Petri-dish.’  A weird thought, but true. I hope they take good care of them. Depending on how well the cells divide and grow and how healthy they look, the embryologist will decide when the best time to transfer them back into momma will be. That will most likely be on Monday or Wednesday, and then I’ll have a few days of bed rest to promote the beginning of a pregnancy. That’s actually one of the greater things that I worry about. Up until this point, science has pretty much dictated what will happen. After the transfer, we do what we can—like take progesterone—to ensure a pregnancy develops, but it’s pretty much up to the other powers that be. It will either happen, or it won’t. We just have to wait and see.  They call it a ‘chemical pregnancy.’  We can fake out the body to make it think and act like it’s pregnant. But then a confirmed, or live, pregnancy occurs when the body has accepted the little embryos and will support them on its own.  That will be the miracle we’ve been waiting for.

This has been an intense and yet exciting week. The part I’ve been most anxious about is over and went well. The transfer will be another procedure, but won’t require any sedation. I think there are a few more emotional hurdles to jump over. The anticipation of the pregnancy test results in a few weeks will be enough to keep me crazy. I am so grateful for Jerry and his emotional and physical support. I’ve been working a lot less lately, to reduce stress and increase sleep and health, and he’s working as hard as ever to ensure that bills are paid and everything else is taken care of. This has taken a lot of communication and cooperation, also. He’s a great husband and support. He’s had his fair share of unpleasant moments through this adventure also, but he’s positive and humorous, and always looks forward. Brooklyn has also been a trooper. I try to educate her a little about what’s happening. She still plugs her ears and says, “I know, I know, you don’t have to tell me.”  Silly girl.  But, she’s a good girl and always full of love and hugs when we need it.  My great family and friends have also been so supportive and sweet.  This has been a great journey so far. And, while it’s not over yet, I can say that I’m so glad we’ve had the wonderful opportunity to experience the miracle of modern medicine to bless our family and learn and grow.  Our little family has grown closer together, and that in and of itself is a blessing. 

Got Drugs?


Today I went to the clinic for another ultrasound....beginning to feel like a broken record .   I walked into the clinic, signed my name, sat on the chair, and the nurse immediately called me back. It was extremely fast this time. I met with Dr Johnstone, the lady-doctor of the group. Again she counted the follicles and measured everything to be sure the meds are working the right way. It was fast and easy. I then met with one of the nurses who went over my current meds. She called Dr Hammoud, who will be doing the actual egg retrieval next week, to see if he wanted to change any of my doses in relation to the findings on the ultrasound. He said 'not for now' and that on Monday I'll come back for another exam. I asked if on Monday he will decide which day to do the retrieval, and she said, "It's now a day by day process." She explained that on Monday Dr Hammoud will see what progress has been made, will adjust meds if needed, and schedule another ultrasound for the next day. We will do that over and over for a few days until he's happy with the progress and feels ready to retrieve those 'expensive' eggs. When he feels like things are ready, then he'll tell me when to take my HCG/Pregnyl shot, and exactly 36 hours later he'll put me to sleep and retrieve the eggs. It's going to be an interesting week, I think.  I'm not sure I want to make the trip to Salt Lake on a daily basis, but we'll do what needs to be done. With first time patients, they have no idea how patients will respond, so I'm sure they play things safe. Monday morning I'll find out the next step.
 
The meds have become more interesting.  After the FedEx truck dropped off a big box from the pharmacy last week, I've had to create a little medication basket and evening routine for all this stuff. I feel like a druggie. Plus, Jerry has started taking his pill twice a day, so I have to make sure that gets done. His medication is a two week round of antibiotics. It's simply to ensure that the 'little soldiers' are all nice and pure with no possible infection or funny business. He got the easy track on the medication side of things, I think.  He's been taking his pills like a good boy, though. This week I started taking the follicle stimulating hormones (FSH). For three days there's a combination of two drugs. The one FSH that I really didn't like was the Repronex. It felt like a giant bruise under your skin for 2-3 days after you take it. Thank goodness this was the one that only lasted three days. The other FSH is Gonal-F. This one comes in the prefilled pen that you dial in your dose each time. It's not too bad. I'm also still taking the Lupron. I'm now used to this one, but I changed the brand of needles, and I swear these new ones are bigger. Two shots a day is tolerable. Three was a little much. And, I can't decide of I'm just becoming a wimp, or if they really do hurt. My poor tummy is feeling a little battered and bruised lately. Can't complain, though. People keep asking me if I've had any side effects from the meds yet, and I really can't say that I have. I think I've been a little more tired and gained a pound or two, but I haven't been moody or grouchy...I don't think. Maybe Jerry is the one to ask on that subject.   I've actually felt pretty good and haven't noticed a big difference.  That's been a blessing!
 
Brooklyn is becoming more and more comfortable with this adventure each day. She likes to watch me do the shots and even helps clean the med vials or load the syringe. Maybe she's a nurse in training! The other night she was sitting on the counter watching and I said something about it hurting. She leaned over and gave me a big hug. I can only imagine what's going through her little head. We talk about things, though. I think she's learning that this is a lot of effort, therefore something improtant to us. Today she did a little relay race at her Grandma Hartmann's house that included giving a doll a bath, drying it, putting on a diaper, and then wrapping it in a blanket. She actually did a great job! I didn't know she could put a diaper on a baby...She will be a great big sister, someday. She's also talking more about having a brother or sister. She likes to talk about what she'd name her brother or sister and actually admitted the other day that she wants to have one of each. She's funny. She's slowly growing into the idea. She's like her mom...has to think about things and get used to them before 'owning' the thought and really feeling comfortable with it.
 
The next two weeks are the ones I've been anticipating for a while. They will include the actual egg retrieval, growing of little embryos, and then the transfer back of those embryos. I'm excited, of course, but also nervous. It's a little weird to plan and anticipate an event like this. It's not really that normal or natural, it's very scientific, yet spiritual, and could possibly be a life changing event.  It's difficult to describe. Yet, we wonder... Will this work, will it not work? Only time will tell, of course. Either way, we will have a new perspective on life and the future of our little family.

"Everything Is Now Included" ?!?


Today we had another ultrasound. For the first time we waited for quite a while in the waiting room. And, for the first time, the waiting room was full. There we all were, couples and individuals, sitting in the room for the same reasons, but not talking to or looking at each other. Nobody dares acknowledge the elephant in the room, I guess.  People of all ages and walks of life were there for one purpose. It was kind of fun to do a little ‘people watching,’ I’ll admit.  Some were talkative with their spouse, some read books, some were fidgety and nervous, and others just stared at the floor. Most were intently focused on their smart phones and pretended like they were doing something important on them. That place could serve as a great social experiment!  I asked the receptionist if we needed to pay a copay or anything, and she kindly said, “Actually no, you’ve already paid in full and everything is now included.”  Thanks…that was a huge copay last time, so it’s nice that you’ll include everything now J.  After 45 minutes we were called back for the ultrasound.
We met with Dr Peterson. He’s the original physician who did our consult. It was nice to see him again and have him be part of the actual care. Things were again ‘normal’ and we’re ready to proceed with the next step and meds. I mentioned my concerns about over response and hyperstimulation. Dr Peterson said, “I’ll go look at your protocol and labs and see if we need to make an adjustment.”  He came back in a few minutes and said he adjusted the dosages a little to accommodate my concerns. As a great physician does, he said, “If you are concerned about it, then I will be concerned about it with you.” I was impressed. I then mentioned my fears of conscious sedation during the actual egg retrieval and that prompted him to sit down and talk more. I’m a little bit of a worrier, and always have in the back of my mind the worst-case scenario. But, I have been sensitive to narcotic pain meds in the past, so I’m a little nervous to be sedated.  Plus, I just have issues with not being awake while things are happening to me…that’s just kind of freaky! He again acknowledged my concerns. He vowed to put info in my chart to communicate these concerns to the other physicians and to have them titrate the meds gently and be prepared with nausea meds. I was grateful for the extra few minutes he spent with us just ‘being concerned’ alongl with me and being an advocate for his patient. Sometimes I think healthcare workers like to smooth things over and minimize patient concerns. We spend a lot of time reassuring patients that ‘things will be fine’ and ‘not to worry.’ And, sometimes that is appropriate. However, today I was reminded that patient concerns need acknowledgement and addressing, not just smoothing. If a patient or family is concerned, we need to act. My own physician was a great example to me as a nurse of how to ‘be concerned’ and present with a patient.
The doctor then directed us to meet in the office with the nurse. This is where we were reminded that the name of the game is ‘hormone manipulation.’ She clarified all the meds and how to give them. There were prefilled medication pens, reconstitution vials, big needles, little needles, charts, and additions to the calendar. I think the medication side of this could be slightly overwhelming. I think it was good for Jerry to hear it all, too.  Between the two of us we will hopefully get it all right!  Less than two hours later the pharmacy called me to verify my address, the medication orders, and payment amounts. They overnight all the meds at once by FedEx. I’ll have them by tomorrow to start them on Monday. 
One day at work I was giving a patient a bunch of medications at the same time. He said, “I hope they all know where to go and what to do!”  I’m starting to feel the same way!
We left the clinic today feeling confident and, once again, reassured that this is the right place to be. Things are going well. We feel supported by the physicians and are excited for the upcoming weeks.

And So It Begins!


Well, we are ‘officially’ part of the InVitro process now, because….we’ve paid the money!  No backing out now! I guess that’s how the world turns—things become serious when the money’s in the bank, right!?  Last week Jerry and I went to the clinic to sign the financial papers and enroll in the shared risk program. We met with the program director and he again explained the details and process.  We asked how many couples decide to be part of the program and he said not many can afford it. They get the one time shot and hope it works. Although this is going to be a few more dollars than we originally planned, the chances of success seem to be increased. He also said that although the protocols and actual processes don’t change, the doctors and nurses are all very aware of who is participating in the program.  He said they are more specific about the way they handle these cases since there is a lot of money, and some degree of guarantee, involved. They have a greater responsibility to give us success, essentially. The physicians will be more likely to cancel the IVF cycle if things aren’t going well so that a better and fresh attempt can be made.  So, although we aren’t ‘supposed’ to get special treatment, it’s hopefully in our favor to be part of this program. We left the office feeling like this is again the best choice for us. The clinical director is very young and when we walked out Jerry said, “I just paid thousands of dollars for a 12-year old to make us a baby!”  It was a little crazy, but trust Jerry to throw some humor into the situation. Again, we were reminded of the many people who have made this possible for us. To have the financing taken care of through the assistance and generosity of so many is a sure answer to prayers and a miracle in the making. It’s been wonderful to not worry about this aspect of the process. We can look forward to the experience without that stress looming over us. Again, being able to hand over that check was a humbling moment.
Along with paying the money, we’ve done what the clinic calls the “Lupron Start.”  Lupron is the first injection medication and the way they “start” the official calendar of meds, lab draws, ultrasounds, etc.  I started these injections on Sunday the 25th and will do them for about four weeks. During the first week of Lupron, I took that and the birth control pills. Then this week I don’t take the pills, just the shots.  Next week they add two other injections. This is the easy week, I guess. Lupron isn’t too bad, though. It’s given into the fat, just under the skin, with a little insulin syringe/needle. It burns a little bit after, but no big deal. The last time I gave myself a shot was in nursing school more than 10 years ago…forgot how weird it is to poke yourself! I think they start with this easy one and build you up for the nasty ones that come later.  Jerry’s thinking he gets to do those ones…I’m thinking I need to think about that! I haven’t really had any side effects from the meds yet. I hope I don’t.  I’m kind of nervous about the bigger hormone stimulation meds that start next week. Some women get something called Ovarian Hyperstimulation Syndrome.  It’s basically an over-response to the meds and the ovaries go crazy. It doesn’t sound pretty. But, we’ll worry about that then, and I’m hoping to just respond normally to all the drugs. My next ultrasound is tomorrow morning. Again the doctor will count follicles and eggs and make sure things are looking the way they want them to before starting those FSH (follicle stimulating hormone) injections.
Brooklyn is still getting used to the idea that we might be having an addition to our family. Her Aunt Laurel and Aunt Jodie are expecting babies. We talk a lot about new cousins coming and how much fun it is to play with little babies and be a big sister. She loves her little cousins, so why not love being a sister?  She’s not crazy about the idea of her world changing, I guess, but is opening up to that possibility. When I think about the possibilities, I get a little nervous too! I get nervous about the logistics like where would a baby sleep in our little house, and how will I work at night, and how will I get anything done?  But, little thoughts and moments…like talks in General Conference about growing our families and having children…remind me that this is a good path.  Whatever the outcome, things will all work out and we will be better because of it.