Another meltdown at table 6, please (post by Jessi)

When you first meet with the Reproductive Endocrinologist to learn more about IVF and how it works, a good doctor will make sure you know what to expect during the process.  My doctor covered all of the usual bases:

1. It’s expensive.  No doubt!  The IVF cycle alone is $9,100.  That doesn’t include medication, legal fees, and all of the other related health care expenses for the myriad of specialists you have to see in order to just begin the process.
2. It’s emotional.  The phrase I remember hearing was “PMS on steroids.”  In addition to the mood swings, irritability, and discomfort associated with hormone treatments, there’s also the “waiting for the other shoe to drop” phenomenon because the potential for failure exists at every step in the IVF process.  What if I don’t respond to the stimulation drugs?  What if there are no eggs in my follicles when they go to retrieve them?  What if the eggs don’t fertilize?  What if they fertilize but they’re not viable?  What if they die in the dish before they make it to transfer day? What if, what if, what if?  Each little step is a tiny victory that just leads to another step with its own unique set of what ifs.  Emotional. Roller. Coaster.
3. It’s all-consuming.  Over the last two weeks:  I’ve had 5 or 6 ultrasounds on 5 or 6 different days;  I have track marks on my arm from the frequent blood draws;  I know all of the parking garage attendants and how long it takes each of them to open the gate;  I have daily correspondence with Nurse Mo or her back up, Nicole; and I’m constantly reminded about the looming nightly injections by the temporary drug store set up on our kitchen counter. 
4. It’s a gamble.  While FAHC’s success rates are better than the national average for women of our age, there’s still a 60% chance of failure.  But, as a hopeless optimistic, I find this one easier to dismiss.  If we were older I’d be more concerned but in terms of success rates, you can’t get any better than what we’ve got.

So yeah, we were and are prepared to effectively handle all of these issues.  Bet you can’t guess what our biggest challenge has been so far???  Like hysterically-crying-my-eyes-out-wishing-I’d-never-started-IVF-in-the-first-place kind of breakdown?  

The fertility pharmacy and Fed Ex.  Let’s start with the pharmacy, shall we?

I’m sure you’ve read Maggie’s post about her love of the fertility pharmacy.  My first experience with them was not as bad mostly due to the fact that I have to self-pay because my insurance doesn’t cover any fertility medications.  

Random note:  Freedom Pharmacy’s hold music has a lame voiceover that says “we respect that you have a choice in pharmacies and we are happy you chose us”  yadda yadda yadda, it makes me want to scream.  We don’t have a choice, you’re our only choice as this is Vermont and not a single pharmacy stocks this stuff.  

My first stimulation was in October.  A couple days before the egg retrieval I needed to take a “trigger” drug.  This is usually HCG (which I had on hand) but due to my hormone levels, the docs decided it would be best to use Lupron.  Now, let me just preface this by saying that the stimulation prep is a cumulative, day-to-day process.  There’s no skipping or stopping meds for a day or two.  And because a patient’s hormone levels can change daily, the meds oftentimes need to be adjusted at a moment’s notice.  As a fertility pharmacy, Freedom is well aware of the nature and circumstances to which their drugs are used and, in response, provides no-hassle overnight shipping.  

Mo calls in a script of Lupron on the morning of 10/29.  I call 20 minutes later to place the order and explain that it’s my trigger so I’ll need overnight delivery.  “No problem,” says the nurse.  “It should be there by 5:00pm tomorrow, 10/30.”  

On my way home from work on 10/30 (which also happened to be Maggie’s birthday and the night of the World Series), I called Benny to have him check for the package.  “Nope, no package” he says.  Ok, I think to myself.  I’ll just call Freedom and see what’s up.  After the regular formalities of confirming my identity and the script I’m looking for, the nurse puts me on hold.  While I’m on hold, I immediately assume the worst and can feel the emotions start to well up inside of me.  Something’s not right.  

Eventually, the nurse comes back (and by this time I’m quietly weeping and half convincing myself I’m just overreacting) and she starts out by apologizing on behalf of the pharmacy.  She explains the order was processed but the package never left the facility.  It’s still at Freedom waiting to be picked up.  

And that’s when the hormonal gates of hell opened up!  

I don’t remember much of what I said next because I was crying hysterically and driving (yeah, I know) but I’m pretty sure I dropped the F-bomb.  I had come all this way, 7 days to be exact, endured dozens of injections, appointments and was almost to the finish line with stimulation and my drug hadn’t even left Massachusetts?  The next few hours were also a blur of phone calls with the FAHC docs, supervisors at Freedom, emails exchanges between Nurse Mo, Maggie and me.  With each passing minute, I was getting closer and closer to the specific time (11:15pm) I had to take the Lupron or all bets were off.  

Freedom was going to make good on their promise and get me the drug I needed to trigger that night. While that was a relief of sorts, they were still 4.5 hours away which means it needed to be en route by 6:30ish in order to make the 11:15 deadline.  Still not trusting Freedom to come through, we worked out another plan for Benny and me to drive to Maggie’s house at 9:30 on her birthday (Happy Birthday Maggie, we’re here for drugs!) and pick up her leftover Lupron.  Meanwhile, an unlucky courier got the worst assignment of his life.  He now had to leave Boston on the night of the World Series and spend the entire evening in the car to deliver the Lupron which should’ve arrived at our house hours earlier.  Sure, I could’ve called Freedom and said that we’d worked out a plan and there wasn’t any need to rush the courier to Vermont, but I didn’t.  Sorry, Mr Courier Guy – it was nothing against you, but maybe you’d consider being a courier for a pharmacy that doesn’t just leave trigger drug orders on the shelf overnight.    Also, you were late.  Good thing I had a backup plan because had I not, I would’ve missed the deadline and, consequently, had to start all over on meds. 

The second round of stimulation has been much longer.  This is actually a good thing and I can tell Dr Davenport is pleased.  My hormone levels have been lower than last time and so for the last few days, they’ve increased my dosage to get them back up.  I only had so much of my meds on hand, and the Pharmacy was closed over the weekend, so Nurse Nicole helped me source what I needed to get through the weekend locally.  On Monday, I called to place another order of meds to get me through to Egg Retrieval.  Again, I needed this shipped overnight.  “No problem,” says the nurse.  Yeah, I’ve heard that before.  A few hours later I received an email from Freedom with a tracking number for my shipment.  What a huge relief.  There must be a note in my patient file that says “don’t ever mess this woman’s order up again.  She will freeeak out!”  

When I got home yesterday my package wasn’t there.  Checked on the status of my shipment with Fed Ex and saw that it was in Williston, VT at 6am and loaded on a truck for delivery at 9:39am.  How precise.  I thought I better call Freedom, just in case.  They advised me that the package was sent via Fed Ex Ground which means they do deliveries up to 8pm.  It was 6pm.  Ok. Fine.

Here’s what happened next:

• 6:10 – Called Fed Ex to confirm that it was actually on the truck like the tracking number indicated.  Woman confirmed it was on the truck and she couldn’t give out any additional information about the truck’s whereabouts or when I could expect to receive it other than by or before 8pm. OK BYE!
• 6:10 – 7:30 – Make dinner, eat dinner, chat with Benny, check driveway for headlights every 2-3 minutes.  Pretend to hold it together on the outside even though I was screaming on the inside.  Obsessively check tracking status to see if it changed.
• 7:30 – Call Fed Ex again to explain my concerns.  “Here’s my tracking number.  This package has medication in it that needs to be taken tonight and I’m worried about it not arriving in time.”  Dude on other end reassures me they’ll deliver it.  OK BYE!
• 7:30 – 8:10 – Sit and fester.  Fidget.  Continue to stare down the driveway.  Pretend to watch the Olympics.  Pace the floor.  Obsessively check tracking status to see if it changed.
• 8:10 – Call Fed Ex again.  Explain that I don’t think it’s coming tonight and ask how I can get it because it’s an emergency.  A different dude puts me on hold while he supposedly checks in with Williston terminal.  Says he’s confirmed it’s still on the truck. OK BYE!
• 8:11 – Email Mo: “So this might just all fall apart at the last minute because even though my tracking email from Freedom says my package is out for delivery, Fed Ex hasn't delivered it yet. They can't do anything to track its whereabouts until tomorrow.  I'm freaking out!”
• 8:11 – 9:00 – Obsessively check tracking status to see if it changed.  Continue to lose my shit.  Decide the best plan of action is to head into Williston and hold a Fed Ex driver hostage until I get my meds.
• 9:00 – Decide that Benny will stay at home in case this mythical creature they call a Fed Ex delivery guy shows up.  Put on the brand new Muck boots Benny got me for Valentine’s day and head into Williston.
• 9:15 – Check tracking status on my phone while driving.  Delivery status updated from “In Transit” to “Delivery Delayed due to Weather”.  What weather?  It was 40 minutes away on a truck in Williston this morning.  

And that’s when the hormonal gates of hell opened up!  

• 9:15 – Full-blown hysterics begin.  Call Fed Ex crying.  They apologize and ask me for my tracking number for the one-thousandth time.  I explain that I need the package tonight and I’m on my way to the hub in Williston to pick it up.  Customer Service lady explains that no one is there and I cannot access my package because the office closes at 4:30.  “Say what now!?!  If you closed at 4:30 then why wasn’t my tracking status updated until 9:15?”  Proceed to cry, scream and beg them to do whatever was possible to get my drugs. 
• 9:20 - Customer Service person #4 transfers me to Jacqueline, in Customer Advocacy.  Jacqueline wants to know what the drugs are for, when my procedure is and what time I’m supposed to take my meds tonight.  She sympathizes with me but gives me no reassurance that I can actually pick up my shipment.  She then puts me on hold. 
• 9:20 – 9:40 – Still in hysterics considering the worst case scenario.  How did I end up in the same predicament I was in October on a tight deadline for meds?  If I miss tonight’s dose, the last 12 days would’ve been for nothing.  I’ll have to stop all treatment, wait for my period to come and go again and then fork over another $4,000 for meds to start all over.  But the worst part of everything going through my head was that I knew I wouldn’t be able to go through this again.  I’m so close to producing 6 eggs (holy crap, I just thought of myself as a chicken) and I just don’t have it in me to start over again.  This could be the end of the road for us, I thought.  Maybe this is all happening for a reason.  Why is the universe so against me right now?  Damn you rural Vermont. 
• 9:40 – Jacqueline comes back on the line with a name and cell phone number of Matt, the only guy left standing in the Fed Ex Ground warehouse.  She said call him when I get there and he will give me my shipment.  “I love you Jacqueline.”
• Five minutes later I arrive at the warehouse.  It was surreal.  That area of Williston is bustling throughout the day with big trucks and all kinds of traffic and noise.  But at 9:45 on a Tuesday night, it was barren.  No street lights, no traffic, just a dark, empty parking lot with a lone trucker finishing up his paperwork for the overnight run.  I walked in looking like a mess with snot stains on my sleeves and puffy, bloodshot eyes and then I saw it, my package of hope.  He asked for my ID, I signed for the package and drove straight to my parent’s house to shoot up.

Fortunately for Fed Ex, everything worked out and we are still on track for egg retrieval this Friday.  Mo was wonderfully helpful and supportive throughout the evening and was so pissed off she also filed a complaint with Fed Ex. Ain't nobody gonna mess around and jeopardize her patient's shot at motherhood.  Thanks, Mama Bear Mo.

 Look out world, nothing is holding us back now! 

Cry, Cry Baby

Here are a list of things that have made me cry in the past few weeks:

Athletes competing in the Olympics and meeting or exceeding their own expectations.

Athletes competing in the Olympics and failing to land their triple toe loop by just a few centimeters and then having to watch it three times in slow motion, followed by a screen shot of their disappointed face. Just heartbreaking.

Bob Costas' eye infection.

My daughter's valentine's card to my son.

My job. Because I hate it. And also because I love it.

A Zumba® routine my Zumba® friends sent me in order to prepare for the 6th Annual Woman Helping Battered Woman Zumbathon® (that takes place March 22nd from 5-8 at Memorial Auditorium).

Every time someone sponsors me for the WHBW Zumbathon®-Maggie Van Duyn's Page (donate here to make me cry!)

My son telling me I'm the best Mommy and giving me a great big hug.

An episode of Criminal Minds.

My older sister's email with a picture of her and her baby bump.

Every time I hear the song Brave by Sara Bareilles. Check out the video and cry for yourself.

My daughter's excitement to build snow forts with her dad for hours in the backyard.

The loaf of bread that I baked. It's just that I've been saying I

want to start baking bread for about 6 months and I finally did it!

Really, just about anything will do it. I attended an ultrasound on Sunday, February 16th at 8:15 AM and Jessi and Ben also had an ultrasound for 8:30. You know, to get an idea of how we were progressing. Although I was told that my endometrium was happy, we didn't really get any more information except that both of us should call back on Monday to find out what to do next.

After the appointment Jessi hands me a gift bag from her parents, Kevin and Joanne. It should be noted that I have known Kevin and Joanne since I was a hoodlum on the mean streets of Essex Jct. The Holcomb's and my mom would constantly call each other regarding our whereabouts and inevitably catch Jessi and I in some sort of lie. Really all the parents involved just wanted to make sure that we were safe, but at the time it felt like they were ruining our fun and just wanted to get us in trouble. Now that Jessi and I are out of the woods (literally and figuratively) in the troublemaking department, we've moved onto babymaking. Kevin and Joanne have been amazing and supportive and wonderful parents to all of their children, but I'm fairly certain that we wouldn't be going for round three without their incredible encouragement.

So I says to Jessi, I says, "Should I open this now, or is it going to make me cry?" Really this is a stupid question because as you can see from the list above, just about anything makes me cry.
Jessi says, "I don't think it will make you cry. I got one too."

Proceed to opening and hey, look at that. I'm crying.  Enclosed is a gift certificate for my favorite massage therapist and a note card that would melt the heart of a Vermont Winter.

Stupid Sarah McLaughlin (post by jessi)

Wow, we are really slacking with this blog thing.  Truth is:  I’m a lazy writer.  It’s not my favorite thing to do.  I even had a full-blown writing meltdown during the first week of grad school in 2010.  Write, write, write, research, read, and write some more.  You couldn’t PAY me to go back and relive that misery.

So here’s a little update on where we’re at – (see what I did there, Mo?  I ended a sentence with a preposition.  Is your blood boiling now?)

Maggie has been in uterus-shutdown-mode for a few weeks now.  This is otherwise described as hanging out in perimenopause land at the end of your rope with no chocolate or wine in sight mode.  She’s been on birth control pills, Lupron injections (shots in the belly) and Estrogen patches.  I think all of our readers will agree with me when I say that hormones are bad enough in naturally occurring doses so take a moment and consider what it must feel like to be all jacked up on crazy-lady hormones.  I texted her yesterday to check in on how’s she’s feeling and got this response: 

That’s equivocal to the old adage my dad always says which is:  “if you don’t have anything nice to say, don’t say anything at all.”  Or in Maggie’s case, keep it brief or break the iPhone screen whilst texting how she really feels.  

In the midst of all of this, she’s also getting ready to instruct for the first time at the 6^th Annual WHBW Zumbathon on March 22^nd.  Here’s a link to here fundraising page.  Go ahead, make her day.  

I’ve also been pumping myself full of drugs in preparation for the egg retrieval sometime this weekend or early next week.  This time around, we reduced the dosage since I responded too quickly last time.  Things have been going much more smoothly and I’m now on day 7 of stimulation.  At my last check up on Wednesday, I had 7 follicles all around the same size which is a good improvement because last time I only had 3 follicles around the same size. 

I’m a little more symptomatic with this stimulation than I was with the first which is weird because the dosage is lower but I think it must have something to do with the fact that I never, in a million years, thought I would have to do this retrieval prep again.  My ovaries feel like water balloons, my belly is swollen and sore from the shots, I hate all my pants and if I see one more story of an abused or wrongfully killed animal I'M GOING TO LOSE MY FRICKEN MIND!  I fully support awareness, people, but enough of the graphic shit on pitbulls and giraffes.  And while I’m at it - screw you and your stupid commercial, Sarah McLaughlin!

Next

Facebook messenger and Google+ have alerted me that it has been a month since we posted anything new. I'm not sure if I sure start with a list of excuses which would include but not be limited too;

**I was super pissed that the last transfer didn't work and didn't have anything nice to say so I said nothing at all.
**I have a two and a half year old and a 5 year old and I was busy preparing/enjoying/recovering from Christmas.
**My two and a half year old chose the week before Christmas to stop going to bed at night, so I actually have had approximately Zero moments of free-time to write/clean/do anything as I spend anywhere from 1-3 hours helping him fall asleep and/or putting him back to bed.  This kid is soooooo stubborn that he will climb down the stairs and over the baby gate that was installed at the bottom of the stairs just to show his resistance. The gate has since been removed (baby gate for sale?).
**We were undecided about what to do next, so it was difficult to know which direction the blog should take us.
**I got the flu.

It took me about a week to really convince myself that it was not my failure. That I didn't do anything wrong. That my body isn't insufficient or unable respond. I never had any fertility issues with my own kids. I basically thought, "Gee, I would sure like to be pregnant" and the next thing I knew...But this is not working for some reason. Nobody really knows why. And that needs to be ok. Because it could work next time.

I saw one of my cousins over the weekend who is a writer. He is a big important writer who writes for big important people (read: a lawyer who writes for lawyers) and when I told him that I was writing a blog he said I needed to write more often. Like every couple of days so my readers know what I'm thinking all of the time. In the past few weeks, there have been many moments where people ask me what is going on and I look down and then mumble something about trying again and moving forward and meds and whatnot.  This is unacceptable! I have got to get my gumption back and really embrace that this was not a failure but just another turn in the road.

So here is a rededication. I will stop making excuses for why I'm not writing and we will tell this story as we intended to tell it. For now, here is the quick and dirty:

We are back to a fresh transfer, where my body needs to get on Jessi's cycle. So I'm back on the       birth control and will likely start the Lupron shots by the end of the week. I'm anxiously awaiting a friendly phone call with Freedom Pharmacy! I sure hope they are useless again! Jessi is getting ready to bulk up on her synthetic hormones and we are pulling for a great big egg dump this go 'round. I hope Ben is up for the challenge! We anticipate that the next transfer will take place mid to late February. We will keep you posted with our gripes, complaints and hilarity. Stay tuned!

No ragrets (post by jessi)

During the dreaded two week wait, which is the time period between the embryo transfer to Maggie and the blood work to confirm whether or not she is pregnant, I drafted a blog post about how our strategy for the second transfer was completely different than the first.  Preparing for the second transfer had a completely different energy.  Instead of the hurried coordination of appointments, procedures, drug-taking, we quietly waited for Maggie’s ovulation stick to show a happy face.  Maggie had two sessions with an acupuncturist, ate some red meat to increase her chi (or at least we think that was the recommendation the acupuncturist gave her) and while Ben and I babysat her kids, I hid a fertility idol in her house because my co-workers, Megan and Ingrid, (read:  seasoned advisors in spiritual/holistic healing) told me to.  Ben was able to attend the second transfer and Maggie took a week off from her workout schedule.  Everything was different so naturally, we’d expect a completely different result.

About half-way through the two week wait, I knew it failed again.  I don’t know how I knew because I’m typically not a negative thinker but I just knew.  Sure enough, Maggie started her period a couple days before the blood draw date and we had been defeated again.  I was mad.  Stark raving mad!   I’m not sure if this is the usual response but considering that I was anticipating a failed transfer coming on, I had already breezed through the first two stages of grief and gotten stuck in high gear on stage 3, ANGER.  Poor Mo caught the brunt of it.  (I’m sorry Mo, muah!) Also, I really don’t think she gets paid enough for having to deliver such terrible news (Make note Dr D.).  I’m sure most women are shocked, stunned or even speechless, not me though.  I came unhinged.  “How is this possible?!”  “Why didn’t it work!?”  “No, I don’t want to talk to Dr D unless he’s got a damned-good explanation!”  And then, after some reflection and a gin-soaked happy hour with Benny, we realized there are no answers.  No one is ever going to tell us the transfer didn’t work because of X and next time we will do Y and it will work.  It’s never going to be that simple and I eventually came to the conclusion that regardless of all the changes we made for the second transfer that gave us new hope, it doesn’t matter.  It’s either going to work, or it isn’t.  Plain and simple. 

And then it came time to make the hardest decision to date – call it quits or soldier on.  Benny and I are happy with either scenario which made the decision even harder.  In both of our previous lives, having a child was completely out of the question.  Before we had even met, we each made the choice for a childless life and we’re both at peace, confident in our decisions and actively embracing the freedoms a childless life can offer.  If all would fail again, we would resume this lifestyle which comes with great perks like traveling, exotic vacations, sleeping through the night, having disposable income for home improvement projects, spur of the moment adventures and getting to live in the world that’s oblivious to the not-so-glamorous parts of parenting.  But, at the same time, we really, really want to have a family.  We want to replicate the awesome family life that our parent’s gave us.  We want to see the world through the eyes of a child again and embark on one of life’s greatest challenges together.  We want it all. 

So it all came down to “what if?”  What if it worked on transfer 3 or transfer 4?  Our lives would be changed forever and if we don’t give it another go (because we still have the means to do so right now) we’ll often wonder “what if?”  And wondering about "what if" is too close to regret.  We're not the kind of people who live with regrets.  Not even a single letter.