Can't talk now, but I heard from my RE

How's that for a teaser? I've got a lot to say, BUT I'M NOT GOING TO SAY IT RIGHT NOW! Thanks for clicking.

I just got off the phone with Dr. K. We had a productive chat that covered everything I wanted to. I will go in soon to confirm that my cyst has gone away and discuss whichever treatment scenario DH and I decide to pursue. And that comes with a big "if any."

Wish I could stay and post away, but — just as Dr. K is trying to catch up on her work after vacation — I am still frantically trying to catch up on work that got the short shrift while I put making it through the IVF cycle first on my to-dos. (Well, it's not "just like" it.)

I should finish my current project tomorrow at the latest. My client has been an absolute gem about accommodating me these last several weeks. She doesn't even know why I had to renegotiate our schedule, but she just said, "Do what you need to do."

I dearly want to experience my normal feeling of slight control over my days before thinking of anything else TTCwise. A rash of evenings and maybe one whole weekend off would be cool, too.

My Pal Trigger

At exactly 8:00 pm last night, DH pointed the HCG syringe at a purple-markered bull's-eye on my backside and said, "Sorry."

My only noticeable s/e was persistent gas bubbles that joined forces overnight to form a big, painful, wake-me-up abdominal balloon this morning. I walked it off, though, and all is fine.

Yesterday's monitoring showed follies-of-interest at 23, 17.5, 14, 13, and 9.5 mm. I was the only one in the room interested in the 9.5 one. Sure seems possible that it might make it to 12 mm, which is where Dr. K said she wanted to see them (she wasn't in the room, btw). When I gave a "Hey, maybe," on that the sonographer chirped, "Oh, I don't even expect to find a mature egg in that 13 mm follicle." Hokay. I opted to continue happy thoughts of having 4 over 12 mm — at that moment — and a little bit of time for them to grow.

Really, who knows what they'll find. If it's pudding, DH hopes it's butterscotch. And if it's rocks, I hope they are diamonds. I'll sell 'em on eBay.

My E2 was 1,545. Not sure where that's supposed to be, but the result meant the difference between triggering last night or tonight. They don't want the 23 mm follie to overmature and do us no good.

The cyst was bigger, but not by too much. I am eager for that sucker's aspiration so it will stop stabbing me.

Retrieval is at 7:15 am tomorrow!

Day 7 and still in the game

Stayed off the Internets most of yesterday. I had to catch up with work. And now I am good for at least a couple of days. Hope my client can't tell that I did what normally takes me 3–5 full workdays in about 10 hours, ending at 3:15 am. Who knows, maybe it's my best work ever.

DH did not believe me the other day when I emailed to say that I was unable to track a thought for more than a minute. I asked if he was calling me a LIAR, and he said no, just a HYPERBOLIST. He hasn't even noticed that since last week I regularly have almost no idea what we're discussing . . . or if we're discussing. I do know when he's talking, of course. And if I ask a question I care about, I can pay attention long enough to take in the answer. But only if I squint.

Today's info:

I got lots of attention and was fine with it. I arrived at 7:22 as they were turning on the main lights, and I was whisked off for bloodwork before I could even fully focus on People's side-by-side comparison of Jessica Simpson's lips from 2005 and 2007. If I am lucky, I will get to read the captions tomorrow.

Four people attended this wanding. (Verbed it!) Sonographer, nurse, Dr. D (today's normal procedure doc), and Dr. K, who came in early to try to see me. She joined Dr. D and me as he was giving his opinion. She missed the part where he brought up my Tuesday appointment and said he did not like that I'd received conflicting messages from the team. I told him I was over it but that, yes, I considered Tuesday's communication with me to be poor.

Sorry for going on and on, but I'm running on drugs and less than 3 hours' sleep and don't have the mental strength to type anything but my thoughts as they come. That's why I will now type that I didn't know it was Valentine's Day until the phlebotomist said the embryology lab was swimming in black balloons. And, did I mention that I walked on a "sidewalk" the other day during the lunchtime rush that was actually the newly paved 4th lane of a very busy thoroughfare? I won't give further details. They make me shudder.

Yes, the report! Feel free to start here:

(1) The 4 decent follicles are hanging in at 19mm, 14 mm, 14mm, and 13 mm. The sonographer went ahead and measured 2 others — 8 mm and 6.5 mm — and called the other 2 "less thans." They did not take umbrage. But the 19 mm one was told to not get too far ahead of the other 3 good ones.

(2) My cyst is still growing. And again, I am to stop thinking about that.

(3) Day 5 E2 was 545, and Dr. K said that was great and expects today's to be great too.

(4) Both Dr. D and Dr. K think we should go ahead but were careful to say that my odds have lowered since the cycle outset based on my response to the meds. They were already low, maybe 15%. But it is so much higher than 0%, which has been our actual success rate since 2003 and our RE-predicted-odds for trying naturally since 2005. I purposely bit my tongue to stop myself from asking for a new percentage. It doesn't matter anymore, because we are either making it to retrieval and taking what we get then or converting to IUI if things look worse just before retrieval. (A few minutes before? The day before? I did not clarify that one.)

Starting here works too:

(5) Current thinking is that I will trigger tomorrow or Saturday, for a Sunday or Monday retrieval.

The rest of my day will include a dog walk, a nap, some kind of takeout, a foot soaking (you are right, Polly!), and maybe the positive meditation CD that tells me my body knows what to do right now. I have acupuncture right after my ultrasound tomorrow, and I'm hoping I can get in for that on the weekend, too.

Zzzzzzzzzzzzzzzzz.

Plugged back in for now

Dr. K called half an hour ago, and we had a good chat. She understood how I got the impression this morning that this thing was a wash. (How about, because the NP said as much when I asked her to comment?) Even if she didn't understand, she said she did, and that helped.

First of all, she still feels that the cyst is a non-concern. They will aspirate it at retrieval but wouldn't want to go in before then. I asked about its possible effects on egg quality and whether it would inhibit further follicle growth. She said there is no definitive evidence that quality is adversely affected or that follicle counts would be better without the cyst. But that, yes, if it doesn't work out, you can wonder. (See, I'm still not getting why the "nothing definitive" thing doesn't make you wonder right up front.)

Turns out I still have 8 follicles. I did not lose 4 from last week. (The NP could have easily corrected this impression during any number of the times that I voiced it.) But 4 have definitely grown ahead of the others and are measuring at 10–11 mm. In fact, contrary to my impression that only 1 of the 4 looked worth anything — an impression which to my mind was confirmed when I said, "So just 1 out of the 4 even looks viable—that sounds bad" and then the NP said, "Yes, the others just aren't where we'd like to see them" — the REs say all 4 of the bigger ones look healthy and right on track.

Was the NP talking about them not looking good if we were pretending this was retrieval day and not Day 5? I don't know. But she went all the way along with my comments about canceling. She encouraged them, spoke comforting words about a future cycle on a different protocol, offered to cancel appointments so I didn't have to, and agreed with my assessment that today's planned acupuncture treatment would be a waste of my energy.

!@^%&^%&$$!!!! Pardon my digression into testiness, please.

Dr. K confirmed that whether the other 4 will grow can go either way — and that it is too soon to tell. She also said that 4 nice healthy ones is about the best she thinks I can hope for. Not that it's not possible that I could get more during a different cycle. But there's no way to know, and why take that chance when we are here now with stims doing their thing and me with 4 tangible egg vessels.

So I will continue the meds (just finished shooting up, actually), get monitored Thursday and Friday both, and we will decide what to do then. She said, "Now is still the time to be hopeful. We can deal with deciding to cancel if we need to." I appreciate that. It happens to be the way I felt before today. I'm not sure yet whether I'll be able to get that feeling back. But I do want to ride things out to the end of the week.

DH's take on the notion of going ahead even if 4 follicles is the best we can do: "It's not like they're going to find pudding in there. Or rocks."

So one hopes, my sweet.

Afternoon edition: Head guy says GO

Just got a clinic call telling me to continue with the meds and come back on Day 7. "Head doc" at the practice has seen it all and wants to see some more. My doc is at the new out-of-town office today. But will, at my insistence, call me before the day is out to discuss all.

I don't know. The nurse practitioner seemed pretty much on board with my thinking. Nothing about this morning's check seemed positive to her.

Cyst bigger, higher E2, precious few follicles (even fewer than before). What am I missing?

Hope to find out.

"My, what a beautiful lining you have"

Too bad everything else sucks eggs.

I pulled the plug on my IVF cycle this morning. Twenty minutes later I'm sitting in a coffee shop with my laptop and a subpar full-fat, all-caf latte. Actually, I finished that while waiting for the computer to boot; it wasn't very hot—or maybe my pain receptors are numb.

I meant to go straight home from my appointment, but I took the northbound freeway ramp when I wanted the southbound one. So I said "Frick it" and pointed my car toward a spot DH and I frequented when we first moved to town almost 10 years ago. Man, we were young(er) then.

At Day 5, my cyst has grown by 75%, and my follicle count is in the dumps: 1 decent one on the right, 2 small ones and 1 disappearing one on the left. Other follicles viewed at my suppression check have vanished.

I'll get my b/w results from my RE this afternoon and will confirm then that we're done for now. I wish I had talked with her after my second suppression check. Not that we wouldn't have proceeded just as we did. It's all a big what if, I know. Yet I wasn't totally satisfied with Dr. L's judgment on that day and now I am completely kicking myself for following it without giving more credence to that little piece of my gut that wasn't on board.

Now here's where I provide evidence that I had reason to second-guess Dr. L's judgment and that I was an idiot for waving off my instinct:

It was obvious that Dr. L hadn't given my chart more than a cursory glance. For four things: he was surprised to learn my age; he had no idea that his partner had recently performed a myomectomy on me (never mind that it was my third in 20 years of living a life of fabulous fibroidosity — and that I didn't need him to define subserosal, convert mm to cm, or question the veracity of my knowledge that I do not have endometriosis); he assumed I was doing a different protocol and gave incorrect "start injections tonight" advice based on that (which I didn't follow); and he was, I felt, more focused on putting on a getting-to-know-you floor show than paying close attention to my actual situation.

I don't know about you, but I prefer that my doctor save both playfully joking with me about my cyst/fibroids/clinic bill and patronizing the nurse ("You're wrong, as usual! But I still love you") till after he's done probing me. "Probing" was Dr. L's word; most at least use the term "wand" — without turning it into a verb.

You know how some guys, some gals too, will grandstand for you the first time you meet? They present an exaggeratedly charming/clever/funny self to seal the deal on that spectacular first impression. They are full of themselves (because they truly are talented, smart, charming, funny, or something good) and insecure with a capital I. They need that immediate feedback that you think they are the greatest, so they hit you with all they've got within your first 2 minutes of acquaintanceship. By the second time you've met, they feel comfortable enough to settle down into a normal personality presentation. And you do like them. Usually a lot. That was my take on Dr. L.

I don't blame him for my cyst growing or my follicles withering. And I don't blame him for answering my questions about oversuppression and why we wouldn't expect the cyst to grow with "In my experience, these shouldn't pose any problems." He gave me the advice he would have given to anyone else. And that's the kicker. Was he framing that advice within the context of my history, my age, anything about my case? I feared not then. And my incredible superpower of laser-like hindsight tells me NO now.

I do blame myself for not calling my RE directly to talk it through a little more. Had I done that, I may have gone ahead as I did. But I wouldn't be so freshly irritated by my visit with Dr. L and soooo mad at myself.

Looking forward to Dr. K calling later. We will figure out next steps.

Listen, Dr. K and I discussed the possibility of a poor response several times before DH and I signed up. I absolutely knew it could happen. I thought maybe it was even likely to. So this really is not a big surprise. In fact, I need to start thinking about it as good news. I had REALLY hoped, that if my meds protocol was wrong for me or I was just not going to do well, we'd get good indication of that early on. Before proceeding to retrieval. And so that wish has been fulfilled.

Yay.

Suppression check, rinse, repeat

Little Miss Cyst measured the same today as she did at my first suppression check Monday. She's also throwing off essentially the same level of E2. Dr. L (not my primary RE) thought it looked like it was "trying to collapse" and agreed with me that yesterday's pain was good. He said that these few days of watching it simply confirms that things look fine for liftoff — and that this type of cyst, in his experience, will not affect the outcome one way or the other. Does that mean you already know my outcome? is what I thought to that. And then I asked more questions until I felt good about making the call.

So, the cycle is back in motion. I'll take my final BCP on Super Sunday, do one more suppression check on Monday, and start my Microdose Lupron on Wednesday. Stims to begin Friday. I'm exactly one week behind my original schedule. Not a big deal.

Dang, that hurts

Did nothing but work, walk, and bathe the pupper yesterday (that's her looking sparkly and smelling clean at breakfast today). No trips to the clinic. I planned to work in the evening, but the late-afternoon headache I'd successfully ignored blossomed over dinner. It turned screaming on me and made me wish I hadn't eaten.

As a rule I don't get many headaches, but when I do they pretty clearly come from stress/eye-strain or hormonal shifts. This one was definitely hormonal. I've been getting the same one every few cycles during ovulation time for about a year. I may be wrong, but I've been assuming I get them during a big ol' estrogen surge as my tired ol' reproductive system struggles to spit out an egg. Obviously I'm not ovulating now, but we know the cyst is producing estrogen. This headache doesn't respond to Tylenol (I think aspirin performs slightly better, but I'm not supposed to take that right now), and it doesn't like noise or light or air. Sometimes a hit of cranberry juice will dull it. Probably any fruit juice would do, but we usually have just V8 or plain tomato juice open with cranberry on hand in case of emergency need for cosmos.

Anyway, the cranberry trick did nothing, nor did a why-not shot of pomegranate juice — also a good mixer. (Just btw, no, I'm not imbibing at all while we're cycling.) So I shut down my computer and took to the bed with my fertility meditation CD. That last part was DH's idea. I was so focused on how those few hours of not working might affect my ability to meet my next deadline that he predicted that lying down with nothing but my regular thoughts might not be the best medicine.

He was right, but I'm still not digging the exercises on this CD. I bought two CDs. One specifically for general fertility and one geared toward taking you through the steps of an IVF cycle, from injections to pregnancy test. I haven't done the second one yet because I haven't started the injects. So I'm just using the first one. While I do benefit from concentrating on better breathing, I don't like what I perceive to be a negative approach to getting me to feel better. The narrative basically tells you that you are infertile because your thoughts make you so. You are blocking the soul of the new life trying to enter your clenched-up womb each month. Your sadness/anger/frustration/stress is the only thing responsible for your infertility. That you are infertile is your fault.

Ouch.

Now, the second part of the exercise tells you to stop everything that you're doing to sabotage your fertility. Yet it's not all that soothing and reassuring. Not to me, anyway. If I were creating an exercise, I'd want the listener to dispense with the negative thoughts. And naturally she would have to acknowledge them. But I wouldn't spend the bulk of the time focusing so closely on them only to then vaguely mention switching over to the positive frame. I would spend most of the time guiding the listener to think happy, calming, positive thoughts. We'll see how the IVF exercises are structured. I may just revert to taking a bit of time each day to do some deep breathing while listening to soothing, uplifting music.

The headache is gone today, thank goodness. But now the cyst-area hurts. I'm feeling sharp, stabby pains when I bend or twist at the waist. And it is sore when I press on it. I hope, hope, hope it's not growing. Here's hoping that it hurts because it is shrinking or has ruptured/self-aspirated. I think that's a good thing to hope for, but I don't have time to research all things Ovarian Cyst today. If that's the wrong thing, God and/or Universe and/or Mother Earth and/or My Fertile Soul, please convert my wish to its correct form. Thank you.

I'll know what's up with it tomorrow.

Note to cyst: You're going down

Today's happenings:

My RE put me back on BCPs this afternoon. I gobbled up a pill as soon as the nurse called with the news. She had told me yesterday that an E2 of more than 50 might delay the cycle. My E2 was 34.2. If you're like me, you may be thinking, "Dude, 34.2 is less than 50." But the RE decided to be conservative, calling my number borderline, and I have to appreciate that. Chances are good that the cyst will shrink on its own, and I'd rather start from that point in a few days than to begin injections now and have the cyst grow and interfere later on. I go back Friday for a repeat suppression check.

I had an acupuncture appointment this morning. I think I fell asleep, but I'm not entirely sure. I do know that when the acupuncturist checked on me at the halfway point I was surprised to learn that, no, it was the lights-on-and-go-home point.

DH took the heavy-duty antibiotic Zithromax last night. Four pills all at once to knock any infection-threatening bacteria right on out of his system. For side effects he reported "waves of something going on" overnight and a quite-possibly-related "flat feeling" during the day.

Suppression check, mock transfer, pay(them)day

During today's suppression check, they found a 23–24 mm cyst on my right ovary. Small enough that we think things will move forward on roughly the same schedule. But big enough that the nurse couldn't get a clear AFC on that side. Had blood drawn to see how much estrogen the thing is churning out. Will know tomorrow and get further instructions on the meds from there.

They also did a mock transfer today (that went beautifully) and showed me the catheter type they use to do the real transfer.

And, I paid the main cycle charges. An ouchie total of about $13K. That's on top of last week's meds bill for just under $4K.

Remember how I thought "Take the Money and Run" might be a sign from the Eagles? That happened the day I originally thought we had to pay up. But I had the date wrong. So, technically, that sign couldn't have applied. I wasn't looking for a sign today, not even thinking about it, but when I pulled into the lot this morning I did get one. The tune that DH tells people is "ours" (but it's not) came on (that would be "Dude Looks Like a Lady"). It made me laugh out loud and reminded me that DH was with me in spirit today.