Tuesday, December 29, 2009

goodbye Caesar salads

I know that pregnant women are supposed to be careful regarding what they eat and drink, which I am. However, never in my wildest dreams, okay nightmare, did I think it would be difficult to find “safe” Parmesan cheese in Dublin.

Last week we purchased the same brand of fresh, Parmesan shavings that we’ve bought for over a year, only to bring it home and discover that it’s made with unpasteurized milk.


What??? This is not fancy, European cheese. This is store brand, regular, old Parmesan. Unfortunately all of the other Parmesan in the store is also made with unpasteurized milk. One of my first outings will be to search for “safe” cheese. Maybe I’ll be able to find it in a specialty cheese shop.

::sigh::

cats in December


Santa brought the cats two bags of treats from the U.S.


nap time


Guinness' favorite place to be. Mmm warm.

There are two scratchers in front of the fire, the coveted place to be. Bella is a bit selfish and usually tries to stretch herself as long as possible, so there is no room for Guinness.



Notice Bella's stretched out paw? Poor Guinness.


I moved Bella, Guinness rearranged himself and stretched out, revenge.


sharing the fire

Friday, December 25, 2009

Merry Christmas!

I didn't do Christmas cards this year, so this will have to do.

Merry Christmas
Wishing you a Christmas filled with peace and love!

Wednesday, December 23, 2009

caught

I was talking to my mom yesterday and she mentioned the lack of posts on the blog recently. I told her that it had been fairly boring around here (which I am thankful for), and that there wasn’t much to blog about. She asked if there was perhaps another reason, cough, cough, the new toy.

Yes, about three weeks ago my husband bought me a new toy, Slingbox. It’s a fabulous device that allows the owner to watch television from the U.S. regardless of where in the world they are living. I had wanted one for a long time, and he finally ordered it as one of my Christmas gifts. My mom was involved because you have to have someone in the U.S. who is willing to hook the device to their tv and computer, and who hopefully doesn’t use their tv very often. When I was put on couch/ bed rest, my mom had the brilliant idea that my husband should give me the Slingbox gift early, so I would stay still. It’s not that I’m a huge tv watcher, but it’s nice to see programs from home once in a while. Oh, and did I mention that my mom has a fabulous cable package and I’m almost guaranteed to find a Law & Order episode on at least one channel. Hooray. Though I will say that watching U.S. advertisements is causing me to have HUGE retail envy.

So there you have it, I’ve been laying around, watching tv, and eating bon-bons following the doctor's orders.

If you live out of your home country, I highly recommend buying a Slingbox. While you’re at it, pick up a Magic Jack too.

hope?

Okay, I finally did it. For the first time since finding out that I am pregnant, I’ve set out more than one syringe; you know, because I might actually still be pregnant when it’s time for the next injection. This probably seems like the most ridiculous thing you’ve ever heard, but around here, it is huge. This is the first sign of hope that this pregnancy might last, that this is really happening.


If this keeps up, I might actually start reading a pregnancy book and order maternity clothes in the next week or so.

Eek.

Monday, December 21, 2009

more intralipids

Sorry for the long silence; there really hasn’t been much happening. Today I had another intralipid appointment. I brought in treats for both the front office staff and medical staff. They seemed to appreciate some sweets for the holidays.

During the infusion, the nurse asked if she could bring another patient back, which I was fine with. I wasn’t sure what to expect because in the waiting area, nobody talks to each other. I was envisioning being trapped in uncomfortable silence for over an hour. The other patient walked in, I introduced myself, and the conversation started. Of course it probably helped that we were sitting a foot away from each other, our infusion bags hanging from the same IV pole. Anyway, she was just lovely.

We had a nice chat about infertility, IVF, intralipids, and area hospitals. It just amazes me that regardless of where in the world you are from, currently live, etc, infertility knows no bounds, the feelings are the same, and the bond between infertile women forms quickly. Within minutes we were laughing about the “regular” people who complain about getting flu shots, snickering about people who “just have sex”, and rolling our eyes about the dumb things people say. We exchanged medical histories, diagnosis, and hope for each other. Where else is it completely appropriate (almost expected) for strangers to share the most intimate aspects of their lives than at the fertility clinic. LOL. Overall a good appointment and my new friend helped the time pass quickly. My next intralipid appointment and ultrasound are scheduled for January 4.

PS- I finally remembered to ask the nurse about the intralipid dose. It’s 4ml of 20%, mixed with saline.

Wednesday, December 16, 2009

scheduling an OB, start early!

When I was five weeks pregnant, there were several people who asked if I’d chosen an OB yet, to which I laughed. It seemed WAY too early for that, plus, you’re talking to the person who won’t even set out an extra syringe for heparin in fear that she won’t need it in 12 hours. So yeah, no OB.

At six weeks, people asked again, and even started to sound nervous that I hadn’t selected an OB yet. Again, way too early, in my opinion. Remember, I was cramping, spotting, and just knew this was going to end. At six and half weeks, the health unit director sent a list of OBs home with my husband for me to look through. She was starting to get concerned about my lack of OB appointment, and told me as much during several phone calls to check on me.

By seven weeks, the nurses at the fertility clinic had joined in, stressing the importance of choosing an OB, ASAP. Apparently there is a baby boom in Ireland, and again, I was told that the “good” OBs fill up their spaces when women are around five weeks pregnant (they take limited numbers of patients per month). Ridiculous, I thought. Again, I didn’t expect this to last.

Seven weeks came and went and I dutifully looked through the list of OBs, comparing qualifications, education, location, etc. I chose four and went to the health unit (yes, a break from couch rest). I thought that having the health unit call on my behalf might give me a better chance since I was apparently so late into the process.

OB choice #1, hospital choice #1: receptionist was out of town, but we were told he was not taking new patients
OB choice #2, hospital choice #1: not taking new patients
OB choice #3, hospital choice #2: not taking new patients
Oh ****
OB choice #4, hospital choice #2: after some pleading by our health unit director, agreed to take me, even though, you guessed it, he was not taking new patients. Phew, appointment made.

After some additional googling and conversations with more nurses at the fertility clinic when I was there on Monday (yes, now into the eighth week), I decided I wasn’t really comfortable with choice #4, and they recommended I try again for choice #1 or go with another OB (not listed as practicing in Dublin on my list, but apparently is).

On Monday afternoon I called OB choice #1 and had a nice conversation with his receptionist. Unfortunately he will be on holiday for the entire month of July (when I’m due), and therefore can’t take me. However he had two names of other OBs that he thinks highly of (one being the OB I had just been told about earlier that day at the clinic).

And so, I called the new OB, who after being researched, googled, and otherwise cyber stalked, had become my new top choice, AND he delivers at hospital choice #1. His receptionist was very nice, though I got the impression that a lot of people must play the “I’m high risk” card to get into him, so she wanted detailed information of what makes me “high risk” and I had to promise to have the fertility clinic send a detailed referral letter, which they had already offered to do. After listening to just half of what makes me high risk, the receptionist said, “Oh my goodness, you’ve really been through the mill.” She said the doctor was booked, but he would likely find my case “interesting” and “challenging”, so she was going to speak with him and call me back.

An hour later, she called and said that although she was going to have to “redo his schedule”, that he wanted to take me. SIGH OF RELIEF. Anyway, my first OB appointment is in January. Until then I will be followed at the fertility clinic.

Moral of the story: if you plan to get pregnant in Dublin, book your first OB appointment as soon as you get a positive home pregnancy test if you want a particular doctor. Since we aren’t Irish (no local insurance), I’m high risk, and need more care than most, I am going “private” which means the cost of maternity care is about 2/3 the cost of an IVF cycle. GULP. For those using the regular system or going “semi private”, you might want to book your first OB appointment six months before you think you’ll get pregnant. I wish I were joking.

Monday, December 14, 2009

8 week 4 day ultrasound

First, the big news, the baby still has a heartbeat!

We had one of our favorite nurses today, the nurse we were introduced to at our first IVF consult at this clinic. It was wonderful to see her again and she seemed thrilled to be doing today’s scan. The baby is measuring at 18.7mm (over double in size from 11 days ago) and at 8 weeks 3 days, so just a day off, versus two days off at the last scan (not a big deal).

Today we were in a different ultrasound room and I don’t think the machine is as new/ good as the one in the other room, so the picture isn’t very clear.


The baby was curled up, sleeping. The nurse was poking at it repeatedly and it still wouldn’t wake up. She said it was the most stubborn she had ever seen; also said it was the most laid back as they usually move more when they are poked at. She referred to herself as Aunt ‘her first name’. Awww, so cute! Then even tried to explain to the baby that it owed her some movement after all the hassle she went through trying to order my meds. We all had a good laugh. After 15 minutes of poking and jabbing, we finally saw some movement. The nurse even pointed out a little hand. Amazing!

I have another intralipid infusion on Monday and I’m still on pelvic rest, supposed to keep my feet up, relax, etc.. I got refills on some meds, a hug and pat on the belly from my favorite nurse, and off we went.

Now I’m trying to book an appointment with an ob (more about that headache tomorrow).

Saturday, December 12, 2009

so sick

Where have I been for the past several days? Mostly on the bathroom floor. I had a really bad reaction to the PIO injections combined with the Crinone. I won’t go into details, other than to say, I was really sick and in a lot of pain from Tuesday evening through Friday afternoon.

By Wednesday afternoon it was clear that I needed help/ medicine, but I didn’t want to bother the RE (yeah, I know, dumb), so I went to the pharmacy. They didn’t come close to having what I wanted, but I was ready to settle for something else and made the mistake of asking the pharmacist what ingredients it contained, mumbled something about being eight weeks pregnant, only to have the item grabbed away. NOT HAPPY. So yes, they actually refused to sell it to me. Of course that is the only pharmacy remotely near the house, so home I went, defeated, still sick, and still in pain. I was in tears, wishing that Target, CVS, or Walgreens were an option.

By Wednesday night, I was seriously considering the hospital (yes, it was that bad). Of course that leads to which hospital. The private hospital that I would prefer is far from the house, ER closes at 6pm (yes, you read that correctly), and doesn’t take pregnant patients. I wasn’t sure if the maternity hospital would take me (clearly not thinking straight by this point). The urgent care type place doesn’t take pregnant patients and likely would have just told me to go to the hospital, which leads to the other choice, the public hospital. While it’s close, and I’m sure the care is fine, it’s still public, crowded, and likely overflowing with flu patients, which I don’t need to be around due to being immuno-suppressed. The other issue is that due to overcrowding, if they decide to admit a patient, the patient often lies on a trolley (hospital bed) for up to three days in the hallway of the ER. I have seen it with my own eyes while on hospital tours, and just the thought was enough to keep me home.

On Thursday I still hadn’t called the doctor, (again, stupid, I know). Basically after several days of drugging myself with “safe” medicine I had around the house, some “safe” home remedies, a lot of tears, rest, some screaming, etc.. I appeared to be on the mend. By Friday afternoon I even managed to eat some solid food.

As of today, it seems that I’ve recovered, and lesson learned, just call the doctor next time. Oh, and place a HUGE order to drugstore.com, just to have certain items on hand.

Regarding the pregnancy, I’m now 8 weeks, 2 days and I thought the PIO injections were helping with the bleeding and cramping, but I think I was just in too much pain and too sick to be paying attention this week. Tonight the cramping is horrible. I have another ultrasound on Monday, holding my breath that there is still a heartbeat.

Tomorrow will be spent catching up on emails, message boards, and blogs. I’ve missed all of you!

Tuesday, December 8, 2009

intralipids at the fertility clinic

As I mentioned before, the fertility clinic is now offering intralipids. YES! The clinic is a lot closer to us than the other clinic they contracted with for intralipids (literally all the way across Dublin), not fun with the traffic nightmare here. So yesterday I had my first dose of intralipids at the fertility clinic (fourth dose of intralipids total). I had two of my favorite nurses and one of my favorite REs hooking me up, checking on me from time to time, and doing vitals. Everything went very well and I was able to get new meds and supplies for the progesterone in oil injections that I started last night. I was hoping that I could drop the Crinone, no luck; now I’m on both.


In other news, I had some leftover meds from the FET in Minsk that I wanted to donate before they expired. I decided to take them to the clinic yesterday and see if they could be given to another patient. I wasn’t sure if the clinic would accept them or not, because even though they are within date and they were manufactured in the UK, they are all labeled in Russian. I was thrilled when the RE told me that they could definitely use them. YAY!

On to the PIO injections, so far they aren’t too bad, though I’ve only had two. The actual injection is a bit more noticeable than the heparin and stims because the needle is bigger and solution is thicker, but not awful. The only bothersome aspects are the bleeding after the injection and I’ve noticed that after just two injections, sitting down is a bit uncomfortable, which I can only imagine will get worse. Overall not as bad as I expected and thank you to everyone who left helpful hints in the other post. I really appreciate all of the tips and tricks for the PIO injections!

update on Guinness

Yesterday morning he must have known that he had to return to the vet to give a urine sample. My poor Guinness sat in the master bathroom and cried, and that was before he knew that I’d brought the carrier in from the garage. I’d slept with an old pillowcase the night before so he’d have something with my scent on it, so I put that into the carrier and then we put Guinness in.

Fortunately the clinic is only about five minutes away, but it was five minutes of crying that kitty cry of “mommy, why are you doing this to me, where are you taking me” cry. Broke my heart. We dropped him off and the vet assistant promised to keep the pillowcase in the kennel with him.


I waited several hours and called for an update. He still hadn’t urinated, though I had a long conversation with the vet. I told her that I really didn’t think that he was diabetic (not symptomatic and too young) and that I also thought the low phosphate level in his blood was secondary to the vomiting on Thursday night. She completely agreed with me and said that at this stage they are just trying to rule things out. Her only suggestion was to eliminate his evening wet food and keep him on dry only, so that’s what we’ll do.

She called about an hour later to let me know that she’d been able to get a sterile urine sample from Guinness. It showed that he’s a healthy, young boy. So yeah, basically still no answers. We drove to the clinic to pick him up and speak with her in more detail. I just can’t say enough wonderful things about her, extremely pleased with her clinical skills and caring nature. I had written a Christmas card for the clinic and specifically included some things about our vet in the note, so hopefully it will be passed on to the clinic director.

We brought Guinness home and he was promptly greeted by a hissing Bella (first time), possibly because he smelled strange and had been away. Later in the evening she also swatted him in the nose, very odd. Anyway, he is home, hasn’t been sick since Thursday, has entirely “perplexed” the vet, and seems relieved that his carrier was returned to the garage. He's currently lying across my lap, looking up at me and purring.

Sunday, December 6, 2009

an evening with the vet

On Thursday night my dear Guinness got sick. It happens occasionally and we aren’t sure of the cause. When we adopted the cats earlier this year, we were assured that they were healthy and up to date on vaccines, however, once a month or so, Guinness gets sick (TMI, vomiting and loose bowels at the same time). Thursday evening was awful. He was shaking, walked into the cabinet, and crying from deep within his chest. Of course I was crying along with him. We called the clinic, loaded the boy into the carrier, and were out the door.

(a little background)
Prior to starting IVF again, we had taken both cats to the private vet for a checkup. We mentioned our concerns to the vet and she seemed more interested in judging us for not allowing the cats to go outside into the “garden”. Sorry, I know that it is customary in many parts of the world to let cats outdoors, but our cats are indoor only. It keeps them healthier and out of danger. That day Guinness was diagnosed as being “anxious” and we were sold an expensive bottle of cat spray to calm the air.

Upon arriving at the clinic Thursday night, I was afraid that we would be faced with the same vet and was VERY relieved to see a new face. She asked a lot of relevant questions, listened as I talked about his symptoms, and gave him a thorough exam, including shaving his neck and taking blood.


We chose to take him home with us that night because being separated from Bella and in a strange environment would have been too stressful for him. The fabulous, new vet promised to call in the morning with the test results.

We started driving home and my husband’s cell phone rang. It was the vet saying that Guinness’ phosphate level was low and to please bring him back. They gave us some phosphate supplements to give him every day and tomorrow we will take him back for a sterile urine test. Other than the phosphate, all of his blood work, including viruses and infections, has come back normal. The vet is concerned about diabetes, but he’s only two and doesn’t seem to be symptomatic, so who knows.

Hopefully we will have some answers tomorrow.

Catholics and IVF

Sorry for the short notice. Tomorrow (Monday), The American Fertility Association is hosting a “webinar” on Catholics and IVF.

From The American Fertility Association website:
“Catholics and IVF: A Pastoral Approach
Are you a Roman Catholic or married to one and considering IVF or other forms of ART for your family? Does the Roman Catholic Church’s position raise concerns regarding your decision?

This webinar will help prepare Catholics who are considering IVF / ART or have a child born as a result of IVF / ART to have a productive and respectful conversation with their pastors from the perspective of their lived experiences. The guest speaker will be a pastoral representative”.

It is scheduled for 1pm, Eastern standard time. For more information, click here.

Thursday, December 3, 2009

I am both shocked and thrilled…

to announce that the baby has a heartbeat! It’s measuring at 6 weeks 5 days versus the actual 7 weeks, but the nurse wasn’t concerned. I’ll have another ultrasound in 10 days and we should be able to see more.

Until then….


Due to all of the other issues, one of the REs recommended that I increase the Crinone gel (progesterone) from two to three times a day. Ack. We also discussed doing additional intralipid infusions, which was to be discussed with yet another RE this afternoon.

The nurse just rang and said that the doctor thinks it’s a good idea to do more intralipids. Lucky for me they are now available at the clinic, so no need to drive to the complete opposite side of Dublin. I’m also supposed to continue to rest and relax.

In other news, the RE also wants me to switch from Crinone gel to progesterone in oil injections. I’ve not done those before because the progesterone in oil (PIO) available in Minsk was made with peanut oil. Since I have a life-threatening allergy to peanuts, I had to use Crinone. I’m less than thrilled about doing PIO IM shots every day, but honestly, I will do ANYTHING at this point to keep this pregnancy, so PIO it is. If any of you have helpful tips and tricks for PIO shots, please share.

Thank you again for all of the kind words, thoughts and prayers. We still have a long, long way to go.

Tuesday, December 1, 2009

cramping, spotting, and now bleeding

All of the things I promised to do (emails, reviews, blog posts) have not been accomplished. Instead my body decided to betray me again, and yesterday I started bleeding. It slowed down overnight, but has started again today. I’m trying to do all of the things that I’m supposed to do, relax, feet up, but I’m just so sad and frustrated.

The paperwork from the clinic stated that I should take a home pregnancy test every week. It had been well over a week since I last tested, so I took it this morning. Positive. Of course it means absolutely nothing since I would obviously still have HCG in my system regardless of what is happening. I thought about calling the clinic and going in for an ultrasound, but I’m already on the schedule for Thursday and it seems pointless to make an extra trip. I wish I were here to give a happier update. For now I’m just waiting, and cramping, and spotting, and bleeding.

Sunday, November 29, 2009

not much to update

Sorry I haven’t been around much. Honestly there isn’t much to say. My life consists of waiting, spotting, and cramping. I’m sick of it and I’m sure you’re sick of reading about it, so I haven’t been posting. The ultrasound is still scheduled for Thursday and the anxiety about what we will be told at the appointment is unreal.

We had a nice, quiet Thanksgiving. We’d been invited several places, but since I’m still on house quarantine decided it was best to stay home. We invited a few people over and kept it small. As of this afternoon, the tree is up and the house is decorated for Christmas. I even managed to wrap a few of my husband’s gifts. The weather has been perfect for staying indoors, decorating, wrapping, and drinking hot chocolate. It’s been raining, windy, and cold, not cold enough to snow, but cold.

Hopefully I’ll have something more substantial to post about tomorrow. I still plan to do some infertility related book and podcast reviews. I also have a few minor things to vent about, so stay tuned.

PS- If you’re one of the many people waiting for an email from me, I’m hoping to catch up tomorrow. I feel like a bad friend, cousin, member of blog land etc, and I have no excuse for not being more timely about returning email, so please accept my apology.

Tuesday, November 24, 2009

I wonder

I wonder what it’s like to see a positive home pregnancy test and feel nothing but joy, instead of some joy and a lot of fear

I wonder what it’s like to use the bathroom without worrying that this is the time you will learn that the pregnancy is over

I wonder what it’s like to feel “safe” enough to start reading the dozens of pregnancy books you own

I wonder what it’s like to not let the tiny amount of caffeine in a decaf latte make you crazy with dread

I wonder what it’s like to not play games with yourself regarding every decision you make throughout the day. Games like, I better not open the next box of Crinone, because I might not need it tomorrow. Or I better not open the next bag of syringes, because I might not need those either

I wonder what it’s like to order the much needed maternity pants without fear of having to return them unused

I wonder what it’s like to feel excitement over a very much wanted and planned for pregnancy, though know that you can’t because in just days, if not hours, it could be stolen from you again

I wonder what it’s like to research nursery furniture, instead of researching how many intralipid infusions it takes to keep your body from once again killing your baby

I wonder what it’s like to have two consecutive hours of no cramping or spotting

I wonder what it’s like

Tuesday update- internet, phones, and cats, oh my

The repairman from the phone/ internet company was here this morning. He repaired the internet (HUGE sigh of relief) and one phone line. According to him, the other phone line and alarm are not his company’s problem, which I agree with, though it isn’t helpful to hear. Now we go back to the housing department, security experts, electricians, etc, etc, etc. I mean really, we’ve only been here 15 months. Clearly that length of time and over 20 appointments isn’t enough to have this resolved (insert sarcasm). And so the aggravation continues, but for today, I have the internet again. Hooray!!!!

In other news, Guinness decided that it was time to wake up at 3:30 this morning. There was a lot of running up and down the stairs, meowing, and overall whining about the difficulties of his feline life. I finally went to get him, told him it was time to close his eyes and go to sleep (yes, I talk to the cats), and he curled up to go to sleep. Enter Bella. Within seconds of Guinness showing signs that he had calmed down and was going to sleep, Bella came in, so Guinness leapt off the bed and the chase (up and down the stairs) began. They finally settled down around 5. Of course it’s now 4pm and they are comfortably snoozing next to each other. Must be nice.

Sunday, November 22, 2009

long, overdue post (immune issues)

A few weeks ago, I promised to do a post regarding my immune issues. Since we are staring up another round of IComLeavWe and might have a few guests visiting the blog, I thought this would be a grand opportunity to give the rundown and a bit of history.

It all started many, many, many years ago when I was diagnosed with a thyroid disorder (hypothyroidism). It wasn’t a huge surprise as several of my female relatives also have thyroid issues. After many years of trying to regulate my thyroid, I seem to have found the trick. Though again, this was years of blood draws, trying different medications, different dosages, moving to Germany and being put on the local stuff (nightmare), all mixed in with a few health care providers trying to save me a dime and ordering the generic. Trust me, spend the extra money for brand name, thyroid meds. Your body will thank you.

Jump ahead and the thyroid is FINALLY sorted out. We arrived in Minsk, Belarus in 2007, already knowing that we had a fertility issue (three years of perfect, NFP charts tend to clue one in to these things) and decided to have some testing done.

The initial blood work was as close to perfect as could be, with one exception, that darn thyroid. Even though my TSH was spot on at around 1, the Anti-TireoPeroxidase was 550.80, with a reference range of 0-34. This immediately clued everyone in that this was very likely an auto-immune thyroid issue and got me sent to the endocrinologist for a thyroid ultrasound. Once again, I was not at all surprised by hearing “auto-immune disorder” because well, my relatives have a ton of those, too. The ultrasound showed that my thyroid is 67% of the normal size and will continue to shrink. Definitely auto-immune, commonly called Hashimoto’s Thyroiditis.

So there we were, quite a bit of time trying by this point, a diagnosed auto-immune issue, a lot of blood work, an HSG, a semen analysis, and a handful of REs (both in Minsk and consulted in the U.S.) telling us that IVF was our best bet, actually our only bet.

Researcher by nature with a medical background, I read medical journals, studies, books, consulted with the experts, etc. etc.. My goal was to have the first IVF supplemented with baby aspirin, steroids, and heparin. Unfortunately my RE in Belarus was uncomfortable using heparin injections until I had experienced three losses. Disappointed is an understatement, but what could I do. Anyway, we did the first IVF with the standards meds, baby aspirin, and a steroid called Medrol. I did conceive triplets, but we lost them fairly early. We went on to do a FET (frozen embryo transfer), but those two never even implanted. And then we had the great political fiasco of 2008 and left the country.

Enter Dublin. I found a great clinic, great doctor, and had a great consultation. After reviewing all of my paperwork he firmly believes that I lost the triplets due to immune issues and my system attacking/ killing them, so I was referred for additional immune testing, first to France, then to Chicago.

Those tests indicated that I have Anti-Thyroid Antibodies, Anti-Nuclear Antibodies, elevated CD 19+5 cytokines, and the Natural Killer Assay numbers dropped considerably when IVIG was introduced.

So the new protocol was set for the standard IVF meds, baby aspirin, prednisone,heparin injections twice a day, and intralipid infusions.

And now you know more about my medical history than you EVER wanted to. There is still a long way to go, but I am now a firm believer in reproductive immunology and the use of intralipid therapy in patients with identified immune issues. I’ll continue to update the blog with resources on this topic that you might find helpful.

More information about intralipids.

reason 1,582 that you should always check with your wife

A department that is also in the building in which my husband works recently had a raffle for a few American items. The items included a can of pumpkin, a bag of chocolate chips, a box of cake mix, and a container of Cool Whip. A mass email had been sent out which I ignored because we don’t need any of these things, particularly the Cool Whip (I'm not a fan of fake food).

Upon returning from work that evening, my dear husband announced that he had bid on the raffle. “How much?” was my first question. Answer, “21 Euros.” Ladies and gentlemen, that is $31. Next question, “Why?” Answer, “We need the pumpkin for Thanksgiving.”

Trying to remain calm I informed him that being the resourceful wife that I am, I had already procured a can of pumpkin for Thanksgiving, and paid all of €3.49 for it.

So yeah, I spent the next few days hoping that we didn’t win the raffle. No such luck. He came home on Thursday with our “prizes” in hand. Fortunately the raffle money went to a good cause, but men, there is a lesson here. Just run things past your wife, it will make life so much easier, and less expensive.

no internet, no phone, but a lot of annoyance

On Friday afternoon I had my third intralipid infusion. I had a great nurse once again. The infusion was easy enough; just like the others, paperwork, vitals, infusion, done.

My husband had some work to do Friday night so I was looking forward to an evening alone (with the cats), catching up the blog, chatting away on a few message boards I belong to, and overall, relaxing.

Everything was going well until around 4pm when the internet went down. I tried all of the tricks, unplugging modems, disconnecting, reconnecting, restarting my laptop, turning on the wireless, turning off the wireless. NOTHING worked. We are paying for the “business plus” plan for our home internet usage and yes, I expect it to work.

At approximately 5pm my cell phone rang. It was my husband calling to find out what was wrong with the house phone. Err, nothing? Nope, I spoke too soon. Sure enough, the house phone is dead AGAIN. Our house phone lines have been down more than they have worked in the past 15 months. The irritation I experience with this house is UNBELIEVABLE. Constant plumbing, electrical, and appliance issues. I won’t even go down the list of cosmetic issues our overpriced, fancy schmancy, Ballsbridge address has. If I weren’t living it, I wouldn’t believe it.

I will save all of the things I have to say about the house until we leave Dublin, but let’s just say, the list is long, very long.

Fortunately my husband took pity on me and brought home a device that I can plug into my laptop to access the internet. It’s slow, but slow internet is better than no internet. The internet/ phone company promised to repair the lines within four business days. They are blaming the problem on the weather, but given that our neighbors all have working internet connections, I’m not convinced.

Wednesday, November 18, 2009

more cramping, more spotting, and more blood work

Today I had an appointment with my GP for blood work. I asked him to do a TSH (thyroid) and another beta. We briefly discussed high-risk obs in the area, though I’m not ready to book anything until a lot more time has passed. He said that they take limited numbers of patients and fill up fast, but I’m just not comfortable moving forward and won’t be for many more weeks. He also said it would take a day or two to get the beta results back. Torture.

As I was paying the bill (€90/ $135USD for a TSH and HCG, grrrr) the receptionist said that she would watch for the results and call me as soon as she received them. I still thought I would be waiting until Thursday or Friday.

Well, she just called.

Beta is 2,520. I’m still pregnant.

The cramping and spotting continue. I’m still on orders from both the fertility clinic and now my GP to relax and keep my feet up, but for now, I’m still pregnant. I even had two minutes of believing that this is real and finally booked the first ultrasound, December 3. I’ll go in earlier if there is a major problem, but by Dec 3, we should be able to hear a heartbeat if there is one.

In other news, none of my pants fit. As I’ve mentioned before, I was still carrying around extra weight from the first IVF, add in meds from the FET, then meds from another IVF= nothing fits. I’m really tempted to order a pair, or two, of pants from the U.S. (they would take a few weeks to get here), but I fear that by the time anything would arrive, this will all be over.

Ah, to be fertile and ignorant, or at least infertile in the U.S. with a few good stores in the neighborhood ;)

Monday, November 16, 2009

quick weekend recap (not very exciting)

I’m still on house quarantine, so weekends are not very exiting around here. I did insist that my husband walk over to the International Charity Bazaar and have a margarita on my behalf. He also had lunch, a glass of wine, did some shopping, and visited with several friends; all while I laid on the couch and worried. Just kidding, I’m glad he had fun.

We were without a dishwasher throughout the weekend (since last Monday to be exact), but as of this afternoon, it’s repaired, I hope.

While we were living in Berlin, we were asked to move from house A to house B, a move we welcomed. Unfortunately the movers smashed in the front of my slow cooker, though it still worked, so I didn’t say anything. The appliance finally died (due to it’s injury? I’m not sure), so I ordered another one. It arrived on Friday, so I made a roast yesterday. I had planned to throw the broken slow cooker away, but there are a few people who would like to attempt to “fix it” first, so I’ll keep it around for now.



the broken slow cooker


The cramping continues. I have minutes of feeling okay, start to have hope, and then the cramping starts again. Since I have numerous pregnancy tests around, I decided to test again yesterday, stupid, I know. Obviously if I had HCG in my system on Friday, regardless of what is happening now, there is still enough to result in a positive home pregnancy test. Anyway, still positive, still cramping, still occasionally spotting, and still scared to death.


I made an appointment with my GP this week. I need to have a repeat TSH (thyroid) test, and might as well have him draw a beta, too. I’ll let you know, one way or the other.

Friday, November 13, 2009

beta #2 is in

148! It doubled. Huge sigh of relief.

The conversation with the nurse was brief (it was the same nurse who told me that it was too early to do a beta on Wednesday). She asked if I had enough meds for the next few weeks, said she would get a referral in for another intralipid infusion, and told me to rest.

I’m still terrified because again, we’ve been this far before, but it’s a start.

International Charity Bazaar

If you are in Dublin and looking for something to do this weekend, check out the 4th Annual International Charity Bazaar at the D4 Hotel in Ballsbridge, Sunday, November 15, 11am-4pm.

Once again, over 40 embassies have come together to raise money for charities in Ireland and elsewhere around the world. Enjoy crafts, food, and drink from all over the globe, a great way to spend the afternoon and help raise money for a good cause. Entrance is just €2 and raffle tickets are available for sale. The prizes are fantastic, numerous trips, gifts, wine, etc..

We attended last year and had a fabulous time. Enjoy!

For more information and a list of prizes, click here

back from the clinic ::waiting, waiting, waiting::

I went back to the clinic this morning for another beta. You know you are a regular when you don't have to check in. The receptionist just buzzes you in after seeing that you've wiped down with the hand sanitizer at the entrance; then as you approach the desk, she says good morning to you by name and tells you to wait upstairs. sigh.

One of my favorite nurses called me back for the blood draw. We discussed the ongoing cramping, and now little bit of spotting :( She said the only thing to do is relax and rest; it could go either way at this point and I'm too early to scan, which I knew. She also said that she worked in a regular ob office for many years before joining the fertility clinic and understands that these pregnancies are “precious.” I assume that was a nice way of saying that IVF patients are an overly anxious, nervous bunch of crazies.

She gave me a little hug as we left and promised to call this afternoon, good news or bad.

Wednesday, November 11, 2009

the nurse called with the first beta

60!

I'm still cramping :( She said that I'm to rest on the couch or in bed, feet up and they will see me on Friday. She stressed that it's still very early, then told me to have a nice evening and called me "love". The Irish are so sweet :)

While I'm glad that we have a decent number, I can't help but be terrified, too. We've gotten this far before only to be devastated.

Anyway, tonight I'm at 60 and I'll take it.

waiting, waiting, waiting

On Sunday I had decided that I’d had enough rest and decided to get back to my normal routine. Bad idea. By Sunday evening I was cramping, a lot, which carried over into Monday.

Monday was a bad day. I received an email that the security team would be here “November 9, Tuesday” ?? to check the alarm. First of all, I was really looking forward to a day alone, possibly a day to rest. Also, last time the security team was here to check the alarm, the phone system was down for four months. Numerous appointments later with the security team, phone company, and electricians, the phones are working again, but I was not looking forward to a repeat. I think I was most frustrated with the email, were they coming Monday November 9 or Tuesday November 10.

On top of that, the dishwasher stopped working, again. I tried running it three times, three different settings, nothing. By dinner time I had yet to hear anything from the security team, had an entire dishwasher of dishes to wash by hand, but was still cramping. Oh, and did I mention there is ANOTHER leak under the kitchen sink and in the powder room?

Then my husband came home from work and informed me that our local grocery stores would not be receiving turkeys until the first week of December. Fine unless you are American wanting to celebrate Thanksgiving the end of November. Apparently turkeys can be ordered through local butchers; yeah, like that won’t cost a small fortune. And so the cramping continued.

As we sat down to dinner, my husband noticed that Guinness was not in his usual spot, begging for people food. Sure enough, the cat was in the foyer getting violently ill on the new door mat. Fabulous. Cleaned up the cat and the foyer, more cramps.

I finally crawled into bed and cried myself to sleep. I knew it was over. I decided to test Tuesday morning just to prove it to myself. It had been 15 days since the HCG trigger shot, no chance it was still in my system, therefore no chance of a false positive.

Tuesday morning I was up early (not that I had slept) and tested.

Much to my surprise


Yeah, pregnant. I showed the test to my husband and unlike the reaction that most couples have to such news, we just gave each other a look of “well, here we go again”, and that was that. Infertility and a previous miscarriage steal the joy that a positive pregnancy test means that you’ll actually still be pregnant the following week, the following month, or even that you might eventually have a live baby. And the cramps continued.

This morning I decided I was done. I had to know one way or the other so I called the clinic to schedule a beta (not routinely done here, a rant for another post). The nurse I spoke to was less than enthusiastic about me coming in so early, though agreed that it was definitely not leftover HCG in my system from the trigger shot.

The receptionist was very nice and agreed to get me in ASAP even though they were “double booked” today. She said to expect a long wait. I held it together until we were sitting on the couch in the waiting area upstairs. I saw my doctor come in to get another couple and lost it. Fortunately within two minutes a nurse called my name. (Crying patients in the waiting area can’t be good for business). The nurse was lovely, talked to us for a few minutes, then insisted she find someone to speak with us after the blood draw, which I told her wasn’t necessary.

She took the blood, flipped through my chart, and asked about my history. I told her about the triplets and the failed FET. She was awesome, completely awesome. She didn’t make me feel like a complete loon for being as scared and nervous as I was. She also said the cramps could be implantation cramps. WHAT? This feels more like, ‘my period is going to start any second’ type of cramps. Through the tears I told her that I never had cramping with the triplets and I lost them, so I can only imagine what cramps mean. Nope, she insisted, it was likely implantation cramps.

Another nurse will call this afternoon with the beta result and I have a second appointment on Friday. I was sent home with strict orders of “couch rest, tv, and chocolate”.

So now, I’m waiting, waiting, waiting……

PS- I’m not sure what to think of it, but every time I’ve been on the couch since the transfer, Guinness is sprawled across my stomach. Maybe he knows something is going on in there. Keep snuggling little buddy.

Sunday, November 8, 2009

intralipids

I had a few extra minutes this afternoon, so I thought I would post some information about intralipids, as this is a topic that has been mentioned several times on the blog.

My reproductive immunologist had given me a packet of information on reproductive immunology and immune therapy. The section on intralipids follows::

"Intralipid
Evidence from both animal and human studies suggest that intralipid administered intravenously may enhance implantation. Intralipid is a 20% intravenous fat emulsion used routinely as a source of fat and calories for patients requiring parental nutrition. It is composed of 10% soybean oil, 1.2% egg yolk phospholipids, 2.25% gylcerine and water. Intralipid stimulated the immune system to remove “danger signals” that can lead to pregnancy loss. The appeal of Intralipid lies in the fact that it is relatively inexpensive and is not a blood product".

Most clinics, including the famous SIRM clinics/ Sher Institutes in the U.S., have replaced IVIG therapy with intralipids because they have been proven to be as effective, but as noted, are less expensive and are not a blood product. I was told that IVIG is approximately $4,000 per infusion, and I’m paying $400 per intralipid infusion, so it’s a considerable difference in price.

For more information, I would recommend the book, “Is Your Body Baby Friendly”, by Dr. Alan Beer. The book is a few years old and focuses largely on IVIG, which as stated, has been replaced at most programs with intralipids. I particularly enjoyed this book because the author acknowledged that reproductive immunology is still a new field and misunderstood by many of his colleagues. Over half of the book is notes, excerpts from medical journals, and studies; fabulous for someone like me who likes to know where an author is getting information.

Later this week I’ll go through my notes and medical records and do a blog post about my specific immune diagnosis and the ramifications of it, but for today, I just wanted to give a rough overview of intralipids and a few resources.

I’ve also decided that it’s about time I start going through the many infertility podcasts and books that I have. The blog will be a good push to do that, so beginning next week, I’ll do a weekly review of a podcast or book that might be of interest. Stay tuned.

Here are a few additional links to reproductive immunology websites:

The Alan E. Beer Center for Reproductive Immunology & Genetics

Rosalind Franklin University of Medicine & Science Clinical Immunology Laboratory
(Rosalind Franklin University in Chicago did the majority of my immune testing)

Reproductive Immunology Associates

Reproductive Immunology Associates Lab Studies

If you click on the individual tests on the websites, they give more information about the testing process and significance of elevated results.

Friday, November 6, 2009

second intralipid infusion

I had the second intralipid infusion this afternoon. It was very much like the first, check vitals, mix intralipids with saline, start IV, start drip, check vitals throughout, done. We were in and out in under two hours.

If all goes well, I’ll go back for another infusion in a few weeks.



Wednesday, November 4, 2009

our little fighters

Apparently we have a couple of little fighters. We had basically given up on the two slower embryos after speaking with the embryologist yesterday before transfer. She said that they weren’t growing as they should be and probably wouldn’t make it to freeze.

Imagine our surprise when she called today to let us know that they were both doing well, they look strong, and they were able to be frozen.

We are thrilled!

Tuesday, November 3, 2009

bad news, good news, and a sixth RE

We arrived at the clinic and while sitting in the waiting room, my fabulous nurse stopped to say hello. We had a lovely chat about the embryos and she assured my husband that they wouldn’t transfer all four, lots of smiles and laughs. Then RE #4 stopped to say hello. It’s nice to see familiar faces and know that so many people are cheering us on.

Finally it was time to go to the IVF suite. I changed and was put in the same bed that I had for retrieval. The nurse took us back to the operating theatre where we were met by the OR nurse I had last Thursday. She did a quick scan and then the embryologist came to speak with us. The good news was that we had two beautiful blastocysts; the bad news was that the other two embryos weren’t growing as quickly. They will be watched over the next day to see if they catch up and can be frozen, but things aren’t looking good :(

I was supposed to have the same doctor do the transfer as had done the retrieval, and I’m not sure what happened, but enter RE #6. She was very nice and best of all, my husband was actually in the room for this transfer, unlike IVF #1 and the FET. The OR nurse was really sweet and made sure that he could see the transfer on the ultrasound screen, even playing it back so that I could see it too.

A few minutes later I was dressed and ready to go. In Minsk they made me stay in the OR and recovery for two hours; going home right away seemed a bit rushed, though I have to trust that all is well. The nurse went over the discharge papers, instructions, wished us luck, and off we went. We are home now and I’ve started the dreaded 72 hours of modified bed rest. Friday I have an appointment for another intralipid infusion.

Considering that we aren't caught in the middle of a diplomatic spat with another country during this IVF, I expect the next 10-14 days to be fairly boring. Just hoping and praying that two little blastocysts are adjusting well to their new home.

Monday, November 2, 2009

transfer is scheduled!

The embryologist just called with the Monday evening highlights. As you might remember from my previous post, we had four embryos as of Friday night. They like to see 20% make it this far. We have 100%. Yes, we still have FOUR growing embryos. None of them are at blastocyst stage yet, but hopefully by tomorrow we will have at least two. The embryologist said that they are “amazed” that we still have four and they are all compacting nicely. If, big if, we have four healthy blastocysts tomorrow, they will transfer two, freeze two. If we have two blastocysts and one that isn’t doing well, the RE that did my retrieval suggested transferring three.

Thank you all for your comments, thoughts, and prayers. It means so much to me. I’ll update tomorrow when I get home.

Friday, October 30, 2009

The embryologist just called!!!

We have four "beautiful" embryos!! They will be watched through the weekend and if all goes well, we will get another call on Monday night and have transfer on Tuesday. The embryologist was really sweet and also very informative about what had been happening in the lab. She kept referring to them as "beautiful." Yay! She did say that she has my chart in front of her and knows of our previous cycles and losses, so to be realistic about all of them hanging on until Tuesday. She also said that each one of them is "very precious" to the clinic, as they are to us. It was amazing. She kept saying "precious", not in a 'our clinic likes good results' type of way, but in a 'these are your miracles and we care for them, too' kind of way. We are very happy!

I hope you all have a great weekend!

Thursday, October 29, 2009

egg retrieval: a little midazolam, a little morphine, and a little nap

Warning, I’m still a little out of it.

We arrived at the clinic this morning and while waiting in the waiting lounge upstairs, my fabulous nurse came in to wish us luck. She wasn’t going to be with me during the procedure, but said that she would stop by recovery to check on me.

At 8am, I took a few Solpadeine (codeine) tablets as directed. Then another great nurse I’ve worked with before came to take us down to the IVF suite. I chose a bed, changed into the lovely paper gown, and met the RE who would be doing the egg retrieval. He spent A LOT of time with us. We went over my history, the legal documents we had signed (in case we have frozen embryos), and the plan of action. He said he was impressed that we had filled out all 28ish pages of paperwork correctly and said that it was obvious that we had put a lot of thought into our decisions.

I asked what meds he would be using for anesthesia and we discussed my anesthesia background. I guess most patients aren’t as interested in discussing drugs as I am ;) He said he would be using a small dose of Midazolam and Morphine because I was “slender”. Then I got nervous. Um, did he not see the extra 35 pounds from two IVF cycles, or my prednisone induced fat face? I laughed and said that I am in no way “slender” at this point. Anyway, he made my day with that comment. After speaking with him, the embryologist came in to talk with us and check, double check, then triple check paperwork, names, birth dates, and my patient id.

Finally it was time. I walked into the operating theatre, hopped up on the bed, and the RE started my IV. The nurse again verified my id, then another nurse opened a window directly into the embryology lab and again, names, birth dates, patient number, etc was reviewed between me, the two nurses, the RE, and the embryologist. Very thorough. As soon as the leads were placed, I was out.

I don’t remember anything until I woke up in recovery. The RE came in and told me the number of eggs retrieved, then the nurse told me to go back to sleep and said she would go get my husband. For the next three hours they monitored my vitals and I slept. I decided it was time to leave and got dressed. Just then my fabulous nurse came to visit and said she would try to see me next week for transfer.

The RE stopped by again to discuss the egg retrieval with both of us. The total count was 7 eggs, and all from the left side. Just like my first egg retrieval in Minsk, he didn’t even bother with the right side. The embryologist will call us tomorrow afternoon to discuss the fertilization report.

I am home now and for some reason, a lot more tired and groggy than I was for my first retrieval in Belarus, and I had a general for that, so I’m not sure where this is coming from. If you’ve made it this far into my midazolam, morphine clouded thoughts, congrats. As of tonight, I’m back on prednisone, baby aspirin, and heparin injections.

Final count, 7 eggs.





Wednesday, October 28, 2009

triggered last night and warning: picture

I was too tired to update the blog after my trigger shot last night. We are all set for egg retrieval tomorrow morning. Today I'm taking it easy and being grateful for an injection free day :) Thank you for all of your kind words, thoughts, and prayers.

HCG


last picture of medical waste


last stomach picture

Monday, October 26, 2009

did somebody call for a fifth RE?

With the anticipated traffic nightmare, and a very stressed out wife, my husband had the wonderful idea to take a walk this morning and speak to the Garda (local police) in our neighborhood. He told them that I had a medical appointment and asked if there was any way to bypass the marathon route. The Garda told him that if we left early enough that we should be able to get out. My husband was also told to be gone at least six hours and that we shouldn’t have a problem getting back in. We hopped in the car and several detours, one hour and twice explaining the situation to the Garda at roadblocks, we arrived at the clinic.

The drive home was LONG. Several detours, lots of traffic, and a few Garda to talk to. Fortunately neither on the way to the clinic nor on the way home did the Garda ask for ID or want to play 20 questions with us like they seemed to do with the other cars. I’m not sure if it was our dip plates or the massive amount of hormones I was emitting, but the Garda let us through and six hours after starting out we are finally home, relatively unscathed.


The appointment:

The RE that specializes in missing right ovaries did my scan again. She said that my lining is “brilliant” and when describing the left ovary and its 8 or 9 follicles, used the words “excellent” and “very good.” We won’t talk about the right ovary and the failure that it is.

I’m officially on the surgical schedule for egg retrieval on Thursday. All was going well until I asked if my RE would be doing the retrieval. Answer, no. I’m not thrilled with this news, however, the doctor doing the retrieval is the RE that I almost chose for our initial consult, so hopefully he will live up to his fabulous reputation. So yes, I'm now onto RE #5 in Dublin.

Sunday, October 25, 2009

getting worried and feeling trapped

So as it’s getting closer to the end, the little, or not so little things are starting to bother me. Tomorrow is an Irish bank holiday, which means most businesses are closed, but I have a monitoring appointment.

1. I only have one box of Luveris left and it will be used tonight. What if I need another day or two of Luveris? I don’t think any pharmacies are open tomorrow. Grrr

2. I made the mistake of reading a couple of the Irish infertility message boards and there are several comments about my clinic and the doctors people prefer. Everyone has a different personality and finds the best fit, no big deal. However, the more I read, the more it sounds like the RE that people initially consult with isn’t necessarily the RE that does egg retrieval or embryo transfer. WHAT? So yes, I’m having a minor freak out today and will likely have a list of questions for the RE doing my scan tomorrow. I hate being “that” patient, but I really want to know what the plan is. I put a lot of time and thought into choosing the doctor we initially consulted with and that is whom I would like to work with. ::bites nails::

3. Tomorrow of all days is the Dublin Marathon. Not a problem right, I’m not running in it. Oh, but there is a problem. Not only is the marathon path down the main street in our neighborhood, separating the main road to our gated community from the side of the street that we need to be on to get to my monitoring appointment across town, but the more research we do, the more it appears we really are trapped tomorrow. We’re still trying to figure out what to do about this. Cross the street, walk a few blocks, and call a taxi? Park at a friend’s house in another neighborhood?

After closer inspection the marathon route actually has our entire neighborhood surrounded, like a prison. Several panicked phone calls to local friends later, we are being informed to take buses, trains, taxis, anything but trying to drive ourselves. Ack

If I can figure out how to add a map of the marathon route, I will. I have a feeling that a good portion of Dublin is going to be standing still due to the traffic nightmare that will occur tomorrow.

Law & Order SVU fail

Our cable is not very reliable, as in there seems to be no rhyme or reason to the schedule or programs shown. Once in awhile, we are lucky enough to catch an episode of Law & Order, a personal favorite.

I was thrilled to come across an episode of Law & Order SVU last night, only to find that it was about stolen embryos. Eep, not what I need to watch just days away from egg retrieval. Of course I realize that the L & O story line is fairly far fetched, but still. I also know that I shouldn’t have watched it, but it was one of those things I just couldn’t pull myself away from. Plus, it’s not like a get the opportunity to watch L & O very often. The episode itself was okay, not great, but okay. However, I thought I was going to come unglued every time they said that they were going to “implant” embryos versus “transferring” them. That my friends is infertility 101. Embryos are not implanted, they are transferred. One would think that with the amount of media attention, good and bad, that IVF has received in the past decade, reporters and writers would catch on, but no. RAGE

day 7 and 8 of injections Warning: bloated, black and blue, stomach pictures

As I’ve mentioned before, I never lost the 20 pounds from the first IVF. Say hello to another 15 pounds of bloat. Ack.

day 7


day 8


the rubbish bin

Friday, October 23, 2009

first intralipid appointment

We drove across Dublin and found parking in what could possibly be the tightest parking garage I have ever seen. Not fun in an SUV. I checked in at the clinic and was quickly greeted by a very kind nurse. She took me back to a room and went over the consents, side effects, etc. and took vitals. Another nice nurse came into the room and went to work. They had me sit in large recliner, put my feet up, and after a bit of searching, inserted the iv into my wrist. One of them brought my husband in and the four of us hung out for a little less than two hours. Every 15 minutes or so one of the nurses would check my vitals and adjust the flow rate of the intralipids. Other than having to sit still, it wasn’t that bad. I’ve been a bit dizzy since I finished and I was told to expect some minor side effects, particularly drowsiness. I go back to the clinic in two weeks for a second infusion.

On a very positive note, while I was chatting with the nurses, one mentioned the name of my clinic. That lead to a discussion of various infertility clinics around Ireland, particularly those in Dublin. Both nurses said that I was at by far the best clinic and seeing the best doctors, so I’m feeling very good about this. Of course as anyone who has gone through infertility knows, this is a roller coaster, so I'm sure the positive feeling will turn into doubt at some point in the next few hours ;)

The intralipids are mixed into a bag of normal saline fluid for infusion. The bag of intralipids was a thick, paste like substance, but once mixed with the saline, it looked more like non-fat milk.




all done

CD 8 appointment and a new med

As luck would have it, my husband’s department decided to close early today and have a happy hour. Being the wise man that he is, he chose to instead accompany me to both appointments and go into the office later this afternoon to work.

At the first appointment, the doctor who specializes in finding right ovaries did just that. She located my right ovary only to announce that it was small and had one lousy follicle. However the left side has seven growing follicles and my lining is great. She added a new medication, Orgalutran, or Ganirelix as it’s known in the U.S. This means I will be getting five injections per day instead of four. She said that if everything goes well at the scan on Monday, I’ll have egg retrieval on Wednesday or Thursday. She took blood for an estradiol level and we left.

Thursday, October 22, 2009

par for the course

While giving me the 7pm injections, my husband informed me that he probably wouldn’t be there for the intralipid appointment tomorrow. He was able to rearrange his schedule to be there for the scan, but not to go across town for the two-hour infusion.

Eh, par for the course, welcome to the foreign circus, such is my life, blah, blah, blah. Do I dream of him having a normal job in the U.S.? Yes. Did he miss out on almost every.single.part of the first IVF and FET in Minsk? Yep. He couldn’t even be there while I was under general anesthesia, nor was he there for transfer, nor was he there for the FET. This is my life, our life. The “powers that be” dictate his schedule and we just play along.

I’m not whining, really, I’m not. So many foreign-service spouses have had it so much worse than me. A good friend med-evacted with a second trimester miscarriage, her husband deemed too important to leave the country to be with his wife. Friends delivering babies in the U.S., their husbands on opposite sides of the world.

So yeah, going through IVF, or at least aspects of it, alone, not a big deal. Just another part of my life.

Thank goodness for taxis

Wednesday, October 21, 2009

CD 6 appointment

I just returned from my cycle day six appointment. As usual, the right ovary did not cooperate AT ALL. After 20 minutes of scanning and searching, the lovely nurse finally declared defeat and on Friday I will be scanned by the doctor who apparently specializes in finding missing right ovaries. Hrmph. It was actually somewhat amusing. The nurse asked if I’d ever had problems with the right ovary, to which my husband and I had to laugh before answering. OH YES. The right ovary that most people can’t find on ultrasound, the right ovary that my first RE in Dublin questioned the existence of, the right ovary that my RE in Minsk didn’t even bother with, including completely leaving it out of the fun during egg retrieval. That right ovary is nothing but trouble.

Oh well, my lining is fine and the left ovary shows two 10mm follicles, one 9mm follicle, and one 6mm follicle. Could be better, could be worse.

The plan is to drop from 450 IU to 300 IU of Follistim, continue with 75 of Luveris, twice a day heparin, baby aspirin, prednisone, etc, etc. On Friday I return to the clinic for another scan, then immediately go to another clinic for my first intralipid infusion. Hope this works!

Monday, October 19, 2009

1st, 2nd, and 3rd day of injections

Warning: bloated, black & blue stomach pics below. I've used all of the tricks I was taught in the OR to minimize bruises and irritation around the injection site, but it still happens.

So far, so good. My fabulous nurse thought I would run out of stomach area within the first few days, but I forgot to tell her that I have 20 plus pounds of weight from the first IVF around my stomach, so I should be good to go until later next week, lots of room to work with. Everything is going well and the heparin is leaving surprisingly small marks, minus the one Follistim injection. Yes, the big bruise is called when Follistim injector pen meets blood vessel. Eh, it happens.


am- heparin


pm- heparin, Follistim, and Luveris


day 1

day 2

day 3

The side effects are fairly minimal, though I'm only a few days in, so we’ll see. Follistim headaches are a joke compared to the Gonal-F that I was on the first time, and no dizziness either. Yay. Just a little bloating, a little weight gain, some irritability according to my husband ;), and I’ve been really tired. Other than that, nothing to report.

pomegranate and pineapple

It has come to my attention that pomegranate is supposed to be good for lining and pineapple is good for implantation. Interesting. Seeing that I’m willing to try, well, anything, and both pomegranate and pineapple are healthy, why not.

Enter, the pomegranate collection.


a fresh pomegranate
V8 Fruit & Carrot (pomegranate & cranberry flavor)
Fruitiser pomegranate & raspberry
Tesco pomegranate juice drink

Next week, coming to a blog near you, the pineapple collection

Thursday, October 15, 2009

accessories

Check out my new accessories.

These

are to go with

these

Yes, I had the first, big appointment today and I was THRILLED that my nurse was available. She did my scan, took blood from both of us for EU infectious disease screening, checked over all the meds, then gave me 2 bags of new accessories.

The scan was easy enough, and unlike Minsk, they actually put up a drape while you get undressed and have a drape for your lap. So fancy ;) Again, I had excellent care in Minsk and I have no regrets; things are just a bit more like the U.S. here. Anyway, had the scan and everything looks great. The EU bloods were fine though I’m still upset that we have to do them every month of treatment for the low price of €380, but it’s an EU law and we will obey. Fabulous nurse checked over the meds that were ordered from the U.S. and everything looks fine. Then we got the accessories, sharp’s containers, needles in different sizes, syringes in different sizes, Follistim pen, brochures, and alcohol wipes.

My wonderful nurse also did a brief lesson in drawing up the meds. I don’t think it will be a big deal because I remember so much of it from when I worked in anesthesia. Also between today’s lesson and the lesson in the embassy health unit, my husband will do just fine, though I might do some of the injections myself; we’ll see.

It sounds like the heparin will be the worst. Fabulous nurse said that particularly with the high dose I’m on, I will be bruised and with the other injections, I will quickly run out of room on my stomach for injections. We discussed other injection sites, not as pleasant as the stomach, but whatever works. I had black and blue bruising with the first IVF meds, but she said to expect black, blue, yellow, purple, orange, green, pink, and red. Hmm, a rainbow of bruising, should be interesting.

The big news is that I thought I was starting heparin and prednisone today or tomorrow and stims next week. Nope, I start tomorrow.

So the days will look like this

morning- thyroid meds, allergy meds, asthma meds, 5 tablets of prednisone, heparin injection

afternoon- prenatal vitamin, aspirin, folic acid, calcium

evening- allergy meds, calcium, heparin injection, Follistim injection, Luveris injection

Let the games begin!!!!

international pregnancy and infant loss remembrance day


Today is International Pregnancy and Infant Loss Remembrance Day. It is a day to remember all children lost through miscarriage, stillbirth, or in infancy. If you or someone you know have had this horrific experience, please light a candle at 7pm this evening (your local time). The idea is that if we all burn a candle for at least an hour, a chain of light will spread across the globe for 24 hours of honor and remembrance.

For more information visit:
Baby Loss Awareness Campaign
Remembering Our Babies

genuine, maple syrup

*the names of people and countries are omitted to protect the innocent and the guilty

Some time ago, we were informed that someone we know (and like very much) had contact with someone at another embassy and could get us genuine, maple syrup. Sweet! We handed over €9 about $13/14 for a bottle and waited. This week my husband brought the syrup home.

Kirkland Signature??

I looked at the bottle, looked at him and shrieked, “this is from Costco.” Sure enough our genuine, maple syrup is from Costco, and not only is it from Costco, it expired in July.

I’m sure it’s fine and we are definitely going to use it, but the real question is not why are unsuspecting, American diplomats being sold expired syrup from Costco. No, the real question is how is it that the other embassy has access to Costco from here and I don’t???

I think we’ll be having pancakes this weekend.

Tuesday, October 13, 2009

Honest Scrap award


Thanks to Circus Princess over at Circus Children for this award.

Rules: Reveal 10 things not previously known about you, and pass along the award to others.

I'm going to cheat and say that since two of the most difficult things I've ever dealt with are infertility and living overseas, if you've done either, consider yourself awarded with the Honest Scrap award.

list:
1. My husband proposed after knowing me for three weeks and two days.

2. My dream kitchen would have a hospital grade, ice nugget machine.

3. I gave up medical school to get married and follow my husband around the world.

4. My favorite place to be is in the OR, as a provider, not as a patient.

5. I’ve ordered the same drink at Starbucks for almost 15 years.

6. My favorite color is white, followed closely by light pink.

7. I’m a native of Washington state.

8. I’m a detail-oriented perfectionist to a fault.

9. My husband and I are both only children.

10. After living overseas without some of the comforts of home, I often dream of the house I plan to build some day and it *might* include a lazy river in the backyard.

phones are fixed, alarm is fixed, I wonder what will break next?

After the missed appointment last week, both the electrician and alarm specialist appeared at 9:45 for a 9am appointment. Whatever, I was just glad to see them both. Two hours of digging around in the phone lines and wiring, the electrician asked the alarm specialist if it could be xyz problem. The alarm specialist said that he had never seen xyz before and it would be “highly unusual.” I piped up and told them that with this house, look for “highly unusual.” Guess what? Yep, it was xyz problem.

Fortunately my instincts were spot on to have both the electrician and the alarm specialist here at the same time. Part of the alarm panel has a “tamper proof” system and can only be accessed by the alarm specialist, so yeah, good thing he was already here. The phones and alarm are now repaired and working, so the countdown begins to what breaks next.

IKEA Dublin



We finally did it, we made the trek over to IKEA. Actually we were just waiting for the initial crowds to die down after the store opened in July. There really wasn’t anything we “needed”, though I’m always happy to buy something ;) The Dublin store is basically like all of the others and almost identical to the store in Belfast. We had lunch, walked around, purchased a few items and headed home, a nice way to spend a few hours.

IKEA Dublin
St. Margaret's Road
Ballymun
Dublin 11

Douglas and Kaldi

On Sunday I thought it would be a good idea to introduce my husband to the mall. While we were there, we decided to grab lunch at a place recommended by a friend. The restaurant itself is a cute establishment, tucked back away from mall traffic. The food was good and the service fair, though certainly not fast, nor friendly. The atmosphere is nice, though tables are a bit crowded together. It’s also very family-friendly as evidenced by the number of small children and infants present.

While I can’t complain about the food or great menu, I doubt we will return any time soon. The service just wasn't at the level I expect, and while browsing other reviews, I've found that I'm not the only patron who feels this way. My understanding is that this is a fairly new location, so we might try it again next year.

I had the Californian salad. My husband had the smoked salmon crostini. Both were very good.

mixed aromatic greens with ham, avocado, pine nuts, tomatoes, pineapple, sweetcorn with a zesty vinaigrette dressing


toasted bagel layered with cream cheese, smoked salmon and scrambled egg with side salad