Call me “Patches”

Now that we know we’re pregnant, the “fun” hasn’t all finished for me.  Right now, I still have to do a shot of progesterone each night (more bruises). Joe has to administer those since they need to go above my rump (thus the black circles so he knows where to inject) And I’m wearing three patches of Estradiol.  Both are needed because my body isn’t naturally producing all of the necessary hormones yet. Some trickery is still needed to make sure the pregnancy is safe.

The shot I can deal with; it’s almost old hat by now.  But these patches are the pits!!  They’re itchy and sticky; they dry out my skin too.  Plus, I’m pretty sure they are causing some pretty bad cramping that, as luck would have it, all hit in the middle of the night (did I mention that I’m already exhausted at the end of each day?).  Fortunately, the patches are only needed for a few weeks, and then I will wean off them. But the wait for that seems interminable right now. I look like I’m trying to really, really quit smoking!

I guess this was just another one of the pieces that was included in the box o’ drugs that I was unprepared for, and am definitely not enjoying.

Let’s do shots – the “receiver’s” point of view

It wasn’t really the shots that ever made me react emotionally; it was really the quantity of what we were having to deal with.  Three shots every night for several days – that’s a lot!!  And the few times when we had to add a different type of needle into the process also made me nervous because I didn’t know if this new needle was actually going to hurt when the others hadn’t so far.  So the days of adding new injections were the hardest, but each one turned out just fine. None of the injections ever really hurt.  I’m just glad I don’t have any real problems with needles.

Here’s the schedule of what I like to call the “pin cushion days”:
1.  Ten days of Lupron injections.  This was to get everything to shut down so that I didn’t have a normal cycle.  Pretty easy stuff – small doses, small needle, really quick.  Maybe only a small bruise or two.  No problem.

2. Ten days of the serious stuff.  This was a combination of Lupron (to make sure the other hormones didn’t make my ovaries go out of control), a dose of low dose hormones and a dose of Gonal-F (another hormone).  The purpose of the second two hormones was to get the follicles in my ovaries to start growing, and to get more than one follicle growing at a time.  Each follicle has the potential to be home to one egg, and we were hoping to get as many eggs as possible.  

Now we were up to three shots every night, so a little strategy was involved.  I had to take turns in which thigh I would give two injections and the third always went in my belly.  Again, the needles were pretty small and the doses were completely manageable.  But every once in a while the angle of the injection (which I was giving myself) would be a little off and I’d end up with a pretty gnarly bruise (as shown in the picture of my thigh). Really nothing that hurt, but seeing that blood was sometimes just overwhelming and dropped a bomb of reality in my lap of everything I was having to do in this process, and it was hard to deal with.  Most of the time it was pretty straightforward to handle, but there were a few days when I just wanted it all to be over.

3. Finally, there was one injection – the trigger shot – required about 36 hours before the retrieval.  It was just one injection (which was a welcome break), but it was a very large dose.   I was already feeling pretty icky with everything that was going on inside, so I was a little nervous that this was just going to make me feel worse.  Another easy injection, and then it was just wait and see what happened at the retrieval.

One thing throughout all of these shots that has been so amazing is having Joe there to help.  As he’s mentioned, he’s had a ton of experience around needles and labs, so he was easily able to help put together every dose of every injection I had to take.  Not having to worry about making sure I was preparing the needles correctly, with the right amount of stuff, every night was a huge relief.  It allowed me to focus on just getting through the injections.  It really meant a lot to be able to rely on him for that part of the process.

Let’s do shots!

I’ll start this with just a bit of exposition.  Women normally release one mature egg/month.  It’s part of their monthly cycle.  “Normal” people get pregnant when one of the millions of sperm cells that are a part of every “normal” sexual experience meet that egg and they, well, get funky.  So the cramping and so forth that happens is the result of 1 (one) egg maturing.  In IVF, they supercharge the hormones – that’s what all the shots are for – in order to get a woman to produce several mature eggs at one time – at least 4-5 and hopefully double digits.  So imagine for a second the discomfort that comes along with a “normal” period that gets you one mature egg – multiply that by 10 eggs and you can imagine the discomfort that comes along with it.

Now.  Enough exposition.  Let’s do some narrative…  As I’ve said – I’m comfortable with needles.  I don’t love them per se, but they don’t bother me.  I’m also comfortable drawing up doses, double checking and delivering the drug.  For me the couple weeks of getting Jill primed and ready to produce a whole bunch of eggs at once was more about helping her – being a part of the routine, and trying to be supportive. 

I know it was a lot tougher for her.  Obviously.  She is not, and has never been, a scientist.  She has not dosed hundreds of subjects.  Spending as much time as I have in healthcare, treatment regimens like this are more familiar to me.  I imagine it was all incredibly invasive for her.  As an observer, it seemed like it was the anxiety before the shots that was the most difficult for her to deal with.  She was always wondering if she was “doing it right.”  Every once in a while she would bruise or there might be a bit of blood – things that were totally normal over the course of 2-3X/day needle sticks.  When it comes down to it though, none of this stuff was normal for her and I was definitely impressed with how she steadily plowed through it all.

Jill covers this subject (much better than I do) as well so I'll put her post up shortly.

As a note -- all of her posts will be in Blue font and mine will be in Black.  Unless, of course, we find a better system...

Box of drugs – the female version

“Holy man!”  That’s what I thought when I saw the size of the box that the drugs were delivered in.  I thought we were only talking about three different vials of hormones with a few needles provided. But this box could’ve held about 6 pairs of shoes.

And when we actually opened the box, it contained more than I was aware of or had ever been told about. I think that’s where most of my anxiety came from in considering this box.  I was prepared for the shots, but I had no idea what this other stuff was for, and I really wanted to make sure that we did everything right so that we got good results.  What if I missed something that the nurses told me?  I mean this box had three different types of injectible hormones, hormone “patches”, three bottles of pills, and four (yes, four) different types of needles.  It even came with a hazardous waste container.  And, we were still waiting for another injected hormone to arrive from another pharmacy company.

I was definitely excited about the process.  We’ve known that IVF was in our future for well over a year, and knowing that (as the person who would be on the receiving end of everything IVF included) had caused a bit of anxiety ever since. Most of the time, it wasn’t something I thought about.  But, now, here we were, ready to start this whole journey. No turning back!

This has been two years in the waiting, and I felt mentally prepared for the fact that this was going to be challenging both physically and emotionally.  It was just that the box took me off guard and took a while to get used to.  The thing that really helped make everything more manageable was the fact that these shots were only really going to last about 3 weeks, and I could certainly live with that.  And, of course, the results at the end could be what we’ve wanted so desperately for so long now.

Big 'Ole Box of Drugs

Having been raised in the US and being a fan of pop culture, I’ve seen my share of drug movies.  Thanks to Scarface, I’ve seen what a big ole pile of drugs looks like.  In addition, I’ve worked in the Pharma industry for nearly 10 years.  I’ve marketed drugs, measured drug levels in patients, studied how different people metabolize drugs, and I’ve even been in a couple clinical studies myself.  

With this background you would think I wouldn’t bat an eye at the box ‘o dope the fertility folks sent us a couple weeks ago (following us forking over nearly $3200) but I did.  It was impressive.  Looking at my wife and thinking that most or all of this was going to be given to her – the majority via needle injection – was pretty daunting.

I think the shock was worse for Jill – I’ve opened boxes full of needles before.  I did some animal testing in the past and I’ve dosed more than my share of lab rats with god-only-knows-what via injection.  For her, though, it had to be intimidating – all those needles, various solutions – I forget sometimes how foreign and, for the lack of a better word, scary it can be. 

Mostly though, this box of drugs represented all that thought and all that planning becoming reality.  We were starting IVF.  This involved handing over the money we had worked for.  This involved starting the meds and the shots every night.  This involved the potential for a baby 9-10 months down the road.  At the time, we were more focused on the procedure of it all – making sure we got the right amounts at the right time – that kind of stuff.  Now – only two weeks later the big picture has started to set it a bit more. 

From my current understanding, the differences between IVF and a traditional pregnancy start about 3 weeks before her egg and my sperm “do their thing” in a petri dish somewhere and continue until about 2 months after “conception.”  This initial round of drugs is used to generate a whole bunch of eggs (which I’ll get into more in my next post) which are collected and removed.  Obviously, in traditional pregnancies, fertilization happens internally (which is called in utero fertilization or just ‘plain ‘ole gettin’ knocked up’).  Then the petri dish dance party happens and they transfer the fertilized egg back into Jill.  Since this happens outside the body it’s called In Vitro, which in Latin means Within Glass.  Then the next round of drugs is used to get all the “you’re growing a baby” stuff happening – which is needed because since fertilization didn’t happen internally, Jill’s body wouldn’t know that it needed to get going.  After a couple months of jumpstarting, her body catches on and she goes off the meds and we basically transition over to a normal OB/GYN and it’s a “normal” pregnancy from that point on.

Please note I said normal pregnancy – NOT normal baby.  No child of mine will ever be called normal.  I simply won’t have it!