Thursday, September 27, 2012

Checking the list

Ding, dong, the Beast is gone! I had my monster of a cyst aspirated late yesterday afternoon, and I'm still amazed that sucker didn't cause me more pain than it did. Dr. M. drained 40 mL of fluid out of it! That's's enough to fill a urine specimen cup, he said. Holy cow. The procedure went off without a hitch and was pretty quick, once they got me drugged and my catheter placed (owie!). Paul  thought the actual aspiration took only 4-5 minutes.

The after-effects of those drugs, though? Wow. It took me awhile to feel mostly coherent, and, like the last two times, that Demerol had the effect of causing me to take really slow, shallow breaths, so there was a lot of "Breathe, Amy!" from both Paul and Sierra. Total flashback to last fall. :)

The Demerol did more than that to me, made me horrifically dizzy so that once I did finally feel like I might be stable enough to stand and get dressed, I had to immediately lie back down on the bed with my shoes on! I got nauseous, too, so Dr. M. had Sierra give me a Zofran. We finally left at about 6:15.

As soon as we started to drive out of the parking lot, the vomiting began. Thankfully, I keep a plastic cereal container with a tight-fitting lid in my car as a garbage container (thanks, Pinterest!), so I ripped the top off and dumped the contents on the floor just in time. I cradled that damned thing in my lap the whole way home, and was puking again as we pulled into our driveway. It didn't get much better...Paul fixed me some chicken broth, Saltines and ginger ale, but after several "fine" moments, up it came. Multiple times. I finally gave up on having anything in my stomach and went to bed after retching again several times.

This morning I still felt "buzzy" in the head and a little shaky, but I got dressed and made it to work. Within an hour, though, I realized that probably the best place to be, and I was headed back out the door 1.5 hours into my work day. I've spent the rest of the day trying to hydrate and eat some bland things (so far, so good), and now, 24 hours later, I'm finally feeling pretty good. (I e-mailed Dr. Z. to let him know how the aspiration went, and also to request something to be given to counteract Demerol if that's what they use for egg retrieval. I cannot - will not! - vomit all the way home for two hours after egg retrieval!)

Now that this is over with, I can earnestly look forward to starting meds on Saturday. I pulled everything out to inventory what I have and compare it to The Plan (B, since A was scrapped thanks to the cyst). Ready to see this? (I have no idea how to stay organized with all this stuff...)

Got IVF meds?
From left to right (and in order of appearance in the schedule):

3-900 iU pens of Gonal-F, recombinant human follicle stimulating hormone (rFSH): I will start with 225 iU of this nightly to stimulate my ovaries to produce more eggs (dosages may be adjusted).

3 boxes (20 ampules, 75 iU per amp) of Menopur, a combination of FSH and lutenizing hormone (LH): I will start with 150 iU of this nightly, also to stimulate my ovaries (dosages may be adjusted).

Ciprofloxacin, an antibiotic: Paul and I both will take this twice daily for 10 days, basically to kill any infection either of us might be harboring within (apparently it's also helpful against inhaled anthrax, in case that becomes an issue).

sharps containers: because the pharmacist didn't think one would be enough. (No more slumming! In our previous four stim cycles we've discarded our used needles and syringes in either a Costco-sized soy sauce bottle, or a used laundry detergent bottle. How sad that I just finally (because I found the duct tape!) sealed and discarded those puppies two weeks ago.)

Cetrotide: this is an antagonist that will prevent my body from releasing the eggs prematurely...that would be tragic. Not sure what the dosage will be or when I'll start, or even how many days I'll take it, as it all depends on how my ultrasounds and bloodwork look next week (stim day (SD) 5 and either SD7 or SD8), but I'm guessing not before SD 7.

Saizen, the recombinant human growth hormone (rHGH): this the magic bullet that might help my ovaries behave less like those of an old woman, and more like those of a younger, more fertile woman. I will start these shots at 0.5mg SQ daily beginning SD7.

Novarel, the hCG trigger shot: this will be the only shot I have to take in the butt (yay!!!). The shot will be carefully timed to be 36 hours before egg retrieval, tentatively on SD10 (10/8), but all subject to my bloodwork and ultrasound results in the preceding days.

Medrol (a steroid) and doxycline (an antibiotic): these I'll start the day of retrieval and continue for 5 days. I'm not sure what the steroid does, but the antibiotic is to prevent infection given they've just accessed my ovaries vaginally with a really big needle.

Hydrocodone: I don't plan on taking this pain pill. I'm not a fan, and will hopefully be able to manage my pain with Tylenol.

Crinone, progesterone cream: I'll begin taking this the day after egg retrieval, and if pregnant, I'll continue at least until 11 weeks (although Dr. M. may want to keep me on it until 16 weeks).

Estrace, an estrogen tablet: I'll begin taking this the day after retrieval, too, to help build my uterine lining and get it ready for an embryo.

Valium, the chill pill: I've been instructed to take this 1-2 hours prior to the scheduled embryo transfer (tentatively 10/15 if we a) get embryos and b) any are reported genetically normal by the lab doing our PGD). They need me to be very relaxed and perfectly still so they can get the IVF catheter in proper position to drop my embies off in exactly the right location for implantation. (Please, no placenta previa this time!)

In front, various needles, syringes and alcohol wipes for my injecting pleasure. :)

I have videos I need to watch so I can get the hang of the Q-caps on the Menopur (no more filter needles, woohoo!) and also see if there are any tips I should have (had) for proper SQ injection technique of the Gonal-F and Cetrotide.

It appears my right ovary has three to four antral follicles (Dr. M.'s quick look), so along with the 4-5 Dr. Z. counted in the left on Tuesday, we should be starting with 7-8 follicles. That's *awesome* for me! The most I've ever seen is 9, and that was at a cyst check in March before our terrible April stim cycle. I'm thrilled to be solidly in the 5-8 follicles range that Dr. Z. prefers to see in IVF cycles like this one.

I'm holding onto that optimistic, it's-out-of-my-hands feeling I've had the last week or so. Who knows, this could possibly work!


  1. Holy drug addict?!?! lol The things we do for our darling kids:)

    I just want to say that the follicle count is awesome! I am hoping and praying that they all come on board with the stim meds:) The more the merrier!

    Good luck and happy injecting!

  2. Oh dear, I feel for you with the vomiting. Ugh, that happened after my last egg-retrieval but luckily, I was already home by the time it started.

    That's a lot of meds! best of luck for a positive outcome all together :)

  3. I'm so happy and excited for you. You have been waiting for this next chance and now you are there. I wish you all the luck in the world.

  4. Holy hell, Amy! I'm sorry I've fallen behind on commenting, but I'm hoping so hard for you guys. That drug roll is amazing. May you get the baby who will be worth every single needle stick and side effect.

  5. Wow. Seeing all the drugs listed together instead of just coming up in conversations makes it seem much more impressive.

    I'm playing catchup, but have everything crossed!


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