Tuesday, September 30, 2008

Ponction

So today was egg retrieval day, or 'ponction' as they say in French. Got up at 6 am and had my betadine scrub shower (yum!). We were at the clinic just before 7.30 am. Went all pretty quickly from there: was shown my room, changed into the hospital gown, hubby left for the lab to do his thing, and a few minutes later the nurse came to have me sign some paperwork and put in an IV for saline drip.

Was wheeled to the OR around 8 am. The OR nurse double checked all my information while still in the hallway, somehow I felt like I was already sedated, but it must have been the stress that made me feel like my answers came out very slowly. Saw that it was my own doc for the procedure, luckily not Dr 'Speed', that would not have been very good to get my stress-level down... The anesthesiologist got to work and I slowly 'floated away'. When I woke up again I was wheeled into the recovery room, it was 8.31 am. Stayed there for about 20 minutes. Was feeling OK, but still out of it - no wonder with blood pressure at 112/47 - 114/51 - 112/53.

Back in my room the nurse again checked blood pressure, bleeding (a bit) and asked if I had a lot of pain - it wasn't too bad, so I gave it a 4 on a scale from 1-10. Hubby came back after about 30 minutes, which was nice. For a moment I thought the pain was getting worse, but luckily it subsided again. At about 10.30 I got a little breakfast. The tea tasted like coffee, so after three sips I left it for what it was. Had some yogurt, toast and water. Blood pressure and bleeding were checked again and we tested if I could get up without fainting or feeling dizzy. Everything was fine, so the nurse took out the IV and I could go to the toilet.

After about another hour they told me I could get dressed again. A few minutes later another nurse came in to give me back my paperwork and told me to wait for the embryologist ('médecin biologiste'). After that I was free to go home. The doctor came in and told me they had collected 14 eggs, everything looked good. They would call me on Thursday about the results and set a time for transfer on Friday.

We were back home around 12.30pm, had lunch together and then hubby left for work. I'm lying on the couch, feeling OK, but a little tired, so I'll take it easy for the rest of the day. Not much pain, just a bit of a dull ache.

Saturday, September 27, 2008

Triggering tomorrow

Ultrasound exam tonight was much more relaxed with the other doctor. He was early, so now the waiting was for the nurse. Not to worry about abdominal pain, is normal. 10 follicles, between 15-18mm so triggering tomorrow evening, ER on Tuesday morning...

Abdominal pain

I've been experiencing some abdominal pain since Wednesday evening. Of course I immediately though I would be overstimulated and they might have to cancel my IVF cycle, but at the check ups everything was normal. I had told myself to ask the doctor though, but Dr 'Speed' really didn't give me any chance...

Because I was driving myself crazy speculating, I decided to call the clinic yesterday and talk to my own doctor. He wasn't there. So I told the assistant, who asked me why I hadn't talked to Dr 'Speed' about it, but she seemed to understand somewhat when I explained why, looked at my file, said nothing seemed abnormal (estrogen levels Mon: 310; Tue: 503; Wed: 882, Thu: 1388 - about 10 follicles, between 10-14 mm in size on Thu), and advised me to lie down a bit and maybe take a dolipran (=tylenol/paracetamol), and talk about it with the other doctor on Saturday.

Yoga class was a good distraction yesterday evening, and today I hardly have any pain either. Maybe it's only between my ears...

Friday, September 26, 2008

Dr 'Speed'

Dr 'Speed' has a regular OBGYN practice, but here at the clinic he's also the expert 'echographiste', i.e. ultrasound expert. I'm slowly getting used to his way of working, but he can still make me feel completely rattled.

He is always late. Most of the time around 15 minutes, but sometimes half an hour, and one time even 45 minutes, which made all of us women with full bladders in the waiting room feeling like we were going to explode any minute.

When he's finally there, you get the impression he tries to make up for his lateness by speeding us all through the ultrasound exams in no-time. If, heaven forbid, your bladder is either too full or not full enough (so he can't see your ovaries on the ultrasound), he'll send you back to the end of the line (which is a real bummer if you initially were second in line, and suddenly you're nr. 10), no mercy. He sees the follicles on the ultrasound, measures the biggest and then is able to write down the size of the rest as well. It seems to be pretty accurate... Before you have time to pull up your pants, he already opens the door to summon the next patient in.

Last year, when I had to come in for my IUI cycles, he somehow realized he was making me very nervous, so he started making jokes to make me feel a bit more at ease. Which helped, more or less.

However, last Wednesday he got me completely confused. While doing the ultrasound he said something like "it's Friday", so I reacted surprised. "Yes, yes, because we'll skip two days... - if you're OK with it" which made me think that he was talking about the time between triggering and egg collection, which confused me even more, because he had just measured the largest follicle being at 13mm, so not big enough at all to trigger ovulation. I already started to panic that I hadn't brought my Ovitrelle, so I mentioned that to him. "No, no, you don't need that". So I told him I was now very confused. "You just take 125 IU of Puregon tonight and come back tomorrow. Au revoir, Madame". Ugh.

That night I had a nightmare: Dr 'Speed' had forgotten to tell me how many IU of Puregon to take, so I asked my own doctor, who told me 500! Which freaked me out, because it was way to much, but no, no, it was necessary, because my follicles were not growing quickly enough... Luckily I woke up at that moment.

The next day I wanted to ask Dr 'Speed' about some abdominal pain I was experiencing, but again, the whole thing went so fast, and then he got a call on his cell phone, and walked out of the room... Before he got the call he'd made a note for the doctor who would do the ultrasound on Saturday, to say that maybe we'd trigger on Sunday, and had written down how much Puregon to take that evening, but had not given any instructions for Friday, which I needed since there would be no ultrasounds that day. The whole thing started to ressemble my nightmare a bit too much...

While the doctor was on the phone, I told the nurse about it all. He's great and we had a good laugh. Finally Dr Speed was done with his phone call. So the nurse asked him about the instructions for Friday 'for this woman who's triggering on Sunday'. "No, that's not what I said, I said MAYBE trigger on Sunday, that's up to the other doctor who'll do the ultrasound on Saturday!" So he added four more question marks to his note, gave the instructions for Friday and off he was.

Before I left, the nurse told me that if I would wake up screaming that night from another nightmare, I should think of him, because he was probably having one too!

late nights

No ultrasound or blood work today, the doctors and nurses have Friday evening off. I'm glad, because the whole week I haven't arrived back home before 8.30pm and then we'd still need to eat (not such a strange dinner time in France, but still). At those times I really miss all the great take-out places we had in the US, no such thing here...

Stimulation

Started follicle stimulation on September 16. Six days of 150 IUs, then first blood test and ultrasound on September 22. I thought I had brought the whole 'how much water to drink to have a full bladder without feeling I'm exploding' down to a science after six IUIs, but apparently the break was too long, because my bladder was too full, so it masked the ovaries on the ultrasound! Luckily it was not doctor 'speed' (who would've sent me to the back of the line) this time, but a more gently one, who just waited while he let me pee (just a little bit, which is pretty difficult if you have a full bladder). The ultrasound just showed 7 follicles - 2x 7mm on one side and 5x 5mm on the other side. I was a bit disappointed, but the doctor said everything was fine, I should continue with 150 IU Puregon and come back the next day...

Enantone side-effects

I was prepared for hot flashes and other menopausal side-effects that Enantone might give me, but not for two weeks of diarrhea! After a few days I called the doctor's office to check if this could indeed be a side-effect.

My own doctor wasn't there, so the assistant told me to call his colleague, the one that usually does the ultrasounds. I've known him since my IUI attempts and he is always very 'speed', something I really had to get used to (if I ever have...). So I got him on the phone and told him that I wanted to ask him about possible side-effects of the Enantone. "You're bleeding!" he said. I did, but I had read that that could be normal, so that did not worry me too much. "Yes, but I also have diarrhea, could that be related?" "Yes, that's possible, listen, everything is fine, I've got a call on the other line, see you at the ultrasound. Bye!" Ugh, if I hadn't met him before I would have been really upset. Now only just a bit...

So I went to the pharmacy to get something to quiet my intestines down, luckily the pharmacist was a lot more understanding than the doctor and confirmed that it was indeed on the list of possible side-effects of enantone. Pff... it finally subsided once I started the Puregon injections on day 20.

Enantone injection

Started my first IVF cycle on August 28 with an Enantone LP injection, to suppress my normal hormone cycle. Thought maybe I could do it myself until I got back from the pharmacy and saw that it was a real DIY package: two tiny bottles, one with powder, the other one with solvent, which you had to suck out with the pink colored needle into the syringe, then add it to the powder, mix, suck it into the syringe again, change to the blue colored needle and inject the mixture into your belly.... Some great catastrophic scenarios flashed before my eyes, so I decide to make some calls to try to find a nurse to do it for me. Finally found one who was able to come by the same day. Nice guy who made the whole mixing thing seem very easy, but I'm glad he did it instead of me. The French system is pretty good, nurse comes for a home visit and you just give your "carte vitale" (insurance card) at the end, he puts it in some calculator, and the costs are immediately charged to the insurance company. It seemed that it's very under-paid though - he was talking out loud while typing away on his calculator and apparently they can only charge 3 euros for the home visit and 2,50 euros for the injection...

A start

Instead of hijacking two excellent blogs on IVF - Fertile Mind and emily the hopeless (see the side bar for links) - with my comments, I decided to start my own. I'm midway through my first IVF cycle, so there will be some 'flashback' posts, but I hope to be able to catch up soon.