Saturday, April 16, 2011

Signing the IVF Paperwork, Overwhelming Much?

Cue the ominous music. Yes, my husband and I did this last year and yes, we filled out the exact same paperwork. However, I think last year we were all caught up in the hurricane of it all to really read the words to some of what we were signing. The same day we signed the paper work we were there to give our blood for testing and that clouded our thoughts. We both hate giving blood and needles. The thought now makes me queasy (or that could be the left over stomach flu). Whatever it was that day that didn't make us realize just what we were signing couldn't have been that serious for us to just blow through the paperwork like it was just a formality and didn't mean much. We just wanted kids. Where do we sign and how fast can we do it?

This time they mailed it to our house for us to bring in when we have our blood work done next Friday. So we got the chance to sit down together in the privacy of our own home, just the two of us to "sign away". Of course the doctor went over everything in detail last year, but you know how that goes. Blah, blah, blah, sign here and here. Initial here. In the meantime, our heads were just spinning with blood work and babies. So I don't blame the doctor at all, I just find it odd we blew right through it all. Because when you actually stop to read it, it's quite morbid at times. Let me explain.

There are a total of three packets of information to read through and sign. The first one is solely for me because it goes into detail about all the risks I am putting myself through. The treatment of using follicle stimulating hormones to increase the number of mature eggs for ovulation is called "Superovulation Therapy". So the packet we first had to read through was the Consent for Superovulation Therapy. It lists all the side effects of the shots and we just had to laugh as we read them. Nausea, vomiting, fatigue, flu-like symptoms such as fever, chills, muscle aches, joint pains, headaches, abdominal bloating associated with pelvic discomfort, and last but certainly not least MOOD SWINGS. They go on to say that additional side effects can be hot flashes and RARELY short term memory loss. Now all of those go away after you're done with the shots usually, but that's a bad two weeks if you know what I mean. My husband and I continued to laugh because I think I had just about all of those and then the following risks as well.  Ovarian Hyperstimulation Syndrome or OHSS can include the formation of cysts (which can rupture if you're not careful) and fluid shifts in your body. Yep, had those too. Now we're hoping for the next risk: MULTIPLE PREGNANCY. Now don't get me wrong. We don't want six or eight, but two. Two would be nice. We just saw a story this morning on the news interviewing a couple who were in the under 1% of pregnancies that turn into identical twins. Only they had two sets of them at the same time! This lady had two identical boys and two identical girls all in one belly. This came from only two implanted embryos via IVF. So, yes, multiple pregnancy is a risk, whether it's from multiple embryos being implanted or those multiple embryos then dividing after implantation.  It goes on to list ovarian cancer as the last risk, but explains the data doesn't confirm this. There are shortcomings in the studies that suggest this so really I wasn't worried about that one at all. Personally, again, where do I sign to try to have a child? That packet was easy enough. I've already been there and done that. I know what's coming.

The next packet was the consent for IVF retrieval and embryo transfer. Obviously both of us read through and signed on the dotted line. Yep, this is what we want. Another shot at our family. It goes into detail describing IVF and the risks of overstimulating the ovaries. Again, yes we know, bloating, blood clots in an artery, flu-like symptoms, allergic reactions, and ovarian cancer. Some of you may have read blood clots and gotten spooked. From the time you start your shots, you are put on a low-dose aspirin to prevent that so again, that didn't bother us at all.  It goes on to explain egg retrieval and its risks. This is the outpatient procedure done under sedation where they puncture each of your follicles to aspirate the eggs from them. Yes, when you wake up, it feels like you were stabbed a bunch of times on the inside with a needle. The procedure takes about 15-30 minutes. I laugh when it says there may be some discomfort because that's not what I experienced. However, that's different for everyone. Some women who have been through the HSG test know more pain I understand. So if you've already been through that, you probably have nothing to worry about! After they tell you how the procedure works they also mention that there could be a failure of that attempt. Some women don't have eggs in their follicles or the eggs weren't mature enough to go through the process of fertilization. That would suck! I was fortunate last time and they were able to retrieve 15 eggs! I hope for the same or more! Let me explain why. With that 15, only 9 fertilized and out of that 9 only 3 were viable enough to transfer. We didn't even have any left over to freeze and save for a later attempt. Usually that's the goal. So, yes, I would like more of them to either be good enough or for them to get more eggs next time!

The rest of the packet goes on to explain the risks involved with progesterone shots you then have to do after the retrieval to create an optimal environment for transfer. More bloating and mood changes, great! The embryo transfer is essentially the same as IUI in that it's done the same way, I think you just feel that much more pressure not to move watching the whole production. The doctors want you to have a full bladder, as if you weren't already uncomfortable enough, so they have a straight shot for those embryos to get to your uterus. More risks of the IVF: it might not work and again, multiple births. You also sign up for which ways of assisting you are going to do with the IVF. We check the boxes for both ICSI and Assisted Hatching because apparently, we need all the help we can get! With IVF, if you achieve pregnancy, there are risks of miscarriage, genetic defects, birth defects or stillbirths. There is some evidence that IVF increases these risks but most studies don't support this. At the end they touch on the psychological risks (ha!), release of liability and financial responsibility. Yeah, yeah, where do we sign again?  All of that may seem overwhelming, and it is at first, but you really have to focus on the positive at that point. It is not likely that you will get all of the side effects, I just happen to be that lucky! No, really, the doctors keep a close eye on you and monitor your every step of the way to prevent a lot of that from happening. Just remember this: you are giving yourselves another shot at having a baby! YAY!

The last packet is what really made us think. You have the option to discard your unused embryos or cryopreserve them. Of course we want to freeze any in the hopes of a future attempt. Well now you have to stop and think about your death, or your husband's death, or both.  And of course you have to think about dollar signs. It costs money to freeze those embryos and keep them frozen year to year, with an initial fee no doubt. Well, we're in it for IVF, we might as well keep going with the spending if it will all lead to a success someday. So they ask you to initial after each question. What happens if one of you dies? What happens if both of you die? What happens if you get divorced? Are you leaving your embryos to someone in a will? (Never thought about that one and still haven't!) What happens if one or both of you no longer wish to store the embryos? What if you cannot be contacted by the program? What happens if the program is terminated and no longer continues? Never knew we had to think about all that, we just want a baby. Crazy!

That all makes you stop and think a little. But in the end, you realize it's all toward the same goal, hope and dream of being a family and having a child together. So the ominous music can fade away and reveal something happier...lullabies, perhaps?

Friday, April 15, 2011

A Little Help To Get You Through

  This book is a devotional I received from a friend last year after in vitro didn't work. I looked at it, set it aside and didn't pick it up again until today. First of all, I couldn't get past the title. Really? A barren land? Not how I want to be thought of by others. I didn't want to ever be considered "childless". I just haven't had children yet. I also won't believe I will ever consider myself childless because we plan to adopt in the future if that is path we are to follow. However, when I picked up this book and actually started reading it, I realized it's so much more that just a label about me. This book is a devotional for 121 days for women that have been struggling with infertility for any length of time. You could have just found out or you could have been struggling for 10 years.  Whichever is the case, this is a wonderful book. Piggy-backing on my last post, it is a wonderful tool to help you stay strong in your faith during this difficult time. Yet, it doesn't just give you the "be a good follower and he will provide" type of devotions.  Vicki Caswell, the author, does a fantastic job of sharing her personal stories with some anecdotes that could help you survive the daily struggle. It gives you topics to think about that you might not have ever thought about before. Of course I had to laugh when one of the days was titled "Say Nothing" which went on to describe what you shouldn't say to someone going through infertility. Her words are exactly how I would think and write them so I felt connected to each story. She has a sense of humor that is exactly like mine, and at the same time feels all the pain of hurtful or insensitive words. Anyone that enjoys this blog, might just want to pick up this book. Even if you don't struggle the entire 121 days of this book, it might help you get through the days you do until you are fortunate enough to conceive.

One of my favorites is Day 51, titled "Lady-in-Waiting" where she explains her thought process after seeing a billboard asking, "Expecting a baby?".  She goes on to say, why yes, as a matter of fact, I've been expecting a baby for about ten years now.  She turns it to the sentimental side of how she still has no one to discipline, feed, cuddle, nurture, love, etc. She hit me hard when she said, still no one to name. Yep, that's me. I want that. But in the end, she explains that it's okay to keep expecting that and to keep waiting, but that we can't allow the waiting to get in the way of us living our lives. Hard to do, I know. A daily struggle for me, when that's all you think about when you are going through the treatments. At the end of that devotional she suggests a book if you are a detail-oriented person (which I am!). It's called, Wishing for a Baby: A Preconception Journal, published by Conceiving Concepts, Inc.  From the reviews I've read, it seemed to be very helpful for the women who used it. However, I'm not sure how available it actually is. Let me know if you find some that aren't "used".

Another favorite is Day 75, "What My Best Friend Does Right".  It just goes through and lists all the things that her best friend did for her and with her throughout it all. At the end it gives the suggestion to make a list of the things your family and friends do right for you to help you through the pain of infertility, show it to them and thank them. Not a bad idea. Also a good way to open up the lines of communication if you don't feel supported enough.

Some of the daily devotionals are devoted to focusing on the husband as well. Make sure he doesn't get left out. He can often get depressed as well and not deal with it in the same manner. You have to help each other through it and keep ahold of your marriage throughout the process. Stay strong and connected and fight the good fight together.

So even if you don't want to be considered "barren" this is still a good book to check out if you are having trouble conceiving. At the end of each day in the book, she has a "bearing fruit" section which suggests ways to apply what you have just read about to your life. Pretty helpful or therapuetic I've found! Let me know what you think if you pick up this book!

Monday, April 11, 2011

The Year Off That Was All In God's Plan

I've been tossing this idea around for about a week. I decided to go through with this post to give those of you out there struggling a new found hope that I was blessed to receive last summer.  During the ups and downs of infertility you feel isolated, alone, a bit freakish and completely broken sometimes all at the same time! Going through all of my IUI cycles in the fall of 2009 I noticed myself getting more and more defeated. Not depressed, but defeated. Seeing everyone else get pregnant was really hard for me. Sure I was happy for them, but mad that I had to be the "broken" one. I felt anxious to get to the next attempt between cycles and overall just because I wanted to give my husband and myself a family. After the fourth failed IUI, I banked all hope on the first round of IVF in March of last year. During those three months leading up to it, I had all the hope in the world that this was the answer we had been waiting for. Why wouldn't I? You're supposed to remain positive, right? Of course, but that can't be the only thing you lean on during a time such as this. So when the news came that the IVF had failed, I was devastated. At a loss for words, angry, bitter and again defeated.  What do we do now?

We had depleted our bank account to pay for all that and had nothing left to try again. The only answer was to take some time off to save up the money to try again. In our heads that needed to be at least a year to also help pay off some of the debt we had accumulated as well. My body, mind and soul needed a break and so did my husband. We were emotionally spent and somewhat lost. Okay, we will enjoy another year of marriage just the two of us, sure, but something's missing in our eyes. I decided to get rid of the 35lbs I put on during the attempts as the first step back to "normalcy" in my mind. I had to get the dead weight of the reminder off of me and fast! I joined a weight loss program and dropped the weight in no time. I decided I was going to do all the things I have always wanted to do in the next year leading up to our next attempt. On our vacation in June I sat there looking out at the ocean compiling a list of exactly what those things would be. 

My "bucket list" for the year started off with delving back into the Bible to read and learn from it as much as I could. Number two was starting a blog about my struggle of infertility. Number three was to learn about a new topic each month to keep myself learning every day, something that has always been a fascination of mine. I like to be informed so I can feel more confident in everyday conversation and validated in my opinions. Something I've always struggled with. I thought I had low self-esteem before! Not being able to conceive a child drops it off the radar! So I had to do something to build myself back up. Number four: run a half marathon to prove that I can and to stay in shape. Number five, which I continually struggle with, is to be as selfless as possible. Don't buy any unnecessary items/wants for myself (didn't last long!). See that's a hard one when you're the type of person that goes shopping to lift your spirits! The last few on the list consisted of different things around Ohio I would like to see, cleaning out clutter around the house and simplifying my life. The absolute last one on the list was to STRESS LESS. Yeah, right, but a good thing to strive for!

Out of all those, I have done most, but was never able to run the half marathon due to an injury. That unfortunately is not in the cards for me. One of the other things on the list was to read more, a hobby I love! The first book I chose was Eat, Pray, Love. Somehow that book changed my life. Since I read that book last summer I have become a completely different person. Reading that book helped me realize a lot about others and most importantly a lot about myself.  I needed this year off to fix myself before I could mother any child. I had to learn to stand up for myself, not get pushed around by others, do what I want to do in life and that meant first changing jobs.  I did all of that finally and it felt great. I lived life on my terms this past year and it has been phenomenal. I have learned how to be a better friend and recognized true friends that will always be there for me and my husband. I have learned to say no when I need to and to take on leadership roles as I feel called to do. For the better half of the year off I thought it was through this liberating piece of literature that I was able to "find myself" if you will. However, at about half way through I realized it wasn't that at all. Sure, that was a great help and the push I needed to start changing how I live my life, but it wasn't the answer behind everything.

I realized it was God. During one of the weakest moments in life, I felt called to turn to Him for help. It was almost one of those fall down on your knees and pray for help kind of moments. What else could I do? Who else could I turn to? No one was going through the same struggle and I felt completely isolated. I find it funny that delving back into the Bible was the first thing on my bucket list. How ironic to me. I have always had faith and never really lost it, just placed it on a back burner when things weren't going my way. But I realize now, it's not how I want it to go, it's all in God's plan. God meant for me to have this year off for myself. God meant for me to go through all those struggles and pain to learn to rely on Him. He is always there, he will never leave me alone. I never have to feel isolated or defeated with him by my side.  How many of you out there felt like turning your back on your faith because "your plan" isn't coming to fruition? That was almost me. I know in my heart that God wants me to be a mother. I know that's in his plan, I just don't know when or how. I had to learn this past year to TRUST HIM to get me through this diagnosis and difficult time in my life. Doing so has made me a more positive person, happier, easier to get along with (most of the time!) and able to stress just a little bit less.

I realized on Friday just how much I rely on him now to get me through tough times. I had my MRI to check the size of my benign pituitary tumor. That tumor is the only thing in the way of starting IVF in a few weeks. If it has grown, we have to do something. If it hasn't we are free and clear to move forward. For the first time in my life during the whole 45 minutes of my MRI all I could think to do was pray. I prayed, sang worship songs and just plain talked to God to get me through. Never have I done that before. Sure, I would pray during a tough time or ask for help, please get us through this, Lord. But NEVER have I completely relied on Him when I was struggling.  During my MRI I was the most calm I've been throughout all of the 5 I have ever had. I kept patient, still and in good spirits. I know he was right there with me. Now, I can pray all day long that this tumor remain small, but that's not the point. The point is that if it is to be, it will be because of God. He already has my entire life mapped out before me. I just have to reach out and follow him willingly each and every day, trusting in his plan.  So if it is to remain small, I know God wants us to try again. If not, then it was in God's plan that this tumor was found when it was. I was meant for this year off to give the doctors time to find this brain tumor that hadn't existed until January. Ironic again, huh? No matter what life throws at me, I will never waiver on my faith again because I know he has a plan. I just have to be open enough to receive the wisdom of it all in his time.

Whatever you are struggling with or waiting for, know that it is up to you to follow Him to find the answer.  I now thank God every day for this year off as hard as it was to wait. Psalm 62:5 "Let all that I am wait quietly before God, for my hope is in him."

I am no longer bitter, defeated or alone. I hope you won't be either after reading this. Yes, there are times when I falter, but I get back up. If you fall down 7 times, you must get back up 8. To have everything I want in the previous post I know I can trust God to give it to me on his time. I find that you also have to go through life looking at things as God's humor.  All those shows on TLC or Bravo or MTV about pregnant people, teens or rich women is just God's humor at work. I have to rely on him and still be light-hearted about it all, even if it is one of the most difficult things to do in life. You could even say those are tests of faith. Don't get caught up in the negative or everyone else's life. That's not your life. Your life is mapped out for you, remember? Just reach out and follow the path that's only made for you. I have to tell myself that every day. Holly, you are not the pregnant teen on TV, Kate Gosselin or a pregnant lady in heels, but you are Holly and you will be a mother someday, somehow, in God's time.