Sunday, November 14, 2010

Injection perfection

On Thursday I visited the fertility specialist to get my first pregnyl injection. As I understand it this injection puts a little bit of HCG in my system, therefore preventing the premature breakdown of my uterus lining that I experienced last month. 

The doctor had me prepared with the prescription, so I had my drugs ready to go and knew what to bring with me. Instead of being worried about the impending injection, all I was thinking about was the holiday notice. I wondered if it would be fixed, or if I would be subjected to erroneous notice for the duration of my wait. 

Needless to say, I was smugly pleased to see the notice had been fixed in the week between my visits. So much so I snapped a record on my iPhone while the receptionist was out of the waiting room....

Having learned from my last visit, I skipped the pile of magazines. While I enjoyed what felt like a win on the revised holiday notice I didn't want to spend too much time looking at the baby notice board either. Instead I immersed myself in my day ahead, reviewing my diary and reading my emails.

My wait was much shorter and I felt great when the doctor called my name. 

So the purpose of the visit was not just to get my injection, but to learn how to do them to myself, so I could be self reliant for future injections. For this particular series I only needed the three injections, one on Thursday, then Sunday (today) and then the coming Wednesday. But as it turns out there was a lot more to it than just the injecting bit.

I needed to be shown the technique for breaking open the glass vials in which the two separate elements to the drug have been provided. My hands were shaking as I was trying to crack them open. Once cracked open, the doctor shows me how to put a syringe together and then draw the liquid out of the first vial. The doctor then squirts the liquid back in the vial and hands it back over to me to do the same. Drawing the fluid up is pretty easy. I then squirt the liquid into the other vial that contains a powder. The powder quickly dissolves and the doctor instructs me to give it a stir with the needle. I then have to draw up the combined liquid into the syringe. This is when it starts to get tricky. I have to be careful not to suck up too much air. Once it is all drawn up I have to hold the needle point up and flick the syringe to tap out any air bubbles. Its just like on tv - only I'm going to inject it in myself and I'm genuinely worried about air bubbles! The doctor tells me the amount of air left in the syringe won't hurt me. So, now I have to swap from the horse needle I've been using for all the drawing up etc to the finer injecting into myself needle. 

This is all pretty simple, but brings me closer to the sticking point, where I have to jab myself. The doctor tells me to pinch some of the F A T (yes he spelled it out) on my tummy and then I need to push the needle in half way. Away I go.... While I'm jabbing the doctor tells me this is the worst of the needles he teaches his patients, because it stings the most. Meanwhile I'm thinking - I'm brilliant at this, it doesn't hurt at all. The doctor gets me to push the needle in a bit further and then I have to slowly push in the syringe. It really isn't hurting. I'm really pleased about that. Once it is all squirted in I slowly pull out the needle. The doctor tells me I've done really well and starts to pack me my very own drug kit for home. Extra syringes, needles, a little plastic cap to help crack the viles open and my very own sharps disposal kit.

As he is packing it all up I check out his tie, this time it is storks delivering babies. This guy clearly likes the novelty tie. He is really warm and likable and the novelty tie really suits him.

My drug kit

Today I had to repeat the injection process at home. I laid everything out and was impressed at my drug kit. I did pretty well repeating the process, only making the one mistake, where I prematurely changed the needle, preventing me from being able to draw up the completed potion. I then had to lever open my sharps disposal container to retrieve the big needle to draw the combined potion up. I flick the syringe to knock out the air bubbles and swapped needles to the finer injecting one. I get ready for the injection - just like in the doctor's surgery, only I swap sides as the doctor had told me to try not to do them all in the one place. I pinch some F A T and got ready for the jab and it stings like a bastard!!!!!

Giving myself my second injection

I don't what I did differently at the doctor's office, but this needle is unpleasant. I persist and push the syringe down. When I draw out the needle I'm left with a little hole that bleeds a little bit. I check and yes I have definitely changed to the small needle. I've got no idea why but this time the injection giving was really unpleasant.

At least there is only one more to go.

Tuesday, November 9, 2010

When the 'love doctor' calls

After remarkably fewer blood tests monitoring my hormone levels than last month (only three) yesterday the 'love doctor' called. 

In our very first appointment we all giggled and thought it was funny when the fertility specialist advised the 'love doctor' would give us a nod and a wink when the blood test revealed the LH spike that means that the next day I will ovulate. In fact last month literally we were told "all go for tonight". It really is strange to have someone (and now anyone who reads this) being across what (and more specially when) we are getting funky.

I love knowing that I am ovulating and when I'm ovulating, but it does mean spontaneity and romance have disappeared from our sex life. But what surprises more is that even with the lack of spontaneity and romance the quality has improved remarkably.

I guess the spontaneity had left some time earlier. Something kicked in after trying to conceive for months/years, where resentment, or anger, or disappointment seemed to underpin much of our baby-making efforts. And then there were the questions about the activities undertaken by one or the other partner, that seemed counter to the baby-making efforts. So for me, Matt would ask questions like why should we even bother when this weekend we are going to be going to [INSERT ANY PARTY] and you're going to drink a bottle of wine, thus undoing the efforts. And for me, I'd wonder, perhaps I've had too much caffeine this week, or sugar, or haven't done enough exercise, or I've worked too long, or drank a glass of wine at lunch....and so on and so on and so on....

Having access to information from the fertility specialist certainly helps because at least now we know our timing is on the money - hence removing a whole bunch of thinking about getting that right. Also given that both Matt and I have quit smoking ages ago and drink very little most weeks the fertility specialist has advised the occasional bender isn't going to be a big fertility issue, reducing the worry about the times we let our hair down.

Less stress about the peripheral issues seems to have made things a lot better for us in the bedroom.

Right now I'm still feeling positive, having just gone through the fertile window and knowing that this could be the month that it all come together again. For those that haven't figured out how this works just yet, in a week or so I'm going to be on the rapid down hill slope in the hideous waiting period - but you'll hear more about that when I get there.

Today I picked up my prescription for the injections I have to start giving myself later this week. I have a short appointment with the fertility specialist to learn how to do this on Thursday morning.

It is hard to put a lot this down, so thanks again to all the great emails, comments and messages of support.

Saturday, November 6, 2010

Melbourne Cup Melt Down

On Melbourne Cup day I had a 9.10am appointment with the fertility specialist. This appointment was going to be my first opportunity to find out what my early not period meant and what my next options are. I felt pretty good in the morning and got the surgery quite early. This was no doubt my first mistake. Sitting in the doctor's surgery with a whole lot of time to think.

I introduced myself to the receptionist, picked up the magazine from the top of the stack and took a seat. Flicking thoughtlessly through the mag I then look up and around the surgery, taking in all the photos of babies that happy mothers had sent in to the doctor, thanking him for their little bundles of joy. All perfect little faces, fingers and toes. I started to wonder how many babies don't make the board because they aren't so perfect. Or how many sad would-be-mothers haven't got a photo to send in. How do these thoughts even come into my head?

Clearly this board isn't supposed to trigger these types of thoughts. And then I notice the notice. Printed on a regular A4 sheet of paper with black type...The doctor is going to be on holidays from 18 December 2011 to 16 January 2011. Hmmmmm.... I think to myself, clearly it is supposed to be 18 December 2010 to 16 January 2011 - I can figure that out. Then I wonder, should I let the receptionist know? Has she already been told by someone else? Does it matter because I obviously figured it out. I would hate that mistake hanging in my foyer, so I resolve I will mention it in passing as I'm leaving. This is so easy and cheap to fix, and maybe she doesn't know and would like to have it fixed.

Back to the magazine (my second mistake) - I read a story about AJ Rochester - the former Biggest Loser host. She has an 11 year old kid. It was only after he was born she decided she needed to trim down. So she was overweight - and a lot bigger than me - when she conceived. I read about how much fun AJ had when she was fat and how she now has healthy relationship with food.

Continuing to flip through the pages there is a story on Octomum, another on the lesbian couple who is pregnant with quintuplets. I flip on, and there seems to be story after story about miracle babies.

I hear the receptionist telling someone on the phone about the holidays the doctor has scheduled, 18 December to 16 January, and think - this is a good time to mention the mistake on the notice (my third mistake). Once she hangs up I say in a friendly tone "Actually the notice on the board says December 2011, instead of 2010." The receptionist replies, with rolled eyes "I think everyone knows what it means." She pauses looks away and says "but thank you."

I try to remain calm. But I start thinking, surely she could have just said, "okay, thanks" even if she didn't intend to change it. Why doesn't she care? Doesn't she hate having that blatant error just hanging there. What about the doctor? Does he care it is wrong? How much of a shit does this surgery give about detail - whether it be the notice about the holidays or my medical details. I try to stop myself thinking about it, but it just goes round and round, until I'm beyond the point of no-return. I start to cry. I walk out of the doctor's surgery and find the bathrooms were I proceed to cry and cry. I'm trying to calm down - after nearly 30 minutes of waiting I find myself unable to pull it together just as my appointment time comes up.

Eventually I manage to dry my eyes enough to go back in. I sit down and pretend to flip through the magazine. Kerry-Anne is on the telly in the corner and another patient is now also sitting in the waiting room. Suddenly the receptionist is really friendly and trying to make small talk with the other patient. She starts talking about how she's a wonderful grandmother and I want to punch her in face. Perhaps the other patient isn't so sensitive on the mother/grandmother thing, but I can't believe this is part of the small talk she attempts in this surgery. I try to stay calm. Ignore her. Just the sound of her voice is now enough to set me off. Breathe.

Finally the doctor calls my name and as soon as I'm out of sight of the receptionist I'm in tears again. The doctor keeps asking if I'm okay - I'm quite certain he is accustomed to crying women given the strategic location of tissues next to the patient chair. He asks if it is something "we've done". I'm quite certain the receptionist has let him know there has been waiting room incident, but what's the point in saying, "your receptionist took a tone with me when I pointed out the mistake on the notice about your upcoming holidays." Normally such a tone wouldn't bring me to tears. So I say no, I'm just a little sensitive about all of this.

And the doctor starts to talk to me about the results of the 10 or so blood tests I've done in the last month. The ones that show the increase in oestrogen, the one that shows the LH surge that indicate when I should ovulate, and then the ones that show I really shouldn't have had my period when I did. I really like the science of it all, and it does calm me down to talk rationally about what's going on.

Given the premature break down of my uterus lining we now need to introduce some additional tricks with hormones to give me the best of chance of getting knocked up. We talk through the options. Doubling the clomid dose is a definite for next cycle, if we aren't successful this cycle. Additionally I can choose between learning to give myself HGC injections (the pregnancy hormone) to trick the body into thinking it is pregnant, and therefore keep the uterus lining, or I can get a compound chemist to whack together a pessary (for the uninitiated that is a pill that gets inserted in the vagina) - delightful - which I have to insert twice a day - and lie down for half an hour after doing so, to also trick the body into thinking it is pregnant!!!

Hmmmmm. I choose injection. From what the doctor is telling me the pessary option is quite unpleasant and then there is all the time just lying around when I'm already struggling to get ready for work in the morning I don't need the half hour of lie down time.

We talk about the results of all the other blood tests that indicate despite the chromosome problem that caused our first miscarriage, neither Matt nor I have any underlying issues with our chromosomes that would have caused that. Matt's got all the right hormone levels to make his contribution as do I. So on that front it is all good.

I tell the doctor I'm pissed off that I waited so long to get to be referred to which he replied, "there's no need to worry, there's plenty of life in the old girl yet." I tell the doctor I like his novelty tie, that is filled with hundreds of different coloured jockey hats.

So I've calmed down and leave again with a fist full of blood test forms to continue with the monitoring of my cycle and help get our timing right. I manage to resist punching the receptionist in the face and take a mental note that if possible I should make appointments for the afternoons, because she only works morning.

I make it to the office by 10am and only have to fend off a few questions about whether I'd been crying.

The rest of my Melbourne Cup was incredibly uneventful. I still felt sad, and have continued to feel sad this week. Rationally I'm so good at dealing with all this, but emotionally it is just so hard.