73 Shots Later Equals New Found Heroes

I try my hardest to be upbeat and positive no matter what the situation. I admit I have my downfalls when I just want to complain and whine about everything. But mostly I keep that attitude in check and pray through whatever it is that is causing me to have the whine syndrome. That being said, I need to whine and complain a little bit- just to get it off my chest!

First of all, I want to say that all you IVF and IUI moms and women out there are now my new found heroes. I have talked to many women who have been through 1, 2, 3 or more IVF cycles. I do not know how you do it. This is HARD STUFF there is nothing easy about the shots, the hormones, the emotions, the retrieval, the bloating, the discomfort, the waiting, the waiting, the transfer....and the waiting. I think if I did not have my hubby, family, friends and God I would probably cry everyday. Luckily I have only cried a handful of times but I do have to admit I get misty eyed more often these days due to the hormone injections and high emotions.

I counted today and so far I have received 73 shots either in the tummy, thigh, arm or hip. Hands down the Progesterone in Oil shots that I started the night of the retrieval are the most painful horrible awful shots EVER! My Hubby deserves the medal of honor for being such a trooper about the shot giving and always being positive when I feel like I just can't take another shot! The PIO shot is supposed to help my uterine lining thicken because IVF shots can thin it out. This will prevent miscarriage so I am doing them and I am going to do it with a thankful heart! This shot continues until I am 8 weeks pregnant...Lord give me strength! Right now both my hips are so sore I cannot even sit down without cringing. (see pic of my hubby getting ready to give me a shot)

Also this bloating and discomfort is for the birds! My ovaries are so swollen you can actually see them protruding from my stomach. At first I was scared maybe I had Ovarian Hyperstimulation Syndrome but I am still peeing, pooping okay and I am not retaining water so I think it is just because I had 24 Follices and they are now filled with fluid which takes 7-10 days to leave your system. Wow! I look huge! How do women work before, during or after IVF? I cannot imagine! You cannot even wear your clothes. Prior to the retrieval I looked about 3 months pregnant and now I look about 5 months. I told Hubby its a good preview at what I might look like in the months to come! ;) I have to pee every 5 minutes and it hurts like I am going to burst every time! The burping and passing gas is out of control- my poor Hubby and in laws- I am so glad they love me and don't mind my issues!

I did the Micro shots of stimulation meds (although with my amount of eggs you wouldn't think so) so my hormones and emotions were not too bad but I could certainly tell my patience wearing thin with my kiddos. I really did feel bad for them...it's like one day your mom is one person and the next day she wakes up and she's Roseanne Barr on crack! I am certain this time apart they have found a new love and respect for me regardless of how I was acting when I left. So I am at peace about that behavior however rash and uncalled for. I was totally open and honest with them about the shots and how they made me feel so maybe they took it with a grain a salt. I can only hope. For all you IVFers and infertility warriors who did the full blown stem shots and meds- you rock and you amaze me!

After all the yucky symptoms, side effect, aches, pains and shots I have to say I am still so very thankful for the experience and to have 11 healthy embryos growing! Yes we got our FERT report today and 11 of the 13 have made it to the next stage of growth. The nurse said 5 are growing on track and are almost ready now. We are planning our Egg Transfer on Tuesday November 16th. The day after my birthday and before our 3 year anniversary. We are so blessed and we know it! I cannot wait to be home and pregnant (hopefully with twin Bryant Babies).

We are still having a good time in Vegas with my in laws! I hate to see them go tomorrow. (see pic of my hubby and I at Hard Rock Cafe today). We've taken in lots of sights and yummy food!

Lucky Number 13 & Yoga at 2 am!

What a whirlwind week! I cannot believe tomorrow will already be one week in Vegas- it is flying by! I am having a blast but I am missing my kids and my dogs soooo bad! I cannot wait to see them and give them love!

I am so enjoying my in laws and hubby being here. Our Egg Retrieval went smoothly Thursday morning. I picked Hubby and in laws up from the airport and we went straight to Dr. Sher's office. We were in and out in an hour. We had 14 mature eggs out of my 24 follices. He was very happy with the results. I spent the afternoon resting and we had a great dinner that night at the hotel. I was pretty sore, bloated and crampy but nothing too bad. I started my Progesterone in Oil shots that night- which are very painful and in the hip- I have to do them until I am 8 weeks pregnant- OUCHEY! I am trying not to be such a whiny baby I mean I have had two kids so I can handle A LOT- right?

The next morning we were off and running bright and early. We went to Hoover Dam- which was awesome and beautiful! Being surrounded by such amazing scenery makes me feel close to God- He has created an amazing Earth for us to live on! I am thankful and humbled by it! We also saw 3 REAL monks there- like in robes and scandals- but they were carrying around probably a $2000 Nikon Camera- I thought Monks did not have care about material possessions? Hhhhmmmm.....

Then we went to Pawn Stars and they were filming and we got to see Rick- way awesome! We had a nice lunch at Planet Hollywood at Caesar's Palace. My nurse called with our Embryo report and was please to announce that 13 out of 14 of our eggs had fertilized. She said we will take tomorrow off- meaning there will be no new news then we will hear from her Sunday morning on how they are growing and if we will do Egg Transfer on Sunday or Tuesday. That evening we hit Fremont Street- which was WOW! It is the older part of Vegas but very very neat! The street has a screen over the top that puts on a light show to music. We saw a lot of very interesting people dressed up and some dressed way down. Vegas is a really unique place! Then we had a yummy dinner at Landry's- love their seafood! The main side effects for the day were discomfort from being bloated and gassy! My nurse said that my ovaries are swollen and taking up more room than usual which causes everything else to feel cramped. I also have to pee every 5 minutes! Which is very interesting when you are walking around and scrambling to find the nearest restroom. She also warned me that the PIO shot could cause constipation so be sure to get Metamucil- which we did at the pharmacy on Fremont Street- the one thing we bought! haha!

Last night was very rough. I woke up at 2 in the morning in excruciating pain! Honestly, I felt like I needed to pass gas for about an hour and I would be fine! At one point I was so desperate for relief I was doing YOGA in the bathroom just to get things moving! What a sight that was I am sure! I was in pain for about 2 hours before I finally got some relief- two Gatorades, two Gas X's and some Metamucil later I was asleep. And yes the PIO shot before in the other hip was horrible- so now both hips are super sore and tender...I am tough...I am tough...I will not be a gripey whiner! Okay...I feel better now...

This morning after a yummy buffet breakfast- which I kept high protein so I could have a BM- which I did successfully after breakfast- I have never been so happy to poop in my entire life! Relief AT LAST! We were out the door at 10 am headed to the MGM Grand. We did CSI: The Experience...very neat we had a good time! My mom in law loves that show- I am glad we got to do that with her! Then we walked what seemed like 5 miles from the MGM to The Venetian in hopes of buying Blue Man Group tickets- we were not up for paying $150 to see them so we are currently on a search for cheaper tix! We had a yummy lunch at The Venetian! A Tuna Wrap for me- then I had to treat myself to a slice of Mousse cake- it was heavenly! I am still feeling bloated but its not painful. I think I look like I am 5 months preggo! I swear! After searching online a bit I read on some discussions boards that after your Egg Retrieval your Follices fill up with fluid that can golf ball sized- in my case- that is 24 golf balls! So I am not alone in this discomfort, swollen, bloated, gassy, constipated feat post Egg Retrieval.

I just really hope it all gets straightened out BEFORE Egg Transfer- I cannot imagine being preggo and dealing with these symptoms simultaneously! I am praying for healing and relief- like ASAP!

All in all we have a great fantastic blessed Micro IVF Cycle- I am super blessed and thankful- gas and all! I am praying we have 6 good Embryos out of the 13- so we can Transfer 2 and freeze 4 if we need them in the future. I am so thankful God has allowed this process to be so successful for us!

Vegas is amazing and I have only seen one transvestite! That was quite a sight! You don't see one of those everyday in Oklahoma...thank goodness!

Fertile Thoughts

I am ecstatic to announce to my fellow readers that I have lost 6 pounds since starting my IVF Diet 10 days ago! Weight loss is so funny- it is always so easy to gain the weight and always ever so hard to lose. This time around, compared to when I lost 80 pounds after having my daughter, it is much harder and easier at the same time. Even though I was just 22 when I lost it with her and the weight just fell off I was losing it for different reasons that I am now. I was still able to eat what I wanted as long I ran and worked out on a daily. Let's face it I am almost 31 now and losing weight is hard! It's not about diet and exercise as much as it is about lifestyle and setting goals!

This time around I am 100% focused on my goal- which is to be the healthiest I can possibly be before we do IVF to increase our chances of success! It's not just about weight loss it's about living healthy. I have changed my way of thinking about food, exercise and taking care of myself. I have changed my eating habits, sleeping habits, thinking habits and increased my exercise level. I am committed to only drinking water, cutting out meat, junk food of any kind and thinking organic all the way! From Shampoo to Food it is all natural! It is very hard to fix one thing for my family for dinner and watch them eat it while eat a protein packed salad! BUT as long as I keep it yummy I know I will be fine with it!

I am amazed at the results. For the first week I felt like I was literally going to starve to death but after the first week my body has adjusted to smaller portions, healthier food and a new way of living! We have 35 days until I leave for Vegas and I plan to lose 10 more pounds...at this rate I am thinking it will be more! I truly have never felt better! I am keeping focused on my goal with fertile thoughts at the forefront!

A LOT To Take In (Not for the faint at heart or weak at stomach)

I am going to be brutally honest and just say that yesterday when my nurse emailed me with my list of meds and then the pharmacy called to confirm my list of meds- I got a little dizzy and nearly had a panic attack! Just look at the names of these things? When the pharmacy called I was jotting down notes in Microsoft Word thinking the spell check would correct them and I misspelled over half of the meds! I got a little worried when the email came and this is what it said: (Keep in mind my hubby will be the one administering these shots!!!!!)

The Sher Institutes for Reproductive Medicine

Medication Administration Guidelines

________________________________________________________________

Tips:

• An ml = cc
• Needles are STERILE, do not touch them before using them to inject and only use them ONCE
• Rotate injection sites from one side of the abdomen to the other, and from one thigh to the other
• With a multi-dose medication vial, swab the top of the medication vial with an alcohol swab before each use
• When in doubt about medication dosage or injection, PLEASE call the office for clarification. DO NOT GUESS!
• There is a nurse on call through the service after office hours. Please call 702-892-9696 before 11pm and the service will promptly page the nurse on call
• Read all of the medication labels before taking the medication to ensure that you are taking the correct medication
• Report all medication errors and unusual reactions to your coordinator as soon as possible

Dexamethasone 0.75 mg Tablet or Prednisone 10 mg

• This is a steroid tablet
• This is given to decrease inflammation and reduce the inflammatory response of your body to foreign bodies (your embryo) before embryo transfer
• Take once a day in the morning with your breakfast to decrease GI upset and other potential side effects
• Potential side effects are insomnia, increase in appetite and bloating.

Lupron (Leuprolide Acetate)

• Lupron is taken to suppress your hormones at the pituitary level, it does NOT suppress your ovaries
• Injection to be given subcutaneous in either the upper thigh (up by panty line) or in the abdomen (stay 1 inch away from belly button) in the AM (between breakfast and lunch) with a few hour flexibility between days (See diagram on page 5)
• The medication comes in a multi-dose vial
• Use the insulin syringes with the orange cap to draw up dose and inject
• Refer to your calendar for dosage and measure units (U) on the syringe
• The most common side effect is hot flashes, this will be relieved by the start of your hormone medication (i.e., E2V or Gonal-F or Follistim
  

Ganirelix/Cetrotide

• To be taken like Lupron, subcutaneous in AM
• Also like Lupron, it is being taken to suppress your own hormones and has a better long term effect with fewer side effects
• Given at ½ dose (125 mcg) rather than prepackaged dose of 250 mcg (same as 0.25 mg)
• Ganirelix:
• To split Ganirelix (prefilled in a syringe) use a 1 cc syringe that does not have a needle and pull down plunger to 0.25 cc.
• Then inject 0.25cc from the prefilled Ganirelix syringe into the 1 cc syringe you have just prepared.
• Place a 27 gauge ½ inch needle on the 1 cc syringe to inject.
• Save the remaining 0.25 cc in prefilled syringe for next morning’s shot.
• Keep refrigerated.
• Cetrotide:
• To split Cetrotide fill the vial of powder with the prefilled water (1 cc) in kit.
• Now you will have 2 doses in vial.
• Use same orange cap syringe that you used for the Lupron and withdrawal 50 Units (½ cc) of Cetrotide for first morning’s injection.
• Save the remaining 50 Units (½ cc) in vial for next day’s injection.
• Keep refrigerated.
• Second dose may only measure up to 35 or 40 Units. This is normal, do not mix up another vial just inject whatever is left for the second dose.

E2V = Estradiol Valerate = Delestrogen

• Not all protocols involve E2V, so if this is not on your calendar then omit instructions.
• This is given to “prime” the receptors on the ovaries to improve response the following week to the stimulation medications.
• This is an IM (intramuscular) injection given in the PM (between dinner and bedtime) in the upper outer quadrant of the buttock (See diagram on page 5)
• Give while lying down to relax the muscle
• Verify that your Delestrogen concentration is 20 mg/ml
• Use a 1 cc syringe without a needle (NOT a Lupron syringe) and attach a 18 gauge 1 ½” needle to draw out the medication to 0.2 cc or the dosage in which you have been instructed to take. Switch needle to a 22 gauge 1 ½” to then inject intramuscularly.
  

E2V 2 mg suppositories

• Not all protocols use the Estradiol Valerate vaginal suppositories
• These are given to ensure that the uterus is being supplied with enough estrogen
• Insert vaginally at bedtime
• These may or may not be continued after CD9.
• Make sure you are inserting the E2V 2mg (Estradiol Valerate) suppositories NOT the suppositories used after embryo transfer which are Estradiol Valerate 1 mg/ Progesterone 50 mg suppositories (or E2V/ P4). If you use the latter in error your cycle will be immediately cancelled.
• Keep refrigerated

Folic Acid 1mg tablet

• Prescription strength folic acid dose (over-the-counter dose is only 400 mcg).
• These tablets are taken to prevent Spina Bifida-type problems in fetus.
• No side effects and can be taken anytime.
• You may opt to take a Prenatal Vitamin instead of straight Folic Acid, this is fine as long as it is prescription strength

SDF (Viagra) Suppositories

• Given to increase blood flow to endometrial lining
• Take vaginally 4 times daily
• No side effects, except possible vaginal irritation from so many suppositories.
• Place the suppositories over the course of a day (with the last at bedtime, unless you are taking E2V suppositories as well) and that it doesn’t have to be exactly a certain amount of hours apart.
• You may wish to wear a panty liner since not all of the wax absorbs and you may experience slight oozing.
• You should try to at least be sitting for 15 minutes after each insertion.
• Keep refrigerated

Terbutaline 5 mg Tablets

• Given to relax the uterine muscle which will allow more blood flow through the uterine vessels
• Starts with SDF suppositories.
• One tablet three times a day
• You will experience the side effects of nervousness, shakiness and a racing heart! If your heart rate is over 120 beats per minute, please skip a dose
• Your body will adjust to the Terbutaline in 2-5 days and you will no longer experience the side effects

Heparin 5,000 IU / Lovenox 30 mg

• Only use if indicated on your calendar
• Twice a day injections, to be given in the AM with Lupron/Cetrotide and in the PM with stimulation medications/hormone injections
• Subcutaneous injection given with a ½ cc or 1 cc insulin (Lupron) syringe
• Verify the concentration of your Heparin. If 10,000 units/ml then your dose twice a day is 5000 units or ½ ml (which is equivalent to 50 units on the insulin syringe).
• You may also use Lovenox 30 mg one a day subcutaneously anytime in the day in lieu of heparin.
• You may experience some bruising at injection site, do not rub vigorously

Gonal F / Follistim

• This is FSH (Follicle Stimulation Hormone) or stimulation medication
• This is given subcutaneously anytime in the evening anytime between dinner time and bed time
• Please refer to packet instructions for reconstitution as can come in multidose vial, single dose vial and Pen form
• Your coordinator will go over instructions with you or you may contact Fertility Lifelines (1-866-538-7879) for Gonal-F product support 24 hours a day
  

Luveris

• This is pure Luteinizing Hormone (LH)
• To be given as a separate injection in the PM with your stimulation medication
• This is given subcutaneously
• The dose is always 1/2 vial (37.5 IU) as indicated on your calendar
• Use the 3ml syringe with 22 gauge 1 ½” needle to draw up 1 cc of diluent
• Inject full 1 cc into vial of powder (this is now 2 doses)
• With same syringe/needle, withdrawal only ½ cc (0.5 ml) and refrigerate remaining ½ cc for next evening’s dose
• Change needle to the 27 gauge ½ “ to inject subcutaneously.

Progesterone in oil

• This medication will be given in one of two dosage amounts, 50 mg (1cc) or 100 mg (2cc). See your calendar for your dosage.
• This is an IM (intramuscular) injection given in the PM (between dinner and bedtime) in the upper outer quadrant of the buttock (See diagram on page 5)
• Give while lying down to relax the muscle.
• Use a 3 cc syringe with an attached 18 gauge 1 ½” needle (or 20 gauge) to draw out the medication to the dosage in which you have been instructed to take. Switch needle to a 22 gauge 1 ½” (or 25 gauge 1 ½” needle if your product is made in ethyl oleate oil) to then inject intramuscularly.

Final Comments

• On CD9 (cycle day 9 when monitoring in our office begins) you will be given a new calendar and instructions once we have determined how you are progressing
• There will be medications you have received that are not on your calendar at this point (i.e., Cipro, hCG 10,000 units, progesterone in oil, Clindamycin suppositories, E2V/ Progesterone suppositories). These will be used post CD9.
  

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Injections sites

Intramuscular injection sites

Subcutaneous Injection Site (use upper thigh or lower abdomen)

I WILL DISCUSS HOW I FEEL ABOUT EACH OF THESE AND THE OUTRAGEOUS COST IN MY NEXT BLOG......I THINK I'VE SHARED ENOUGH FOR ONE BLOG POST :)

JUST A LITTLE THOUGHT: "HOW DOES ONE TRAVEL WITH A CARRY ON THAT COULD BE PASSED OVER FOR A DRUG LORD WITH SYRINGES AND ENOUGH FERTILITY MEDS TO KNOCK UP A SMALL ARMY?" JUST WONDERING!!!