Barely tenured

Maybe I don't want to

All spring I've had to hold myself back from everything having to do with the upcoming IVF cycle.

I made a little color-coded schedule with cycle forecasts, academic dates, vacations... I pored over it daily. Once I had my first post-failure LH surge (on day 21!) I was able to fill in estimates for 4 straight months. Whoops! I missed the March slot for the coculture biopsy; well, let's fit the HSG in instead!

I was happy to have a good reason why we weren't finishing the upstairs bathroom or buying still more shoes for Miss T. No, not when every extra dollar should go to improving the lifestyle of some of Cornell's best-paid employees!

But now it's time to really get going. I should surge today, then have my biopsy next week. I need to get the HSG images and report to Dr. D pronto. The cycle itself is on track for late May.

And I'm procrastinating. I'm not making the phone calls. I fear this cycle. I know, once more, that all of this can fail. That it probably will fail. Especially so, now that I've moved on to the world of obscure poor-responder protocols. I find myself backing away.

So, certainly part of the issue is that I've now had a totally crappy cycle at Cornell, and I'm going back to the scene of the crime. I fear pain. On a smaller scale, dealing with this clinic over the phone is always, always horrible, and that's what I get to do for the next several weeks.

But, I think what really tipped the balance of emotion was doing our taxes. We got them in on time! (A real improvement over last year, and, I think, the year before that.) And, this year there were no big institutional screw-ups to deal with. However, one of the consequences of last year's big payroll computer screwup ("Ohindinois? Where's that? Naaaah, I'm going to send your money to Iowassouri instead... I know where that is!") is that we effectively paid double local taxes in 2007, which pushed us into alternative minimum tax range, and... and we had to send a good chunk of the IVF nest egg to the IRS, all of a sudden.

I felt naked and exposed. This isn't all just a game. By choosing to cycle, I am also choosing to make my life worse in the short term (no upstairs toilet! no spiffly new sandals!), and the futures of some other people just a little more precarious (putting off college savings, underfunding the 401k).

I am very, very lucky, perhaps unspeakably lucky, that we are able to do this at all, and that the things we are sacrificing are not, e.g., food and shelter. I am going ahead this time. But the doubt is looming large.

Still sort of on track with both projects

So: I have promised myself one entry per book chapter read and corrected. I've actually fallen behind: I've made it through 3 chapters, and not posted at all until now. We'll see how it goes from here.

So spring break almost sucked rocks, but not quite entirely.

I got the flu the week before. Only canceled class on Wednesday (if god forbid it happens to you, just STAY HOME, damnit, especially during the early achy stage). I was feeling a bit better on Thursday so I went ahead and got my HSG (at this point any slips in schedule would derail cycle number 5 badly, so driving 40 miles each way with a fever seemed pretty mild). (Oh -- and why is this test part of the current plan? Dr. Data just wanted to check that nothing's odd in my uterus, like fibroids too small to see on ultrasound, or a lurking polyp. No one gives a damn about my tubes).

Both tubes were clear, which made it a much less horrible experience than my first HSG, back in (eeek) late 2002. I went up to our old local clinic. Dr. Brash is long gone, and the doctor who pumped in the contrast dye -- and who maybe did our second transfer there? but who can remember -- didn't take it personally that I'm going to Cornell now. "Say 'Hi' to Dr. Data for me!"

Then Beaker and Miss T. caught the flu too, over the weekend that started break. We'd hoped Beaker wouldn't -- he's missed several colds that came home with me or Miss T. this year -- but no. The flu is bad news for Beaker. Every year he's pre-armed with antivirals, which he took, but he still took to his bed for three days. There's still the lingering lung inflammation, which is very bad. His exercise tolerance is the worst I've ever seen.

We'd been planning to go visit Beaker's parents for the whole week, both getting half-days or so of work done while grandparents and grandchild communed. We hemmed and hawed and coughed through Thursday, when we finally, crazily, set off on the 7-hour drive. Everyone seemed better enough. I took big chunks of Thursday and Friday for grading -- I'd fallen horribly behind the week I was sick, and when I'd been hoping to get caught up -- and then the first half of break had been taking care of sleepy grumpy toddler and achy wheezy dada. Beaker played with a tractor, and Miss T. planted potatoes with her grandpa. There was sunlight and company and laughter. And then Sunday we drove home.

After the 4-day break, my e-mail contained no horrible surprises. (Plenty of continuations of existing stressful situations, but no new ones). And I find myself strangely optimistic, once again, about the book project; that I squeaked out any progress at all during break (feverish toddlers nap more than healthy ones) comforts me.

Life in the next few months will be a marathon leading up to the next vacation -- which will be a week at a cold but pleasant midwestern beach with family and friends at the end of June. Finish out the semester, then do the IVF cycle in late May, then spend a week with the co-authors in mid-June, then, finally, eat strawberries (I hope they'll be in season) and watch cormorants dive with my nearest and dearest.

That other project

So -- I'm not pregnant. You knew that, I knew that, but it took an very unpleasant two days and screaming at nurses over the phone to confirm it, and then Dr. Data did our follow-up consultation just two days later and convinced me that we weren't crazy to be trying again and next time they'll use the X-ray lasers on my ovaries and he thinks we still have a 30 percent chance per cycle and... and I slurped up that sweet sweet Kool-aid, hugged Miss T., thought about how honestly more difficult life would be with anther little banshee, and tried to get some work done for a change.

But, the other 2008 project. The book. The damn book. Out, out, damn book. Leave my life and let me work on other things! Dr. Wow has insisted that we start an intensive cycle of proofreading. Two chapters a week, for both of us junior co-authors. Of course the monster must get a close reading on its way to doneness. And getting it done is, of course, the goal. But there are still giant gaps! in later chapters! that need to be filled! by me!

I just wanted to publicly record that today, some six weeks after Dr. Wow suggested the plan, I finally started in. In fact, I just filled in a missing hyphen on page 1.

Yay me!

The short version

Negative HPTs on both Sunday and Monday mornings (11 and 12dp3dt).

Superlocal lab stabbed my elbow at 7:45 a.m. Monday, but CORNELL NEVER FUCKING CALLED ME.

It's almost certainly the fault of superlocal lab, I bet they looked at those HARD progesterone and estradiol tests and said gee, it'll take us a WEEK to get those done, she doesn't really need that hCG stat, does she? but STILL. DAMN. CRMI should have at least called to tell me they didn't have results yet, and ask if I'd gotten tested.

I could call and bully my way through to the RE on call, but I'm too tired. Instead I'm just gonna leave a whiny voicemail on the nurse line tomorrow morning. And take one last PIO shot, just for kicks.

SEND HELP

KIDNAPPED BY PROGESTERONE BURP

STOCKHOLM SYNDROME BURP

PIO CONVINCED GUT BURP

GUT CONVINCED BRAIN BURP

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Yes, the crazy is here. I know it's the drugs. The hormones want me to believe. I hate it. And love it -- why not spend a few days giving in to the delusion? C'mon! It'll be fun! -- and hate it.

(The academic timing is identical to my first cycle, by the way. Five years ago that was. After that one I think I resolved to never again get a BFN after the start of a semester. Ha. Ha. So the second cycle's BFN hit a week before classes started. That wasn't any better than a week after.)

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Am going to test myself on Sunday. They only told me Monday because Cornell doesn't do betas on weekends. Saturday will be 11dp3dt, which should be late enough to be convincing. I don't want to get the news cold over the phone at work.

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Before I test:

-- finish unpacking bags from New York trip.

-- pay largest portions of largest bills for cycle.

Today:

-- order more PIO

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BURP

6dp3dt

I am starting in on my one-week-post-transfer migraine (which has occurred in all my cycles, regardless of progesterone dose, regardless of outcome) and I am going mad.

THERE IS NOTHING I CAN DO. I can fanatically try to plan out how the next cycle will go (not too early to worry at all, since scheduling will be a bitch; to do late May it may be necessary to have the co-culture biopsy during my first natural cycle following). I can think about how much easier it will be to not be pregnant while teaching. I can talk with friends who are done, quite done, with the whole IVF thing, and who remember their cycles just as those horrible times that ended in tears.

But nothing will make me stop wondering, stop overinterpreting every twinge and burp.

I have -- mostly -- stopped talking in my head to the embryos. (I don't think I did at all, last time. Four was too much of a crowd.) I no longer believe that they're really there.

My most salient remaining symptom -- still stronger than the headache, but probably not for long -- is the achiness on either side of the butt where the giant needle goes in every night.

What brings on the most crazy: going to the boards. I can't stop, though (for one thing, I had to look up the Cornell shutdown dates this spring and summer). Look! There are two 37-year-olds who put back 4, with high cell counts, and who failed! Twice each! At Cornell! There's someone who changed protocols and her response got even worse! There's someone in tears because only 5! 5 of her eggs fertilized! There's a 41-year-old with lots more follicles than me! There's someone whose last cycle was cancelled, who has lots more follicles than me!

Tomorrow is the first luteal bloodwork. That's where they don't tell you anything, and just keep the data for, ahem, "future cycles." Last time the local lab was too slow with results, so Cornell called me up and told me to double my PIO dose. Let's just say that I'm going to try a different local lab this time.

P.S. Miss T. developed a splendid cold over the weekend; high fever, raspy cough, three days of severe grogginess. She's on the mend now, and should be able to go back to Box-O-Tots tomorrow. I haven't caught it yet -- but of course any feelings of disorientation could be ascribed to early stages of that.

On a scale from 1 to 10...

... of the possibilities actually available, after just those two eggs fertilized:

We're at an 8, I'd say. Both kept going. One 8-cell, one 6-cell. The 8-cell looked a little messy to me, but Dr. C. was honestly optimistic about both of them.

Beta on February 11.

My last day in Weatherwood

Or, why I needed to get the hell out of there. Warning: long, self-indulgent, probably incomprehensible. I promised myself I'd write it down, and it seemed like I should get it out before the new kind of crazy that PIO brings...

... yes, they put me on just half a cc, and I just got some bloodstains on a Helmsley washrag that I was using as a hot compress afterwards.

Another disappointment

Three mature; two fertilized.

So my make-me-happy scenario has become best-possible-but-not-very-likely.

Last time I remember being disappointed that only 5 were mature and fertilized; I remember Dr. C., at transfer, being surprised at how well the fertilization and early divisions had gone, since we had 4 good and 1 crappy embryo. "Usually we need to get 7 or 8 mature eggs to get this many embryos."

They recommend transferring 3-4 for my age range. We're not going to be there.

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I hate, hate, HATE the rhythm of a cycle. The sheer number of points at which you get a tiny bit more information, where you can update your subjective probability of success (Cornell, I'm sure, could crank out an exact number based on their experience: a 37-year-old w/one success, but crappy response in current cycle, average fertilization w/ICSI, yada yada yada: maybe something like 12% if we get one embryo, and maybe 20% with two? refine for cell counts and fragmentation as appropriate...). It kills. Imagine what this process would be like, how different it would be to experience, if it took just one day: get yourself to the clinic by 4:30 a.m., go home at 8 p.m., knowing if you're pregnant or not.

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On the other hand: we did get fertilization, with Beaker's five-year-old frozen immature sperm. That's the medical miracle right there. I should call andrology and make sure that just one vial got used. (If not, that'd be another huge body slam.)

Early this morning I realized it was okay that I hadn't changed my plane tickets yet -- since, if there was no fertilization, I'd just get on a plane today. We haven't been cut off that hard, yet, and I'm going to call the airline now, to reserve a Thursday flight.

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If this fails, and even if we never make it to the beta, will I be able to forgive myself for trying? For hoping? For going away from Miss T. for this long? (Beaker says she's starting calling me "Emma" instead of "Mama.") For letting down my co-authors? ("I'm going to be in New York for two weeks by myself. I'll be able to get a lot done." In between, you know, family angst, pacing the streets, forced three-hour-naps, and tearing my hair out.) For lighting the money on fire?

Will I be able to remember the things that make us ambivalent about trying? (Well, the things that make us ambivalent other than how much it sucks to try.)

Shaking

I just triggered. Aimed that big ol' sucker at the ballpoint circle on my butt and stabbed.

There have been 4 follicles of decent size on my last two ultrasounds, both done by Big Names. Estrogen plateaued just below 800. Last time, with 5 mature, it plateaued just below 1000. So, two strong indicators for 4.

What would make me happy: retrieve 6, of which 3 are mature, and 2 good-looking embryos at day 3. That'd make me feel like we weren't dumb to try.

What Miss T. wanted to tell me, when she asked Beaker to call me at cattle call this morning: "The blue car's mama went to New York." Repeat after me: the stakes are different this time.

When I will get to go home: Thursday.