Bionic Mamas

you're not losing a vagina, you're gaining a son

News From the Front

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The bottom of the front, specifically. The front bottom, if you will.

The appointment went well. Dr. Baby Factory did not, after all, yell at me, you will be relieved to hear, though as always, he had that sad look that Sugar reminds me is mostly just how his eyebrows are shaped. His hair’s gotten a bit shaggy, as if the four years since we’ve met (is that all?) have taken him from being the 11-year-old star of the piano recital (as I always thought of him after seeing the picture in his office of him sitting ramrod straight up on one of the Today Show’s couches) to a 15-year-old with a garage band and a penchant for eschaton.

Dr. BF is who first suggested I go to Dr. Russian’s practice for OB, although in fairness he specifically recommended Dr. Robot, who left the practice in my first trimester.  Nevertheless, I decided I would tell him to rethink recommending them, if not for Dr. Russian’s appalling manner (which I know you all believe me about, but which could sound like the whining of a delicate flower) then for the way Dr. Skinny, the head of the practice, dismissed out of hand my was-that-an-abruption bleeding in the days before labor.  It is with deep pleasure that I report to you that he already has a call into Dr. Skinny, because he keeps having her patients come to him, get pregnant, and then refuse to return to her practice.  (Smart women!) So I guess it’s not just me.

While we’re on the subject of Dr. BF, can I just say what an absolute artist that man is at a pelvic exam? Seriously, he is the only person ever whose haven’t hurt; even his double pap smears don’t hurt. (Yes, I am a special snowflake and regularly cry over medical messing about in my lady business(es).  My cervices are on the inside for a reason.) I have to say that here because, 1) it is worthy of praise, and 2) there is no non-creepy way to express this sentiment in the moment.

So, the various bottom lines:

  • I will be making a lot more “bottom” jokes around here in the coming months.  Enjoy.
  • My CD 2 numbers are, I think without digging for my old notebook of data, the best they have ever been.  (FSH 5.6, E2 a shockingly low-for-me 39.)
  • My famous endometriomas (aka, “chocolate cycts,” if you are into ruining your ability to enjoy chocolate forever, which I am not) have apparently disappeared (?) (!).  Is this even possible?  I have noticed less back pain in the past few months, but I certainly felt plenty in cycles since being pregnant.  I am befuddled.  I’ll work on being glad, but right now I’m too confused.  At any rate, the dildo-camming didn’t give me the usual sensation that a smoldering rat is trying to scramble out of my lower back, which was a nice change.
  • We have lots of embryos, and Dr. BF seems optimistic about our chances, or as optimistic as his eyebrows will allow.

Scheduling is a bit of a annoyance, more so than I had anticipated.  I have the good insurance for six months, March-August.  I naively assumed this meant time for several cycles, but I had forgotten that the Baby Factory closes for IVF and like matters three months of the year, and two of those months are April and August.  When the scheduler explained that an April cycle, which was what I had begun to imagine, wasn’t going to happen, I felt bathed in adrenaline.  March?  March?!?  That’s so soon! But waiting doesn’t make a lot of sense, under the circumstances, so March it is.  Then I drank the warm apple juice she’d brought when I got woozy missing the half-gallon of blood they’d siphoned off for still more tests.  When a few molecules of sugar reached my brain, I remembered that I can’t do March, because Dr. BF wants me to come back early next cycle to see if a polyp is what’s making me spot so much before my period or if it’s just my good buddy endometriosis.

So May it is.  I am not entirely sorry to wait, though I had gotten myself slightly excited about Just Doing It.  I am worried that between the possible polyp and the closures, my six months of insurance just became three (and that’s assuming there’s no polyp or that it can come out quick-like in April).  However, billing had a surprise for us: the less-good insurance (under whose begrudging, code-careful auspices we had this consult) actually covers quite a bit more than we had thought.  Doing a cycle with them would still be more expensive than with the good insurance, but it sounds at the moment like it wouldn’t be impossible, especially if we planned ahead and got the drugs while I’m still on the good plan.

May gives me time for a few more visits to the favorite cocktail bar I am just now falling back in love with.  It also gives me some time to get worked up about various parts of this whole gig I wasn’t expecting.

For instance: more shots.  When I was first contemplating IVF, I decided I could deal with the little needles for stims but not the big ones for progesterone-in-oil, and Dr. BF agreed that I could use coochie bullets — excuse me, vaginal suppositories; excuse me, non-American readers, pessaries — instead.  They were messy and sort of annoying, but I was never sorry to be missing the intra-muscular missile to the butt I’d read about on other blogs, still less the bruises and lumps and lingering scar tissue.  But I guess now I get to learn for myself what all the fuss is about, because Dr. BF says (and, I regret to say, that the study I found on the topic agrees) that the delivery method really does make a difference in FET cycles.  Dr. BF says that during my IVF cycle, I was making some progesterone on my own, but that during a medicated FET, I won’t, which means that small differences in efficacy can mean big differences in results.

So one thing I guess I could use about now is some PIO pep-talking, should you have any on hand.  I’m not upset by needles per se, but I am no great fan of personal pain, especially deliberately inflicted, in my own home, every day for three months.  Call me crazy.  However, I also realize that a miscarriage I would always fear I could have prevented is worse.  Great choices, these are.

Okay, I know there are worse choices, I KNOW.  I know that, as subfertile lesbians go, I am sitting very pretty, what with the good clinic and the good insurance and the bewildering array of embryos.  It’s just…I had forgotten what this part, when fear and uncertainty loom so very large, feels like.  Frankly, I thought I got to skip it this time.

Mel asked the other day, after my first return to the Baby Factory for CD 2 blood work, whether I found that some of being back was much easier and some was ten times harder.  Yes.  That is exactly how I found it.  At first, I was giddy, almost, being back in such a powerful place without the dread and exhaustion I remember from the last time around.  This is a cinch, I thought, walking right up to the check-in computer to type my name.  The first time I came in, I stood awkwardly in front of the receptionist’s desk for some time before a woman in a pompadour, whom I did not yet know was nosy as the day is long and none too quick on the uptake, informed me in one of those New York lady klaxon voices that still startle me that I was doing everything wrong, as though it weren’t understandable that a person might imagine their office worked like every other office on Earth.  This time, the receptionists were new and muscle memory guided my hands through the menus as surely as if they were ticket machines at Grand Central.  Bam! I thought, jabbing the CD2 bloodwork button, my doctor’s name, my insurance carrier.  I got this.  I even made a self-deprecating joke about sperm to the guy ahead of me in line.  (Sorry, sir.  I should probably not be allowed in public alone, at least not while giddy.)

As I waited for my name to be called, a strange nausea crept over me.  I hadn’t, I realized, been comparing my present-day self with the me who had first come to the Baby Factory at all; I’d been comparing myself to my memory of that person, a memory colored by knowing that my first visit was only the beginning, that there were miles to go, disappointments and fears and more than a few crying jags.  In fact, that very first me, the one the receptionist startled, was a lot like this me: happy, excited, hopeful.  I had mainly wanted to go to an RE because of my mysterious lady-part arrangement and because my insurance covered it and the Gyn I’d gone to was a dick, so why not?  I imagined we’d leave with a plan, buy some sperm for home use, and have a baby in less than a year. Although our story ended happily, that original me sure had another think coming.

The PIO surprise was like a bucket of cold water to the face in part because I thought this time was going to be so easy.  Aren’t FETs supposed to be so simple compared to a fresh cycle?  I suppose it is simpler, in that I don’t have to come to the office much and won’t get OHSS this time, but I had forgotten that simpler isn’t the same as easy.  I know what to expect from an IVF cycle, but an FET is nevertheless new to me, bringing with it all the anxiety that attends medical novelty.  That I know how to get to the clinic and where to buy a coke after they exsanguinate me for science does not mean I know anything about what’s going to happen, and worse, it doesn’t mean I have any control over the results. I know I’m a lucky subfertile lesbian, but dammit, why can’t I just be a fertile one?  I thought skipping the rounds of IUI this time would make me feel fertile, but that fantasy is crumbling now that I remember that this “fertility” still involves doctors and needles and tenacula and fear.  I never really believed this when we were trying to conceive the first time, but it turns out this secondary infertility jazz is, to paraphrase Smarshy’s memorable image, just a different bag of ass.

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14 thoughts on “News From the Front

  1. Smarshy always said it perfectly. Going back to the clinic made me feel calm in the sense that I knew what to expect… and terrified in the sense that I knew what to expect. Sending lots of good thoughts for this leg of the journey.

  2. Aw crap. I was pitifully naive – I thought it was going to be so simple and comparatively painless. The PIO shots sound horrid. I think you should get a present every day after the shot. Like three months of Chanukah except shots instead of candles.

  3. The PIO shots are not horrible. At least not if you get some numbing cream like Emala or such and put some one first then cover it up with tagaderm and let it sit for 30+ minutes. I did them for 10 weeks because it was a gestational surrogacy. Since your using some of your genetics it shouldn’t take as long to get your hormone levels up! It’s worth it and I even did every single one on my own. You can do it!!

  4. Omg why did you tell me that about PIO? I’m needle-phobic and only managed IVF with the help of my magical Emla cream. I did coochie bullets too – and TMI but I actually did them rectally… Works the same and is WAY less messy. Sounds worse, but is not. We’re starting to think about thinking about trying an FET and this makes me want to cry. In fact if the RE tells me that I will probably have a breakdown in his office. I feel your pain.

  5. First, I’m very pleased to hear of the impending bottom talk. Front bottom, that is. That’s some good stuff!

    Second, the formal besmirching of Dr. Skinny’s formerly not-that-bad name is also delightful news. Well done Dr. BF!

    Third, I miss Smarshy.

    Fourth, PIO is survivable. No fun at all (sorry, but I can’t lie to you), but after a while, it just is what it is.

    Fifth, GOOD LUCK!!!!!

  6. Ha, “news from the bottom front”! I love a good vagina pun.

    You’re telling me that returning to a fertility clinic isn’t like riding a bike, beyond the sore crotch? Unfortunate. I hope that this time around is as fast and painless as possible!

  7. Okay…first off, wishing you only the best!

    FETs are much simpler (okay, I haven’t actually done one, but hormonally speaking, IVF-DE is the same thing) than fresh. PIO isn’t the worst thing in the world… but if you really don’t want to do it, I alternated PIO with prometrium (taken vaginally, that is), as according to my RE the shots have a long half life. My P4 level was always stellar. But the needles are much scarier looking than they actually FEEL; it’s the muscle-soreness that kind of sucks.

  8. I totally get you with the weirdness of going back to the clinic. It was easier because I knew the ropes, but also harder because I knew what was at stake now. And my chart is still super big. It’s not like I got to have a new one for 2.0 attempts, so every time I go in I’ll be staring at that monstrosity and knowing that the other women are staring at it too.

    Ok, I do have FET and PIO experience. I hadn’t realized that the PIOs were better for FETs and am a bit depressed about this since I had the hive issue with the PIOs with my pregnancy with E.

    But, until the hive issue, they really weren’t too bad. I didn’t do them myself. Q. did them, and when he was away for a week or so I just went to the clinic. I know women who have done them themselves, but I wasn’t that brave. And Q. got really good at them.

    They are a pain in the ass, but provided you don’t do something stupid like keep trying to run while your muscles get progressively more and more irked with you (hand is up, yeah that was me), they shouldn’t cause too much residual soreness.

    I like May as an option because that is a February baby, which means right when you start to hit the end of your rope as a result of totally normal newborn antics it will be spring and you can get OUTSIDE.

    Also very glad to hear the clinic’s formerly good name is becoming less so. Hurrah!
    T.

  9. Like Turia, I didn’t really mind the PIO shots. Like Turia, I developed awful hives (second IVF cycle, the first was okay) and had to stop doing them. But then I developed breakthrough bleeding while on just suppositories, so I ended up using progesterone-in-ethyl oleate shots PLUS suppositories for my FET cycle that gave us Bunny. Having to do both was a drag, but the shots weren’t too bad. I think I prefer them to the nasty discharge from the coochie bullets. Plus, you can’t give yourself a shot in the ass so you can put Sugar to work.

    So I guess we really could be cycle buddies again. We’re looking at April or May right now. I hope we’re both successful on try #1 this time around!

  10. Your description of feeling both confident (because of knowing all about the process) and scared (because of knowing all about the process) feels so accurate. Yay for Dr. BF’s optimism about your chances! And glad to hear that he took your concerns about your OB practice seriously.
    Also, I am looking forward to many more bottom jokes.

  11. Wow, May! I’m feeling waves of unchecked excitement over your FET that only a commenter could have. I just feel really hopeful that this time will be way different and you’ll have another baby soon.

    The PIO shot protocol sucks. We never had to do shots (Fern’s IVF study protocol dictated suppositories) but we did do a couple butt needles in Fern. It was terrifying to contemplate, but really not so bad (according to Fern). I think i was actually shakier than she was (I had to lie down for a minute after giving the shot…). I understand the mixture of excitement/confidence and fear when contemplating #2. I know it’s different for us because we switched, but I was also both confident (we were starting SO much further along the medical intervention spectrum than with Fern and we knew what we wanted) and terrifying (untested body, the memory of what we’d been through.)

    I can’t wait for May!

  12. Bwa ha ha! Thinking you were going to do a FET right away is about as close as you’re ever going to get to an oops pregnancy, huh? I’m glad everything seems to be in order, and that it’s just logistics that’s keeping you from getting knocked up, stat. In the mean time, enjoy the hell out of all those cocktails.

  13. Yes, Bionic, why *chocolate* cysts? Why? Such an unfortunate association. I move to call them henceforth something nasty like oxtail soup cysts. Bleah.

    Other than that, I had Many Thoughts To Share on the subject of PTSD, and Open Letters to the medical community for their better education, but for the moment, I will confine myself to just wishing you the best. May! Yay!

  14. You hit the nail squarely on the head with this one. I have officially now seen my RE for a longer stretch of time than any other doctor in my life, including my Pediatrician, which is madness.

    FETs are easier. I have a tried and true method for IM injections. Warm the oil in your bra for 5 mins minimum before the shot, take the weight completely off the side you are injecting (if someone else is injecting you, leaning on the sink with your weight on the opposite leg works. If injecting yourself, sitting on the toilet works) Grab a pinch and slide the needle in smoothly and straight.* Shake vigorously, and WALK. I can’t emphasize the walking and rubbing enough. Walking moves the oil quickly through the muscle tissue preventing lumps. I managed getting these shots for the entire first trimester w my twins (my plo was so low I was doing injection every day AND vagina bullets bleh) without looking like a black and blue assed baboon. 🙂 I was taught this method by the nurse giving me my depot Lupron injections and it has never failed me. Good luck!

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