Bionic Mamas

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

Post-Ovulatory Items

15 Comments

Sshhh, internets, the Bean is sleeping. Finally. I should be in the other room, using this time to finish my semester grading, but the Bean is also sick, and if I move, nap over. So how’s about some items, since I’m here for the foreseeable?

Item: for those following along at home, I was finally deemed worthy of triggering on Saturday. Transfer day is Friday. Cross your fingers, if you don’t mind, for an easy transfer and a conclusive beta to follow. Of course, I’d prefer a conclusively high beta, but what I’m most focused on at the moment is numbers that mean I get to go on our planned summer trip of friends and family and beautiful, quiet places in the north woods of Michigan. When I ran this idea past Dr. BF, he said it was all fine as long as they were satisfied nothing ectopic was happening. No one wants to risk a rupture that far from a hospital, not even me.

Item: There will be Valium at the transfer, and don’t think I haven’t made mention of that to every warm body I can find at the Baby Factory. (I know some clinics always use Valium — and I find their logic of reducing uterine contractions convincing — but mine doesn’t.) Look, I know things have changed in the down-there department, post-Bean, and it’s wholly reasonable to suspect at least one of those pesky cervices is a little easier to navigate now that six pounds of baby has gone through it, but I don’t care to test that theory for no good reason. A tiny part of me is holding out hope that Valium plus baby plus lack of septum (and therefore more space for the hand that rocks the speculum) might mean no tenaculum, even. A girl can dream.

Item: I mentioned this to the nurse who took my blood on Tuesday (progesterone check), and she asked if my inseminations had always been difficult. They were, I said, but less bad with the Valium. I think the first one, with no Valium, was traumatic for everyone, not just me, and for me it was downright ghastly. (To say nothing of the pressure I felt to think warm, welcoming thoughts for a baby, while I was getting stabbed and prodded to the point of tears.) Yes, she said, I think I was there.

And you know what, I feel downright comforted to know that she remembers. The Baby Factory is a big place, with a lot of patients, and this was some time ago. I just looked back at the post I wrote at the time, which in no way captures the horror — no doubt I was imagining some future baby reading about his beginnings and didn’t want to scare the mite (guess who hasn’t filled in the birth story page of her son’s baby book?). We don’t need to go back over such old wounds as that, but suffice it to say that directed coughing in no way distracts from the pain of having yet another cervix stabbed with pointed tongs yet another time, and that seeing the doctor break a sweat isn’t very calming. No one said anything much about it at the time — and what could they have said that would have done anything but worry me? — but I am relieved to know that my impression of the day wasn’t crazy.

Item: That the transfer is on Friday means a doctor I haven’t met before (I think. Unless she was at the aforementioned IUI of nightmares.) will be on duty. And thank heavens for that. Had it been Thursday, we could have had the same guy who did the Bean’s ET, which has a cute aspect to it and all, but also has the less winning quality of requiring me to spend more time pants-less with a paternalistic asshole.

Seriously, I don’t know what this guy’s deal is, but it certainly could use a slightly more robust idea of his patients’ bodily autonomy. I found myself in stirrups with him again last week. He looked at my chart and said, in a disbelieving tone, “natural FET cycle? Why would you do that?”

You know that thing when some guy asks you some supposedly neutral question, like what your name is or why you look a certain way (usually: not thrilled just to be near him), and you just know that no matter what you say, you’re about to get hit on/told you are misbehaving/both? (And okay, I’m sure there are instances of women doing this, but stick with me here.) And you seem, in that moment, to have a choice about how to respond — to take the question at face value or to address its obvious subtext by ignoring him/ rolling your eyes/ telling him off — but really, there is no choice, because either you are going to walk right into the condescension (by being nice), in which case you aren’t allowed to complain about it, or you are going to socially overreact, which means you get called a bitch? Anyway, Dr. Paternalistic (who shares a name with a city in California, if you are local and curious) is like that. There’s no right answer. Except instead of his being a stranger on the street, he is the only one in the room wearing pants, and he’s holding an ultrasonic baton.

Gamely, I said, “why not?” And really, why not? My actual doctor thinks my odds of success are the same this way as in a more medicated cycle. But he didn’t like that answer, because this kind of cycle means I have to come into the office a lot, which, by the way, I haven’t indicated any impatience with, because I don’t actually mind. So I said that I liked that this cycle meant I could avoid the progesterone shots (since my body will make its own, meaning the suppositories are sufficient insurance). This isn’t an insignificant reason, to my mind — a few extra office visits versus stabbing myself in the increasingly lumpy ass for three months? No contest — but he looked unconvinced. “Also,” I said, bracing myself, “I liked the idea of letting my body do its own thing, since there’s no indication of any problem with my hormones.”

“I GUESS,” he replied, with all the self-effacing deference I’d expect from a fourteen year old. And then he stuck a dildocam in my vagina. Because that’s how this game goes. At least there’s no septum for him to make me feel bad about anymore.

Item: I cried on the bus ride to school after that. I’m sure it’s frustrating, as a doctor, when patients don’t make the same decisions you would — hell, I’m frustrated by other people’s decisions all the time — but maybe make a distinction between decisions that actually have anything to do with health outcomes and those that don’t. And then maybe try not to be a jackass, also.

Item: On the other hand, the nurse who gave me my trigger shots (two, because they are subcutaneous now and therefore weaker) on Saturday is in my good books. She, too, noticed and commented on the NATURAL scrawled on my chart. They don’t do many cycles this way, and that note has a lot of highlighter on it. “Good for you! Making your own follicle!” And then she stabbed me in the stomach (because that’s how this game works) and we talked about people eating their placentas. Not our thing, we agreed, but no reason others can’t do it. Imagine that.

Item: For the medical record, the progesterone is different this time. Last time, it was little waxy bullets from a compounding pharmacy, but this time I was given a choice between Crinone twice a day or prometrium thrice. My decisions was entirely based on math: 2<3. So far, the crinone is fine, except for making me crampy and leaving an absolutely revolting substance behind for removal during shower-time spelunking. Still, I will take gross over painful any day of the week.

Item: For the further medical record, following an awful morning of intense nausea, I decided to be pushy and ask if I really needed the doxycycline I'm on, given that I've had no invasive egg retrieval this time, no one thought I needed prophylactic antibiotics for an IUI (which is not essentially different from an embryo transfer), and my stomach is still all ducks and drakes from this sinus adventure. Message relayed via nurse is that I can indeed stop it, and I think I shall. I shall carry on with the methylprednisolone (how much extra do you think my insurance paid for the pre-metabolized version of a cheap, old drug?), as I can see the medical point of that one.

Message goes on to say that I must also stop taking Prilosec and Pepcid post-transfer, which is less good news. (Sinus doctor wants me to stay on both for another month while things heal; they a not presently back to normal.). I remember from last go-round that Dr. BF didn't even want me taking lysine for cold sores while under his wing, so this is hardly surprising. Lysine is an amino acid, for crying out loud; it's in FOOD. Similarly, I was directed to take both Pepcid and Prilosec while pregnant with the Bean, though admittedly later in the process. I guess every drug is suspect except the fertility drugs, which we all know wouldn't hurt a fly. I am at heart a Good Girl, though, so I will try for a bit and cry to my new OB if things get hairy.

Item: I can't believe the Bean is still asleep, but I woke him up prematurely yesterday (following his passing out on the floor in the late afternoon, following heroic meltdown, following utter refusal to nap earlier) and he still didn't go to sleep in a timely manner last night.

Item: Acid reflux and moral purity be damned, Sugar and I are going out for what I hope is a last-gasp cocktail tonight. Which means the Bean will have a babysitter, and sleep, well, that's her problem.

Advertisements

15 thoughts on “Post-Ovulatory Items

  1. Paternalistic assholes can shove those wands up their self-righteous, know-it-all behinds. We’ve got a few over here too and I never ever know the right approach. Have a good last-gasp tonight and here’s hoping for the very best.

  2. Thanks for the update! I’ve been wondering how you were doing.
    Also, “shower-time spelunking”! Ha! Love it.
    And I agree that fertility doctors can be weird about any medications (you know, except for the crazy body-changing ones that THEY prescribe). Mine didn’t want me to take extra B6 for my crazy nausea even though someone else from his clinic later gave me a paper which suggests taking…B6 for nausea!
    Have a lovely time tonight and I hope this is your last cocktail for a good long time!

  3. I am sat fuming. FUMING.
    That, right there, is a man who may be competent, but is ultimately No Good.

    I am crossing EVERYTHING.

  4. Ah, doctors. I thought CCRM’s famous protocol involved tons of antacids! (You will be shocked to hear that I would probably both take it anyways, and lie to the doctor.)

  5. Hey! Hoping everything goes splendidly!

    I might have overlooked something, because I’m not functioning on enough sleep to read clearly…. but I’d totally vote for Prometrium over Crinone. Have you looked into pricing? I thought Crinone was wicked expensive (I’ve never actually had insurance coverage for it) but always got Prometrium for a cheap copay so I guess I’m wondering if taking it more frequently isn’t still a better deal… And it worked great for me (took 200-600 mg daily, depending on the cycle).

    Wishing you well. And a speedy recovery for the Bean.

    • Thank you! That is really useful to know. My insurance is paying this round, but if there is another round, I won’t have drug coverage (unless I can be sneaky and order the drugs while still on the good insurance). I was quite gobsmacked when I saw the cost of the crinone.

      A number of people seem to prefer prometrium, and I wish I’d had time to solicit opinions before deciding, but alas, the first I knew there was a choice (there wasn’t, last time) was the phone call requiring my decision.

  6. I am sneaking on from the library, so can’t say much except to say GOOD LUCK!!!! (And that doctor is an asshat.)

  7. I find all suppositories revolting and would gladly trade my Endometrin for butt shots. I didn’t know P made you crampy. That hasn’t happened to me before. You don’t think my phantom “implantation cramping was that, do you? I also didn’t know subcutaneous trigger is less potent. Could that explain why I didn’t ovulate when they thought I would?

    Anyways, here’s to our natural FET cycles! Let’s hoping trusting our bodies was the way to go. But yeah, can’t hurt other than the loss of a month of trying. It was worth it to have those extra weeks to me, and will be even if it doesn’t work.

    • You do realize you’re asking these questions of someone who once decided she had an ectopic pregnancy in her kneecap, right? It’s possible I am just crampy by nature and sometimes attribute it to something in particular. (But I don’t think that’s the case, this time: cramping is a common side effect, and I was having pretty un-ignorable cramps 1-2 hours after a dose. It’s less strong now.). That said, if YOU weren’t generally having cramps from your progesterone, then I see no reason to assume that wasn’t implantation. No reason at all.

      I don’t really know about the ovidrel, except that this time, one of the nurses mentioned that they do two shots, “just in case,” now that it’s sub-q. When I was last doing this, my clinic only used IM triggers. The only thing I know about failed triggers is that, when I talked to my RE that time around about triggering with Lupron to lessen my OHSS risk, he said Lupron had a fairly significant failure rate compared to HCG, something around 10-15%, as I recall. (And then I further recall my parents’ advice about answering questions posed by attending when on rounds, including “if it seems like it should be a small number, say 10-15%, so grain of salt there. The other options, if you were wondering, were, “if it seems large, say 85-90%, and if you have no idea, say that it concerns mechanisms of the sodium-potassium pump, because chances are, the attending doesn’t understand it, either.)

  8. Catching up!

    There’s a certain sort of doctor who should be kicked sharply in the taint on a regular basis. Alas, alas.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s