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Follistim Vials

Posted by vintagemother on December 2, 2009

Cool Stuff:

Since yesterday was day 7 of stims, I knew I had enough meds since I purchased: 3*600 + 300 for a total of 2100 iu’s.

But, since I’ve been taking 225 iu’s each time out of each 600 vial, I thought that I may have to poke myself 2 times with the follistim pen-to get some out of 2 seperate vials.

However, my 600 iu follistim pen had enough meds for 3 225 doses! I still have a tiny bit in there!

I’m looking forward to my u/s today, a little apprehensively about my follies ranging in size so much. But I do know it only takes 1 and I am trusting God to know what I need.

I hope to spend some time learning about pio shots today.

Happy Wednesday!

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CD 10 U/S after 7 Stim Days

Posted by vintagemother on December 2, 2009

I feel like I don’t stop moving/running all day. Maybe if I were more organized it wouldn’t feel that way. But people keep telling me I look really organized. I guess I just feel like I can only do so much. A big part of my day is spent just being a mom. And trying to be the kind of mom who’s not over-busy and rushing her kids and always telling them to SHUT UP or BE-QUIET. When I worked more (at home) and was more efficient, that’s what I had to do-spend a good portion of the day saying “shhh”, or “quiet”.

Now that I’ve allowed myself to do less, I feel “bad” about doing less. Augghhh! Mommy guilt sucks!

Today, I did the following:

• Spent some time being my DH’s girlfriend at about 4am, LOL.

• I woke up early to take DD to her school by 7am for a school related out of town trip related to sports.

• DS forgot his HW, so I agreed to let him go to school late and to bring him and his homework back to school on my way to the RE clinic. • Had my Follie check-supposedly we’re doing really well according to the RE and the Nurse

• Me and DH had the oil changed and went to the mall to finish up Christmas shopping for our kids

• Picked up kids from school-DS’s eye got hurt by a kid and his pencil • DS and I returned his football equipment

• It’s now 4:45 and we’re at the in-laws house. I needed to jump on their laptop and email my assistant.

• I’ve been working from my blackberry all day and it finally died.

I still need to do the following:

1. Clean my house

2. Do laundry

3. Pay my assistants

4. Balance my checkbooks

5. Pay HH bills and Business Bills

I don’t know when I’ll ever feel like I have enough time to do everything and the guilt is making me feel badly!

When I look at the list above, I feel like I don’t do much. I think that “SAHmommy-hood” is simply a full time gig and that’s why everyhting else seems like it doesn’t fit.

I want to take a NAP!!!!!

Follie Report:

Endometrium Lining: 13.2

E2 level: 1608

20

19

18

17

16

15*2

14*2

13

12

11*2

10*3

I think there’s “less” on the report today, since he didn’t count them all today if they wouldn’t be near the size needed for retrieval.

I asked my RE why one of my ovaries takes longer to find, always. He told me that: Ovaries can move 3-4 inches potentially. The sigmoid colon can push it over. I also asked when will I start the PIO? After retrieval. I may continue until 1st and 2nd betas. I may continue until 6 weeks ultrasound. I also wondered what the rest of my medicine calendar will look like. The nurse told me that the antibiotics and at least 1 of the suppositories will also start after ER. We wondered about sex. We were told we shouldn’t BD before retrieval. Prior to transfer is good. No sex until after 1st ultrasound sometimes.

Cuz I’m crazy, I put my follies into a grid so that I can track their growth:

20 0 

19 0

18 *1

17*2

16*1

15*2

14*3

13*2

12*4

11*8

10*2

20

19

18

17

16

15*2

14*2

13

12

11*2

10*3

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Monday in IVF Land, 1st U/S Follie-check

Posted by vintagemother on December 1, 2009

Today was a great day in IVF land. I had my ultrasound and bloodwork done at 10:30am. The RE and Nurse said I’m responding well / beautifully. I had to whip out my blackberry to record the answers to a few questions I had. Below are my Q&A’s: 

 

1. What are my follie sizes?

 

  • 17
  • 16
  • 15
  • 13
  • 12*3
  • 11*4
  • 10

Left ovary (the difficult to find ovary)

  • 18
  • 17
  • 15
  • 14*3
  • 13
  • 12
  • 11*4
  • 10 

2. What are the # of days bedrest/taking it easy I’ll need to do after ER?

 

None are required, but I should rest until I feel better. Many women feel better within 1-2 days

 

3. What is the # of days bedrest/taking it easy after ET?

Same as above

 

4. What is How will you decide when to trigger? Size 18-21 is ideal. Size 15 and over may be ok. Under size 15 are usually empty.

 

5. How does the sperm analysis done recently in November compare with the last one in April?

The total count went up from 14 to 27 million, although motility and morph percentage stayed same – 2%. Normal/Healthy motility is 14%. So, our total of motile/usable sperm increased from approx 2 million to approx 4 million

 

 

Misc: Will do ER 36 hrs from trigger

 

6. Last E2: 7 precycle – I don’t know what this means… I know my E2 levels are ok, though.

 

7. Lining: 12 (RE likes at least 9 or 11, I think. Can’t remember) Either way, mine is fine/great

 

We’ll go back tomorrow at the same time to check on our follies. He thinks we may need 2 more days in order to make sure we have enough of the right size. Both the Dr and Nurse told me I’m responding well, actually they said “beautifully”.

 

Symptom-wise:

  • I’m in a good mood
  • I cry at the drop of a hat
  • I have some bruising in my tummy – since I have brown skin, I’m thinking the bruises aren’t looking as bad as they are. My tummy hurts to the touch in some areas.
  • I’ve been tired and craving naps – this is not abnormal for me, though
  • Lots of EWCM!
  • Emotionally, I’m feeling a little bit sad that me and my DH can’t make a baby by ourselves.  A part of me today resents having to have another man help us.  I love my DH and I really hope that deep down, he’s ok with this in vitro fertilization cycle.

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Nov 30: Day 6 of Stims

Posted by vintagemother on November 30, 2009

Today was day 6 of Follistim and Luveris. This was the “meat” of the IVF cycle, since for the last few days, I’ve been taking 3 injections and 3 pills each day.

I was really feeling the effects of the follistim- pressure in the groin/urethra, bloating, gas and fatigue.

I’ve been taking my lupron, dexamethasone and prescription PNV’s between 6 and 7am. I’ve been taking my luveris and follistim between 9 and 10pm.

I’m exited about going in for the ultrasound and E2 tomorrow at 10:30am. I can’t wait to find out what’s going on in there.

I hope I remember to ask my RE (or whomever does the ultrasound) what follicle size my RE considers “mature” and I want to record my own follicle sizes.

Today, my DD (age 14 1/2) wanted to give me my follistim shot, so I let her. My DS (age 10 1/2) cried. He told me he thought she was going to poke the baby in the head or hurt me. Awwww. He’s so sweet!hj

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Luveris

Posted by vintagemother on November 29, 2009

I’ll be taking my 5th dose of Follistim tonight. I’ll be taking my 3rd dose of Luveris tonight.  The Luveris has been giving me some challenges because I have to mix it and then draw it up. It doesn’t seem to want to draw up easily, I get huge air pockets and I’m not sure why.  I hope DH comes home on time to help me mix it and draw it up tonight.

If you want to know why/how I could be so confused over an injection, read the email below from the nurse at my clinic. I am so glad that they took the time to email me detailed instructions without my asking but I seriously don’t understand them. Since it’s 7pm now, and I try to take my night time injections between 9 and 10, I can spend a few hours studying the directions.

Good morning! Tomorrow night you will start the Luveris injections. Your dose is 0.5ml. To mix, use either a 3cc/ml syringe or a 1cc/ml, whichever you feel more comfortable with. (I don’t know what she means by 3cc/ml or 1cc/ml. I only have 1 cc/ml syringes, so I guess it’s a moot point)  Use an 18 or 22 gauge, 1 1/2 inch needle to draw up the one ml of liquid that is in the Luveris box and mix it with the powder. Then withdraw 0.5ml for that evening’s dose. After removing the needle from the bottle pull back on the plunger until you see air in the top of the syringe. (I may have missed this step)This ensures all the medication is in the syringe rather than in the needle. Change needles to inject. It is a subcutaneous injection so use a small 25 or 27 gauge ½ inch needle. Once mixed Luveris is good for 24 hours. The remainder of the medication can be placed in the fridge to be used to following evening. Don’t be alarmed if the second dose in the vial is less than 0.5ml when you draw it up. Below is a link if you would like a visual aid for mixing purposes. Just be certain to follow the dosage instructions that I’ve stated above.  

Huh?

The link to more instructions follows: http://www.education.designrx.net/PatientPortal/MyPractice.aspx?UAID=2f242609-79a4-404b-9dd9-4c9cd22c9ad7&ID=566ad891-88b8-48ab-ad8b-cd48beeb89dd

 
  Luveris® Instruction Video(Click on the “Instructions for Use” tab)

(Click here for larger image)

What is Luveris®?
Luveris® is a hormone used to support Follicle Stimulating Hormone (FSH) therapy. It is used with follitropin alfa (Gonal-F) to stimulate a follicle(egg) to develop and mature. The therapy used when a woman desires pregnancy and her ovaries can produce a follicle but hormonal stimulation is not sufficient to make the follicle mature.

How Do I Use Luveris®?
Here are step-by-step instructions for taking Luveris® (lutropin alfa) injections:

 

(Click here for larger image)

Flip plastic caps off of 1 vial of diluent and as many vials of powder as you have been instructed to use

Makes sense to me!

 
Clean the rubber stoppers of all vials with alcoholMakes sense to me!
 

(Click here for larger image)

Using a 3cc syringe with a 1 ½” needle (make sure the needle is on securely)
Pull the plunger back to the 1cc mark

OK Makes sense to me. This is just like all the other injections. I need to pull air into the needle 1st to avoid air pockets.

 

(Click here for larger image)

Insert the needle through the rubber stopper of the vial of diluent.

Yup, ok makes sense to me.

 
Push on the plunger injecting 1cc of air into the vial of diluent (to break the vacuum)OK This makes sense. But, I usually get some air and hear a popping sound when I remove the needle, almost like I put too much air pressure into the bottle.
 

(Click here for larger image)

Invert the vial.

 

(Click here for larger image)

Pull the tip of your needle down close to the rubber stopper

This part gets difficult, since I usually get HUGE air pockets, signifying I don’t have the tip of the needle completely submerged into the liquid. Or maybe it’s because some air gets into the needle/syringe because the needle is removable???

 
Withdraw 1cc of diluent by letting go and then pulling back on the plunger.This step was really hard last time.  I could hardly withdraw the diluent because of the huge air pockets. ): I also couldn’t withdraw ALL of the diluent.  After several tries, I did get most of it, though. I think that’s ok.
 
Remove the needle from the vial Ok sounds ok
 

(Click here for larger image)

Inject 1cc of diluent into the first vial of powder if it does not dissolve instantly, (swirl don’t shake) the contents

I only have 1 vial of powder and liquid, it should work out ok to just put it in.

 

(Click here for larger image)

Invert the vial, withdraw all the liquid (make sure the tip of your needle is as close as possible to the rubber stopper, you should be able to visualize the tip of the needle through the break in the rubber stopper)

I think I should invert and only withdraw .5cc’s, since that’s all I’m taking and I’m scared to accidentally inject too much. Last time, I did decide to only withdraw .5cc’s.

 
If you are using more than 1 vial of powder inject this mixture into the 2nd vial of powder This doesn’t apply to me. Thank goodness! I don’t need more complications!
 
Continue injecting the mixture into vials of powder until you dissolve all your recommended powders This doesn’t apply to me. Thank goodness!
 

(Click here for larger image)

If you are injecting subcutaneously remove the 1 ½” needle and replace it with a ½” needle

This was harder than it sounds, since the needles don’t easily come off and on. But, OK I think I get it, after I withdraw the medicine I need into my syringe, change out the needle to a smaller needle. I just wonder, why?! Why can’t I withdraw it using the smaller needle.  It might have something to do with air pressure/pockets/bubbles.

 

(Click here for larger image)

Gently push on plunger until air pocket is gone and expel a drop of liquid.

This was easy enough. The next step is to inject and that’s not as difficult as the mixing part.

 
 

Other cool stuff: I can FEEL my ovaries getting full. Since I took clomid earlier this year, I know the feeling. When I wait to go pee, it feels like there is a big ball in there. I’ve been feeling little twinges in there, too, particularly on my left side. At my ultrasound on Monday 11/30/09, I’ll try to remember to find out how if I have more follicles on that side. Other side effects I’ve been feeling include being tired, but when I’m not tired, having increased energy.

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God and Worry

Posted by vintagemother on November 29, 2009

I want to blog about something not directly related to my IVF cycle, except that I’m going through the stress of it while cycling.

 

On Friday, I had a conversation with my DD’s principal about God.  In an amazing manner, he graciously shared with me some Words of God that relate to a circumstance I’m facing I mean, my daughter is facing. (See, I was taking on her cares and I can’t do that, I can only be there for her) It was revealed to me that many of our cares and worries need to be cast upon God.  As a mother, due to personal past situations and human nature, I’ve been trying to stand in between my child and pain and that’s not in God’s plan.

 

I now know that God is the only one who can control the outcome of this situation. A flaw was pointed out to me in the way that I was handling a serious situation between my DD and her Bio-Dad.  My DD is 14 ½ and has expressed fear in regards to seeing her (mostly estranged) bio-dad.  We are currently involved an open custody case because he wants to force her to visit him overnight. 

 

Because of my DD’s intense emotions regarding this issue (my stomach is getting in knots now just typing this part); I’ve been trying to protect her by going to court, worrying, stressing, etc. I keep crying worrying about her.

 

However, I now realize that I need to step back and allow God to protect her. My job, as her mom, is to hold her hand and show her earthly motherly love, but not to “shield” her from pain, since I can’t do that. I need to allow God to perfect both her and me as we (she) goes through this trial. God allows us to go through things in order to give us the opportunity to grow and become more like Him. I know that God will also never allow us to be hurt. It is His goal that we behave Christ-like even in bad situations, because that draws us closer to Him. I knew a lot of this stuff, but hadn’t related it to the current circumstance.  

 

I realize now that I need to trust God to protect her and that God will not allow her to endure bad things. 

 

I was making this my battle, and it’s not.  Her bio-dad twists things and tells (everyone) that I won’t let him see her and that I’ve poisoned her against him.  I know this isn’t true, but have allowed myself to get sucked into arguing/defending myself while advocating for my DD. 

 

I need to remember that I do want them to have a positive relationship, I don’t want her to hate him and I think it would be better for her to harbor no resentment towards him. She is the one who doesn’t want her life – sports, education, activities – disturbed by someone who hasn’t really worked to be a part of her life and has been rude/mean/threatening when he has been a part of it.

 

I don’t know if she does hate him, she and I don’t talk about him, much. I do know that she is scared to visit him.  Obviously, my flesh wants to stand in the gap and shield her, but now I know that I CAN’T DO THAT.  I can only be there for her, show her Christ, show her bio-dad and the courts Christ through me, pray and lean not unto my own understanding.

 

This is the Lord’s battle.  I’ve had to depend a lot on my DH for support and reassurance that everything will be alright, which was a BIIIIIG step for me. I “know” that in the end, it’ll all be alright, but the battle aspect of getting from here to there has had me unreasonably STRESSED OUT. I know it’s not God’s will for me to be stressed.

 

So, I have a reassurance prayer: This is not my battle, God will protect T. God please perfect me throughout this so that I can be a model of how to lean on God and how to use God’s word in a situation. I want them to have a positive relationship, but I don’t know how to force her to visit him since she doesn’t want to – for various reasons.  She will not have to visit him is she doesn’t want to. No matter what happens, she’ll be ok, because God is taking care of her. She is His.

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Happy Thanksgiving

Posted by vintagemother on November 26, 2009

Chocolate cake – done!

Raspberry cheesecake – done!

Banana nut bread – done!

Butternut squash and parsnip soup – done!

Living room, kitchen and playroom – clean!

DH is doing the real cooking – turkey, ham, mac – n -  cheese

To be done:

Get dressed!

Clean office? maybe (-:

Make brussel sprouts

Make cider

Make mexican chocolate

Make another drink

And this evening, I’ll need to take Luveris for the 1st time! – I have to mix it…??!!

Updated 10:58pm

Get dressed and showered! – done

Clean office – not done (-:

Make brussel sprouts – done and yummy!

Make cider – done

Make mexican chocolate -done

Make another drink – Rudolf Spritzer – done

Luveris – done! Confusing! I had to mix powder and liquid, I kept getting huge air pockets, I couldn’t get the needle to attach properly. My mom, sister,  SIL /best friend all wanted to see me do the injections.  And it was getting late and I was getting tired, so I did them on the couch in the living room.

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Day 2 of Stims

Posted by vintagemother on November 26, 2009

It’s the day before Thanksgiving. I’m in the car waiting for DH to finish grocery shopping so I can go home and shoot myself up.

I got a little worried yesterday after I took my 1st Follistim, because after I finished taking 300 units of a 300 cartridge, there was plenty of medicine left.

I did some online research and fond out that they typically overfill the cartridges by quite a lot. I came across a tip that said to mark on the drug bottle the fill line before and after, so that you can eyeball the fact that some is gone.

Since I followed the steps slowly and carefully and since my tummy feels a little funny at the injection site today, I’m sure that I took the medicine correctly.

I’m a member of a couple of TTC/IVF boards – baby center and fertility community. 2 ladies got their BFP’s today and yesterday. It’s so exciting! Some of these women have longed for a baby for a long time and don’t have any babies at all. I am just soooo happy for them.

I’m planning to cook a bunch of stuff today for Thanksgiving. It’s 10:30pm, though and I’m not even home yet, so I’m not sure if my plans will work out.

Either way, it’s a good way for me to think about something other than IVF. I keep rubbing my belly where I injected the Follistim-I can “feel” it.

I just remembered, I still need to clean my office before people come over tomorrow.

It’s way past my bedtime. Now I’m trying to decide if I should try to wake up early or start cooking tonight. Really, DH is cooking. I’m just trying to throw together some sides-veggies and deserts- that are semi-healthy. At least, made of real ingredients.

I start Luveris tomorrow. The nurse coordinator emailed me today with the dose- I didn’t even have to ask her tom (-: I love Sher / SIRM!

I feel like this IVF cycle will be complete and I’ll be pregnant so soon, now. I started stims yesterday and I’ll be done by Monday (probably) unless I coast or add a day, which is not likely. I am very confident I’ll stim well, since I stimmed overly well on clomid. Since Thanksgiving is tomorrow, I think the weekend will fly by and then I’ll be in the office for my monitoring ultrasound Monday.

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Getting Ready to Start Stims

Posted by vintagemother on November 22, 2009

I’m getting ready to start my stim medications on Tuesday! Yeah! I’ll be taking 300 units of Follistim for 2 days and 225 for 4 days.  I just spent almost an hour “studying” how to use the follistim pen on the follistim website.  Although DH and I were trained on how to use them by the nurse, I really can’t remember how. The videos on www.follistim.com were really helpful, though. 

DH and I saw 2012 last night. It was a nice “date”.  If you’re thinking of seeing it, it is good.  I won’t spoil it for anyone else, but I did like it a lot. 

 

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Faith, Secondary Infertility and IVF

Posted by vintagemother on November 18, 2009

While this is not a blog about me going back to school- especially since I don’t know if I’ll be going back to school, I want to record my thoughts on school.

I’m thinking about my teenaged DD a lot.  You see, I’ve been in court with her bio-dad 2 times since Oct 6.  The 2nd court date was yesterday, and we have to go to mediation tomorrow-which I am happy about and dreading at the same time. 

Yesterday, my stomach was turning flip flops as I sat at the table with the label “protected person”.  I really feel that I felt additional movements in my tummy that can be attributed to the lupron and/or BCP’s. Or, maybe the ivf meds are making me more emotional. It was wierd.  I was very nervous and could also feel and “hear” my heart pounding like it was going to pound out of my chest. My stomach was doing little bitty mini jumps over and over. I’m not usually that nervous about court.  It could be because this court date brought back a lot of bad memories of the time I was in a physically and mentally abusive relationship with her bio-dad.  The memories may have arose because since this court date was regarding violence and not money as our usual court dates have been.  Or it could be that stress and IVF medication are a BAD combo.  Or it could be because my own daughter’s grandma wouldn’t hug her at court. ): That shouldn’t hurt me like it does. But it does.

I don’t know. I’m trusting God that the stress from that day won’t ruin my cycle and that I can get through the rest of the cycle without too much stress. I had a headache last night and keep getting them today.  I think they are stress induced. 

I think that it’s “strange” to be experiencing 2 ends of the parenting spectrum at once. On one end, my DH and I are trying to expand our family using in vitro fertilization and on the other end, I’m facing something that, while I wouldn’t wish it on anyone, could/will happen to 50% of families going through IVF now. I pray it doesn’t, but divorce is too common.

As far as DD, I don’t know how to say it any clearer, but I love her and she is my heart. I was very young when I gave birth to her.  It was just me and her for so many years. When I wasn’t working or going to school I was hanging out with her. Luckily, as a teen I didn’t need much sleep so we still spent a lot of time together. (;  We are/were very close.  She looks just like me. She acts like me. She’s almost the age I was when I had her and it scares me. It scares me into wanting to keep her even closer during this time.  I’ve kept her close for many years. I started being a SAHM to her when she was 4.  I put her in good, Christian schools for most of her education and when she went to public for a few years, you better believe I was involved on all of the PTA, GATE, etc. committees and went on all the field trips and knew all of her teachers.

My “investment” in her is evident- she’s well rounded, involved in several sports and is a straight A student.  So you better believe, I’m not changing my recipe for success. 

I mentioned Faith in an earlier post. I want to go back to school. Is it fair that her bio-dad got to go to and finish college and I didn’t, since I decided that being a mom was more important than school? Well, yes it’s fair. It was my choice to stop going to college because God showed me it wasn’t in my kids best interests for me to leave them at daycare from 6am-6pm so I coud work and go to school.  Plus, I wasn’t progressing- I kept dropping classes because I wasn’t as focused as one needs to be at the University level.

I think it’s a shame because I am “bright”. I was “gifted” and I wanted to become a Dr. (woah, I’m feeling waaaay sorry for myself right now, aren’t I?? must be the ivf meds)  I am happy with being a SAHM. But, I guess what I’m saying is I think that going back to school wouldn’t allow me to be home 24-7 and that’s what I think my kids still need.

I found an evening nursing program, but I’d have to miss her basketball games. It would also mean I wouldn’t be at home from 4pm-10pm daily.  I LOVE going to her games – and my son’s games too.  This year, she’ll be a freshman on the Varsity basketball team and I want to make some time (preggo or not) to help her develop as an athlete.  Soccer is her main sport and  she excels at it, since she’s played since she was 4.

They’re having an out of the area tournament in early December and I got the idea to go.  Well, one of her friends parents hinted I should go. I told the coach I’d like to go and he said I could drive and all the girls cheered that I was going.  My daughter wasn’t even there.  I love it when teenagers let you “in”.  I think it keeps them  away from bad stuff.  And you know I know about bad stuff! having had her so young.  

Then, I realized that the day we’d be leaving is the likely date of my trigger shot and we won’t be back until 5 days later, so due to IVF, I can’t go.  I was bummed out. I felt bad enough that I can’t go to the trip because we’re going through IVF.  But, it’s a minor sacrifice, I think. 

However, going back to school in the evenings would mean I’ll miss her entire season.  I do think my daughter needs me. I hope this isn’t all about my needing her.

Even DH, who has a lot more patience than me, isn’t looking forward to these court dates and all this other stuff right now. He doesn’t get nearly as upset as me, but even he said he wishes this drama could wait until after the holidays. 

I’m kind of sad. Must be the hormones. I don’t usually cry this much.

I don’t know what God wants me to do about my desire to go back to school. I’l pray some more.

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