Just got back from Heather & Jeff's house. We had a wonderful Christmas dinner with their family and my Uncle Bob. We also opened lots of great presents. Dan and I got some great baby stuff! We also got a box full of information about my mother's side of the family for our genealogy research.
Reading to Cole, one of his favorite activities.
Comparing Pregnant belly sizes (I am 22 weeks, Heather is 16 weeks)
Cole wants to go for a walk in his daddies shoes
Patiently waiting for Christmas dinner to be served.
Dan and I did our final Christmas shopping Friday. Included in that trip was getting some maternity clothes for me since I can no longer button my pants! So I got a couple pairs of pants and shirts that should cover me for the next couple months.
I forgot to mention the 2 stats I remember from the exam. The baby weighs 12 oz (so next time you take a drink of coke think of Dex) and his Head Circumference is 170mm. Both measurements are right on track for 20 weeks.
Went to the doctor today for my big 20week ultrasound and checkup. Our baby is officially a baby boy! His heartbeat was strong in the 150s and all his measurements looked good. Below you can see some of his photos. He was moving all around and was hiccuping for a good portion of the exam which was pretty funny to see.
The only potential problem from today's visit is I possibly have "marginal cord insertion". Based on the angles they could get they think the umbilical cord is going into the side of the placenta instead of the middle, which could lead to various problems such as growth problems due to not enough nourishment (which hasn't happened yet, he measures 20 weeks still) or possibly problems during the delivery. Nothing really do be done right now about it except monitor his growth via ultrasounds to make sure he stays on track. So normally I would be done with ultrasounds until the birth but I will be getting one in 4 weeks in addition to my doctor checkup.
I am pretty sure that last night I felt my first baby kicks. I have felt a couple more kick-like sensations today at work. All mostly low down on my belly. I cant wait for the coming weeks when these get stronger so Dan can feel it also.
My belly is getting to the point where jeans and T-shirts are starting to get uncomfortable. Supposed to grow quite a bit from now on, so its going to make this winter interesting trying to stay warm with my coat not fitting around me soon!
Next Thursday is the big 20 week ultrasound appointment at 1pm. I hope everything looks good that day and I am sure I will be posting several pictures of him (we think its him :D ) for everyone that day.
Just wanted to wish everyone a Happy Thanksgiving! We just got back from a wonderful and filling dinner with our friends and hope everyone out there had a nice holiday.
Apparently my baby is the size of an avocado now. I find that interesting for some reason.
A couple days ago Dan and I rearranged our house some. We had been using a room upstairs as our office. But it was pretty cramped and got pretty hot in there with all the PCs we have going. So we moved our desks and PCs down to this empty space we had in our living room and will be turning the old office into the nursery. That still leaves us 1 empty room for visitors so they don't have to sleep in the living room with the dogs :) Hopefully that will encourage frequent visits from our mothers to help out with this whole baby thing.
Had my quick 16 week checkup today. My vital signs were all fine and the baby was once again doing great with a nice strong heartbeat in the 150s. The doctor said in a few weeks I should begin feeling the baby move which would be amazing! We scheduled my 20 week big checkup for December 11th. The main event on this day is the detailed ultrasound.
Also, Congrats to the Florida Gator football team - SEC East Champions!!
Although it pains me to have done so, Ali and I traded in my Ford Explorer toward a 2008 Ford Escape. The Escape drives like a big car, whereas the Explorer drove like a small truck. I will miss my "truck" (Ali always makes fun of me for calling it a truck), but with the baby on the way we needed something with four doors. Ali stumbled across the USAA car buying service online, and we jumped at the deals they had for new 2008 vehicle. Essentially, the USAA discount is about what (I figure) a decent negotiator would haggle the price to, but without any skills required on our part except using a web browser. Indeed, we spoke with Matt Sander of Woody Sander Ford (Cincinatti) and he said we were the dealership's first USAA sale. As of date of purchase, they had been a member of the USAA program for three days, and had six new customers inquiring on the phone and in person about purchasing vehicles.
Here is the pricing breakdown.
Sticker price
$26,315.00
Incentives from Ford
$3,750.00
USAA Discount
$1,775.00
Base price
$20,790.00
Total off Sticker
$5,525.00
Tax
$1,620.00
Price out the door
$22,410.00
To Ali and I, this seems like a good deal. The vehicle itself is very nice and drives strong and solid. It has a 3.0L V-6 and automatic 4WD. The documents say it can play MP3's, and I think it may actually play MP3 CD's (not just auxiliary-in). It has lots of features that I don't care too much about, except for the cruise control and digital compass :)
I am officially in my second trimester and that's a wonderful feeling. I no longer worry about a miscarry all the time and can sit back and enjoy a relatively morning sickness free day! Tuesday and Wednesday I was in Columbus visiting my sister and to babysit Cole on Wednesday when his daycare is closed for the day. On Tuesday Heather and I went to babiesrus and 3 hours later emerged with a full registry list. It was certainly helpful to go with someone who has just been through it and had insight as to what she thought was defiantly needed and what was not. I would have just picked out a stroller based on color but she was pulling it down off the shelf, folding it up and popping it back up a couple times, pulling out the car seat part and basically putting it through a test of how easy it would be to actually use :) Lucky for me I can borrow some things from Heather and my cousin Amber that the baby will only use for a couple months. My sister wants to throw me a baby shower sometime in February, so hopefully some of you guys can come!
But probably the highlight of my trip was when we went to Cole's daycare to pick him up and when he saw us walk in he got a big smile on his face and said "Ali" and ran over to give me a hug :D Nice to know even though I only see him like once a month he loves me! Wednesday was a full babysitting day filled with dancing, watching Super Why on PBS and eating/throwing food to the dog.
You can view the registry at Babies 'R Us. And if any of you parents out there notice that I am lacking a "must-have" item, let us know!
Just thought I would let you all know I followed up with my OB doctors post-kidney stone incident and they really didn't have much to add on that front besides drink more. However, they did let me know that all the blood work for Downs, Cystic Fibrosis, etc came back normal so things seem good there. My next OB appointment is Nov 10th, but its going to be a real quick 16 week checkup - basically just a momma and baby vital signs check.
Hope everything is going well with my friends and family who follow the blog. This weekend is a huge football game between Florida and Georgia, so be sure to cheer on those Gators!
So yesterday I was at work and lately I feel like I need to urinate about every 30min from my uterus pressing on my bladder so I am not a big fan of drinking as much as I probably should be. Well on one of my frequent trips to the bathroom I all the sudden get this sharp pain on my left side along with a nice combo of nausea and faintness. I walk back to my co-workers apparently looking very pale (which living in Ohio for 2 years will do to you anyways) and tell them I don't feel so good. Being nurses they love to jump on possible exciting cases so they throw me on a stretcher and make me go to the ER. Now just lying down I feel a lot better and if I was at home I am sure the crisis would have ended there. The pain had basically gone away and it feels nice to be flat in bed. In the ER they drew lots of blood, urine and did an ultrasound. Here I was of course happy to get an unexpected check of the baby (HR rocking in the 160s). The ultrasound showed a small kidney stone and some fluid on my kidney. So they gave me a liter of IV fluid and I got to watch TBS for 4 hours until they deemed me fit to go home. My instructions are to rest, drink tons of fluid and check with the base OB doctors and see if they want to follow up at all with me.
In unrelated exciting news, Dan and I are going shopping for a new car/truck/SUV type thing with 4 doors since neither of our cars have 4 doors and we think that would be helpful so we don't kill our backs with getting the baby in a car seat.
Ali & Dan - 12 weeks pregnant Debbie & Joe - Dan's sister, 8 weeks pregnant with twins. Julie & Jim - Joe's sister, is 13 weeks pregnant.
So basically every one is having a baby within a month period! And its everyone's first child so that's a lot of craziness to spread around to all the grandparents :)
Edit - post is edited because someone else wants to wait longer and stuff to tell people. Also our friend Anna is pregnant! Crazy summer this will be.
Today I had 2 doctor appointments. The first was with a doc on my medical team. I got a physical, pap smear and baby heart rate check (167 bpm), went over my previous lab work (all good except low hemoglobin of 11 - so placed on Iron supplements).
The second appointment was with the ultrasound tech. This was wonderful! The baby was just swimming all around, it has 2 legs and 2 arms and a bunch of fingers, a nice spine, a strong heart and a large head. It measures a whopping 5cm long, yet despite being tiny I found it pretty easy to identify the body parts. It helps to know that bones are white on ultrasounds so its easy to see its spine and fingers and skull. It also measures exactly to the day(11 weeks, 6days) keeping my April 29th due date on track. But perhaps the most exciting part, and somewhat unexpected this early, was the tech telling me with 90% certainty that we are having a baby boy! Dan and I are both thrilled to have a boy and tears were shed by both of us on this news. If the 90% proves to be true, his name will be Dexter (still working on a middle name)
Today's scan combined with some lab work, so perhaps in a week or so I will know info about chance for Downs, Cystic Fibrosis, and other fun stuff we hope not to deal with. The scan part measured normal, so just waiting on lab work now.
Next appointment is in 4 weeks, Next ultrasound is in 8 weeks. At the 20week ultrasound they should be even more certain about the baby's sex so until then we will be working on staying healthy!
Today I had my group meeting with the OB nurses. There were probably 6 pregnant women there for the information session. Before we all got together they took our weight & blood pressure and scheduled my appointment with the nurse practitioner. (Oct 14th, Tuesday). My blood pressure was great as usual, I remarked to them that several times at work I have checked my heart rate and it was ~120, during my check in the office today my heart rate was only 108..they didn't seem concerned as your blood volume is greatly increased during pregnancy.
At this meeting we saw several different groups from the hospital. The OB nurses went over what we could expect during some of the early appointments. A nutritionist went over that information. A person from Family Advocates group talked to us about support programs they offer (baby classes, financial classes, etc) And they gave us alot of handouts, videos and books. In fact they gave us 3 big books for free (What to expect when your expecting, what to expect the first year and what to expect in toddler years).
So next Tuesday I have 2 different appointments. First thing in the morning (8am) I meet with the nurse practitioner and I assume get a baby heart rate check and physical. Then at 11:15 I have an appointment with ultrasound for aNuchal scan. This scan along with some blood work looks at certain birth defects. The main things they check for is Downs Syndrome and they will look at its heart and make sure all four chambers look normal.
For several weeks I have been feeling a bit queasy but it has turned up a notch the last several days. Thankfully I dont throw up easily but I defiantly feel on the verge sometimes lately. I also feel dull aches alot in my pelvic region - I guess my body is expanding. Tomorrow I meet with the nurses at the OB clinic on base, I think its just going to be getting a bunch of handouts and stuff but I am sure to let you know if anything exciting comes out of it. Its weird going from such frequent checks and ultrasounds to several weeks with no information. I really want to hear the baby heartbeat again to make sure everything is going ok in there!
Thursday-Saturday I will be out of town at Amy's wedding. I cant wait to see my college friends who I haven't seen in a year or so. Hope everyone is doing well, be sure to cheer for the Gators this Saturday when they play LSU.
Just a few things going on here in Ohio. My dad has been up to visit, he had a couple weeks off from work after he fell and broke 3 ribs so he decided to drive up to Ohio and visit all of us. Dan has a CT-Scan next Thursday as part of his normal follow-ups. Hopefully things continue to stay stable with his scans. My next appointment is next Wednesday, its a meeting with the nurse at the OB clinic with a group of other pregnant ladies. They are going over things like nutrition, how things are done at their clinic, etc at this meeting. It will still be a couple weeks until I see a doctor and have an ultrasound or heartbeat check I think.
Other than all the medical stuff Dan and I have mostly been catching up with new TV shows that are finally back on. We love our old favorites - Heroes, Dexter, Entourage, The Office. And have added in a great new show from HBO called True Blood.
Had a great ultrasound today. The baby had a rocking 173 heart rate and has grown very nicely. The baby measures right on schedule and I have officially graduated from my IVF team to the regular people doctors! I am no longer on any fertility drugs except vitamins which is very nice also. Well that's all from here, not sure when my next appointment will be I have to call the other clinic and set something up. I hope you are all having a wonderful day.
Just thought I would post something since its been a week. I am a bit nauseous most of the day but nothing to bad. Also my breasts feel like they have lead balloons in them! I actually like having some symptoms. as they are somewhat reassuring. Dan is working hard at school and the dogs are laying around on the couches as usual. Been watching alot of football the last couple weeks and can't wait to finally start playing some SEC schools. But really not much exciting things going on here. October will be a bit more interesting as my father will come to visit and I am going to a wedding in Massachusetts.
I am sure you can tell from the crystal clear ultrasound image that there is a small child in my uterus. From those who cant see I will attempt to break it down for you. On the main screen is my gestational sac like last week (black blob) and snuggled in on the left side of the black blob is a slightly larger than last week gray blob. Now if you were present for the ultrasound which I was and Dan just made it there by minutes after driving across town to the wrong clinic you would have seen the gray blob dancing all over showing off its 127 bpm heart rate. (bpm = beats per minute). On the right side of the picture is a zoomed in version so he could measure, he measures 0.59cm which is perfect for a 6 week 5 day ultrasound. The very bottom it says I measure 6 weeks 3 days plus or minus 2 days with a due date of 5/1/09 based on that measurement.
Needless to say, we are all pretty happy here. Next ultrasound is in 2 weeks, until then keep the good thoughts and baby dust heading my way!
I have successfully defended my prospectus. Since there appears to be some confusion, here is how the process works at AFIT:
1) Complete course work 2) Complete specialty exam written portion (qualifying exam or "quals") 3) Perform background/related research for topic area 4) Complete specialty exam oral portion (prospectus defense) 5) Perform core research, writing dissertation along the way 6) Defend dissertation 7) Graduate
I completed step 2 a few months ago, and today I completed step 4. I will now embark on the dissertation, which takes the following form:
Chapter 1: Introduction to the domain and problem area Chapter 2: Background/related research -- current state of the art Chapter 3: Define problem that will be solved and how success or failure will be measured Chapter 4: Document results Chapter 5: Conclusions and summary
Chapter 4 may in fact be many chapters. The prospectus consists (roughly) of the first three chapters, and mine weighed in at 102 pages including front and back matter. The average dissertation at AFIT is about 240 pages total.
The graduation date cannot be less than one year after the prospectus defense. I am officially considered a PhD candidate, and hope to graduate on 9-Sep-09 (9-9-09).
The egg transfer was exactly 3 weeks ago, but technically I am called 5 weeks 5 days if going by estimated due date of April 29th, 2009
Well, the good news is there is a little gray blob (yolk sac) inside the black blob (gestational sac) They want to get another ultrasound in a week. What we would hope to see at that ultrasound is the yolk sac and a fetal pole (like this picture here). Best case would be a heartbeat, but that's a 50/50 shot this early.
They also saw tons of fluid in my belly and very large ovaries from my OHSS (which is much improved now since we lowered my medicines).
I hope the little guy keeps growing, keep praying and sending baby dust!
My HCG today was 666. It keeps going up but sure is being slow about it. I have read that most people double their HCG in 48 hours but some take 72. It seems I am more of a 3 day doubler. They want to check yet another level tomorrow and do an ultrasound on Monday. Hopefully those will go ok and tomorrow's HCG is above 800! The ultrasound hopefully shows a gestational sac in the uterus and a yolk sac (Sounds like a chicken!). It would be too early to hear a heartbeat or anything like that.
So think extra thoughts for me this weekend and send me lots of baby dust!
Dan's big news is next Tuesday (September 2nd) he will be defending his thesis. This is one of the major milestones for his PhD. Hopefully it goes really well for him!
He has a meeting with his new Urologist today, just a quick meeting to make him aware of Dan's case since Dr. Lewis has moved just in case anything happens in the future.
He has been riding motocross every other weekend since he got his bike, and below are a couple pictures he wanted to show. The first is him jumping, the second is him after 30min of racing around in the dirt. The dirt is even on his teeth! I thought it was gross, but he was strangely proud of it :)
My level today is 408. So little walker or texas ranger is slowly but surely getting stronger. Getting yet another level on Wednesday and as long as the number keeps going up they plan on doing an ultrasound in 2 weeks. Its funny I find these past few days more nerve racking then the initial blood test. I am glad I am pregnant but since the only other time I was pregnant I miscarried I think I still find it hard to believe.
The HCG today is 194 and progesterone is 228.48. They said that sometimes when the progesterone levels are so high that we don't see a doubling of the hcg level in 2 days. The good news its the level is higher and a good number for day 11. Its most likely 1 baby, not sure if it was walker or texas ranger who held on :)
Repeating the labs again on Monday, so lets hope it keeps going up!
On the OHSS front, I am still super swollen. I have gained like 6 pounds of fluid in 4 days and I am tight as a drum. I feel like I have jumped from not being pregnant at all to like 4-5 months pregnant in 1 week.
edit - Doctor's office called back. I am decreasing the Progesterone from 200mg three times a day to 100mg twice a day.
My HCG level on 9 days post 5 day transfer is....drumroll....118 Yea! That's a great day 9 level
My progesterone was a whopping 265, that tells us why my abdomen is so swollen. Its normally 25-50 at this time. For now I will continue the progresterone 2 tabs three times daily, but depending on the progesterone level on Friday it may be cut back or stopped all together.
So I am repeating the levels on Friday. We expect the hcg level to double in two days, so hopefully Friday's is around 235
So apparently all this swelling is not normal. I got diagnosed today with moderate Ovarian Hyperstimulation Syndrome. This is a potential complication of doing fertility treatment, and occurs in approximately 1% of patients! (I am so special). Basically my symptoms are: Abdominal bloating and bloating all the way up to my lungs, increased abdominal girth (39inches!!), Mild Shortness of Breath, and some fatigue. It hurts to lie flat so I am actually sleeping with 2 pillows under my head and 1 under my knees. Yesterday when I was taking a shower I had to stop and sit in the shower because I thought I would pass out from the humidity in there, so figured it was time to let my clinic know how I was feeling.
The plan is daily weights, abdominal girths and hydration. I need to drink plenty of Gatorade to keep my hydration up. Basically fluid is leaking from my ovaries and the follicles into my abdominal cavity and as long as my ovaries keep producing progesterone they will keep secreting this fluid. Now the silver lining here is that the clinic says I am probably pregnant, as if I wasn't my symptoms would have gone away after 3-4 days post egg transfer (I am 8 days post transfer). However since your ovaries keep producing progesterone the entire first trimester this is something I will be dealing with for weeks and could get worse. In extreme situations you get so dehydrated that your kidneys stop working right and you need IV Fluids or even an abdominal tap (long needle into your belly to suck out fluids as if I was a liver patient with ascites or something.)
So that's the excitement here, I am clinging to that silver lining so I am not going through all this for nothing!
EDIT: You see a 2nd line right? Faint but being only 8 days post transfer....
So not much to report, after 4 weeks of busy excitement, shots, ultrasounds, bloodwork, etc now there is nothing to do! Since the egg transfer on Monday my main goal was just to feel somewhat normal again. I was so bloated and swollen from about Monday-Wednesday from my large ovaries & fluid that for Monday and Tuesday especially it was actually painful to breathe or move around. I felt full from my throat to my pelvis like everything was just swollen. I kept making up diseases that I am sure I had like toxic mega colon and other fun stuff. But now I am feeling more normal, I dont feel like running any time soon but I can bend over and touch my toes again!
Ok, enough complaining. In one more week I will do the blood test that hopefully shows defiantly one way or the other if the IVF worked. I am hoping for an HCG level around 100, anything above that would be super, below that would be a bit worrisome. No matter the level they will repeat it probably 2-4 days later to see the trend (hopefully rising). I dont "feel pregnant" but no one should at this point.
Not much else to report, its going to be a long 7 days.
The laboratory report this morning was that only one blastocyst was frozen. The three remaining embryos were cultured overnight but upon further inspection two candidates for freezing were abnormal blastocysts with inner cell masses that were “not good”. They were not frozen. Not the best news in the world but its ok. Should this current cycle not work we can try with the 1 frosty next cycle.
Not much else going on, been resting alot and watching Olympics non-stop (How about that swimming relay and men's gymnastics!). The 2 blastocysts are supposed to break out of their shell somewhere between day 7-10 and implant. So until then I guess they are just floating around in there :) Hopefully they start digging in tomorrow and get ready for a long 9 month ride.
Ok, I am all back from my whirlwind morning. I had acupuncture at 10, embryo transfer at 11 and then another acupuncture session at 12. I am feeling good and hopeful. The transfer itself was really simple, took perhaps 2minutes. Basically they did an external ultrasound just to check how my uterus was laying (they wanted it basically in a straight line so its easier to get the catheter in). They then went over the embryo report. We had 3 grade 1 blastocysts, 1 grade 1 early blast, and 1 grade 1 morula. The remaining ones were still slow to grow and not good candidates for freezing. They double checked that I want to transfer 2 and that I wanted to freeze the other 3. Tomorrow they will be freezing the 3 that I didn't use giving us a good option for our next attempt. After we told them we want 2 placed back, it was "load and go" time. They loaded the 2 best ones (pictured below) into a catheter and inserted it into my uterus. They were watching the catheter progress on the ultrasound until it was near the back of the uterus. They then injected the embryos out and you could see two little flashes of light on the screen. They then double checked the catheter to make sure that both were inserted and I was done.
My temporary name for these 2 guys are: Walker (Left) and Texas Ranger (Right)
The lead embryos have no fragmentation and the cells look even, making them class 1. The lead embryos are also beginning to show signs of compaction which is the next stage of development. While the slower growing ones will most likely not be the ones we transfer on Monday they will be good candidates for freezing as long as they keep growing. And then we can use the frozen embryos in another try later on.
Blast Development
2pn stage (1 cell with 2 pronuclei)
Cleavage stage (2 to 10 cells)
Compaction
Morula
Cavitation
Early Blastocyst
Full Blast
Hatching blast
Hatched blast
The plan is now set. Tonight I do another HCG shot (but only 0.5cc instead of 1cc). This is a booster shot. It will promote secretion of progesterone by my ovaries which aids in implantation.
Monday I have acupuncture set for 10am. Then the IVF Clinic at 11am for an 11:15 transfer. I should be home by noon. And then at 2pm I have another acupuncture session.
Then I wait 11 days until they can do the pregnancy test and see if it all worked.
"There are 6 4-cell embryos, 1 3cell and 2 2cell embryos. All embryos are Grade 1 except for a couple at grade 2. Saturday AM a day 3 report will be given to Dr. Burwinkel and I will confirm tomorrow AM by phone if a Saturday or Monday transfer will be done. I am guessing at this time that it will be Monday but I will call as soon as I know."
Embryos are graded on a scale of 1-5 with 1 being the best.
I am very excited that all 9 embryos are dividing and growing!! If we do go on Saturday, it would be around 9:30am.
EDIT -- HAPPY BIRTHDAY MOM!! I hope your having a wonderful birthday, if you tune into NBC tonight you can watch some Olympic fireworks in your honor
Out of the 18 eggs retrieved yesterday 12 were mature and injected with sperm.
Out of 12, 9 fertilized and will be growing and dividing over the next couple days. (75% fertilization rate which is just below the average of 80%)
Tomorrow I will get an updated report about the number of embryos and how they are growing in order to determine if the transfer will be on Saturday or Monday.
I am super excited to have 9 embryos to work with, hopefully those nine will all have a great day growing.
Just a quick note - I am feeling fine. Mild cramping but not bad at all. I did sleep until 2pm when we got home but that was Tylenol #3 assisted sleep. I am very excited that they got 18 eggs and that Dr. Groll thinks we can maybe do the 5 day transfer. Thursday and Friday (and maybe Saturday) I will get a report telling me how many were mature and how many fertilized.
Dan is taking good care of me and you can see his detailed review of the morning below.
My mantra for the next few days is "Divide and Conquer", which is what I hope all my little embryos are doing.
Ali and I went to the fertility doctor this morning for the egg retrieval. We left at 0610, and arrived at the doctor's office at 0629. We met a couple nurses, a very nice anesthesiologist, and Rex, the embryologist. Each was very patient and answered all of our questions. Rex said that they don't normally take pictures of the embryos as that prolongs the length of time outside of the incubator. However we will get a picture of the final 2 they select to put in on the day of transfer. They took Ali away at about 0700, right on schedule, and I had enough time to watch about three sets of highlights on ESPN before Dr. Groll came and got me.
Dr. Groll reported that the procedure went very well and Ali was doing fine. He also said they are going to try for a five day egg growth/replacement cycle, as those embryos that remain strong for long enough to meet the five days outside of the womb tend to have a higher rate of pregnancies. However, he said if some proportion (not sure of the number) of the embryos did not appear strong enough to make that time window, that he would then opt for a three day replacement as there is clinical evidence that shortening the outside-the-uterus-incubation cycle yields a higher probability of successful pregnancies in these cases.
When I went to see Ali, she was understandably doped-up and tired. I forgot to bring a camera, so I had to edit this picture of what Ali's transformation looked like:
We spent about 20 minutes allowing Ali to recover, during which time she dined on a bountiful harvest of a half-can of Sierra Mist and four (4!) crackers. Next time I fuel up, I expect to see a noticable improvement in fuel economy due to Ali being 18 eggs lighter on the way home.
At roughly 1100 this morning Rex will clear away the excess cellular tissues and other organic materials from the eggs and assess their overall qualities. From approximately 1300 to 1400 he will inject each egg with a sperm according to the previously documented ICSI process. They will email Ali tomorrow morning with the results of everything that has transpired from the time she left the office through tomorrow morning's embryo inspection. She will continue to receive updates and instructions for medications and schedule on a daily basis.
She is still sleeping now, after a taxing early morning. She starts a new and exciting medicinal program this evening, which along with her new iPhone, I am sure you will all hear/read about shortly.
First off I would like to say my butt still hurts from that shot yesterday. I e-mailed my IVF Nurse to make sure this is ok and she said it could hurt for 24 hours...walking up stairs is just killer I feel like I have a gun shot wound to my butt or something.
Since I dont know how I will be feeling tomorrow I thought I would post a little bit of information about the Egg Retrieval (ER) and Intracytoplasmic Sperm Injection (ICSI) which will be taking place tomorrow at 7am.
Egg Retrieval
Egg retrieval is a minor surgical procedure that is performed under deep sedation by an anesthesia provider. A vaginal ultrasound probe along with a thin aspiration needle is placed into the vagina and under ultrasound guidance the needle is inserted through the back wall of the vagina into the ovary. The doctor then punctures each follicle with the needle tip and aspirates the fluid from the follicles. The fluid is collected into sterile test tubes that are passed along to the laboratory where the contents are screened for an egg. The egg retrieval should last about 20-30 minutes. Not all follicles will have an egg and not all eggs will be mature, but hopefully we will have somewhere around 12-15 mature eggs to work with.
Intracytoplasmic Sperm Injection (ICSI) Because we are working with a limited supply of sperm that Dan banked prior to starting chemo we are using ICSI. This procedure takes a single sperm and injects it into an egg. Dan's sperm are currently frozen still but will be thawed first thing in the morning. They should survive well from the process but since we are using ICSI they will just select the best ones they can find.
I found this cool video on youtube to show you how its done under the microscope.
Fast Facts: Lining: 12mm Right (4) in mm: 12,16,17,18 Left (13) in mm: 11,13,13,13,14,15,15,16,17,18,18,18,19 E2 Level: 1918
So right now we have 5 mature follicles(>18mm) and several more that should become mature by Wednesday morning. My doctor is very happy with my group of follicles and thinks we should have lots of ones for fertilizing.
I will be doing my trigger shot tonight at 7 pm. This injection is of a medication called HCG, which causes the eggs to complete the maturation process. This is taken only once in the cycle and is a shot deep into your muscle. Release of the eggs should occur about 36 hours after the shot. Since I will still be at work at 7pm one of my coworkers will be giving me this shot.
Egg retrieval is scheduled for 7 am on August 6th.
edit - That shot is THICK! I am still feeling it in my butt 3 hours later.
Fast Facts: Lining:12mm Right Ovary (4) in mm: 11, 13, 15, 15 Left Ovary (10) in mm: 11,11,12,12,13,14,15,16,17,17 E2 Level: 849
My right ovary is so lame.
They have pushed my egg retrieval day one day to maximize the number of mature eggs and to get my E2 level higher. I have modified my calender to show the new dates of things. The goal is to have as many 18mm and larger follicles on egg retrieval day so that they are mature eggs. So if they all grow another 8mm they would be like 19-25mm on egg retrieval day. If they went with retrieval on Tuesday as planned there would probably be 3-5 non-mature eggs which have no chance to fertilize so its worth waiting an extra day.
It will be interesting to see how my ovaries feel after 4 more days of growth because they are already pretty weird feeling. They don't hurt but my lower back feels full.
Next ultrasound and bloodwork is Monday - so as always I will post once I get the lab call in the afternoon.
My cousin Jason had his 2nd child a couple days ago, Jason Robert - 9lbs 4oz. Just wanted to share a nice photo of Jason, and his son Jason! Congrats to Jason & Amber, and big sister Grace on the arrival of baby Jason.
Also my dad recently got home from a trip to Israel. Both my parents went to Europe for 2 weeks on vacation but then my dad went to Israel with a group of fellow Baha'i. I just love making photo slideshows so I offered to make one of his trip, check it out if you like. You can view it below or view at youtube for better quality - Select "view in higher quality" directly below the video on the rightside.
Getting my blood drawn. Anthony is the best vampire on base. Both Dan and I love when he is the one who gets to draw the blood.
Fast Facts: Lining: 10mm Right Ovary: 4 follicles. Size in mm: 10, 11, 11, 11 Left Ovary: 8 follicles. Size in mm: 8, 8, 10, 10, 11, 12, 13, 13 E2 level: 411.5
Mature follicles are 18mm-22mm. They should grow 2mm per day, so they are on track for being mature eggs by Tuesday's Egg retrieval - That would put them all 18-23mm if they continued to grow at this rate.
My lining is also good, 10mm. Studies show a very direct correlation between thickness and success rates. I also had a triple-line endometrial pattern, which studies have also shown to be very important with increased success rates.
Next appointment is Saturday for another ultrasound & blood level. The follicles should be all ~4mm larger and my E2 level should be around 1000 or so.
Well just thought I would mention the few symptoms I have had from the hormone shots. A couple days I have had a headache which apparently is a common side effect of Lupron. But the biggest side effect I have is crazy hot flashes! I am normally pretty cold, but not for the last week. I am burning up especially the back of my neck. So not really hot flashes, more like constantly hot with occasionally small bursts of lava.
That's all for today. Tomorrow is an ultrasound and blood work so I should have an update for people in the afternoon. Hopefully there are a couple more follicles and they are getting bigger and hopefully my E2 is continuing to double.
I have not talked about my acupuncture sessions yet so I figure its time to share how that is going. I have had 3 sessions now. Each session lasts about 30 minutes. 5 minutes is them placing the needles and hooking them up to a low level electrical stimulation. Technically this is called Electro-acupuncture. Once everything is set they put on nice soothing music and let me be for 25minutes. The sessions really are relaxing which is the main goal of doing it. Each session consists of about 16-24 needles depending on what she wants to do. My first session there were needles all over, the next one seemed to focus more on my belly and these last one there were alot more in my legs. Supposedly the ones she added this last time will help me develop nice thick and receptive uterine lining for implantation. Who knows, but figure it cant hurt! The needles or electrical current dont hurt at all.
One cool thing that happened was when I was coming in today there was a woman there who came in to tell them she was pregnant. She had been trying for 6 years and this last attempt at IVF she added in acupuncture for the first time and she got pregnant! My acupuncture doctor was so excited, she said it is her 4th pregnant lady this year (not sure out of how many). So it was a nice success story to hear heading into my treatment.
Totally weird angle here but that's me, hard to see the needles but I have 3 in each foot, 1 on each calf, 3 around each knee, 4 in my belly, 2 on each arm and 2 on my head. (you can click on the picture to see it larger and see the needles)
E2 was 104.7, which is right where it should be. I was really hoping it would be above 100 today and it was! I will continue the same Gonal-f dose (225u) and see Dr Groll on Thursday for another ultrasound and E2 level.
Hopefully everything keeps going down the right path :)
So Friday started my 2nd daily shot, gonal-f. The gonal-f is in a very convenient prefilled pen. I just dial up my dose (225units), pull the plunger out until the arrow lines up with the 225 mark, inject it into my belly and then push the end until it clicks 6 times. A pen holds 450units so it only lasts 2 shots. After my blood work on Monday my dose may go up or down depending.
Gonal-f is a gonadotropin hormone, it consists of recombinant human follicle stimulating hormone (r-hFSH). FSH is necessary for the recruitment, growth, and maturation of the ovarian follicles.
I will be on this shot for 10 days with the goal of around 20 mature follicles, a mature follicle is 18-23mm in diameter. I am still on the lupron shots to prevent ovulation of all these nice big eggs until my medical team is ready to go in and extract them. Although 20 is the goal number, the minimum number of mature eggs to go ahead with the egg retrieval is 5. Hopefully I will have much more than that since not every follicle will have a mature egg, of the eggs you get around 70% will actually fertilize and of those that fertilize maybe half will continue to divide normally. So starting with 20 follicles you might actually only get 5-8 good embryos, then they would pick the 2 best and put those in me.
Here is an action shot of me injecting the pen. As you can see I have 1 really big bruise from a lupron shot and about 3 little bruises. Seems like every other day I give myself a bruise on injection! My belly is starting to look crazy.
I had my baseline lab work done today and another ultrasound. The main lab that we are following is my Estradiol (E2) level. Estradiol is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo implantation. This lab is a key marker (along with my ultrasounds) for how my follicles are developing, how many follicles I have and also how thick my lining is. The more follicles I have and the bigger they are, the higher the E2 level is. My E2 level today was 13. A baseline E2 level should be less than 80, with studies showing numbers on the lower end prior to stimulation with the gonal-f to have better outcomes.
Today's ultrasound showed 11 little follicles. 4 on my right ovary and 7 on my left ovary. There are probably a couple more that were too small to show today. The goal by egg retrieval day is around 15-20 follicles, so I am right on track there. The minimum number to continue is 5 follicles and my left ovary beat that all by itself. You can see 7 follicles below (dark shapes) on this example ultrasound. So both my lab work and ultrasound were very positive. Yea!
I also updated my calendar a bit to include a lab data section and added in my acupuncture sessions.
Well I am on day 3 of my Cole babysitting job while my sister and Jeff are in Chicago. I gotta say I learned a few things. First thing I learned is daycare is a pretty sweet thing. Being with Cole is wonderful but I don't know how stay at home moms can come up with stuff to do every day. Secondly, watching him mimic you and learn something is pretty amazing. He is a master at giving me a high five now and it just cracks me up every time. But really the biggest thing about these days that run though my mind is, will this be the closest I ever get to being a mom - these 3 days? It's a pretty depressing thought that hopefully doesn't prove true.
So on that note, my shots are going fine. I have a couple bruises on my belly from the shots. I already bleed really easy and they have me on baby aspirin which is just making my bruise more. Thursday I add in my 2nd shot, gonal-f. Thursday I also have an ultrasound, blood work and my first acupuncture session. So there should be more updates coming at you Thursday and Friday with all that stuff.
Oh and I hijacked Cole's blog and posted some gators videos on it, check it out :)
We finally got to break in the motocross bike this weekend. We went to a local track and spend about 2 hours just setting everything up, watching Dan ride and then having Dan teach me how to ride a motorcycle. I was certain I would fall over, but amazingly I never did. Course once you look at the monster hills I was riding over you will see why I didn't fall. Dan pictures are up top and mine are below. That 5year old was burning past me, haha!
I was told the hormone injections would give you weird dreams. I didn't expect them to start on Day 1. Last night I had the weirdest dream, I was baby siting Cole and all the sudden Richard from Lost (aka, the "Other" who doesn't age and wears far to much eye liner) and Gwyneth Paltrow came in the house to steal him. Instead of just attacking me they told me they had a good diversion tactic, they started waving my Wii Balance Board (the thing you stand on when playing Wii Fit and other games) back and forth to distract me while they tried to take Cole...but since they warned me that they were going to try and distract me I foiled their plan and kicked their butt and Cole was safe.
Totally random, but thought it was funny. I will pass on any other weird dreams that come along.
I was very nervous going into my ultrasound yesterday. I have never had an ultrasound with no cysts on my ovaries and if one was there we would not have started the IVF. Thank goodness it all looked good, my surgery a couple months ago removed all the endometriosis and I finally get to start!! I made a calendar of all my medicines, ultrasounds/labs, etc and posted it in the links section to the left. As I move on from one stage to the next I will of course be updating the blog. Hopefully its smooth sailing from now on.
Since I hope this is a somewhat informative blog I will also talk about the costs for IVF so far. Lab Fees: $2785 (includes Embryo culture, Ooocyte ID from follicular fliud, preparation of embryo for transfer, sperm isolation & complex preparation, Intracytoplasmic sperm injection) Facility Fee: $2,830 (use of facility, staff, coordination of services, equipment and supplies) Anesthesia Fee: $558 (for egg retrieval) Sperm Storage: $360 (1 year of storage)
Lucky for me I am saving several thousand dollars because I was able to get all my medicines filled by the Air Force Pharmacy. I will also be doing 3 of my ultrasounds/lab work at the base which will also save me a couple hundred dollars each time.
In other news, as I mentioned the other day Dan's 3 month CT was good - no change from previous scans. For those who want to read the actual report here you go. Page 1 & Page 2
Finally, I made a photo slideshow for Cole's 1st birthday. It ended up being a huge project that had to be broken into 2 parts in order to upload onto youtube (even split into 2 I couldn't get it on yahoo which limits size even further) I hope you enjoy them. You can watch it directly from this site (but I would keep it small) or you can use the link to youtube and right under the video it says "view in higher quality". If you click that you can make it full screen and enjoy! It is pretty long, but Cole is just so darn cute I couldn't cut anything. Make sure you have sound on also.
This morning I said goodbye to my Mom who was in Columbus vising Cole for his 1st birthday and then went to the Columbus Sperm Bank to pick up some important cargo. Prior to Dan's chemotherapy in January he went to the sperm bank three times to give us a shot at making a family the not so old fashioned way. This large cargo container holds inside a liquid nitrogen dewar which then holds inside it the 15 little vials of frozen sperm. The IVF clinic figures we will need 2-3 vials per attempt depending on how well they thaw and what the quality of them is after the thawing process.
This afternoon I will deliver the sperm to my IVF Clinic and go in for my ultrasound and bloodwork. I have been on birth control pills for exactly two weeks now with one week to go. If my ultrasound is good, no cysts, I can start the Lupron injections on Thursday.
Dan's new dirt bike and trailer. The trailer came in 13 boxes and Dan put it together after taking over the garage for 2 days. The bike is 2003 Honda CR125. He also received all the gear he needed slowly over the last 2 weeks from various online stores and eBay. This Saturday we will be hitting the track and I am sure some action photos will follow!
This short film was made by someone on the infertility forum that I read daily (ivf-infertility.com). I thought it was very well done and wanted to share it with you guys.
Dan called the oncology nurses today to have them read the results to him since he will not be meeting with Dr. Wood until July 10th. They said it was good - no changes from the last CT-Scan. Still an area of scar tissue that apparently is no bigger or smaller than previous and should appear the same on future CT Scans. So Dan continues down his path to remission. Perhaps on the 10th we will scan in the actual report so the medical types that follow this blog can read it. Very good news for us, next scan in 3 months (10/1/08)
I picked up all the medicines that I should need for in vitro today. They are (in order of use) 1) Ortho-Novum (birth control pills - hahaha) 1 daily for 3 weeks 2) Lupron 1mg (0.2ml) SQ injection daily for 14 days - that is the really small box in the middle and the 14 syringes. This medicine is to suppress my luteinizing hormone and estrogen production. Lupron will allow the ovaries to produce multiple eggs. without the fear of premature ovulation 3) Gonal -f (not sure the dose or how long I will do this yet) This is the 4 boxes of medicine. Its a pre-filled syringe. Each syringe should be a couple days worth of medicine depending on how the labs go. It could be once a day or twice a day depending. This medicine will cause the eggs to develop and grow. 4) Novarel (HCG - trigger shot) this is an IM injection given 36 hours prior to egg retrieval. 5)Doxycycline (Antibiotic) - 1 tablet twice a day for 11 days. This is given around the retrieval time to reduce infection. 6) Xanax and Tylenol #3 - both for the egg retrieval process as its supposed to be painful. 7) Prometrium (Progesterone) - This hormone will act upon the lining of the uterus to make it receptive for embryo implantation. As part of the egg retrieval process, progesterone-producing cells are removed along with the follicular fluid and oocytes, making the ovaries unable to produce progesterone sufficiently. Progesterone is vital for endometrial development and continued embryo support. - This is the only one that will not be fun..its 1 capsule three times a day in the vagina. And I have 180 pills of this with 3 refills!! That's kinda crazy. I guess its nice I don't have to do the Progresterone shot as I heard that one really hurts (real thick liquid IM) Sorry for the tmi (too much information) on that one! 8) Not shown is my daily Pre-Natal Vitamin and my baby aspirin that I also take daily.
So the game plan is suppression, stimulation, retrieval, transfer and maintain. If everything falls perfectly into line we are looking at an 8/8/08 egg transfer day, which just happens to be my mom's birthday and the start of the Olympics!
So kinda just hanging out for 2 weeks. On July 14th we have an ultrasound, blood work and a meeting with the IVF coordinator scheduled.
First off tomorrow Dan has his 3 month checkup CT Scan. It will be another week or so until we meet with the doctor for the report, but as soon as we know it we will pass it along. On a personal note Dan has decided to start riding motocross again. He has bought a bike, gear and a trailer already. Most are being delivered this week to us. The bike we need to drive up to Ann Arbor Michigan to pick up. This is something Dan has done since he was like 3 years old and easily his favorite activity despite all the risks and injuries that have gone with it. There are several tracks within an hour of Dayton so plenty of places for him to ride around in the mud.
As for me, tomorrow I officially start the IVF protocol. I start on birth control pills for 3 weeks in order for them to time easier all the other shots and tests they need to do and also help prevent any nasty cysts from forming again.
And on a scary note, my little nephew Cole is vacationing in NC this week. Well apparently yesterday Cole was eating with the family and started choking. His little face looked scared and he was making no noise at all. Heather luckily had read an infant first aid book my mom had given her (All parents NEED to take infant/child CPR) and was able to start back blows/chest thrusts and eventually he spit up the fruit cocktail that was blocking his air. Needless to say everyone there was very shook up and crying. I cant even imagine how scared Heather must have been and so thankful that Cole is ok.
Today I traveled to Columbus and went with Heather and Cole to COSI ( Center Of Science and Industry). Its a super fun science museum for kids and adults. There is a large kids zone on the 2nd floor with stuff to do from infant to preschool and Cole just had a blast. We played for about 2 hours before we were all tired. Heather should be posting some additional pictures and maybe a short film of Cole walking on her blog so check it out. But here are some of my favorite pictures of me and my nephew. The bottom one especially, that was in the medical section and I ace wrapped his head like I used to enjoy doing to myself! Check out the cool x-rays of a frog and snake in the background. COSI was super cool, cant wait to take him again. Perhaps when my mom is up for his birthday . Oh and Cole is 2ft 6 inches tall, a laser beam measured him. Science is fun!
So this afternoon I met with the acupuncture doctor. This was just an informal meeting to find out why I wanted to do acupuncture, to ask any questions I might have and go over what they think should be done. She showed me the needle, which was strangely flexible and even gave it to me to take home and show Dan. Its probably 1.5 inches, very small diameter and solid (not hollow like a typical medical needle). She said she has worked alot with in vitro over the past couple years and has a plan they like to follow. Basically they want to do acupuncture on day 3,5,7,9 (of my Lupron injections) and then before and after the egg transfer. She said the sessions would take 20-25 minutes and she would use about 20 needles in my feet, hands, abdomen and head! She said I could do some sessions during the 3 weeks I am on birth control pills if I want to just relax or know how it feels but doesn't think its necessary. It was an interesting meeting and I think it will be fun to try.
So we are still in a holding pattern. Probably another 7-10 days before I start on the birth control pills. In exactly 2 weeks Dan has a follow up CT-Scan, however his appointment with Dr. Woods to read the CT Report isn't until the 10th of July. As soon as we know anything from that we will let you guys know.
Totally unrelated note, Dan and I just finished watching Dexter Season 2. Its a cool show and worth renting :)
Comparing Pregnant belly sizes (I am 22 weeks, Heather is 16 weeks)
Cole wants to go for a walk in his daddies shoes
Patiently waiting for Christmas dinner to be served.
