Monthly Archives: August 2012
“When a man and a woman love each other very much…”
I was four going on five when I heard those words from my mother. She was definitely prepared for the question after telling me I would soon have a little brother or sister. We sat in the chair and she opened a book to an artists picture of an egg that was the size of a silver dollar. She turned the page to an artists picture of a sperm that was about 8 inches long. She then said “When a man and a woman love each other very much, the man puts his sperm in the woman. The sperm then meets the egg inside the woman and that makes a baby.” It’s one of a handful of memories I truly remember from my childhood. I also remember looking at that big picture of the sperm thinking it must hurt mommy. And I know I wasn’t satisfied with my mother’s explanation, because that book became my new favorite. Trying to figure out how dad got that big sperm inside mommy was a rainy day hobby of mine.
Resisting the urge to join my wife scowling at the mother with one kid already, this memory crossed my mind. And I wondered…If this works, how would I answer that question? This sure is taking a lot longer and a lot more complicated than the story my mother told me. Do I tell him about how the doctor was so fascinated by my wife’s full bladder, that for grins he measured it at 66mm. Will she want to hear how we watched the doctor measure the lining to see that it was a healthy 8mm. Or the blood tests my wife had to take to check her estrogen levels, and how happy we are they’re normal. In the end, I guess the essence of the story is still essentially the same. Just instead of being vague to avoid talking about sex, we will be vague because it’s too flipping complicated.
I’m to give the trigger shot at exactly 11pm tonight. Egg retrieval is scheduled for 9 am sharp on Saturday. Yep, definitely more complicated.
Searching for a relaxing day
Since we started the stimulation shots, it feels like I’ve been constantly busy worrying about something. That something mostly revolving around drugs of some sort. But now that we are coming upon the end of this part of the journey, I’m finally feeling relaxed. No more worrying about taking my pill twice a day. I’m finished, for now, with having to order more drugs from the specialty pharmacy and making sure someone will be home to sign when they arrive. The anxiety of giving my wife a shot no longer bothers me.
Last night I came home to a wonderful chicken and rice dinner the wife prepared, where we had an interesting conversation about sore, swollen boobs. We raided the goodies from the hurricane supplies we thankfully didn’t need. Sat together on the couch watching the hurricane coverage to make sure our relatives in Alabama were safe. Laughed and joked about the idiots on TV trying to stand up and talk into a microphone in the middle of the storm. We then finished the night giving each other shoulder rubs. This morning I made pancakes and we laughed at each others weird dreams. Yes I still had to give her shots, but my head is no longer obsessing about them. I’m feeling really good, almost normal. The wife is dealing with the discomfort of swollen boobs and swollen ovaries, but her mood is pretty good too.
A couple of weeks ago I connected this blog up with google in the hope of helping others, so their search engine can find this blog. As a bonus, I get a nifty report telling me what people searched for when they list this blog in their results. So today I looked at the list and found:
— “my wife hates me ivf too expensive”
I’m sorry your wife hates you and I completely understand thinking ivf is too expensive for you. I would shop around. You may have been referred to a clinic that has a high price tag. I felt the same way and lucked out that our clinic’s rates are reasonable enough for us to afford it. If in the end you just can’t afford ivf, her seeing you make the effort should stop her hatred of you. (I would still sleep on the couch for a while until she gives you a thumbs up.)
— “male torture”
Either you have real psychological issues, or you are in a troubling relationship and need assistance. Please get some help. I feel like I should call the police, but I’m not sure what I would tell them.
— “male troture”
See previous answer and a typing or spelling course may also be of benefit.
— “What do they do in the consultation for IVF for the male?”
I hope this person came to this blog and found some answers. Unfortunately those answers are simply ejaculate in this cup and stick this needle into your wife’s bum. But I’d like to think I’m helping somebody.
The date is set
My wife hates looking stupid. I hate looking stupid. That means in our pursuit to avoid looking stupid, we end up looking stupid. That’s what happened last Friday when the receptionist told us our primary doctor would be at the beach office today. I thought she was talking about our normal clinic office close to our house. My wife was aware they had 2 more satellite offices, knew it wasn’t our normal location, but thought she was talking about the one closer to us. Since neither of us wanted to question the receptionist about her use of the term “beach office”, we ended up agreeing to the appointment at the office farthest from our house. We didn’t need to see our primary doctor. Other than our consultation visits, we haven’t seen him. Most of our procedures have been performed by our primary nurse, or the guy my wife refers to as Dr Pain. Dr. Pain has his own primary patients, but performs procedures on other patients if you schedule it on the day his rotation is at your chosen facility. He just happened to be the doctor on duty at our clinic both times my wife had the procedures requiring a catheter. Dr. Pain is very nice, but very matter of fact. On Friday he was out the door before I realized he was done.
Even though we had to drive for an hour and a half, this worked out for the best. Our primary doctor has more of an instructor personality. He will go over what he is looking for and the reason behind it, whether you are interested or not. I am interested, so I find him fascinating. He explained how the goal is to have as many follicles between 18mm and 22mm. Those are where the doctors are pretty confident fully mature eggs reside. Right now they are anticipating about 9 follicles in that range on the egg retrieval day. They will extract eggs from smaller follicles as well, but the odds are lower they are mature enough to work once fertilized.
Our primary nurse is back from vacation on Wednesday, so our next visit is at our local clinic on Thursday. The doctor was 99% sure we would be giving the HCG shot Thursday evening for egg retrieval on Saturday. I’ve set up the countdown clock. Trying to stay cautiously optimistic, but my success at that is waning.
Focus on what is in your control
I think I give great advice. Others may disagree. I do know for a fact I am great at not following my own advice, and always end up kicking myself afterward. So here is some advice I think I should be following and struggling with.
Separate what is in your control from what is not in your control.
While going through the IVF process, many worries will start planting themselves in your thoughts. Why did this happen to us? Will I have enough sperm on the day it’s needed? Will we harvest enough eggs from my wife’s ovaries? How many of those eggs will turn into embryos? Will we have enough embryos to store for a frozen cycle? Will the embryos attach? What if she miscarries?
These are all worries that are completely out of your control. It’s as pointless as worrying about rain on a special day. Nothing you say or do will make it rain or not make it rain. For some reason the mind gravitates to these types of worries. However, if you are worried it might rain on a special day, you can schedule it during a month that statistically has little rainfall. Or you can make alternate indoor plans if the date of the special day can’t be changed.
Similarly there are aspects to this IVF process that are in your control. You can control mixing the medication properly. Following your doctors instructions. Making sure you perform the injections the same time every day. Staying on top of your medication so you don’t run out. Your reaction when you are accused of walking too loudly. These are all aspects of the process you can control and should be the focus of your attention. These are the only parts of the process where you can be a success or failure at.
At the very root of all this is the question, “If you can afford IVF, are you willing to make the attempt for a family?” Answering “no” is the only way you fail. If you answer yes, make each part of the process in your control a success. A negative result can not change that.
I have no control over the results. My doctor’s job is to worry about how many follicles are growing. My job is to make the odds as high as possible for good results to occur. If in the end we don’t have a child, I will be sad about not having a family. But I am not going to feel like a failure.
That is still the woman you love!
During the stimulation phase, it is important to keep in mind what you are doing to accomplish your goal. Your wife will love you one minute, despise you the next, and then be frustrated with your inability to read her mind. This is normal and not her fault. The drugs you are putting into her body to stimulate egg development are behind these mood swings. Don’t sweat it. Just store any weapons you have at a buddy’s house for a few days. Buy some paper plates and plastic ware at Dollar General and you will be fine. I promise.
We went to the big city today for our next ultrasound. One of the doctors did today’s and he counts completely different then how the nurse counted the follicles last time. So now I’m not sure what is going on. I just know the doctor is increasing us to 4 Bravelle and 2 Menopur. In addition we get to start the Cetrotide shot as well to stall the ovaries from releasing eggs.
That’s where we stand at the moment.
The flavor injector
Here is my IVF guide for any male who is giving a loved one an IM (intramuscular) injection at home.
First of all, get the nurse to outline the target area with permanent marker. Then remark the area every night before bedtime. This takes the guesswork of the proper location out of your hands and allows you to place all the blame on the nurse. Normally I’m the type that will accept responsibility, but in this case it is all about redirecting blame. Not if, but when you have a bad night, you are going to have to do this again the next night. You don’t want the feeling of guilt clouding your mind.
Follow the instructions for mixing the shot, then replace the needle on the syringe with the sterile needle you will be using to inject your wife. Now make sure she isn’t tensing up. If she is tense, it will hurt. Make her face the wall and avoid mirrors and shadows. Seeing what you are about to do next will just make her tense up, it’s your job to not let her see. Wipe the target with the alcohol pad, then remove the air out of the needle so there is a bead of medicine at the tip. Now comes the hard part.
You know how she thinks you are cold-hearted when you are really just feeling indifferent about something. Well figure out where that dial is within yourself and crank it to 11. For the next 20 seconds that thing in front of you is no longer your wife. It is a slab of meat. A turkey in desperate need of flavor injecting before you toss it in the oven. With confidence, slide the needle ALL the way into the turkey. Pull on the plunger a little bit and if you see blood, pull the needle out about 2 millimeters, no more. The deeper the needle the better. You don’t want that flavoring to come back out of the turkey. Now start slowly pushing on the plunger as you begin counting seconds. You want to finish between 5 and 10 seconds. The closer to 10 the better, but not longer than 10 or the spell will wear off and the turkey will turn back into your wife. (Edit: The progesterone in oil is very thick and is better to go really slow. Just takes more willpower to keep up the turkey illusion.) Now once all the medication flavoring has been inserted, count for 5 more seconds to make sure all the flavor stays in. Then confidently remove the needle and put the cap back on.
Now it is safe to be concerned about your wife.
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(Edit: I’ll be modifying this section as I learn new techniques.)
I poke the tip of the needle in the skin slowly, then quickly slide it the rest of the way in. Some prefer just darting the needle all the way in. I have horrible aim, so the poke/slide method works well for me and the needle goes exactly where I want it to go. But she’s the one receiving the injection, go with the method she prefers.
Once you start, DO NOT STOP. Stopping will just make things worse. Just keep thinking how good that turkey will taste when it’s done.
Do not scold your wife for flinching. I was informed this doesn’t help.
Do not ask her if she is ready, this just causes her to know when to tense up.
When you are giving daily injections for several days, you will be alternating from one side to the other. Try to stay 1 cm away from the spot you used 2 nights ago.
Once in a while you are going to come across a needle that isn’t as sharp as it should be. How can you tell if you have a good needle? You can’t. Not without compromising its sterility. She will complain that the shot hurt, when it was performed the same way the night before and it didn’t hurt. This happens and just remind yourself that it is not your fault. (If you are using the poke/slide technique you have a chance of avoiding this issue. As you slowly poke the tip into the skin she will let you know it hurts before you’ve punctured the skin. You can then swap the dull needle out for another one that should be sharp and try again. If you are using the dart method..well it’s the needles fault it hurt!)
Out of the 7 shots so far, only one hurt because of a dull needle. Two had a slight burning sensation because I was being a chicken and didn’t have the needle in all the way. The rest didn’t bother her. Follow this recipe and you should get through this process with minimal discomfort.
For more tips from the female’s perspective, check out infertilitydoessuck’s post PIO injection tips.
Power of positive emotion
I’m finding keeping my emotions in check to be increasingly difficult. I know this procedure has less than a 40% chance of being successful. I’ve read other blogs talking about the heartache of going through the process without success. But I find myself dangerously excited nonetheless. It is hard not too.
I originally started this blog as an outlet for myself to get some things off my chest. I planned to wait until we received the BFP (big fat positive) or BFN (big fat negative) before telling anyone close to me. The stress of going through this was enough, I just wanted to avoid a list of phone calls I had to make to give updates. I then came to realize this is a good way to distribute information from a central platform. It avoids the need to repeat myself over several phone conversations. So I let a few people close to me know about my blog. They seem to find it informative, interesting and agree that this is a good way to easily keep others in the loop as our progress continues. Today we decided to include a few more family and friends. I can make a post the moment I have any information and avoid the dilemma of whom I should call first. It is proving to be one of my better decisions.
Anyway, my shot technique appears to be working. All the medication stayed in with minimal pain.
The wife feels bad about me having to drive to her work the rest of this week to give her the shot, but I really don’t mind. It was important to keep her mornings free for the ultrasound visits, therefore she requested the evening shift all this week. I’m just glad that after 3 weeks they finally fixed the air conditioning at her work.
The percolator
In addition to injecting my wife every evening with her cocktail shot, my other responsibility is to take Doxycycline twice a day for 10 days. While it can be annoying answering the same question twice a day, I’m glad she does ask. The one time she doesn’t ask if I took my meds would be the time I actually forgot too. And I know if I wasn’t there administering the shot, I would be asking her about that everyday.
Today we had our first followup visit. The ultrasound found 5 follicles on the left ovary, and 4 on the right. The nurse then marked the bullseye locations again for the shots. I’ll take all the help I can get. Last night I made sure the needle was all the way in and pushed slow and steady on the plunger. The wife didn’t feel the burning sensation and none leaked back out. While I would like to think the lack of pain was my master technique at work, it may have been my wife’s thoughts were preoccupied with her current customer. Sorry the lady thinks we are conspiring to tell the government about her getting her hair dyed, but if it keeps my wife from thinking about the needle I’m poking in her back, I’ll take it.
While my wife’s body percolates egg development, mine is busy killing bacteria. So far, so good.
The office called and they are raising her medication to 3 Bravelle/2 Menopur. Our next visit is on Friday.
Art of the injection
The nurse goes over the basic information on how to mix the drugs and where to inject the shot. What they do not realize is giving someone an injection is second nature for them. For the rest of us, that still leaves many unknowns. These injections are considered IM (intramuscular) injections. For the medication to be absorbed properly they need to be injected into a muscle. That means the needle is thicker and longer than the subcutaneous shots I was giving myself a few months ago.
Putting a needle into someone else, especially a love one, is not as easy as you think it should be. Not being a professional, how do you overcome that desire not to cause another person pain? As you push the needle in farther, you start to worry, “Is this hurting her?” When you should be thinking, “Am I deep enough for the medication to work?”
I’m also struggling with how fast to push the plunger once the needle is in. The first one I pushed in at a slow steady pace and she asked why it took so long. For the next two I was quicker and she noticed more of a burning sensation with those two injections. I don’t know if that was because I missed the muscle, or because the medication was inserted faster. I also noticed some of the medication coming out after I remove the needle. Is this normal? Am I doing something wrong?
Physically anyone can do it, but there is an art to being good at it.
Thundercats are GO
This morning we met with the nurse handling our case. They couldn’t understand why I wanted to take a picture of the folding chair. Laughing they permitted me to do so. While the wife had blood taken to check her hormone levels I went back and took a picture of my first mistress.
The nurse then took a quick look at her uterus lining using the ultrasound saying everything looked good. After stupidly arguing with a nurse where a hipbone was, I was glad she marked the location to give the shot, because I would have been way off. Which also allowed me to avoid taking a test shot on myself. I already shot myself 38 times, this is her turn.
In the afternoon the clinic called saying the blood work came back and we are to begin the shots tonight.
tick
tick
tick
I start mixing the shot cocktail at 6:40 and it takes forever trying to get all the medication out of each vial is very frustrating. I finally get it all ready and just as I’m about to stick the needle in my wife…I freeze up. It was a whole lot easier giving myself a shot than it was giving her a shot. I think it was more painful for me as she claims the shot wasn’t too bad.
1 down…9 to go
IVF male 