Two Surgeries & Some medication 2009, part 2

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Stepping into real time for a moment:  Wednesday morning, on the twelfth day of the twelfth month of 2012, I am going in for my twelfth egg retrieval.  That’s got to be good luck, right?  Here’s to creating some beautiful embryos and then freezing them; all previous IVFs we have put what are called ‘freshies’ back in. They’ve always been grade A, and yet the embryos either didn’t attach to my uterus or I had a chemical pregnancy.  I suspect that this is because of the altered state my body is in directly after the stimulation, no surprise considering what my body and I go through. Freezing is something we haven’t tried yet, and I suspect THAT will be the trick.  Here’s to lucky number twelve!

And now for Two Surgeries & Some Medication 2009, part 2

I often think of the movie “Requiem for a Dream” when I think of the ritual of taking of drugs, and the actual reaction of my body to drugs. As already mentioned, I am sober for many years, as somewhere along the way I developed an allergic reaction, to put it mildly, to what started out as recreational drug taking. And so it’s a highly sensitive thing for me, to put drugs in my body that I know are going to change me.

But let me give this some perspective:  a pre menopausal woman who is healthy ovulates an egg every month.  When going through fertility efforts, the goal is to force exponentially more follicles into growing into eggs before forcing them to ovulate. Force is likely a violent word, and while I’ve begun to look at the drugs as my friends, I am highly cognizant that I am forcing my body to do something unnatural.

I was warned of the side effects of Follistim, which include weight gain, irritability, night sweats, and insomnia.

The ritual of taking these drugs carries qualities that if someone isn’t already OCD, she may become addicted because of the repetitive qualities of the actual act:

Open the Follistim Pen, put in the cartridge, consult the ledger to be reminded which side of the belly the drug went into yesterday, deduct prescribed amount from the size of the cartridge (which comes in 300, 600, 900 plus some undetermined amount of overflow).

Disinfect my abdomen on either right or left side, depending which side it went into yesterday, making sure to have disinfected the top of the cartridge upon putting into the pen-like device.

Twist knob to control how much the dose is; for AI it vacillates between 150 and 225 (I would later learn that the dosage goes up as the prescription increases for IVF efforts).

Apply needle, and then first twist off big needle cap then remove the smaller one.

Squeeze fat of abdomen slightly and put the needle in.

Press on the dosage amount, which releases the fluid into the body. Keep fat of body squeezed and once the inserting is done, keep needle in for around 5 seconds.

I of course keep it in for 10, because the drugs are so intense that everything seems to me like it’s in fast forward and keeping the needle in for 10 seconds will counteract the fear that I’m counting way too fast.

Once dosage is in, I carefully would remove the pen and needle, and now take large needle cap and twist on before pulling off the actual needle.  Put into the disposal needle kit.

If you’re lazy and have beautifully manicured nails that could get chipped by opening the disposable container that the pharmacy has provided, perhaps you throw the needles in the trash – like I, on occasion, did and do.

Then it’s time to calculate today’s dosage in the calendar, and make note of which side ‘took’ the shot.  Then back to the produce section of the refrigerator the Follistim cartridge and medicine and case goes, as it a perishable medication.

The actual FEELING the drug gives is pretty gnarly.  On one occasion, I described the feeling moments later as if I could hear a dog barking 3 miles away; my shoulders tense up and raise immediately.  I feel the medicine rushing through me, and course through my blood stream.  I have to actually remind myself to breathe.

I was already an insomniac, I theorized some residual effect of my earlier drugs years, and now I experienced increased restless sleeping.  I would sweat profusely after only minimal exertion.  My already overweight body would get extremely bloated.  And yet I was highly optimistic, and incredibly determined.

Once Dr. T believed the follicles were ready, I had two; he prescribed an HCG shot ($52.94), which triggers the follicles-now-turned-into-eggs into ovulation.  I had done this on previous AIs as well so was somewhat familiar.  The shot had to be given to me by Craig in my butt, at an exact time determined by Dr. T.  The reason for the exact time is that within 36 – 41 hours this medication will force the eggs to drop, and the doctor had to make sure the sperm could get to those eggs before that window closes; the procedures would be scheduled accordingly.

I would have to remove the exact portion of saline water from its bottle, drop it into the vial with the powder, and then swirl around gently until everything was mixed.  Instructions were very specific that this medication could not be shaken, so of course I was hyper paranoid that any wrong activity would stop the medication from working and thereby disrupt the mission I was on.  Once all of it was mixed, I would pull all of the medication out into the 3cc syringe, switch that needle with the 25.5 needle, pull my pajamas down, and tell Craig exactly where to shoot it: at a 90 degree angle – after he had disinfected the area with an alcohol swab.  (I had gone into the doctor for the previous HCG injections.)

He was so nervous the first time, which I thought was funny, as by this time I had undergone 2 surgeries in that year alone and for that past week daily shots; my belly had bruises all over it; for me, it was just another necessary step, and I didn’t have time to flinch.   Even when blood came out after he removed the needle and swabbed the area, I pulled up my PJs nonchalantly, with a sense of real accomplishment at having done the next step, as prescribed.

This cycle’s AI #1 and AI #2 followed, with Craig producing his specimen at home, and then him rushing from our home in Venice to the doctor’s office in West LA, where he would drop me off with the sperm in a brown paper bag that also held any necessary consent forms, before he would then proceed to work in our shared vehicle. I would turn the specimen in at the pre-designated appointment time, usually around 7:30 AM so that Craig wouldn’t miss any work, which meant I was typically the first patient and on a few occasions arrived before any of the staff.

I would wait for 1-hour for the sperm to be cleaned to get the best swimmers, and then be guided into the doctor’s office at which point the doctor would ~ like in all other AI appointments I’d had by this time ~ confirm that the sperm was Craig’s therefore mine by checking name and birthdate, and then insert it into my vagina with a catheter.  Once complete, I would wait 20 minutes often with my knees to my chest to invite those beautiful little sperm to find my egg, before I checked out at the front desk (approximately $560 for the sperm cleaning and the Artificial Insemination at this office), and then walk over 3 long blocks to the bus stop which included walking under a freeway overpass, which was always pretty gross, and then take 2 buses home.

And the day of my 2nd AI, we would have sex, too, and then that night, begin inserting a medication called Progesterone into me vaginally, that was meant to decrease chance of miscarriage.

20 days later, unfortunately my period arrived.  I was sad and of course highly disappointed, but simply picked up the phone and made an appointment with Dr. T for Day 3, once again.  We went straight into another cycle, which meant approximately another $1,000 in medication, since I had some left over, plus of course the costs for the doctor visits, the sperm cleaning, and the bus fare.

A complete week of Follistim at 150 a day, followed by 2 AIs and sex on both days, and I started the Progesterone again, this time one day early.

It had been 20 days since the last day of my last period, and I had a little blood spotting when I wiped.  I guess I thought it might be my period, but it didn’t actually come that day.

Or the next day.

So on July 9th, 2009, I took a pregnancy test that came up positive.

Over the moon.  Through the roof.  Elated.  Happy.  Grateful.  Thrilled.  I was beside myself with happiness, and scheduled an official blood test with Dr. T’s office the next morning.  And low and behold, a total of 12 AIs, at least 10 tries of sex timed to ovulation, 2 surgeries, countless ultra sounds and doctor visits, and almost $15,000 later, I was pregnant.

And we could not have been happier.

Where do I start?

CHECKING INTO THE HOSPITAL:

I went to the doctor on Monday, November 23, 2009, thinking it was going to be a pretty normal 23.5 pregnancy week checkup, and while I was telling Dr. B about the trip we were taking to Florida to visit with Craig’s Dad and Step-mom for Thanksgiving – with plans to leave the next day, as clothes lay on our bed at home, waiting to be placed into our luggage, and our seats already claimed on the American Airlines flight – in his very thick, usually un-discernable Israeli accent, my OBGYN very clearly stated, “You are not going anywhere,” and checked me immediately into the hospital.

Over that next couple of days, I learned I had an incompetent cervix, which meant that the weight of the baby on my weakened or short cervix threatened early delivery; that I would be in the hospital for the rest of the term.  I learned of specific landmarks that I wanted to get to that would ensure the health of my still unborn son, who we had named Finley:

Once I got to week 24, I would get a steroid shot that would expedite the maturity of his not yet formed lungs.

Once I got to week 25, Finley’s chances of survival would rise from 15% to over 50%.

When I met week 28, the percentage that my baby would have Cerebral Palsy and other diseases would decrease significantly.

And so on.

We had a calendar placed in the room, and every day, right after a nurse opened my blinds as I lay in the bed with my head at the bottom of a 45 degree angle – in the Trendelenburg position, which was meant to encourage gravity to keep the baby inside, I would ask that day’s nurse to rip yesterday’s date off the calendar.  I had a sense of commitment regarding my task / mission / responsibility to keep Finley safe, and every day brought me a little closer.

For 11 days and 10 nights I stayed in that hospital with my legs practically in the air so that gravity could do its job and keep Finley in.  Friends and family brought black & white cookies from my favorite deli or my favorite lollipops, flowers, and celebrity tabloid magazines.  Pictures my nieces had painted for Finley were taped to the wall.  My husband, Craig slept there a few nights, and we’d hold hands or he would bring his computer and do work stuff there or we’d watch sitcoms and movies on that horribly small hospital TV, and he would rest his hand on my belly and talk to our baby.

I was permitted 1 shower during this entire time, and had to go to the bathroom in a toilet placed in the bedroom directly next to my bed, as part of the prescription to minimize my physical movement, even though the real bathroom was only 10 feet away.  I grew to hate the period of time that I had to wait for the nurse to come and empty this toilet of my body’s movements.

Every day, multiple times a day, the nurses would check my blood pressure and his heartbeat.  It felt like a new nurse each day, and each one would ask me his name.  “Finley,” I would respond, proudly.  I would show them where he was lying in my belly so that they could find his heartbeat easily; he tended to be in the same, low place.

I was prescribed two different kinds of stool softener so that my body didn’t have to strain too much.  I wasn’t on any special diet other than the usual pregnant woman diet, but I was guided to eat a lot of fruit so as to keep my body regular.

On the morning of December 3rd, 2009, a Thursday, while having a bowel movement, my water broke.  While nothing had prepared me for this, I knew that this was what had happened immediately, as I felt a release in pressure and then saw a strange clear ‘cap’ in the bottom of the makeshift toilet.  I immediately rang for the nurse.  She swiped some cotton swab on my inner thigh, a litmus test of sorts, which confirmed immediately that yes, my water had broken.  It was 9:35 in the morning.

And the panic set in, and who I was before that moment flushed away, as what happened next has entirely changed who I am.  What happened next broke my heart.  What happened next has dictated how I get through every minute, of every day.  It has defined my relationships with myself, with my husband, with my friends, my family and God.  It has changed my very beliefs about life and what my purpose is.  And for you to even try to understand that, I will now tell you a bit about the search for my son Finley.

THE EFFORTS IN 2008:

I guess I first started thinking about him in late 2007, and then Craig and I started seriously chatting about him in early 2008.  So, I was over 2-years sober when we first began our efforts to get pregnant, in May 2008.

I didn’t know that I wanted a boy, and I certainly didn’t have his name in mind.  I just knew that I wanted to have a child with Craig.

Craig and I met in June, 1998.  I was 27.  He was 28.  I let him pick up on me at a great dive bar in Venice Beach called Hinano Cafe, where they serve burgers and beer, have a great jukebox and accept cash only.  It’s not the kind of place I expected to find the love of my life, so we embarked on what I presumed was a summer fling.  Over time, our lust turned into love.  And, despite the years I had spent spiraling into drug addiction – a story for another time, we formed what I like to believe was an enviable relationship.

I don’t remember the details of our first monthly efforts, but Craig and I had been together by this time for almost 10-years, and the romance in our lives had changed dramatically in that decade.  So, from the very first time we tried for our baby, there was a sense of pressure.

In June, we were heading to France for a work conference in Cannes, with plans to visit our favorite spots on the Italian coast afterwards, and as producing commercials was my profession, creating schedules came naturally.  I immediately put together a calendar of my important “woman days”.  I included when I got my period, how long it lasted, how long it had been since the previous one, and made guesstimates based upon the fine reading in those ovulation kits on when we should try.  While I’ll suppose my peers packing for Cannes that year were getting waxed and choosing their favorite bikinis, I was busy calculating how many tampons and ovulation tests I would need on the trip.

The day came on the calendar for us to try, when we were in Bordeghera, Italy, truly the most beautiful place we’d ever been. If this was in the first few years of our relationship, this would have been the perfect place to make love and conceive, but I was all about procreating, and was very, very sick with a bit of exhaustion and some sun stroke, and in between gulps of EmergenC with that oval shaped window in our room overlooking that boardwalk and sea, Craig and I had sex.

For many months in my life I was particularly grateful when I got my period, but the next time it came, I was sad and disappointed, and I decided to be more proactive in our efforts.  I was going to produce this pregnancy!  I went to my gynecologist and asked her what we should do.  She said the first thing was to test Craig’s sperm.  The tests came back that he had a lot of sperm, but there was some discussion about perhaps decreasing any baths or Jacuzzis, and it was suggested that we consider doing Intrauterine Insemination (IUI), also referred to as AI or Artificial Insemination, a process in which his sperm gets cleaned and then put inside me during ovulation – so that we have the best swimmers at work.

We tried again naturally with the guidance of the ovulation kit that August, and still, my period came.  So, we decided to move forward and try AI.

The thing about AI or any fertility effort is that it takes serious coordinating.  One can’t schedule meetings or social plans or vacations or anything having to do with life in advance, as the woman’s bodily functions dictate the plans.

First I would have to monitor how many days it had been since my period, then I would start using the over-the-counter (ovulation kit $35 – $41 depending upon if it was on sale), then I would make appointments with the sperm lab and my doctor to perform the procedure.  It would take 1-hour and $180 to clean Craig’s sperm at the Lab in West Los Angeles.  We would grab breakfast during that hour, after which Craig would return to the lab to retrieve the sperm, and we would rush to the doctor in Santa Monica (since sperm is only ‘good’ a limited time both outside and inside the body) with the sperm kept warm (the tube tucked safely in my bra), with the insemination charges at my doctor coming in at $140.  Then we would repeat all of those exact actions (and costs) the very next day.

And, to compliment those 2 medical efforts thereby truly maximizing our chances, Craig and I would also ‘get romantic’ after the 2nd AI.  I was busy producing all of the planning and definitely didn’t appreciate the stress it put Craig under to perform so exactly; there were windows of time and rules as to when the last ejaculation could be – and I dictated the information in a way that was by no means ‘romantic’.  When we’d finish, there wasn’t a lot of cuddling, but me telling him that he’d done a good job – like he had finished first in a track meet or something – as I immediately held my knees to my chest and asked for a pillow to be placed under me to elevate me at my hips, a physical position that invited his sperm to swim their way to my eggs.

All the while, I was working at a production company as the executive producer, which means I was bidding jobs, chasing leads for possible jobs, going to shoots, helping the directors with their creative treatments, traveling, and overseeing the sales staff and company’s personnel.  Adding this baby production into my daily schedule came naturally to me, but the amount of coordination and the lack of ability to EXACTLY plan stuff kept me busier than even usual.

When I didn’t get pregnant that time, my doctor said we should check my body to see how it was working.  She indicated that the first thing we should test were my fallopian tubes.

I’d been forewarned a bit about the procedure, which is called a Hysterosalpingogram, that it’s uncomfortable and there is cramping and so on, but nothing really prepared me for the very cold blue dye being rushed through my Fallopian tubes and on into my uterus via a tube, with my legs spread open, as they photographed and documented where the fluid is going, if it is moving, whether it is stopping, the shape of my uterine cavity – and so on.

I recall there being some discussion then and there, under the bright lights of the lab in which all flaws are pronounced, by the specialist – who suggested that there may be some sort of bend or intrusion or something on my uterus, but in good form for litigious and medical reasons, the technician wanted to wait to discuss with my doctor.

I was uncomfortable for a bit after the procedure, but had no choice but to switch gears and race to a music video shoot that one of my directors was shooting in Malibu, for a pop star you’ve definitely heard of named Lady so&so.

I started living a dual existence, which reminded me of my years as a drug addict, in that I had to segregate and balance two huge areas in my life; nobody in my professional life would have guessed that only an hour before I was having dye shot up my tubes with a suggestion to take it easy afterwards.

For my next visit, I switched over to a new OBGYN, who was my previous doctor’s business partner in the same practice; Dr. C, my wonderful female doctor with a fabulous Irish accent, thought Dr. B would advance my efforts in my need to find Finley.

Dr B had a very thick Israeli accent and his bedside manner wasn’t as comforting as my previous doctor.  But he would utter short phrases like “I like what I see” and “Perfect, perfect” with his hand pressed against my belly as he moved my ovaries to a place where he could see things better.  He was happy to find how my uterus looked and confirmed my tubes were operating fine, but he saw a cyst that he said needed to go away before we continued our efforts, so he put me on birth control pills for a month.  When I returned the next month, on day 3 of my period, he said the cyst was gone and we could try again, and recommended that I up the ante a bit and try a fertility drug named Clomid.  The Clomid cost was $40, and was meant to stimulate the follicles – which eventually turn into eggs that can be fertilized.  And I also was prescribed HCG, a medication that’s a ‘trigger’ shot, which induces the ovulation at an exact time that then makes the AI efforts even more timely.

On Thanksgiving morning 2008, I was on a conference call with Russia about an upcoming commercial that one of my directors was slated to direct concurrent to racing to see the on-call Irish doctor at their office in Santa Monica, to have her put the trigger shot in my ass.

Thanksgiving.  On a conference call.  Rushing to see the doctor.

And still, a couple of weeks later, my period returned, and the cyst had, too.

So after 7 months of trying in 2008, we had done 3 rounds of Artificial Insemination and still no progress.  And because attaching a monetary value to the efforts helps put into perspective the commitment needed, I will continue to outline the costs throughout this story.

Going into 2009, we’d spent over $3,000.