Feeling Better

I feel quite a bit better today. Yesterday I drank 1/2 gallon of Powerade zero (I don't like Gatorade) and at least that much water, probably more. Loaded up on protein at dinner and again for breakfast today. Sat with the heating pad on warm last night while I just rested.  I am significantly less bloated today and the pain is 90% less. I'm going to keep up the fluid and protein today, get this all flushed out of my system.  I felt well enough to shovel the driveway this morning after we got about 4 inches of snow overnight.

What happens after canceled IVF?

No one told me what to expect after my cycle was canceled. My last Follistim and Menopur were on Tuesday, last Ganirelex on Wednesday. Wednesday I felt normal, Thursday I was starting to feel pain in my ovaries, more bloating, pressure.

Today (Friday) I'm fairly uncomfortable. I've gained 3 pounds of water weight since Wednesday, my ovaries are quite tender and my lower abdomen feels full and sore.  I had a ruptured ovarian cyst back in April and it feels a lot like that, except not quite as painful. If I'm sitting still I'm pretty okay, the jarring of walking hurts, bending hurts and please do not touch my abdomen!

I called my RE office and talked to the nurse, she said to expect it to last at least a few more days, more like a week or two, basically until I ovulated on my own since I didn't get the HCG shot. She offered to call me in pain killers but I declined.  She said it takes a few days for the medication to stop working then some more time after that for my own hormones to get back on the job.

It is frustrating to me that when they cancel your cycle they don't tell you what to expect. I was too overwhelmed when I was at the office on Wednesday to think about asking. I guess that I naively assumed that when I stopped the meds the symptoms would go away, that is not the case.

I've asked online and many people have advised me to drink lots of gatorade and up my protein intake.  The protein thing gave me pause and I started doing some reading. Apparently protein can have a large impact on an IVF cycle. Lowering carbs to less than 40% of daily intake and upping protein to more than 25% can greatly increase your chances of success. I'm going to be starting this for next cycle.

My RE wants to wait until February to start a new cycle, he says he wants to wait for all the medications to have time to get out of my system before starting again. He has not yet decided on a new protocol, we are hoping to get the meds ordered before the end of the year though to get them on this year's taxes.

Cancelled

This cycle is canceled; I did not make enough eggs.  Here are my actual follicle numbers from Monday and today.  Based on size and growth I would have only had one, two tops to get big enough before I had to trigger.   They want the follicles to be bigger than 20mm  to trigger and they grow at an average of 2mm a day though mine were growing slower than that. 

So logistics, I stop all meds today except the steroids which I taper off over a period of forever (aka a month).  My RE is going to review my chart and response and decide on what approach we want to take next cycle. Next cycle will either be in January or February, some of that depends on my body, when I get my period and what approach is decided on.  

In terms of money, we will be out what I spent on the meds I used this time which is around $3,000. The rest of the funds will roll over to the next cycle (need to confirm all of this with the clinic). 

So I'm really bummed right now, feeling very down and irritated. Its been a bad year all around so maybe a clean start in the new year will be better. 

I'll post again when I know more. 

Saving Follistim Overages

I made a video on how I've been saving the overages in the Follistim cartridges. I started off with 2 600 units vials and 7 300 unit vials.
I did 600 units out of the 600 unit cartridges
I did 375 units out of each 375 unit cartridge

I have 78cc of overages saved which equals 647.4 units. At $524 for a 600 unit vial that is $565.15 worth of medicine!

Each syringe mark is 8.3 units (on a .5ml insulin syringe)
A full syringe is 416 units

I hope this helps someone else save some money!

Update

I emailed my reproductive endocrinologist, he is not the one that has been doing my ultrasounds, that is at the other office, anyway he called me back this afternoon. He said that its a little early for me to freak out, that we'll see what Wednesday's ultrasound and blood work shows. He wants me to come over to his office after my ultrasound and talk to him.  I felt better after talking to him but then worse again when I found out my estrogen was only 134 today, it should be higher than that on this day of stims. Oh well, not going to stress, we'll see what Wednesday brings. I am going to move my shots a bit earlier in the evening though.

Follicle Check

I had my blood drawn to check my estrogen level this morning and an ultrasound to check my follicles.  The lab lady had to stick me twice to get blood.

The ultrasound showed 6 follicles total. 1 at 15mm, 1 at 11mm and 4 (2 on each side) at less than 10mm. That is not as many as I was hoping to have today.  I stay on the same medication protocol until Wednesday and go back in for another check. The doctor said my egg retrieval will likely be on Saturday or Sunday.
She said that follicles grow an average of 2mm per day, so I'm hoping some of the smaller ones can catch up!

My left ovary was hiding again and my bladder was too full ,not a requirement I just didn't go pee, I'll have to remember to do that on Wednesday.

I've been having leg cramps, the doctor said that could be from the medications.  Otherwise symptoms are about the same.

I have these worries in my mind that I had more follicles since I has having quite a bit of pain on Saturday and they matured and ovulated early. I know the doctors know what they are doing with this but these are the kinds of things that go through my head.

Anyway, for your amusement a picture of the exam room this morning while I was waiting on the doctor to come in.

Started Menopur

So I'm on day 4 of stims. I added the Menopur last night. It now takes me a solid 20 minutes to do my evening shots; from getting everything out of the fridge, prepping, mixing, shooting and putting everything away.  I'll run down side effects so far below, but lets just say I'm glad I take the Follistim at night and can go to bed right after.  I "nicked" something when I did my Ganirlex this morning. After I did the shot there was blood in the syringe and dark blood coming out of the injection site. I emailed my nurse and she said while the fatty areas are not usually vascular that I probably "nicked something" and to avoid that area in the future.

So for the Menopur, I think I did something wrong, the vials seem to be pressurized and its hard to get the mixed fluid out, I'll re-watch the video again to see if I can figure out what I did. I got it mixed but it look a long time to get it out and get the air out.

Meds I am on now:
Dexamethasone: .75mg once daily AM
Ganirelex: 125units once daily AM
Follistim: 375 units once daily PM
Menopur: half vial once daily PM
Folic Acid: 1mg once daily PM


Symptoms

Headache: pretty constant now, it gets worse as the day progresses
Dizziness/Lightheaded: Right after Follistim (10 minutes after) it is really bad and I have to lie down or fall down, some episodes throughout the day otherwise
Forgetfulness: milder now than when I was on the Lupron but I still do not feel fully myself
Tiredness/Fatigue: mild, I mostly attribute this to poor sleep
Hot/Cold Flashes: starts within 10 minutes of Follistim injection, lasts throughout the night
Cramps: the equivalent of mild menstrual cramps off and on
Emotional: some increase in emotions (see note)
Hunger: starving all of the time

Note on emotional state: I thought that I was not experiencing any emotional side effects until I had to deal with a small family crisis yesterday and fell apart. This is unlike me so I blame it on the drugs.

One of those mornings

Last night about 45 minutes after I did the Follistim shots I started feeling unwell. I already had a headache but it intensified and I started going back and forth between hot and cold and feeling more fuzzy headed. I also had some cramping, I am sure that the Follistim could not work that fast so maybe that was in my head. I went to bed and had a hard time falling asleep. I feel better this morning but still not right. Headache is still present and I feel weak, it hard to describe, its like if you have low blood sugar and get the shakes without the shaking or if you've worked out really hard and your muscles just feel exhausted.  I forgot to mention yesterday that I've been having small cramps in my legs, they had gone away for a few days but are back this morning.

So this morning I go to do my Ganirelex injection, I had split it yesterday so it should have just been shoot and go, but no, of course not. I went to get the air out of the needle and the plunger stuck and then gave way and I shot 1/3 of the shot across the room.  So had to get out another pre-filled syringe of Ganirelex,  take the needle off the one I just screwed up, inject the proper amount back in to it, put the needle back on. Then I had to get another empty syringe and put the dose into it (.25ml), then a third syringe to get the rest out of the pre-filled syringe because I don't know how much is left in it. Overall I'm about .1ml short on Ganirelex now. I have to email my nurse and find out what to do, hopefully its not going to matter, I'd really rather not buy another whole one because I screwed up.

Oh and I walked off and didn't take my dexamethasone this morning.

Update: The nurse called back and says we can wait until my ultrasound appointment on Monday to see if I need to order more Ganirelex or not. Also my Estrogen level last week was 5, which she said was good.

Stimulation has begun!

Let the follicles grow!!!   I did my first Follistim shot a few minutes ago. I spent some time debating about the best time to do it since it needs to be right around the same time each evening. I settled on 9:30pm.

I read the instructions for the pen and primed it and dialed in my dose.  My dose was 600 units today and the pen only goes to 450 units in a dose so I did 2 doses of 300. I did one shot in each side because I've been going back and forth on sides for my daily shots, no real logic to this other than I prefer not to shoot myself in the same place twice! The shot is harder to do and takes longer because the plunger one the pen is not smooth, it turns in clicks so its a little awkward and you have to push a little harder.  The areas are burning and itching but not horribly.

I am starting to get some spots on my belly where some of the shots have bled, I'm guessing that will only get worse now that I'll be up to 3 shots a day at least.

So the vial was 600 units, everyone told me about overfill and I'd read about how to get the overfill out of the vials since this stuff is SO expensive. I don't know if you can see here but I used an insulin syringe to get the extra out of the vial and it was about .15ml, which if the conversion I can find is right is about 125 units!!!  That is close to $200 worth of medication!!!

Other than that, not much to report. Low grade headache for the past couple days that gets worse towards evening, still not discounting that it could be sinus/allergy related. Hubby is still sick but *knock wood* I haven't gotten it.  I've had a few dizzy spells today, a couple bad ones, again, not sure if its the meds or sinuses.
Oh, and my memory is still bad, I feel like I'm walking around in a daze most of the time, very unfocused. (I had to edit the post to add that because I forgot)