Under The Weather – The 411

baby - under the weather

For the past few days, I have been miserably sick.  After my surgery on Friday, I woke up in the recovery room with fluid in my lungs, coughing and feeling sleepy.  On Saturday, when I got up, I was still coughing, but also had an extremely sore throat.  I called the doctor on call and was told it should clear up in a couple of days.  All weekend, I coughed up phlegm and nursed my sore throat with sugar free lozenges, hot tea with organic honey and lemon slices, and ate soft foods.

My throat is still very sore and the coughing is subsiding.  I made skillet mac n cheese with a cheddar and provolone bechamel, thinking it would soft and easy to get down… NOPE !  I ate a little bit but my throat was so raw that I felt like butter was coating my throat and it was burning.  I gave up and just made a big mug of tea and added some rum to it for a hot toddy.

Surprisingly, I am still experiencing some bleeding.  I thought it would have stopped the same day as the surgery as it did before.  The last time I had a D&C in June, I was pregnant… well, I was carrying an expired eight week old fetus.  After the D&C, the bleeding stopped the next morning.   Today is day 3 after the procedure and I am still having off and on bleeding.   I am mad because I want to go to the gym and start lifting again, but I am not going to as long as I am bleeding.

I did go out to a birthday party on Saturday night for about four hours.  I was sore and tired, but I promised my friend I would be there and I would bake a bourbon red velvet cake and a rum infused guava jelly cake.  I baked the cakes, boxed them up, picked up my best friend, then went to the party in DC.  We have a great time.  I sat most of the party.  I am still feeling a bit of pulling in my abdomen.

I stayed in bed most of yesterday, with the exception of the time I spent making the mac n cheese.  I have rested today as well.  I am so tired of this bed rest stuff ! If you know much about me, I am not the sit still and do nothing kinda girl.  After watching everything I had on Tivo and several hours of Law & Order SVU and Criminal Minds, I have had enough of tv for a while. (well, until tonight when Major Crimes comes on lol).

Tomorrow, I will work on my book outline.  I am trying to find busy work I can do from my laptop on my bed or the couch.  I hope to return to the gym on Wednesday.  I have dropped 24 pounds so far and I hope to continue to work out even after getting pregnant.  I just do not want to overtax my body.

I hope all is going well for the rest of you ladies !!

 

 

IVF #4 Underway – Hysteroscopy with Biopsy – The 411

baby - sick

Yesterday, I arrived at Lenox Hill Hospital at 5 am, an hour before I was to report.  I sat in the waiting room and watch Law and Order until it was time to go upstairs to the 10th floor to the same day surgery center.  I went up and checked in and was quickly taken to my pre-op room and met with the intake nurse.  I was given my gown, robe, and socks to change into and then the nurse brought me a warm blanket.  My nurse came by to ask me the same questions I had already been asked by the intake nurse and another nurse.  I then met with the Anesthesiologist and he asked me the same questions then explained what he would be doing.  I asked what meds he would be administering and I was getting propofol and toradol if needed for pain.

Next, the surgical resident came and asked me again the same questions and introduced herself and shortly after Dr. Moisa came in to introduce herself and ask me about my IVF journey and other questions, as she was filling in for my OB, Dr. Karamitsos.  Soon, I was taken to the OR, removed my robe, adjusted the silly cap they gave me to cover my hair, laid on the table and was freezing while they got me warm blankets, hooked up a monitor, put in my IV and then gave me an oxygen mask.  I remember the propofol going in because it burns, starting in the vajayjay and then quickly coming up.  The last thing I remember is the Anesthesiologist telling me I was going to sleep now and feeling the burning in my chest.  I woke up at 9 am in the recovery room and was coughing up phlegm.  I asked for pain meds and then I went back to sleep until 10 am.

I was ready to get up out of there at 10:30 or so and my make up artist had to come sign me out and take me to Penn Station because the hospital would not release me on my own.  One of my producers was supposed to be in the city awaiting a call from the hospital, but he did not show up due to a sprained ankle.

I got to Penn Station and waiting on my train the DC (which was 5 mins late !) I slept all the way to DC on the Acela and then got off and my mom came to get me.  I got to my mom’s house, and went straight to bed.

This morning, I awoke to a very sore throat and chest congestion.  I called the doctor on call and he said as long as I did not have a fever, the irritation from the tubes they put down my throat should clear up in two days max.  I explained to him that I have a history of pneumonia and I can not afford to get sick going into an IVF cycle.  He assured me that it is just irritation and a little fluid from the moist oxygen.  Hopefully this does clear up and if not, I will go to the emergency room here tomorrow evening for antibiotics.

Thanks for all of your well wishes and support and SpiritBaby, thanks for texting to wish me well just before my procedure!  I was so touched !  🙂    I was in surgery and my mom was in Northern VA undergoing chemo.  What a day !

 

 

IVF #4 – Hysteroscopy with Biopsy Tomorrow – The 411

baby - surgery

This morning I went to LabCorp on my way to the gym to have six tubes of blood drawn for presurgery prep for my surgery tomorrow.  I had to have a CBC,  Complete Metabolic Panel, HIV, TSH, HCG, and some other test I have never heard of.  I am so sick of them always sticking me in my left arm.  Thank goodness that arm and vein have healed since it has had a little rest since October.

After my labs, I ran to the grocers to get chicken breast, fresh mushrooms (to make garlic mushroom chicken) and fish fillets.  I had fish and hushpuppies for breakfast after I got back from the my morning weight training.  Today was leg, glutes and abs day. Note, I have lost 22 lbs thus far !!

I am going through mental withdrawals since cutting out beef and pork from my diet.  In doing research, I learned that pork, beef, and lamb are carnivores which produce a sugar that human bodies do not.  By eating it, our immune systems inflame and go into attack mode.  It is advised that we consume no more than two grams per day.  Since I have autoimmune issues and I need to keep my immune system at bay, I have temporarily cut those meats from my diet.  I will eat chicken, turkey and fish from here on out.

So, I am trying to figure out what to wear tonight ! I am in DC area at my moms and the temperature has plummeted.  It is NEGATIVE SIX outside with the wind chill !  UGH.  It is going to be snowing in NYC tomorrow.  I will arrive in NYC tomorrow morning at 5 am and have to report to the hospital at 6 am for my procedure.  I will be on the table at 7:30 am so please send up some prayers and well wishes for me at that time.  The procedure should be thirty minutes tops.  I am nervous because my OB is not on call tomorrow and one of the female doctors in the practice, whom I have never met, is doing my procedure.  For those who know me, I research the HELL out of doctors and staff that I deal with and do not like change at all !  I wish Dr. K were able to do my surgery, but it is what it is…

IVF #4 – Precycle CD3 – The 411

baby - ivf 4

Yesterday, I had my first precycling baseline appointment and bloodwork.  The transvaginal ultrasound shows that I have six follicles on my right ovary and three on the left. My blood work is all normal. I am now scheduled for my hysteroscopy with biopsy on January 9th at Lenox Hill Hospital, which will be my cycle day 20. I am continuing with weekly acupuncture as well.

Last night, Dr. Kiltz returned my call regarding the next steps of my protocol.  I spoke to Dr. Grossman earlier yesterday morning and he said we would defer to Dr. Kiltz’s protocol.  Dr. Kiltz had to look over my chart and figure out what he wanted to tweak for this protocol.  He stated he wanted to shake things up a bit.   Today, I got my precycle instructions for IVF#4.  I will be taking my normal supplements and prenatal vitamins until January 7th.  Starting on the 7th, I am to start taking Estrace tablets twice daily for seven days. Then I am to call with my next period to do a day three monitoring/ baseline appointment and start stims.  I will not be taking Estrace for three weeks and Endometrin the last week and starting Lupron like I did before.

I did discuss with Dr. Kiltz my desire to do a double trigger this next cycle, which is proven to mature eggs.  The hcg trigger shot is taken 36 hours prior to retrieval as normal.  The next morning, I will go in for blood work to test the hcg level and then that night, I will either do a lupron trigger of over 20 units or another hcg trigger.

I will be doing Saizen, 300 Gonal F, 300 Menopur, 5 Lupron (I assume) along with Synthroid and prenatals during stims.  After egg retrieval, I will add neupogen, lovenox, prednisone (20mg) and weekly intralipid infusions. I will be doing a two or three day transfer of all embryos this time instead of waiting until five day.

Merry Christmas to you all !

Hysteroscopy and Biopsy (Womb Scratching) Aiding in IVF Success – The 411

baby - hysteroscopy

The procedure, known as womb scratching, or endometrial biopsy, feels much like a pap smear and costs approximately $200, hardly breaking the bank compared to other treatment-associated costs. When timed one month before an IVF cycle, a woman who receives womb scratching is twice as likely to become pregnant as a woman who does not undergo the 15-minute procedure.

baby - hysteroscopy 2

How is womb scratching done?

Laurence Jacobs, M.D. of the Fertility Centers of Illinois says the biopsy uses a Pipelle to lightly scratch the endometrial lining. “Local injury of the endometrium produces an inflammatory reaction resulting in increased white blood cells (leukocytes such as macrophages) which secrete growth factors and cytokines. These substances regulate blastocyst implantation and placental development”, he states. This stimulates the uterus’ receptivity to the embryo and increases the success rate of live birth. The most acceptable use of womb scratching is in women with good egg quality, but failed IVF cycles.

The procedure can be performed in-office by an OB/GYN trained in the “four quadrant uterine biopsy”, a method of cell collection similar to a pap-smear or cell collection for cancer screening. However, it is most efficient to combine womb scratching within a fertility treatment protocol or an already scheduled hysteroscopy if fibroids or polyps are suspected.

Dr. Jacobs claims the procedure carries little risk to the patient for pain or infection. In fact, doctors are so confident in the success that many, like Jacobs, offer it routinely to IVF patients who have failed previous cycles despite good embryo quality. Jacobs says, “At the present time, the endometrial biopsy should probably be reserved for those patients failing IVF despite good or excellent embryo quality, where uterine receptivity appears to be the major underlying problem.” Endometrial biopsy may not be the best option for patients of advanced maternal age with a history of failed IVF cycles due to genetically abnormal or poor quality embryos. In that case, genetic testing may be employed to verify the quality of the embryo and genetic soundness prior to embryo scratch.

How effective is womb scratching?

Several recent studies, including a British study published in Reproductive BioMedicine Online, confirm that womb scratching can double the success rate of pregnancy and live birth when performed at the right time.

“Timing is everything”, says Jacobs, “It’s very important to do an endometrial biopsy at the right time. In one study where the biopsy was performed at egg-retrieval, the women who had the procedure experienced lower pregnancy rates than controls.” It is currently believed that the best time to perform the scratch is once or twice in the month preceding an embryo transfer. It should not be done in the same cycle as ovarian stimulation for fresh IVF, or estradiol for a frozen embryo transfer (FET).

Consult your doctor to determine if womb scratching is an option for you.

Source:  http://www.fertilityauthority.com

Additional Resources:

http://www.dailymail.co.uk/health/article-2808964/How-scratching-lining-womb-double-chances-having-IVF-baby.html

http://abcnews.go.com/Health/WomensHealth/womb-scratching-technique-boost-ivf-success/story?id=17365332

http://www.thetimes.co.uk/tto/health/news/article4248667.ece

IVF #4 Upcoming – The 411

baby - ivf egg and sperm

Last night, Dr. Robert Kiltz, who owns CNY Fertility Center and Spa, called me and said he wanted to schedule a phone consult with me for Saturday morning.  He said he was reviewing my file and would call me.  This morning, as promised, he called to discuss my latest failed cycle and to make a plan to move forward.

He wants me to try one more cycle with my own eggs prior to moving on to donor eggs.  He feels that I have good equality and is happy that he sees all my embryos making to blast.  He feels that I need to do a few things:

–  Add Saizen / human growth hormone to my cycle to improve maturation and egg quality

– Use neupogen post transfer

– Do a neupogen wash

–  Do a Hysteroscopy with biopsy

– Do an endometrial scratch on day two of my cycle to improve implantation

– Continue on an estrogen priming protocol

– Use 300 Gonal-F and 300 Menopur with Lupron for stims again

I have decided to give my own eggs one more last shot while I am saving up for a donor egg cycle.  I am going to detox my body first.  All of these hormones have take a toll on my body.   I am going to start a protein train on Monday (protein shakes only, apple sauce, sf popsicles, sf jello, water, diluted apple juice, oatmeal).  I will actually start by drinking only water with lemon, cayenne pepper and grade A maple syrup for two days to detox my body from my sugar habit.  It really does work !  By drinking loads of the lemon cayenne tea, it cuts sugar cravings and helps you follow the Bariatric diet more easily.

For those that did not know, I had gastric bypass surgery March 31, 2004.  When I follow a strict diet for short periods, it helps me refocus and I also drop weight pretty quickly.  I want to get back to my starting weight prior to starting stims.  I should be able to drop the few pounds I have gained due to the hormones.  It can only help with my quest to get pregnant.  Weight loss releases the hormones that are stored in body fat back into the bloodstream.  This is why a lot of women who became infertile due to obesity find themselves pregnant unexpectedly after gastric bypass, lapband, or significant weight loss.

Ironically, one of my friends out of the blue reached out to me late yesterday and said that God had laid on their spirit to relay to me to hold on…. that my bundles of joy were on the way.  I told my friend to go back and relay a message for me…  I will hold on, but can He speed up this timeline ! lol