Week Three

Week 3 has officially started, which means the introduction of needles... Yikes! Friday, I went down to the pharmacy to pick up my first inject-able drug. I don't believe I've mentioned this before, but the only pharmacy in the greater DSM area that supplies fertility drugs is Bauder's Pharmacy. The pharmacy is located on Ingersoll and is east of 42nd street. This is a really neat old style pharmacy complete with the soda / ice cream bar with stools so you can sit right at the counter. The pharmacist is a very nice and knowledgeable man. He's is probably in his mid 50's to early 60's and you can tell by the way he works that this is definitely not his first rodeo dealing with these fertility drugs! Friday's trip to the pharmacy was to pick up Lupron. The pharmacist did a little show and tell with me to ensure that I knew what I was supposed to be doing when I got home. I had a pretty good idea of what to do from listening to the Mid-Iowa Fertility nurse and I also knew that I would have a pretty good expert to help me out on Saturday for the first shot. The expert would be nurse Cindy aka the best mom ever!! As I went to pay for the drug, the pharmacist said that the whole bag (syringes, lupron, and alcohol swabs) needed to go into the fridge. I gave him a look and said "Really? The whoooole bag?" He responded with: "Well, no" and smiled at me like okay smart ass get out of here so I can help the next customer.

I couldn't leave Bauder's without purchasing a vanilla malt (again this is an old style pharmacy). I got sucked in.... I knew the malt would be delicious... and let me tell you, that was the best malt I've had in years! I "drank" that malt like it was the last thing I was ever going to eat! I hope I don't have to go back to the pharmacy too many more times... this will be a bad, bad, bad habit to get into!

I worked Saturday which was probably a hidden blessing because that kept me from stewing and fretting about the shot that awaited me on Saturday evening. I had asked the expert if she would be willing to come down and stay overnight to assist me with that first shot. I am sure that she got a little bit of a kick out of watching how nervous I was for this first experience! However, I am definitely grateful that mom and dad were able to come on down and stay at our home. There is nothing better than the care of your mother! After another lesson on how to fill the syringe, the time had finally come. I hesitated quite a bit. That first step to stab yourself with that needle is tough, especially because I've never done that! I'm not sure what made me go through with the motion, but before I knew it... the needle was gone and in the skin. With shaky hands I pushed the plunger in until all the medication was gone and in a swift motion pulled out the needle. I cannot believe I just did that....

Mom helped me fill the syringe one more time tonight before she and dad took off to go home. Again, I don't know what got into me to give that shot tonight, but I found a way. I can't say that the shot tonight was any easier than the previous night, but I have hope that the next couple weeks will be easier. I only have 23 more nights for that drug... BRING 'EM ON! Injection site was a little red and irritated after the shots, but nothing too out of control.

On a side note my thumb is still healing well and the nail is getting closer to being fully grown out! Major accomplishment for this week was being able to remove my right eye contact using my right hand. Since the day the accident happened, I've had to use my left hand to remove both contacts! I feel more efficient now as I can take both of my contacts out at once rather than one at a time! Small wins....

Week 3 is officially in full swing!
ALJ

Week 2!

I was issued my official IVF calendar this past week! I was pretty excited to get the calendar to help me "map" out what is happening when! I bet this surprises you all that I like to have a schedule :)....OR maybe not! The biggest thing for me is that the calendar puts a little more clarity into the whole process. I am for sure starting to see the light at the end of the tunnel!

Today officially brings us to week 2 on the calendar! At work we keep talking about celebrating the small wins... so I guess I'm bringing that to my personal life and celebrating the small wins! Today started 2 different types of antibiotics for me and a z-pack for C. The antibiotics for me will continue until next week.

My thumb is healing rapidly! I am impressed with how fast the nail has grown back and how many more tasks I can complete with my right hand - small wins now... :) My biggest accomplishment for the past week was the ability to hit the space bar with my right thumb instead of using my right pointer finger. This was somewhat of a weird thing to re-learn or re-train my brain to use my thumb instead of bringing that pointer finger down. I know... weird that I didn't just use my left thumb to space, but that seemed really awkward- almost as weird as trying to throw with my left arm.

Until next time...
ALJ

Waiting Game....

Waiting game... nobody likes to play the waiting game.... especially this girl! After C and I went to the couples learning session, I knew that it would be another month of waiting to start the process until I had my next cycle. As much as I feared that I wouldn't start my cycle "on time," I just had this hope deep down that I'd start my cycle naturally. Something, anything at least would go right and I'd start my cycle and we'd move on! At least that's what I had hoped for...

Unfortunately, hope was not in our corner this time! Good thing they have medications that will kick start my cycle. I am taking 7 days worth of provera pills to kick start Aunt Flo. For now that's where we're at... waiting for the cycle to start! After my cycle starts I'll have to start a daily routine with a handy dandy little calendar which will tell me what to take (pills or injections) on what days.

• Week 1: Daily birth control pill and a "baby" aspirin

· Week 2: Daily birth control pill, a "baby" aspirin, and 2 types of antibiotics to rid my body of nastiness!

· Week 3: Daily birth control pill, a "baby" aspirin, and start injections of Lupron (Responsible for stimulating the ovaries to develop follicles and has the effect of "quieting" the ovaries to prevent the spontaneous release of the eggs prior to the egg retrival)

· Week 4: Daily “baby” aspirin, Lupron, a baseline ultrasound to make sure everything is developing well and start with injections of Repronex & Follistim (both stimulate the ovaries to produce several eggs in one cycle)

· Week 5: Daily “baby” aspirin, Lupron, Repronex, Follistim, and every other day scans and blood draws to check the progress!

· Week 6: Egg retrieval process should happen sometime at the end of week 5 into beginning of week 6 after an injection of Ovidrel (causes expulsion of the egg from the follicle). Progesterone injections (help maintain the endometrium to help prevent miscarriages) start up until the point of embryo transfer.

· Week 7: Late week 6 into early week 7 will be the embryo transfer day!!! Bed rest the day of the transfer and the day after and Corey will have to take me as I “get” to take a valium tablet before the transfer.

· Week 8: After the transfer I wear a Vivelle skin patch (estrogen), not sure for how long as the information sheet copy was cut off at the bottom of the page.... handy.

Again, the waiting game will occur during these weeks, but I can only expect that hope will be in our corner this time and finally baby J will become a reality. I am still super nervous and anxious as I was after the couples learning event. I don't know that either of those will go away until I can see the reality that baby J is on their way into this world. The clinic provided me information sheets on all the drugs, risks of in vitro, side effects of injections, and a handy sheet on stress and infertility. The nurse at the clinic expressed that if your life was stressful at this time or your job was stressful, maybe you should wait to start the process. Seriously....this entire process stresses me out... I have hope that I'll start to settle down once things get going...

I'll appoligize now that if I act different than normal, act in a rude manner, or disinterested in any conversation/situation with you (my audience), I am truly sorry! No doubt will all these stimulation drugs, the stress of the whole process, and farm related things will cause me to be slightly preoccupied....! Just know I count on you all as my support system and love you all very much!

HAHA now you all get to play the waiting game until my next update.... how you like that?

ALJ

Words

I've been trying to come up with the right words for this post for a while now. I'm still not sure if I've got them or will ever have the right words, but here goes....

Our world was rocked with the sudden passing of Corey's brother Chris. At this point in time, I'm not sure that we understand god's plans for Chris or the future. Right now I know that we will miss this very kind and loving husband, father, and brother more than words can express. Our hearts go out to Julie, Allison, and Casey.

Corey and I made it to the couples learning session at Mid-Iowa Fertility. This was a 2 hour power point session! All of the information about the in vitro process was good to learn and talk about, however, very overwhelming. Overwhelming in a sense that there was so much information thrown at us in such a short period of time. The nurse also described the medications that I will have to be taking, how to inject the medications with syringes, and how to mix the medications. I have a lot of anxiety about all of the injections that I will have to give myself. I am definitely not a needles person at all and have never given myself a shot before. Eventually, I will need to have a shot in the back side of my hips...the nurse mentioned that this would be the worst shot and the biggest needle. She mentioned that this shot would most likely need to be injected by someone other than myself. I am unsure if Corey will be able to give me this or any of the shots for that matter, but we will cross this bridge when we get there...

I am somewhat confident that this whole needle / medication process will be alright once we actually get started. I just need to get over this beginning stewing and fretting stage! Medications will most likely start mid to late March. The nurse said that it takes about 35 days from the start of medications to the egg retrieval process - if all goes well. Approximately 5 days after that will be the embryo transfer. Again, a lot of anxiety because this all sounds so good and I will have a nice little calendar /plan to follow, but there is no guarantee that this will create baby J. I will always stay positive and never give up, but I think it is normal to have anxiety about the process.

My thumb continues to heal at a steady pace. The nail has grown about 1/3 of the way across the nail bed. I am able to use my right hand for a few tasks, but do experience pain when I forget that it is sensitive! I had a doctors appointment on Tuesday. The doctor who performed the surgery said that my thumb looked like it was healing well. He proceeded to squeeze on the sides of my thumb and asked if that hurt... well it was a little sensitive...! He squeezed out a little bit of infection.... Soooo, I am on antibiotics and he was going to do a lab test on the infection. Dang it! On the plus side, he still said it looked good and mentioned that I wouldn't need to come back! Hoping that before I know it I'll be back to normal and using my thumb more than EVER!!!

I hope you all can take the time to express to your family members how much you love them, as one never knows when the unexpected may occur. With that said, I love you and miss you all.

Until next time,
ALJ

Lumberjack?

Two weeks ago today, almost this exact point in time, I smashed my thumb! Yuckkkk. Life sure has been challenging to operate with one hand! You really do not know how much you depend on your dominant hand and a thumb to do pretty much every daily task imaginable. Tasks have gotten much easier as of lately due to less pain and sensitivity in my thumb. Still, tasks such as brushing my teeth, opening bottles, doing anything with my hair, starting my truck, putting on a seat belt, and one last one...pulling up my pants after going to the bathroom :) are a daily struggle!! Those of you who really know me, know that on an average day I'm not very fast in the showering department. So, you can imagine how much longer this takes with my left hand only and my right hand covered in a gallon sized ziploc bag. Again, I am significantly experiencing less pain, but now my only complaint is that the thumb gets so hot and itchy! The extra dressing keeps my thumb even warmer !! I have an appointment on Tuesday (1/31/12 - cannot believe that time is flying so fast that February is almost here!) to get this dressing off my thumb. I am a little nervous to see what my thumb will look like and if I will experience pain when they remove the dressing. I am also anxious to find out if I will have to keep a dressing on my thumb, a splint of some sort, or if I can let the thing go freeeeee and wild?

I mentioned that life has been challenging, but really in the grand scheme of things my life is pretty much blessed. I have great support from family, friends, and best of all my husband. This has really hit home in the last week or so when I got the news that a brave little boy lost his fight with cancer. To learn more about Eli Horn visit his website: http://www.elihorn.com/blog/. Eli was the grandson of one of our "rural neighbors" living only a 2 miles from Corey's parent's house and our house as well as a friend of my mother. Mom and Janice have known each other from their time at the University of Iowa - nursing. Eli was a brave and courageous boy that we should all take inspiration from.

Last update I mentioned that C would be having some blood-work and potentially genetic testing. The blood work test results came back and his hormone levels are A-OK. I spoke with Dr. Young and at this time he really didn't think that genetic testing was necessary. I had the appointment for the HSG (hysterosalpinogram) test, which everything looked normal. The dr. was able to tell me the results almost instantly. I had a funny moment during this exam though. Obviously something is wrong with my thumb based on the dressing and wrap. I have had multiple looks and questions. When I explain how my thumb got injured, there are a few who have no idea what a log splitter is or how it would be used. However, at this HSG test the nurse was trying to make small talk, which is fine, but after I explained what happened to my thumb, this is how the conversation went. Amber - " I smashed my thumb in a log splitter, broke the tip bone, and had to have surgery to repair a laceration." Nurse - "Ohh dear, that sounds terrible. Is this what you do for work?" Uhhhhhh - Seriously lady... no... I am not a LUMBERJACK....

Anywho, when I spoke with Dr. Young about C's blood-work, I told him about the results of my HSG test. He mentioned that from here we would basically need to start going into the in vitro process. He told me to call back when I started my cycle. I told him that was all fine and dandy, however, my last 2 cycle's had to be induced by taking progesterone pills. He told me to stop by and pick up an in vitro check sheet, and a prescription for the progesterone. The check sheet basically is a map of what we need to do to get the process started. First step was to talk to their financial department to get all of the insurance things figured out as most insurance companies will require prior approval before providing coverage. The checklist also contained a coupe more tests to complete and sign up for a couples learning session. I am sure C is just definitely looking forward to this... bahahah :) !!!

I am assuming I will have another test once my cycle starts, so this is our next direction and will most likely be my next update. Until then, thumbs up for a few more days...

Love,
ALJ

Thumbs Up

I have a few things to update you all on since my last post! Starting with the name of the post "Thumbs Up."

Corey and I were splitting wood out in the field north of our house. We cut down a rather large tree out in the field / cow pasture a month or two ago and have slowly been chopping and splitting wood from that tree. We've gotten about 4-5 truck loads of wood from the tree and expect to have about one more left. The pieces that were left on Sunday were huge chunks from the base of the tree and required splitting. As we have done for a couple years now, Corey would run the splitter and I would pull off the pieces and toss them into the back of the truck. Well, this time Corey and I were discussing something (I have no recollection what about anymore) and I was getting tired. Somehow I managed to place my hand on the butt of the splitter and my thumb slipped down on the splitter. Corey started moving the blade towards the piece of wood sitting on the splitter. The 22 tons of force from the splitter blade smashed my thumb between the piece of wood and the butt of the log splitter.

I immediately screamed out in pain for him to stop the splitter but by then it was too late (11:30 am). I whipped off my glove and was in shock from what I saw. I couldn't move until I saw Corey run. He ran to his toolbox in his truck to get some box paper towels and wrapped up my thumb. From there I ran to the passenger side of the truck and got in while Corey unhooked the splitter from the hitch and got max into the truck. We flew out of the field and back to the house as neither one of us had any ID's, insurance cards, or money. We got into Corey's new truck and from there we flew to the ER in West Des Moines. The ER was super busy and I paced in the waiting area for at least 20 minutes before they finally got me into a room, as I couldn't sit from the throbbing. From there the nurse asked me to strip down to a t-shirt layer. Well damn, I had on my Carhart coat, Carhart overalls, sweatshirt and finally my 2 t-shirt layers. I thought she was crazy asking me to remove the paper towel bandage and pull my hand through my coat. I had to remove the paper towels and saw the grossness again. I warned Corey not to look as I knew he was going to get fainty....

By 12:37 they took my BP in the room and I was off to get an x-ray of my hand to see if anything was broken. When I got back from the X-ray I made Corey take a picture of my thumb because I knew mom would love to see that (I'll spare you all)!! I think that might have done Corey in, as he decided that he might just lay down on the floor on my pile of carharts. By 1:30 the Doctor finally came into the room to assess the damage. He said that on first glance of the x-ray, that my thumb tip bone (distal phalanx) was broken, but the radiologist had not read the film and confirmed that it was broken. He was going to wait to hear from the radiologist before proceeding but he did inject lidocane in the base of my thumb which helped relieve a little pain (1:45 pm). Corey decided to lay down again but not for long as a lady walked in and was asking for insurance and payment details. She left about 2:00 pm and shortly there after the doctor walked in ready to work on my thumb. I couldn't watch but I knew he removed my nail and had started stitching up the laceration that was uncovered from removing my nail. There was a cut from the left side of the first knuckle to the right side of the nail edge. As the doc started to stitch up the cut the pain intensified greatly. He added more lidocane, but that wasn't cutting the mustard and I let him know. He seemed shocked that I could feel what was going on. I could tell he was super nervous at this point and he admitted that the cut was a little more than he could handle (half amputation) so he called in a hand surgeon (2:20 pm).

The hand surgeon finally showed up about 2:50 pm and took a look at my thumb and decided that indeed surgery tomorrow (Monday) would be the best option. From there I'm not quite sure what transpired as the pain continued to increase and the lidocane was wearing off meanwhile my thumb was just chilling out still slowly bleeding. Corey had called his parents to come into town to pick up Max as he was waiting in the truck because we brought him along. I didn't want Corey to take the time to go into the house and get his collar to keep him in the yard while we were gone...I just wanted treatment asap! Anywho, like I said I'm not sure what transpired but it was about 3:15 and the pain was OOC (out of control). Corey's parents walked in during my worst point and I am pretty sure the word got out that I was super uncomfortable because 6 people working at the hospital came in all at once. They finally hooked me up with an IV at 3:30, which had antibiotics and morphine. Thanks you generous man who shot me up with that first dose of narcs after being in pain for 3+ hours. By the time Corey left to get max into Darrell and Joyce's car and came back, I was a whole new person. Pain under control and heavy heavy heavy legs...wooohoo for morphine!!! The paramedic then wrapped up my entire right hand to stabilize the thumb for surgery the next day. I looked like lady liberty....just without a flame. Before I left they shot me up with another dose of morphine... THHHHHaaaaannnnkkkkk You! They also gave me prescriptions for antibiotics and percocet.

Lady Liberty sans the Flame

Soooo not only was I thinking about what my thumb would look like after all this, will I have a nail after all this, but is the surgery tomorrow (Monday) going to mess up my appointment at Mid-Iowa Fertility Clinic???? I wasn't completely sure as they would have to squeeze me into the surgery schedlue so anytime I got was the time I got. I was to wait until Monday to hear from the Ortho Surgery Center with an appointment time and go from there. Thankfully my appointment at the fertility clinic was at 10 am and the surgery appointment was at 11:45 am. I was able to go to both!!!

The appointment at the clinic was basically just an initial meeting with Dr. Young but we do have another direction to go in. Unfortunately, Corey's results from the second semen analysis was worse than the first. Motility and count were significantly lower and still really low. Dr. said that there is two routes with C: blood test to check out his hormone levels which can affect the motility and count and / or a genetic test. If the hormones turn out low then they can do supplements to help raise the levels. The genetic testing looks at the chromosomes to see if you can actually reproduce or not (I wouldn't think the genetic side would be the issue considering his father had kids and so did his brother). Doc said that with the levels C has, not even looking at my issues that in vitro would be the only successful route.

I have a HSG test scheduled for Friday at 4:00 pm. Doc said this would be good as it is important to have unblocked fallopian tubes even if you go with the in vitro route. Doc said that with the in vitro, they would have to go in and do an egg retrieval process on me. From there they will grade the eggs based on their reproducibility. He said if they look good and with my age, then they would most likely do only one egg at a time. Less chance of having twins!! However, if the eggs are in question then obviously they would do two to increase the chance of success, but never more than two.

You'll have to excuse me for this post if it is choppy or has misspelled words as I only used my left hand and I may or may not be influenced by some pretty good narcotics! Again, we'll see how things are going after my test on Friday as well as the hormone test results we'll get back on Corey by next Thursday. I also have an appointment on the 31st for my thumb. So until then THUMBS UP!!

Love you all,
ALJ

Hormones!

Well, as expected, I am starting another 10 days of progesterone pills to induce my cycle as it has been 6 + weeks since the start of my last cycle. Once I finally start my cycle, I am supposed to call the Doc and set up an appointment to get a hysterosalpinogram /he-ster-o-sal-ping-o-gram/. That's a mouthful, but luckily almost no one calls it by the full name...they just say HSG test. The test involves placing an iodine-based dye through the cervix and taking x-rays to help evaluate the shape of the uterus and whether or not the fallopian tubes are open or blocked. In my case, the key to this test is identifying if the fallopian tubes are blocked.

Well the waiting game is on again until the two appointments scheduled on the 10th for C and the 16th for me at the fertility clinic as well as the HSG test which is TBD.

Until next time,
Much Love,
ALJ