Day 3 Intralipids. Zlin->Brno

Day 3 is described as DIFFICULT and that is putting it mildly.  Poor Duncan is just all over the place with sleep and the time difference really hit him hard.  So Day 3 started at 1am when he woke up just upset.  He didn't calm down until 3am and didn't sleep until 5am.  Needless to say, we were all very tired and not in the best of moods.
We ate breakfast in the hotel and went back to the room to reorganize and pack up. I ran into another couple that spoke English and was there with their 3 year old.  Him and Duncan played for a bit while we chatted and shared our experiences.
Then at 11 it was time for my intralipid infusion IV treatment.   Intralipid is a sterile fat emulsion.  The active ingredient in Intralipid is soya oil. Soya oil consists of a mixture of mainly polyunsaturated fatty acids. It also contains egg lecithin as an emulsifier, which is isolated from egg yolk.  The theory is that it helps women who have had recurrent miscarriage, multiple failed IVF cycles or multiple failed IUI cycles. Intralipids deactivate natural killer cells in a woman’s body which may prevent embryos from implanting and growing properly in the uterus. We have done intralipids with two transfers, one at SDFC with our two normal PGS tested embryos that resulted in a BFN and then again here in Czech with my last pregnancy.   The science goes back and forth on it if it actually helps, but the good thing is it either helps or does nothing, but it doesnt have any negative risks, so we keep trying it. Ryan and Duncan escorted me back and then left to check out of the room and go play at a park downstairs.  
As I mentioned in a previous blog post, the state of my veins are not good.  After living with infertility for so long, and having so many blood tests done,  I have developed scar tissue in my veins.  About 3 times ago, the phlebotomist mentioned it would soon be an issue and the 2 times after that it was increasing harder to draw blood.  Well lucky me, it all culminated today and it became an issue. I was in a room, laying down on a cot and it started with 2 nurses.  I'll spare the awful details, but it concluded with 5 nurses, 1 doctor, 5 attempts in 4 different places and finally 1 IV in my wrist. This was very painful and on top of all that, took every single ounce of energy I had, not to pass out. What should have been a 45 min IV, now became a 2 hour IV because they had to use a smaller vein. 

Finally it was over and they came to remove the IV.  The nurse doing that part didn't speak any English.  She took out the IV and I'm guessing told me to put pressure on it in Czech,  which I didn't and next thing I knew she turned around so I thought she was done and I went sit up and blood just started flowing.  That just about did me in right then and there.  Luckily I was already in a bed so I just laid back down.  She turned back from her paperwork, saw what happened and cleaned me up and rebandaged me and said to wait in bed.  Another nurse came in that did speak English.  At first I thought she was there to see if I was OK.  But then she told me my next appointment was in another room.  I assumed this was for my blood results.  Well it wasn't, it was to take more blood.  See I thought they drew the blood before they hooked up the IV.  Remember I can't watch and they don't speak English this came as a shock.  After all I just went through, I now had to try and give blood.  At that moment, my weakness and fear crept in and I lost it and just started crying.  I asked it I could go back and lay down and do the blood draw back there.  The nurse then realized I was crying and called for back up.  Now a team of nurses were back with me.  4 to be exact.  1 kept saying sorry and the others only spoke Czech.  They decided to go back in through the wrist again and this pain was even worse than the last time, but at least it was very quick.  One nurse kept stroking my hair and another nurse held my hand. They were very sweet and really tried hard to comfort me.  I was just wrapped up in emotions and it all came out at that moment. Being so far from home, being alone it just got the best if me.  They sat me up and gave me a big group hug and tried to show me that it will all be ok even though they didn't know the words.  I will remember their kindness forever.  One of the nurses spotted Duncan outside and opened the window and told me to come over to see my boy. 

That stopped the tears and brought me back to some peace and strength.  Sometimes we just push through the tears and do what we have to do. Dealing with infertility isn't easy and some days are harder than others.  Mark this as a difficult day.
I then met with a doctor who added an additional progesterone pill to the mix.  So in two days I will start the transfer protocol.  The clinic has it's own pharmacy so I grabbed the pills and we headed out.  On a more exciting note, there was a TV behind the reception desk and they were playing Octo Hiity.  I am now officially obsessed with their music television.  It's amazing! 

We left Zlin and headed to Brno.  I had intended for us to visit a science center, but because everything took so long, we didn't have enough time.  So instead we went for a stroll around the city center.  There was a cute farmers market outside our hotel so we stopped and got fresh strawberries, tomatoes marinated in garlic and basil and caper berries. We snacked on those and walked for a bit.  The last time we were here I was on bedrest and never left the room so it was nice to finally see the city.  Before we left, I had found a Thai restaurant that had vegetarian and gluten free choices.  I had fried rice with veggies and Ryan had pad thai.  It was delicious.  On the way back to our room, we stumbled upon a stage with live music.  It was a rock band singing loud and in Czech.  Duncan loved it.  After each song, he said "more music". So we sat there and listened and slowly this metal band put my son to sleep. In his early days Metallica used to do the trick and I just love my little rocker dude and his love of music.  I took a slightly longer route home to window shop and try and discover a bit of the city.  Todays ordeal still weighed heavy on my mind so it was nice to just be casual and walk.  We landed back in the room and made for a quick good night.  
Thanks for Reading,
HEATHER

6 Days To Go - Intralipids

So last night I started spotting and freaked out that they were going to cancel my cycle.  By morning the spotting had stopped but I was still really nervous.  At 10am I went for my monitoring appointment.  Kristen was my nurse which was great because she knows me so well and could calm me down.  During the ultrasound, she measure my lining about 5 times and each measurement was over 8 which is great.  The lining is where it needs to be and it has grown since the last appointment so things are moving in the right direction. They took my blood to test the estrogen levels, which came back a little low but still in the normal range.  They added an extra vivelle patch so now I'm on 3 patches changed every 3 days.  I also got the rest of my calendar for the rest of the cycle.  Because of the spotting and my anxiety over all this, I requested another monitoring appointment.  I didn't want to go almost a week and then just show up for a transfer so I am going back on Friday for a piece of mind appointment.

At the appointment we turned in all of our consent and legal forms.  We both signed on the dotted line to transfer 2 embryos.  So it looks like we are going full steam ahead with transferring both embryos.

The bigger news of the day is that today was the day for my intralipid infusion.  This has been a long time coming.  I originally scheduled an appointment with a company that does them way back in June for September.  When I came back from Hawaii there was an email waiting for me from the company stating that they were going out of business in San Diego and they were cancelling my appointment.  I scrambled all of last week to find another place that could do in and compared cost.  The intralipids could have been done at my doctor's office, but the costs was really high.  I was able to find an outside company that did it for 1/4 of the cost and after 5 IVF cycles, every dollar counts at this point.

Here is some info about intralipids from an article on ABC News. 

Intralipid infusion therapy is a sterile fat emulsion containing soy oil, chicken egg yolk, glycerine and water.  The infusion is in liquid form and administered intravenously.  It is a non invasive procedure carried out in clinic as part of a treatment cycle.  Research has found that raised natural killer cell activity (toxic white blood cells) can act against an embryo and prevent its implantation into the endometrium.  This is known as implantation failure.  In addition, some autoimmune disorders can also have a detrimental impact upon the healthy implantation and early progress of an embryo which can also cause implantation failure and early miscarriage.  Intralipid therapy is designed to combat these factors.

My appointment was at noon today.  The company was located in a business park.  Inside it had a room for infusions, some admin cubicles, some offices and a giant lab where the make the IV drugs.  I walked in and picked a chair.

I have had a few friends do this ahead of me so I knew what to expect and what to bring.  I bought a neck pillow, a blanket, magazines, my iPod, some snacks and an eye mask.  They provided water and snacks, but none of the snacks were gluten free some I'm glad I brought my own.  The neck pillow definitely made it more comfortable.  The blanket was to put over the IV so I didn't have to look at it.  The magazines are really easy to read as compared to a book.  Remember you only have one hand, the IV arm is not that usable and a friend of mine that brought a book was unable to read it with just one hand free.  The iPod just helped to pass the time.  From start to finish I was there about 2 hours and 45 minutes but part of that was arriving early to fill out paperwork.  The eye mask was in case anyone else was in the room with me.  They have three chairs and can book all three at the same time if needed.  I would have worn the the mask if someone else was in the room, I am just not very good at looking at needles.  Luckily I had the room to myself.

I had a small amount of paperwork to fill out and a ton of questions to answer.  My main concern was making sure that every single thing was latex free.  After my last latex allergy issue with my last surgery that is the last thing I wanted to deal with.  After everything checked out they started to make my infusion in the lab.  The weird thing was that it was bright white.  I wasn't expecting that.  All the other IVs I've had have been clear so it was just weird.

I tried my watermelon trick again and it worked like a charm.  The IV was started on the first try. They connect the intralipids to a machine and the drip starts.  From this point, it takes a little less than 2 hours to finish.  So I put my neck pillow on, placed the blanket over they IV on my arm, put my iPod earbuds in and tried to relax.  The nurse didn't stay in the room with me, but about every 20 - 30 minutes would come in and check on me, ask me how I was feeling and then would take my temperature and blood pressure.

The IV was not painful but the whole experience was upsetting.  It brought about a lot of emotions.  I was mad.  Mad that I was there having to do this.  Mad that the whole infertility journey is just so unfair and takes forever.  Mad that I am in the position of pumping weird things into my body on the off chance that this will work.  I put on Pantera and just went with my feelings.  Pantera is the best band to listen to when you are upset, it is just angry pissed off music.  About an hour into the treatment, I started to feel less angry and just accepted of the situation.  I read my magazine and switched to listening to Velvet Revolver.

There was very little physical side effects of the intralipids.  The main thing is the arm with the IV in it got really really cold.  I was glad I had the blanket to cover up looking at it as well as keeping me warm.  I also got really tired towards the end.  As soon as it was over, i came home, through on some pjs and took a quick nap.  However, that could have been the stress and anxiety of the day finally being over too.

For those folks in San Diego, here is the information about the clinics in the area that do intralipid infusions.

Corum Infusion Services
858-576-6969 (phone)
866-484-4397 (fax)


Crescent Healthcare
858-547-8487 (phone) 
858-578-5372 (fax)

Thanks for Reading,
HEATHER

FET Progress Update

Today was my first monitoring appointment for this FET cycle.  I always try and make the first appointment of the day so hopefully I will spend less time in the waiting room.  So at 7:30am off I went to the doctors office.

At an FET monitoring appointment you do an ultrasound and get blood work.  The ultrasound is to check your lining and to make sure your ovaries are silent.

I have been off the birth control pills for a little bit now.  Now I'm just taking Lupron and wearing Vivelle patches.

My side effects haven't been too bad, just the usual Lupron issues of weight gain, headache and breast tenderness.  The Lupron shots themselves don't hurt, the needle is very tiny.  Next week I start the Lovenox but for not I am handling everything pretty well.

The results of the ultrasound were really good.  My lining is already at 8 and it is triple lined.  This means that it is actually ready right now for implantation.  However, the doctor likes to do the transfer closer to when I would have naturally ovulated.  The good news is that they moved my transfer up a couple days so it's a few less days of stress and anxiety.

Everything is based on working backwards from the FET date so I spent the day on the phone rescheduling all my appointments leading up to the transfer.  Next week is going to be a busy week but full of good things.  I have a couple more blood draws, an acupuncture appointment, another ultrasound monitoring appt, chiropractor, infusion, teeth cleaning, hair appointment and lots and lots of yoga.

When we came home the other day there was a dandelion growing outside our kitchen window.  I have lived in this house for a year and a half and there has never been one until now.  A dandelion is a very common symbol of infertility for several reasons.  It is a symbol of hope and the root is a common herb used because it is high in Vitamin A & C and thought to help with hormone balance.  When we saw this in our window waiting for us we took it as a very positive sign.

Thanks for reading,
HEATHER

The Calendar & The Protocols

We received our calendar and all of our protocols and everything else that comes along with an FET.  Its exciting and nerve wracking, high anxiety, tons of fear and lots of hope and literally about every other emotion that goes along with it.  We have consulted with our naturopathic doctors, our reproductive endocrinologist, our acupuncturist, our friends in our support group, our friends in our online support group and of course the internet.  We decided on a protocol that we both feel comfortable with. We are literally doing everything we possibly can to help our embryos implant.

Our protocol includes; bcps, lupron, vivelle patches, prednisone, dexamethasone, lovenox, endometrin and antibiotics.  For treatments and procedures we are doing the scratch (Ryan is out of town but luckily my Mom is available and she will go with me), intralipids and acupuncture.  I have 4 blood tests along the way to make sure that all my hormone levels are where they should be and the last one is specifically to test my thyroid.  At the transfer, along with the embryos we will inject hcg in the catheter.  If I stay on track and all the blood tests and ultrasounds look good then our FET is tentatively scheduled for Sept 30th.  And then all that's left to do is hope and pray that this works.

Here is my latest calendar (written out on my Chargers calendar).  It is so much easier to have it all written out.  With so many drugs it makes it much easier to keep track.  Its also a great visual to know where the end goal is.  Once I start the injections, I start crossing the days off and counting down how many needles I have left.  It's little things like that that help me get through the craziness of fertility drugs.  31 injections until our FET.  Our last IVF cycle we did over 80 shots so just writing 31 makes me feel so much better.

August

September

Thanks for reading,

HEATHER