Grief is OK

The world can be an amazing place but it can also be mighty brutal. It is inevitable that at some point in our lives we will experience grief. Whether it be the loss of a loved one, an act of violence, a breakup, a natural disaster, a freak accident, an illness or disease.

Maybe the grief isn’t the result of one big devastating event, but rather a multitude of little things piling up until it feels suffocating and debilitating and you simply can’t dig yourself out. Maybe you fear that your reasons for feeling grief are inadequate. Maybe you will keep it to yourself because it seems a little silly to ask for help.

The reasons for grief may be vast and complicated but there is no doubt about it, grief will catch up with you one day, you cannot shut it out or run from it forever. When that grief finally catches you it may stop you in your tracks. It may make it hard for you to even breathe. It may make life feel unbearable. It might make you feel broken and alone. Maybe you will feel like you will never ever be, the person you once were.

Eventually though the grief will ease and by the time you have put all the broken pieces of yourself back together, you will find that yes, in fact you were right, it did change you. You may be stronger, or wiser or more empathetic.

So why if we’ve all been there, there are still so many people who know diddly squat when faced with someone who is dealing with grief?

Instead, people march around this world sticking bandaids over people’s gaping wounds. These bandaid warriors say things like “it wasn’t meant to be” “this wasn’t your time”. They start a lot of their sentences with “Oh well, at least…” as they desperately try to pick positives out of the rubble.

I can only assume that they think they are helping the wound heal by sticking these measly bandaids over the grief stricken person. Maybe they walk away thinking that their naive attempts to erase the grief actually worked.

Of course I know that they don’t mean any harm by their actions. The statements they use to patch over the grief are pretty ‘harmless’ after all…or are they?

I just want to tell them all to please stop trying to sweep it under the carpet, because grief is in fact OK. And if they don’t know the right thing to say there are two words that are a pretty safe bet “I’m sorry”. Sometimes no words are needed at all, maybe a good long hug will suffice. But please, please stop with the bloody bandaid statements because all they are doing is tearing that wound a little wider.

I want to say a huge thank you to all the women who commented on my previous post. And for the women who shared their heartbreaking experience with either a natural miscarriage or D&C procedure. It not only took guts to open up and share your experience with me, but it also took a mountain of kindness. I feel completely overwhelmed just thinking about all your compassion that carried me through that awful day. After reading your comments Scott and I decided to proceed with the D&C. And since the procedure I can say with certainty that your guidance helped us to make the right decision.

It all went very smoothly and physically I feel quite alright. Apart from a bit of lower back pain that was quite uncomfortable last night and a small amount of bleeding on the day of the surgery, it almost felt like nothing had happened. As one fellow blogger summarised perfectly “it was such a minor procedure I was almost disappointed that it didn’t match with my emotions”.

For me the hardest part of the process is the fact that my husband and I deal with these things very differently. It is no fault of his that he doesn’t know how to deal with grief. But he made that day harder for me and possibly even for him because grief made him uncomfortable. And it was this discomfort that led him to repetitively say things like “chin up”, “just relax”, “it’s not all bad”.

Yep he busted out the bandaid statements in full force because I guess he panicked and didn’t know what else to do. I was mourning the loss of the one thing we wanted more than anything, whereas he was thinking – Let’s just get ‘it’ out and move on so that we can start again. The more casual the words he used, the more pain I felt.

That morning when I woke, I felt so shockingly numb, like I would never be able to get out of bed again. I finally convinced myself to get up and I went and showered. When I got out of the shower I looked at my naked body in the mirror. I looked at my swollen breasts and the rivers of veins across my chest that I had marvelled at in wonder each day as they grew more and more prominent and all I could think was “Fuck you body”.  Why all the pregnancy symptoms this week, WHY? I hated how cruel this was, that I had finally begun to believe this pregnancy was real just before it was taken away. I cried and cried. I went outside and sat in the sunshine and read through all the comments on the blog. My mind was made up. I needed a D&C. I needed it as soon as possible.

So I rang my specialist’s office. When the receptionist answered I didn’t really know what to say. So I kind of stuttered out a bunch of half sentences. “I’m miscarrying…um I mean…I’m going to miscarry…my baby stopped…I only found out yesterday…I need to book in for…um…the procedure…he said he could do it today…but that was yesterday…so I’m not sure”. The receptionist spoke gently, “Oh honey, that’s awful. I’m so, so sorry” then she let me sob into the phone for what felt like an eternity. She didn’t attempt to wrap up the call she just let me cry. She told me that she would call me back as soon as he had finished his appointment. And she did. A few minutes later the phone rang “He can do it today, don’t eat anything or drink anything, he will call you soon to confirm the time”. Ok so it was happening.

The surgery wasn’t until 3pm. I hadn’t eaten dinner the night before, or breakfast so I felt starving and quite weak and spent most of the day in bed crying on and off until it was time to go to the hospital. Scott drove me up there and the closer we got, the more I cried.

The hospital staff showed so much compassion towards me that it shocked me. The admissions nurse, told me “Let it all out sweetie” as she went to get me more tissues. My specialist came into the waiting room, he sat down beside me and held my hand and spoke softly “Oh darling, I’m so very sorry. We will look after you today, ok.” When I went to meet the anaesthetist I said “Nice to meet you Patrick” to which he responded by giving my hand a gentle squeeze as he said “I really wish we were meeting under better circumstances”. The nurse who took me through to theatre rubbed my back as we walked and told me she was sorry.  I couldn’t have asked for better treatment. In fact it wasn’t until the very end in recovery that Scott and I encountered another bandaid wielder. One of the nurses exclaiming how lucky I was. And then proceeding to fill my head with all kinds of hopeful ridiculous thoughts like “oh you’ll probably go on to conceive naturally now” to which we responded that we will always need to do ICSI due to sperm quality. “Oh but you can improve sperm you know” yes we know because we spent $6000 at a naturopath and Endocrinologist.

She was one of those verbal diarrhoea bandaid folk. “Oh so this is your first pregnancy…You’ve been trying for 3.5 years?! Gee what took you so long to try IVF…So how many are in the freezer then…Oh none well that’s no good at all…So the eggs mustn’t have been any good then…so next time you’ll have to start from scratch…and it costs so much money to do that doesn’t it…amazing you got pregnant though…so lucky…enjoy your rest now…cause once you have kids hahahaha…”

I wanted to tell her, “Please stop whatever you are trying to do and remove my drip so that I can go home and grieve. I want to grieve. It is normal to grieve. It is ok to grieve.” Once we left, Scott said she was an absolute dickhead and I agreed. And I wondered how he could see fault in what she was doing and yet not recognise his own bandaid statements.

I look around this blogging community and there is something very significant about it. No one here is making bandaid statements and I guess in a way that’s what we are all here for.  The people here know that these statements cause more harm than good. They know that grief does not represent weakness, but a strength to come. Without it you cannot heal nor grow.

We are united by our common goal. We all want to be parents in one way or another and for whatever reason, it is a very difficult goal for us to reach. So from all corners of the earth we walk together, certain in the knowledge that while grief is probably going to totally kick our ass, whenever it does we will have this space. A place to grieve, a place to bare our darkest thoughts, a place to heal.

 

 

 

 

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Embryo Update “Call me tomorrow”

I’ve been holding out on doing an update because I’ve been waiting for some concrete news (I bet all the IVF veterans out there are slapping their thighs and laughing at this, ‘concrete news’ and ‘IVF’ indeed do not go hand in hand). So I’ve given up on the concrete stuff and decided to update with what I’ve got.

Basically, we still have no idea what will happen this cycle. Well technically, we do have options but each option has a rather gigantic risk, so we are letting the specialist guide us on this one. I’ll go over them at the end of the post after I’ve gone through a rundown on the Embryo development over the past few days.

So most important news first – the only two fertilised eggs are still going by some miracle. Currently on Day 4 of development, Grade 3 (I kind of flipped out when I heard this but the specialist tells us is an average grade, not necessarily a bad thing!) From Googling, I discovered grading appears to vary from clinic to clinic…you know what that means? – Step away from the search engine & trust your specialist!

EMBRYO DAY 1 (day after egg retrieval & day of my last post)

Saturday 21st Feb – 10am

Phone call with specialist. Doc gave us the devastating news that out of 11 mature eggs only 2 fertilised. At this stage one was showing fragments, it appeared as though only one Embryo was in the running. Specialist advised not to start on next lot of medication, he wants to avoid Embryo transfer this month if possible. My last blood test showed progesterone levels were rising prior to egg pickup, this means conditions were not ideal for implantation. Doc said “The fragmented one can still come good at this stage, call me tomorrow 7pm”

EMBRYO DAY 2

Sunday 22nd Feb – 7pm

Rang Doc, he didn’t answer (immediate crazy-hormonal thoughts that he is avoiding our call because he doesn’t want to give us bad news). Phone rings, Doc begins “Sadly…” (oh shit!) “the embryos aren’t developing as fast as they should be” Scott and I silently make wtf-does-that-mean-faces at each other. The doc goes on to explain that it isn’t necessarily a bad sign. He will check how they are tomorrow morning, if they aren’t looking strong then we may transfer then (DAY 3). Although the chance of implantation is low it’s better than no chance at all. He advises to hold off on starting the meds still, and assures me it won’t be too late to start on the same day of transfer if necessary. “Call me tomorrow 9:30am, I’ll be in theatre but I’ll call you back” We hang up the phone. Scott rubs his face and says “This is way too stressful”

I feel a little sad, I don’t want our only 2 embies dying in a dish, but on the other hand I’m going “HOLY SHIT THEY ARE STILL GOING – THIS IS A MIRACLE”

EMBRYO DAY 3

Monday 23rd Feb – 9:30am

Scott insists on taking the day off work in case of either news (he wants to be there if we are transferring, and he wants to be there if it all falls apart). We make the phone call together again. The Doc sounds cautiously optimistic, they have divided further (OMG “THEY”- YOU MEAN THEY ARE BOTH STILL THERE – We are in complete disbelief) They are both currently grade 2 and could make it through. He is hoping they will continue getting stronger, he advises to wait another day to see how they are looking. Hold off on meds again. “Call me tomorrow 9:30am”

EMBRYO DAY 4

Tuesday 24th Feb – 8:30am

So we are supposed to be calling the Doc at 9:30, so why on earth do I have a missed call from him at 8:30am??? Oh no, what’s wrong! We call straight back without even listening to the voicemail. He tells us that the embryos have “moved on” again Scott and I make wtf-does-that-mean faces at each other. Is that some kind of specialist talk for Embryo heaven? He clarifies they have divided further – one 8 cell and one 10 cell. OMG I’ll put my heart back in my chest – HALLELUJAH! I wonder if the specialist can tell that I’m verging on psychotic yet or if I’m doing an extremely good job of concealing it. The only thing is, they are one day behind (Currently equal to Day 3 Development). Apparently the slow growth isn’t necessarily a bad thing either. They are now grade 3 and he is hoping that they may even make it to freeze. Depending on how they look at Day 5 we will either transfer or try to grow them further for freezing. He advises that I may need to come in after lunch for transfer “Call me tomorrow 9:30am”

So I’m beginning to see a pattern with all this. Maybe I’ll start to develop an eye twitch whenever someone says “call me tomorrow”. It’s too bad that tomorrow feels like a gazillion years away, especially when you are confined to the couch because your ovaries hurt when you walk (ok sorry I’ve got my whinge out of the way now).

SO THE OPTIONS ARE:

a) GO AHEAD & IMPLANT SINGLE EMBRYO THIS MONTH

PRO: Avoid possibility of embryo dying in dish

PRO: Teenie chance of pregnancy, which means 1st IVF won’t be completely fruitless.

CON: Embryo very unlikely to implant this month (given my hormone levels)

CON: Only one embryo will be left, and odds not in our favour that our only embryo will make it to freeze.

b) NO TRANSFER, WAIT & HOPE THAT AT LEAST ONE EMBRYO WILL MAKE IT TO FREEZER

PRO: If an embryo makes it, our prospects for implantation will be greater next month

PRO: Won’t have to go through round of injections & surgery for a Frozen (FET) Cycle

CON: Extremely risky, as they may not be strong enough to make it.

CON: Prospect of it failing and having no embryos to transfer after huge emotional and financial investment is terrifying.

We’re hoping they’ll be strong and we have no idea what the right thing is to do.

I must say, I’ve never been a fan of gambling.

 

 

My IVF cycle – The Technical stuff

 

I’ve spoken about emotions a lot on this blog so far but I haven’t really touched much on all the scientific stuff. I’m currently on Day 16 and finished my injections a couple of days ago, so I thought it may be useful to do a post about my specific cycle and give a rundown on any side effects I experienced.

Firstly, it’s important to note that each IVF cycle will vary slightly from person to person. This will be dependent on the circumstance as well as the specialist’s informed opinions and preferences.

There are different protocols for IVF treatments.

The protocol I’m doing for this cycle is what is know as ‘IVF Antagonist’ (sounds fancy right?)

There are two main types of drugs involved in this Antagonist cycle.

1.Follicle Stimulating Hormone (FSH/ Stims)

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Scott armed with the Gonal-F EpiPen for my very first injection – would you trust this man?

WHAT IT DOES: Stimulates the ovaries to produce many follicles (which hopefully contain healthy eggs)

WHAT I’M TAKING: GONAL-F (125IU)- In the form of an EpiPen (subcutaneous injection into the lower abdomen)

HOW SCARY IS IT REALLY: Not scary at all!!! I could inject this one myself after Scott did the first injection (I will reiterate that I am not good with needles at all- if I can do this anyone can!) It honestly doesn’t hurt at all, it’s super easy to insert because it’s such a fine needle. Sometimes you may bleed a teenie tiny bit (1 tiny drop). Also, I bruise easily yet never got a bruise from this one.

SIDE EFFECTS: Hardly anything significant at all – woooohooo! Just a little bit of bloat going on, nothing terrible. Some mild hot flashes.

2. Gonadotrophin Releasing Hormone (GnRH)

WHAT IT DOES: This is where the antagonist part comes into play, as it prevents the pituitary gland from producing Luteinising Hormone (in a normal cycle this is the hormone responsible for releasing an egg).

WHAT I’M TAKING: ORGALUTRAN – In the form of a single use needle (subcutaneous injection into the lower abdomen). Must be taken at exactly the same time each day!

 

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Orgalutran – a teenie tiny needle that had me terrified for no reason

HOW SCARY IS IT REALLY: How on earth can this tiny little needle strike so much fear in me? They should have just encased it in gigantic white plastic cylinder, so you can’t see the syringe part (like the EpiPen) because for some strange reason that plastic cylinder makes everything seem ok. So the nurses kind of had me freaked out about this little guy right from the start. They kept saying that it’s a slightly thicker needle, so a bit harder to go in. So I spent the first few days being a total chicken and forcing my mum-in-law to inject me haha!

Once I got to the point that I could watch it go in, I started thinking “hmmm, I think I can actually do this”. One morning as I was trying to psych myself up to do it, my mum-in-law messaged saying “Am I doing your injection today?” I took that as a sign and decided that I would be really brave and do it myself. I didn’t do a very good job to be honest because I was really shaky and the air bubble was not really in the right place inside the needle, so I could kind of feel it which felt a tiny bit strange. But the sense of accomplishment afterwards was pretty damn good! And I definitely got better at it after that. I only got one tiny little bruise from this guy.

SIDE EFFECTS: Immediate side effects at site of injection, nothing dramatic, just a tiny rash, a little bit of stinging and itchiness. It all subsides within 2 hours.

I was also getting a bit more bloated after taking Orgalutran but I can’t distinguish whether that was due to Orgalutran or Gonal-F. My boobs were super dooper sore and massive too (well massive for me haha), once again not sure which injection is the culprit for this or whether it was a joint effort from the two.

Other drugs involved are:

  • MELATONIN – in the form of a tablet – YAY it’s not another needle!! (apparently a powerful antioxidant to improve egg quality)
  • OVIDREL (which is ‘Human Choriogonadotrophin Alfa Hormone’ or ‘HCG’ – thank goodness there is an abbreviation!) In the form of an EpiPen (subcutaneous injection into lower abdomen) This is the Trigger Shot (to complete egg maturation and to release the eggs, taken very specifically at exactly 37 hrs prior to egg collection surgery, the eggs will release at 38hrs. Yes it is that specific – isn’t the human body amazing!!)
Processed with MOLDIV

Ovidrel – My final injection to release my eggies!

Below is a calendar of what my IVF cycle looks like:

DAY 1 (of cycle/period) – Advise clinic, collect drugs & learn how to administer them with the nurses at the fertility centre.

DAY 2

  • Blood Test first thing in morning – 7am
  • Await instructions from Specialist as to whether you can start injections.
  • Take 1st FSH injection of Gonal-F (125IU in my case)
  • Take 5mg of Melatonin at night (tablet)

DAYS 3, 4 & 5 

  • Daily FSH injection of Gonal-F (125IU)
  • 5mg of Melatonin at night

DAY 6  & 7

  • Continue FSH injection of Gonal-F. Continue Melatonin
  • DAY 6 – Commence Orgalutran injections (must be done at exact same time every day)

DAY 8

  • Transvaginal Ultrasound & Blood test to determine whether dose of FSH needs to be increased/ decreased or cycle cancelled.
  • Gonal – F was increased in my case to 200IU as my follicles weren’t the right size (too small)

DAY 9, 10, 11

  • Continue Gonal-F, Orgalutran & Melatonin

DAY 12

  • Return for additional ultrasound and blood test to determine if we proceed to egg collection.
  • Follicles have increased in size. Egg collection booked for day 15
  • Continue FSH, Orgalutran and Melatonin

DAY 13

  • Last day of Injections – Continue FSH, Orgalutran and Melatonin
  • Take trigger shot at 10pm (this is 37hrs prior to egg collection surgery on DAY 15

DAY 14

No injections today!

DAY 15 

  • Egg collection
  • Arrive at Day Hospital at 9:30
  • Semen sample to be provided to hospital
  • 11am Surgery
  • Release from Hospital 2-3hrs post surgery time
  • The scientist will take any eggs that are mature and inject them each with a single sperm (they will select the best sperm of the bunch to do this). This process is called ICSI and is different to IVF. ICSI is used when the sperm sample is not as strong.

Next step is waiting to see which eggs fertilise (this happens overnight)

Then to wait and see if any fertilised eggs divide to form Embryos

If everything is full steam ahead you will commence taking further drugs to support your lining and to encourage the embryo to embed.

Embryo Transfer usually occurs within 2-5 days if you have some healthy Embryos and your hormone levels are sufficient.

In my instance we will only be transferring a single embryo. This is because multiples actually increase your risk of many issues throughout your pregnancy.

So there it is, the technical stuff so far, I’m sure there will be more to come!

 

 

 

Today I saw my Follicles

It’s currently day 8 of my cycle and at 7:00am this morning I had saw my follicles for the very first time. I had a transvaginal ultrasound, which was all over in the matter of a few minutes.

There they were on the screen, looking terribly uninteresting to be honest. Just a few black holes in some grey matter.

WHAT ON EARTH ARE FOLLICLES?

Follicles are sacs filled with fluid in which an immature egg develops. These follicles are located in the ovaries. When a follicle finally reaches an ideal size, ovulation occurs, which results in the rupture of the follicle and a release of the egg from the ovary.

SO HOW MANY FOLLICLES IS IDEAL FOR IVF?

Apparently 10 is ideal however the specialist is usually aiming for anything between 8-12 follicles. If there is too many you are at risk of Ovarian Hyperstimulation Syndrome and your treatment will likely cease until things are deemed safe by your specialist. From what I’ve read, you can still proceed with the egg collection if you have at least 3 good ones.

DOES SIZE REALLY MATTER?

Yes it absolutely does! At time of egg collection the little guys need to be bigger than 17mm in diameter. Your oestrogen levels will also be checked (blood test) to make sure they are consistent with this picture. If they aren’t the right size, your cycle will likely be called off for the month.

HOW MANY TIMES HAVE I SAID FOLLICLES IN THIS POST SO FAR?

Eight times!!! (yep that’s quite the overkill)

Which coincidentally happens to be the number of follicles I had!

Things are currently a little rocky because my 8 follicles were a bit all over the shop in the size department. Some were 12mm and some were only 5mm (they still have a week to continue to mature).

At this stage the FSH I’m taking (Gonal-F) will be upped from 125 – 200IU in the hope that they will do some growing over the next few days.

This follicle growing business is tricky stuff. If you grow them too rapidly they won’t be good quality, you are also at risk of overstimulation. So it’s best to start the FSH dose off low and increase if necessary.

In 4 days time (Tuesday 16th) I’m heading back for a follow up scan and bloods. If they haven’t gotten big enough the cycle will be called off.

So not the greatest news today but we are hopeful that things will pick up.

I’ll be sending my follicles good vibes for now, grow little follies, grow!

Let’s do this thing!

12hrs post blood test, I got a call back from the specialist. He apologised for the delay in getting back to me and then he said “you’re all ready to go”.

I was out to dinner with a dear friend at the time I received the call. I actually felt incredibly emotional – a mixture of excitement and feeling bloody terrified. I was really glad to be there with her because she truly radiates positivity which negated the sheer terror side quite a bit.

After a few tears, I called Scott and gave him the good news. “We’re doing it, this is it”

I headed home shortly after. I called mum on the way and cried some more (they were happy tears).

When I arrived home Scott looked like a tonne of bricks had just hit him. He was very quiet. We gave each other a big hug. And then I got out my whiz bang drug kit, we dialled up the needle, both as terrified as each other and before I could even pinch my abdomen skin together he was coming at me with it (he does this ‘bull at a gate’ thing whenever he is nervous). Meanwhile I was going ‘Whoa hold on a minute’ laughing, Scott was not laughing at all – he was definitely ‘in the zone’.

And then it was in, and over…I barely felt it and I even snapped a pic (note: I am not good with needles at all, so this fact is remarkable).image

I messaged a couple of close friends and our parents, and then we took the selfie that you see here. I look at this picture and can see our emotions written on our faces. Those wet eyes say to me; happy, scared & above all hopeful.

This is it, this is really happening -the most testing month of our lives has just commenced and it will all be absolutely worth it, if we can finally bring a baby into the world.