Archive for February, 2011

Feb 25 2011

IVF Part Two: Flurry of Tests and Consents

Published by under Infertility,IVF,The Man

The Man and I had both had a bunch of tests done when we were first starting treatment for infertility, but once we came under the care of Dr. Singh at WSU, the testing had to start over, because it had been about three years since the initial tests were performed. For The Man, this meant another semen analysis and getting a vial of blood drawn. For me, it was slightly more involved. I needed:

  • Blood work requiring nine vials of blood. I’m not totally sure of everything they were looking for, but I know one of the things was making sure I was not a carrier of the gene that causes Cystic Fibrosis. If I was a carrier, The Man would also have to be tested to see if he was a carrier. (I ended up not having the gene).
  • A regular pelvic ultrasound
  • A Pap smear
  • A sonohystogram – boy, was THIS pleasant. Or not. My advice is that if you’re having this done, take three ibuprofen about 30 minutes before the test. It might help with the cramping.
  • A trial embryo transfer, which basically is them pretending to transfer embryos to make sure they’re not going to run into any issues.
Because WSU is near Detroit (actually in the city of Southfield), and we live about two hours away, a lot of those tests were consolidated to save us driving. On one day I got my blood work and pelvic ultrasound. We drove back a week later to do the Pap, sonohysogram, and trial transfer. I was quite glad that I had The Man with me after the second day of tests, because for about 30 minutes afterward, I felt like someone had punched me in the guts, repeatedly.
If I had been over 35, I would also have had a Clomiphene Challenge test. If I were over 40, I would have had to have a mammogram done within the past year.
After all of our tests were completed, we had to meet with Kris, who is one of the nurses at WSU who works with patients on what to expect and guides them through the process. At the meeting, we went over everything that would happen during the process, including all the drugs I’d have to take, and all the tests that would be done during the process to monitor me for ovarian hyperstimulation. The class was overwhelming, because you’re covering a ton of information in under an hour, but the point is not for you to come away having memorized all the steps you will be taking. The point is to give you an overview of what’s coming up, and to answer any questions you might have. WSU also gave us a big packet of information including a timeline and all of the information on the drugs I’d be taking. Kris gave me her direct number and told me to call her immediately with any questions.
One important piece of information we got from the class was that once we started on the stimulation drugs, I’d have to be at WSU every couple days in the early morning for testing. This led us to decide to book an extended-stay hotel for the duration of the stimulation/implantation period. We just couldn’t see driving back and forth to Detroit, leaving our house at 5 AM every other day or so.
The final step is signing the consent forms. I’m not sure if all places are this form-heavy, or if WSU’s lawyers are just overzealous. Dr. Singh told me that they were working on consolidating the forms, which would be nice. We had about five separate consent forms to sign, and each consent required multiple signatures. The forms we had to sign consisted of:
  • Informed Consent to IVF Procedure: Outlining the general risks and possible outcomes (or lack of outcomes) in undergoing IVF
  • Informed Consent to Gonadotrophin Therapy: Because the injectables you use during IVF may cause ovarian hyperstimulation, which is a potentially serious condition, and can be fatal if left untreated (in rare cases), we had to sign this consent saying we understood the risks.
  • Informed Consent to Micromanipulation: Not every IVF procedure requires micromanipulation, which includes Intracytoplasmic Sperm Injection (ICSI), which is using a needle to inject one sperm into one egg. Micromanipulation may also include assisted hatching, which is chemically weakening the cell walls, allowing the embryo to more easily hatch. But, Dr. Singh recommended ICSI in our case, so this consent was necessary.
  • Informed Consent for Cryopreservation: This is if you want to store your excess viable embryos for later use, in case the procedure doesn’t work or you would like to try for more children later. This form contained a lot of decisions like: what do you want done with the embryos if you both die? Or divorce? Or one of you dies?
In addition to these four, we had to sign a separate agreement with the cryopreservation facility, basically agreeing to their storage fees and saying that we know that not every embryo survives cryopreservation.
Once the consents were signed and the tests were done, we were ready to go, theoretically. In reality, we had to wait for a month or so for our financing issues to be resolved, which was fine with me. I needed to gear up for the next phase: stimulation. But before that, we had to get a whole bunch of drugs.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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Feb 25 2011

IVF Part One: Making the decision

Published by under Infertility,IVF,The Fam

For us, the road to IVF was probably longer than most people’s, and that was completely our doing. It took us a long time to get through all of the diagnostic things and other treatments that couples try before they come down to deciding on IVF.

Our infertility journey started on November 1, 2007. That was the day we first met with our first “infertility” doctor. This doctor I have referred to in other entries as “Dr. F”. He was a member of the same physician’s group where my normal gynecologist practiced. He took us through a lot of the earlier testing: The Man’s sperm analysis, my blood work, and an HSG. Everything came back normal. After the initial rounds of testing, he recommended that I go on Clomid and we start doing intra-ueterine insemination (IUI), which would boost our chances of pregnancy. I think we ended up doing six rounds of Clomid and six IUIs before we called it quits on that treatment. All of that testing/treatment had taken about a year, and we’d had no results. We waited for a few months before going to another office visit with Dr. F, and at that time he basically told us that his belief was that I had endometriosis and that I needed a laparaoscopy.  Since we had pretty terrible insurance, that meant we’d be paying the cost of the procedure out of pocket, an expense of about $10,000. I was skeptical that I had endometriosis, because I had exhibited absolutely no symptoms. He also told us that if we were going to do IVF, that a laparoscopy wouldn’t be necessary, because IVF would bypass the problems caused by endometriosis. We decided after that appointment to stop seeing Dr. F, because he didn’t want to do anymore testing, and he also didn’t do IVF. It’s worth noting that his bedside manner was also deplorable and he never made us feel comfortable or like he was in control of the treatment. It was discouraging, because we didn’t know what we were supposed to do next. A comprehensive plan was never outlined, and we never felt like we knew where we stood.

After a few more months, my friend Julio recommended I go see her doctor, so I did. This doctor, Dr. S, worked in the same group as Dr. F. She was nice, but basically all she did was get me an ultrasound to check for Polycystic Ovarian Syndrome (PCOS), and when that was negative, she said the same thing as Dr. F: we can do a laparoscopy if you want, but I would recommend IVF because that will get you a baby.

It was at that point that we contacted Wayne State University Physician Group, who set us up for an appointment with Dr. Singh, a reproductive endocrinologist. This was in February 2011, which meant we had drawn our treatment out for over three years. I don’t think that, looking back, I would have necessarily moved any faster. I knew that since all of the tests we’d had done indicated no problem on either of our ends (our official diagnosis is Infertility of Unknown Origin), we would either just get pregnant out of the blue, or wind up needing IVF. I think I needed to take everything slow to get my brain to process the fact that I would eventually be undergoing IVF, which is by no means a simple process. Also, both of us were young enough that we could afford to take our time. In November 2007, when we began treatment, I was 29 and The Man was 32. If we had been closer to our mid-30s, we would have felt more urgency to move the process along.

We began the testing and assessments associated with starting IVF in February 2011. By the end of that month, if we had wanted to, we were ready to proceed. However, our finances required us to delay beginning for at least a month. It was nice to have a month of breathing time to process what we’d been through and what was coming next.

The IVF Series

Part One: Making the decision

Part Two: Flurry of tests and consents

Part Three: Drugs and money

Part Four: Stimulation

Part Five: Retrieval

Part Six: Transfer and waiting

Part Seven: Pregnancy Testing

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Feb 23 2011

One of these things is not for shaving.

Published by under Beauty,Rants,The Man

Since The Man has started shaving with a straight razor, I have become sort of familiar with the different little props that guys get to assist in the Big Shaving Routine. When he was shaving with a regular old Mach 3 safety razor, his shaving supplies consisted of razor, shaving cream, aftershave. But NOW, oh NOW, we have:

  1. Two straight razors.
  2. A set of “hones” for sharpening.
  3. A strop. (The strop hangs in our bathroom and has inspired several tentative questions into what exactly we get up to in the bathroom. I guess people see a long, wide, leather strap and their minds go right to The Bad Place)
  4. Copious amounts of shaving soap.
  5. A brush.
  6. A scuttle.
  7. After shave balm mixed up by Dr. Mom.

He really likes his new shaving routine. He thinks it’s interesting. I like it, too, because now I have an excuse to go to antique stores and look for things like straight razors and shaving scuttles and stuff. And this brings me to the point of this post.

ATTENTION SELLERS: MUSTACHE CUPS ARE NOT FOR SHAVING.

I don’t know how many times I’ve seen a mustache cup listed online or in a store as a “shaving mug”. The first time, I didn’t know any better, and I was left puzzling as to how a round cake of shaving soap was supposed to fit on that little half-shelf that mustache cups have. For those of you who are lost, here is a mustache cup:

Mustache cup.

It has a little shelf, so that a gentleman with a grand mustache can drink his tasty beverage without getting his fine facial hair soaked in tea or coffee or whatever.  The little shelf holds his ‘stache out of the drink, and everyone is happy. But it is not a shaving mug. I can see how it could be confusing, because it kind of has a shaving scuttle set up. You see, in a shaving scuttle, there is a shelf for the soap to sit on. Warm water goes into the resevoir underneath, to heat the lather and to dip your brush in. It looks like this:

Scuttle MugSee how the shelf is a whole circle? That’s because cakes of shaving soap are ROUND. They come in ROUND SHAPES. Not in little half moon shapes.

What’s even more annoying is when the vendor knows that a mustache cup is not supposed to be used for shaving, but in the product description says “this mug was used to keep a man’s mustache out of the drink but I think it would be great for shaving too kthxbai”. Because that is STUPID. Some girl whose boyfriend or husband or father uses shaving soap is going to see that and go “Oh, OK, I’ll get that for Bob”. And poor Bob is going to open that up and be like “WTF?” Because how many guys are willing to take a piece of soap and a knife and whittle their shaving soap into the proper shape to fit onto that little shelf?

Do not be fooled by vendors who don’t know their business or who are trying to fleece you into buying something that will not work. Mustache cups are not for shaving. They are for mustaches.

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Feb 17 2011

Tales from the grocery.

Published by under Snippets

This happened several years back, but something I read today made me think of it.

Anyhow, a few years ago I was doing the grocery shopping at Meijer in the middle of the day. Around here, most of the people in Meijer on a weekday afternoon are elderly, with the occasional college kid sprinkled in. I needed eggs, so I went to the egg cooler, where several other women were already congregated. I grabbed an egg carton, opened it up to check for breaks, saw a broken egg, and put the carton back. The other women were doing the same thing – I think a stocker must have dropped a pallet or something because there were a lot of broken eggs that day. So, me and a few older women are standing around, all looking at our cartons of eggs, when a kid probably in his early 20s comes over and grabs an egg carton, too. He opens it up and looks at his eggs, looks at the rest of us (who are still examining our own eggs), looks back at his eggs, leans in toward us and quietly asks, “What are we looking for?”

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Feb 14 2011

My very own picky eater.

Published by under Pets

If you could see a picture of my cats’ evening “treat bowls”, with no provided context, you might jump to the conclusion that I love one of my cats much more than the other one, and therefore reward her with like…six times the amount of tuna the other one gets. The reality of the situation might, in fact, be more disturbing.

The cats don’t actually get tuna every evening as a treat. They get it because they are taking Cosequin, on the recommendation of my vet. Since they are officially Old Cats, the vet thought maybe some glucosimine might help stave off any joint pain. Cosequin comes in convenient “sprinkle capsules”, which is a succint way of saying you take apart your average gel-cap and pour the contents onto food. But, as mentioned previously, one of the cats has a pretty serious food allergy, which means special vet food. And the canned version of this vet food is something neither cat will consistently eat, mostly because it looks like canned cat food, after you have wrung every possible drop of moisture from it. It’s very weird. So, they get Chunk Light Tuna in Oil. The ingredient list is reassuringly one item long. Less reassuringly, it reads “Fish”.

OK, I’m off track. We were talking about portion size. Why does one of my cats get a huge heaping forkful of tuna, and the other has to suffer with the barest minimum possible that will dissolve medication? Well, it all has to do with their personalities and medical issues. The one cat, the one who gets the Wee Bit of Tuna, is Destiny the Brain Damaged. She is, as her name might imply, not the sharpest knife in the drawer. Besides that, she can’t see very well and she also doesn’t like to chew very much. So, once she licks food to the edge of her bowl, it pretty much ceases to exist in her mind, because unless she is SUPER INTERESTED, she often will not pick it up using her teeth. This means that if I give her a reasonable amount of food, most of it won’t get eaten. This means that most of the meds also won’t get eaten, rendering the whole exercise futile. Therefore, she gets a wee bit.

The other cat is Fate the Bully. She’s also Fate the Fast Eater and Fate the Greedy. If I don’t give her extra food, she will finish in a big hurry, and then go over to Destiny and muscle her out of the way so that she can eat whatever Destiny hasn’t had the chance to get to yet. And, Destiny is not a cat who can be redirected after an interruption. Once she’s been pushed away or distracted, she’s done. No more eating for awhile. And that is also why I try to feed the cats when The Man is not going to be in the kitchen. He’s a good man, but he is a cupboard slammer and a pot banger, and Destiny is skittish. If he’s in the room, it’s more than likely going to result in her walking away from her medicinal tuna for the evening.

That’s why I say that the reality of the situation is almost more disturbing than the fallacy that I love one of my cats more than the other. Because the reality is that, in order to get a non-essential supplement into a highly neurotic cat, I have to dole out precise portion sizes, and then stand around in the kitchen policing the way the cat eats, the other cat’s attempts at food robbery, and the frickin’ ambient noise level. And then, if I’m lucky, the cat might eat 80% of the seven shreds of tuna I actually put in her bowl.

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