Hormones Week 1

August 22, 2016

Hormones Week 1:

Days 1 – 6

*Disclaimer: The prescribed medicine, drugs, doses, results, and other related information is not to be used for medical advice, self-medicating, changing your nurses or physicians orders, or recommendations for your treatment. Each person, response to the cycle, and other health related facts can vary significantly. Different variations of responses and outcomes can occur from person to person based on health, age factors, and other circumstances. These details are just the medical facts from my stimulation and cycle. None of this information should be used to compare or contrast your instructions or progress.

Hormones Day 1 (Saturday)

“To move the world we must first move ourselves.” –Socrates

Everything I thought I knew or previous experience of helping my friends go through IVF cycle felt like it had gone out the window when I became the patient. I barely take Tylenol for headaches or Midol for period cramps, but all of sudden my apartment was transformed into a nursing station. I quickly learned and discovered that I make for a bad drug addict.

It was day one of injections for the fertility meds. I couldn’t help but feel like men have it so easy. What if I don’t mix these drugs right? The thoughts of fear and doubt start to creep in. I was wishing I had someone to be here and hold my hand. I just kept thinking about all the countless women who completed IVF before me. Many of those women were doing IVF and injecting these meds into their bodies because this was their last shot at becoming a parent. I’m lucky that this hormone cycle was not a make or break situation for me. If they can do this in the most stressful time in their life, so can I especially since I don’t have to carry that same burden. I need to suck it up I told myself and just do it. No looking back it was almost 6 PM and time for my first shot. Minutes later my phone rang and one of my friends who had done several rounds of IVF herself asked me to come over for dinner and she would help me get started. I welcomed the offer and loaded all the medications to take to her house.

I’ll start off by explaining how I did have anxiety about injecting myself. I am not particularly scared of needles especially working within the healthcare space. I have seen much worse situations. It is more of this unnatural thing to inflict pain or stick a needle into your belly on purpose that got me. But once that initial shock was over, I began to think the shots themselves were not particularly bad. Dealing with the side effects like breast tenderness, hormones fluctuations and body’s physical reactions to the medications, however I learned soon after were much harder.

I was assigned to inject 2 shots on the first day (Follistim and Menopur). The easier of the two drugs I think was the Follistim pen. Once the medication was loaded into the pen, it is very hard to mess up your dosage amount. I was prescribed 150 iu of Follistim for day one medications. If you pull the dial back to far, just keep going and it will go around like a clock and start over. I wanted to go slow, but before I knew it my friend had already given me my first dose. It wasn’t bad really. I didn’t even feel the needle, just a light sting after the medication was delivered. I learned later that leaving the meds to warm up a bit before injecting helped avoid that sting feeling.

The second drug I was prescribed, Menopur required mixing a solution with a powder. I had seen this done with other friends, but didn’t really understand it. A thick needle is used to draw up some solution from one of the vials then mix it into the powder vial. That equals only 75 iu. If you are prescribed more than 75 iu like twice that amount (150 iu) you need to mix that solution with two powders, which I didn’t understand at first. Keep in mind, only the powder is the medication. The vials with the liquid are only filled with sterilized solution. Once you draw up 1 cc of solution and place into the powder, lightly swirl the mixture around being careful not to shake. Next, completely draw up all that is in that mixed vile into the syringe. Seemed easy enough at first until I realized I needed to change the needle before injecting into my stomach.

“There all done.” My friend exclaimed as she finished swabbing my midsection and sticking me with the second needle. She helped me place a band aid over the injection site. I stared at my stomach for a second. Well that didn’t seem hard I thought. Before long I had a plate of food in my face and was in mid conversation catching up. It wasn’t until I got home later that night, that I rubbed my stomach and thought about the day. Not as bad or scary as I originally thought it could be. Okay, only like 12 or 13 more days to go I thought as I climbed into bed. As I drifted off to slumberland, I started to dream of baby names … Vivienne, Emma, Audrey, Charlotte … Vincent, Emerson, Gabriel, Ethan …

Hormones Day 2 (Sunday)

“When we are no longer able to change a situation we are challenged to change ourselves.” –Viktor E. Frankl

The next morning I woke smiling, not because daylight savings time gave me an extra hour in my day, but because I had the most wonderful dreams. To help pay for some of the out-of-pocket costs associated with egg freezing, I started hosting using home sharing site Airbnb. I went about my day preparing for the new guests I was expecting to arrive soon. The day flew by and before long it was time for my next round of shots. I scrambled to set up, line up, and get all the supplies in order. Just like the day before, I was a bit nervous but confident I could get the meds right all by myself.

After the help and moral support from my friend the night before, injecting myself today should not be nearly as challenging. I felt more comfortable already about sticking myself and administering the drugs into my body.

I started off with my required dose of 75 iu of Menopur to make sure I was mixing it correctly. As I plunged the needle into the vial I remembered how I forgot to withdraw 1 cc of air into syringe before placing into the cap. I started over and pulled the plunger back to the 1 cc line. Carefully, I put the needle back into the vial and withdrew the solution and started to mix it with the powder. Swirled it between my finger tips a few times and was just getting all the medication into the syringe. I was starting to inject my 150 iu of Follistim when my cell phone rang. It was my new guests arriving.

Crap, I thought as I looked at my medication mess on the counter. What will they think of me? I couldn’t help but ask myself. Oh well, I may never meet these people again, so who cares. I ran downstairs to retrieve my guests and then proceeded to explain to the cute couple how I was in the middle of egg freezing, so don’t mind the mess on the counter.

The girl’s eyes perked up as she reached for my arm. “That is amazing,” she said. Receiving support from a complete stranger made me realize how empowering this whole experience really was. Before long we were deep in conversation over the egg freezing process and I nearly forgot to tell them all the check-in details.

This experience left me feeling like if this young 20-something-year-old girl from Texas is interested in this procedure how many other people may not know about egg freezing and the details involved that would be interested to learn more. That realization was validation how creating a platform that could share this important information was relevant. She inspired me to press on. My daily hormone injections were administered without issues. Another day down and only a week plus or more to go.

Hormones Day 3 (Monday)

“Perspective is everything when you are experiencing the challenges of life.” –Joni Eareckson Tada

After 2 days of injecting myself with hormones, I had the routine down. Make dinner, take my antibiotic, inject myself with hormones, wash the dishes, relax with some reality TV, get ready for bed just like the day before … almost like a new routine I had created. I started to excited to go home after work each day.

It felt like I had this secret plan I was completing. No one really knew I was in the middle of egg freezing except my parent and a few very close friends. I wasn’t sure how I was going to feel. I didn’t want to answer a bunch of questions, so for the first time ever, I decided to just keep these details to myself for now. I’m not sure why I didn’t feel like sharing right away, but this situation felt different.

In full disclosure, I usually live my life 100% open, not that anyone important is paying attention, but that is just how I always live. I don’t have secrets or anything to hide. I like being just me. I hope that what I am doing with my life helps or encourages others. My life has been freeing to living this way. What I learned is how egg freezing can make you feel vulnerable and exposed. I wasn’t sure who would support me, who would say I was crazy, and who would think I was being dramatic. These emotions were so raw for me. As each day passed, I could start to feel my body change, mediamorph, and feel things I had never experienced.

By the end of day three, I could tell my hormones were in full effect. My body had been hijacked. I could go between crying to experiencing rage to uncontrollable sensitivity for no good reason. I couldn’t figure out what was wrong with me. Snap out of it I kept telling my head, but my body was in charge right now.

The body is a really remarkable and miraculous engineering. For all of those that don’t believe in God it is hard not to when you are going through something like this. Nature just takes over. Reminds me of a saying I use to hear my mom say, “There are 2 forces one must never fight against. One is Mother Nature. The other is love.” All of sudden, it is like I understood that statement better than I ever had before.

We all know the powers of love, but it takes seeing Mother Nature to understand her. I was literally watching Mother Nature take over my body right in front of my eyes. Remarkable and magical, nature was preparing my body for one of the most common natural things life has been doing for over thousands of years … reproduction. Until one goes through this experience it is hard to explain the magnitude you feel in the moment as your body changes. I imagine this is similar to what pregnancy would feel like. It was like a preview of the future and what it might be like some day.

Hormones Day 4 (Tuesday)

“A little perspective, like a little humor, goes a long way.” –Allen Klein

Finally, after three full days on the medications, I was asked to come into the clinic and check my progress. I liked to call these appointments as my morning monitoring. I was scheduled for this cycle monitoring that included routine ultrasound and blood work.

As part of my daily commute, I usually ride my bike to my office if I’m not traveling to one of my hospital systems. Since biking was part of my normal commute, I got up an hour earlier to bike first to the fertility clinic for my 6:30 AM appointment. Luckily, the clinic was not far from my office because biking was more painful today then I remembered the previous days. My jeans hurt around my mid-section and waist.

I’m not the type of girl who claims I can “feel it” when I ovulate or even complain about PMS symptoms, but today I was uncomfortable as my body was changing hourly. I felt bloated and puffy. I also remember tossing and turning the night before to get comfortable night sleep. I tried to keep my mind in perspective, this was a small sacrifice for the privilege to preserve my reproductive health and do something for my future self.

As I sat in the waiting room waiting for my name to be called, I couldn’t help but notice all the other women sitting in the room with me before it was even 7 AM. As I began scanning the room of the women who seem to be in as much discomfort as I felt like I was in I realized there were a mix of ladies with smiles on their faces and a mix of couples nervously clutching onto each other by the hand. It was hard to tell who had been here before and who had never experienced this before. I was amazed by the packed waiting room. I knew I was at one of the larger clinics in Chicago, but I really couldn’t believe how full the waiting room was. How would they ever see me on time so I could get to work without being late, was mostly what was running through my mind.

Before long I was called into a room for my ultrasound. The procedure was not unpleasant but felt surprisingly soothing. It was like I was having my ovaries massaged and coaching them to keep growing. After my ultrasound, I was sent to a different waiting room to have my blood work taken. Getting my blood drawn was probably my least favorite part of the morning monitoring. I always wished I made a better fashion choice or wore a different shirt to easily access my veins.

During my wait, I saw my physician Dr. Beltsos in the hall talking to a few nurses. I decided to just pop my head out the door and say hello. Dr. Beltsos eyes lit up as she asked how I was feeling and doing on my medications. I explained that I figured it out, except I was still a little unsure about the Menopur mixing. She stared at me puzzled for a minute as I described what I was doing. She then signaled a nurse to come over to re-explain and show me a demo of how to mix the Menopur correctly. It was a moment of panic as I realized I had been mixing the drug incorrectly. Ladies take note, what I learned is that only the powder is the medication. The saline solution that is required to mix into the powder is only sterile water and contains no medicine.

After feeling rather silly for obviously not watching the teaching video or reading the instructions carefully enough, I was given new instructions on how to fix the mix-up. Since we caught it early on day three versus later down the line my doctor reassured me that based on my ultrasound alone that it was obvious I was responding to the meds well and it wouldn’t affect my success in this cycle.

From that point on, I became very vigilant and asked more questions for any medicine mixing if I thought there was a chance that I didn’t grasp what was being asked of me. I learned later I could have hired a nurse to help for like the first week and be coached through the process. I became a little obsessed about it all I started researching YouTube for any “How To” videos that could also continue to educate me. It is very humbling to make a mistake. I felt like I was an army of one fighting this battle all by myself. I vowed in these very raw moments to help simplify and make this process for other women easier so they never had to feel this way.

You can now learn from my mistakes … all you need to do is know which medication is which and understand the mixing unit amount from the amount that actually gets injected into your body. FYI: the labels on the syringes with units cc and ml are interchangeable or one in the same.

Later that day, I was called by one of the nurses who reviewed my results with me over the phone and gave me the increase dosage level of 150 iu for both Menopure and Follistim to make up for the medication schedule I had missed the in the first three days of hormones.

Here are the results from my first cycle check up.

Ultrasound results (21 follicles of interests)
Right Ovary: 11.5 mm, 10.2 mm, 9.9 mm, 9.8 mm, 9.0 mm
Left Ovary: 12.4 mm, 11.7 mm, 10.3 mm, 9.2 mm

Blood work results
Estradiol level = 326
Progesterone = 0.4
LH = 3.3

Hormones Day 5 (Wednesday)

“Hardships often prepare ordinary people for an extraordinary destiny.” –C.S. Lewis

By day five, I felt like I was getting hit by a bus. I started to have black and blue bruise marks all over my stomach. Clearly, I would not make for a good drug addict. Today was an off-day from my morning monitoring visits. During the first week of hormones, I was only asked to come into the fertility clinic every other day to make sure the prescribed treatment plan was working effectively. I was lucky that I was responding well to the medications even with a minor mix-up of the prescribed dose the first three days.

When I was riding my bike to work that morning, I could tell I was going much slower than normal. My usual 7-8 minute bike ride turned into a more like 12-13 minute commute as I could feel every bump in the road as it trickle through my body. I had to remind myself how this was a better option than walking, but in all reality, I started to hate moving in any form. The ride home was equally painful. I dreaded the commute. But it was a necessary evil to start and complete my day. Since avoiding exercise is highly suggested, I tried to justify how commuting via my bike was the maximum / minimal effort I could do without actually working out. While I hadn’t been consistent with working out, I did feel like no activity during this time would have been okay. When your body tells you to slow down and take it easy, it’s best you listen.

Later that day, I received a call from the clinic and given the instructions to continue my 150 iu of both Menopur and Follistim medications for that night. Symptoms such as breast tenderness, bloating, and fluid retention were really starting to be present and take over. Clothes started to hurt. Anything on my body felt like a thousand pins and needles poking me. I don’t want to sound dramatic here, but I was very uncomfortable. I wouldn’t say I have a low pain tolerance, in fact I seem to fight through pain well. However, I do feel like I was acutely aware of every change occurring under my skin and because of this awareness focused on each of these discomforts. All in all, I was fine and survived another day.

While these eggs that I was working on freezing may or may not become children someday, I felt like I might as well have been pregnant. The two-weeks of medications and injections caused my body to share the same hormone-swollen breasts and belly which was also accompanied by emotional turmoil that most pregnant women endure.

No bump, no baby, and I’m already making parental sacrifices for my future kid(s). In the heightened emotional state induced by hormone overload, even anodyne comments had the power to reduce me to tears or rage. I was amazed how affected my emotions had become. I couldn’t explain why I felt this emotional. I was in a state of feeling ultra sensitivity and vulnerability.

My best advice for this time is to hibernate a bit and keep yourself positive. I did a little contact with the outside world as possible. The emotional roller coaster can be so miss understood that I felt like it was best to use the little energy I did have to relax and letting my body recharge. Tomorrow is a new day. You can do this I told myself. Let’s just find a good movie and drink some tea.

Hormones Day 6 (Thursday)

“Life is either a great adventure or nothing at all.” –Helen Keller

My cousins were coming to town today. We had planned this trip several months before and long before I knew I would be taking hormones at the same time. The timing of the visit snuck up on me and I tried to muster up as much energy as I could to host them properly.

Today, I was instructed to start my first Ganirelix shot that morning. Ganirelix prevents ovulation and releasing of your eggs with natural progression into your fallopian tubes. I was running late this morning. The last few days were catching up to me as I rushed to my early morning monitoring appointment to get my progress medication checkup. I was on the schedule every other day for ultrasound and blood work. By this time, I knew the drill and figured out the system. I wore easier to change in and out of clothes.

I was feeling less perky than normal and it wasn’t long before my cousin noticed. At that point, I opened up and explained how I was in the process of freezing my eggs. I wasn’t sure what kind of reaction I would get, but to my surprise, she responded with kind and inquiring questions about the process and wanted to learn what was involved.

For the next two days, we attended the workshop called, the Storyline Conference as we had planned. The seminar focused on telling a better story, figuring out what you want, and living your dream and doing it to your max potential which was very motivating and inspiring. It seemed perfect for what I needed in those moments. I forgot about all the hormone shots I would have to endure later that night.

During the lunch break, I heard back from the fertility clinic regarding my progress and results from the day’s tests.

Ultrasound results (15 follicles of interest)
Right Ovary: 15.9mm, 14.8mm, 13.1mm, 13.1mm, 12.6mm, 11.4mm, 11.1mm, 9.1mm, 8.5mm
Left Ovary: 16.6mm, 14.9mm, 13.5mm, 9.8mm, 9.4mm

Blood work results
Estradiol level = 821

Later that evening, I completed the usual 150 iu of both Menopur and Follistim, while ordering takeout with my cousin. We chatted about the new details going on in our lives and spent quality time refreshing each other on upcoming plans, future goals, and planned our next day of lectures at the Storyline Conference. I went to sleep with peace in my heart that night. I felt enriched from the day’s activities. I was tired, but tomorrow was Friday and could “sleep in” since I didn’t have to go in for my morning monitor visit. As I feel asleep on my back as I snuggled with my dog. Life was good.