Question Time

In carrying on this theme of "Help--I have no idea what the bloody hell I'm doing" in regard to IVF that has, and will be, permeating my blog for the next month or so, I have some questions for all you learned folk out there.

1) Retrieval: Tell me all about it. I know a local is used, but I truthfully don't even know what that means. Well, I know it isolates a certain area, but how much does that affect the rest of your body post-surgery? Will I be wandering around in a drugged stupor akin to the Nyquil Haze I know and love? I know, a child-like question to ask but the only surgery-type thing I've had was a tonsillectomy 15 years ago. How much recovery time is needed? A day of bedrest? 2 months (crosses fingers)?

1a) What do you tell your employer? I've got the added complication of needing to travel to London - 2 hours away, so I might need to get there the night before. With all of my IUIs and their related scans, I have just told my boss that I have hospital appointments. Since I have always been back within an hour and a half, no one has asked any questions. I would be inclined to take a sick day or two, but obviously as I could be in transit the morning of the transfer, it would be difficult to phone in sick without arousing suspicion. I know I could just *tell* my boss but that's not going to happen. I work in a small office and I don't trust her not to spread the news. I'm thinking I may just tell her ahead of time that I'm going into the hospital for a small outpatient procedure and I will need to take the rest of that day off for recovery.

2) Egg quality: I have this fear, which I hope is irrational, that I'll get to the point of retrieval and realise my eggs are baaaaaaaaaaad. Though it would explain a lot, it's not something I want to hear. How often is poor egg quality discovered at this time?

3) Transfer: Is this just like the process of IUI? If so, I can handle that.

4) Coffee: Yay or nay? I know you are told that to increase your fertility you should cut down on caffeine. I tried that for three months last year and guess what? There ain't no baby in this here stomach. Hence, I'm sticking with the caffeine.

5) I did have a fifth question, but my caffeine adled mind has deleted it.

I do know that I would like to kick my faux British ass for totally dropping myself in it the other day. I left a comment on a blog in reaction to a post about the high cost of IVF meds in the US. I was all, "Check this out muthafuckas, I pay next to nothing here in the UK. God bless the Queen" and all that shit. The next day, I got a bill in the mail that was all, "Check this out bitch, here is a bill for £600 for your medications and an added bill for £200 just for blood tests." Now deflated, I was all, "Fuck the Queen and George Bush."

After the foot-in-mouth debacle, I tried to be optimistic. When compared with paying for IVF itself, the bill for the meds is virtually inconsequential. I likened the situation to when I used to drive a much loved, but truthfully rather rustbuckety 88 Honda Accord. My Accord, christened Rudy the Bohunk after "Rudy Ricecheck" in Sixteen Candles, had all kinds of problems. It was in the shop at least once a month for one problem or another. After two or three major repairs in the region of $500 draining my already limited finances, anything under $300 was considered fantastic news. After yet another car problem, my mechanic phoned and said, "Pru, I'm afraid it's bad news." :::major exhalation from him:::: "It's going to be expensive to fix this. I think you're looking at $200-$250." Expecting the worst, I was thrilled, much to the mechanic's surprise.

I'm saying that I am an 88 Honda Accord. Light blue. A fair amount of money has been poured into this old wreck, so what is another £600? I just hope that if this IVF fails I will not meet the same demise as Rudy the Bohunk, may God rest his jalopy soul.


Manuela said...

Normally it's fun being one of the first commenters... but since I'm just a couple weeks behind you on the ol' IVF train I was actually hoping to see answers to some of your questions...

I'll be back later...

yellowgirlnc@yahoo.com said...

Well, I just finished my first IVF. In the 2ww now. The ER for me was kinda hard, cause one ovary was hard to reach. I *know* it was hard, b/c the "conscious sedation" they gave me would have me sleep, then wake suddenly and yell "oww!", then go back to sleep. SEVERAL times. One time, I think I said "drugs" instead of "oww". I think most people have a MUCH easier time, though. If it hadn't been for my shy ovary, I think I would have just slept through it. They had me walk to the operating table and lie down.... afterwords, they had to shake me awake and ask me to move over to the gurny, which I did and promptly fell back asleep. As an aside, I spent most of the day recovering at the clinic b/c my blood pressure kept dropping; however, MOST people (everyone else that day anyhow) recovered and were able to go home an hour post-op. You'll want to go home and sleep or take it easy for the rest of the day regardless.

Re work: I told my employer that I would be having some minor outpatient surgery the last week in Oct but wasn't sure exactly when. I implied "girl issues" (or rather, he assumed them) and left it at that. I think the girl issues bit helps explain WHY you don't know exactly when you will be out.

Re transfer-- now that I've scared you about ER, the transfer is PIECE OF CAKE! Like IUI, only easier, cause they use u/s to see where they are going.

Good luck to you!

Lindy said...

I've only gotten as far as the retrieval, but it's quite fresh in my mind, so I'll tell you what I know.

The anesthesia used seems to vary widely. At my clinic, they do retrieval and transfer at a major hospital (because that's where they're embryology lab is located and they don't want to move the embryos from place to place), so that may give them more options.

I was given a choice between what they were calling general anesthesia and an epidural. I had a bad experience with an epidural during labor and I most definitely did not want to be awake for retrieval, so I chose general. It isn't really general though because they don't intubate you and the drugs are a bit lighter weight. They used something called propophol or something like that. It's "twilight sleep" anesthesia like that used for a D&C. If I woke up, I sure as hell don't remember it, and that's for the best. The recovery from anesthesia was far better than I had from my apendectomy or laparoscopy. After both of those procedures, I vomited for a few hours and my blood pressure plummeted. No problems with that yesterday. The procedure started at 8 am, was done by 8:40, I was awake by 8:45 and ready to get dressed and drive home by 9:30. I felt a bit drowsy and calm the rest of the day, but that was probably the valium they gave me. I was very very sore yesterday (retrieval day), and less so today. Today I have a horribly painful stomachache, but it seems that that's due to the doxycycline/medrol combination they have me on for a few days surrounding retrieval and transfer.

As far as work is concerned, I have a very flexible schedule and I work from home, but I did need to tell them I wouldn't be working this week and half of next (I decided to take off from the earliest possible retrieval date until three days past the latest possible transfer date). So I said I was having outpatient surgery some time this week (depending on the doctor's schedule) and that I'd need to be on bedrest to recover. Only one of my bosses made further inquiries (probably out of concern for me) and I just told her vaguely that it was for a gynecological issue. I figure you can vaguely paint the impression of a laparoscopy and that sort of fits the time span and unpredictability of doctor's schedule.

korin said...

1) For ER I was out like a light. Fabulous drugs, didn't feel a thing. However, once we got in the car to come home, i feltlike i'd had my ass kicked from the inside out. Spent two days with a hotpack on my belly watching tv andknitting.
1a) I am my own employer, so I can't help you there.
2)I dont' know.. sounds like a good question for your doc (yeah, that's a cop out answer.)
3)They gave me valium for my ET.so i was soooooo happy for it. easy as pie.
4)Coffee... as long as it's one-two cups a day, I'm sure it's fine. I quit caffiene years ago, so it wasn't on my mind.

Good luck!! :D

ms pickled eggs said...

* For the ER they just gave me IV drugs. They were pretty rubbish, but then I have the same problem at the dentist. Most people sleep through the ER, I just went OW OW OW, but then I'm a freak. Was 100% fine by the following day.

* Bed rest isn't recommended or necessary. They only tell you to take it easy because you've just had a foot long needle jabbed up your nethers. Won't make a blind bit of difference to the outcome.

* I told employer that I needed time off for minor surgery. However I know plenty of people who had their GP sign them off for a vague reason such as a virus.

* Bad eggs - if your fsh is good, it's unlikely that this will be your problem. And if it is, a different drug combo could help. 'Proper' bad eggs are unlikely.

* Transfer - piece of cake, no drugs given.

* Caffeine - everything in moderation. The odd cup won't hurt.

* Have you asked your GP if they will prescribe the drugs on the NHS? Some will, so it's worth a shot. Otherwise there are some pharmacists who sell the drugs cheaper. I know there is one in Peterborough, I'll do some investigating if you like?

Anonymous said...

I had a general for the ER - thank goodness. The waiting to go into surgery was the worst bit. Coming out of it I didn't feel too bad and just wanted to go home. They make you wait an hour and eat a sanwich before you can go. But once I was home and the anaesthetic wore off totally I was in real pain. It lastest about 5 days I think. I lay around with a heat pack too. I had only take a couple of days off work, so had to keep phoning in sick. I just said I had the flu....
I was still in pain at the ET - I noticed that noone else was limkping around though - I think I was just unlucky. But the ET itself is fairly much like an IUI, they just spend a few more minutes at the start making sure their instruments are all in the right place, cos once they are ready to go they only have a moment to get the embryos out of the solution and into the right place.
I haven't given up coffee, but have cut back to 2 weask cups of instant of a morning. Truth be told I'm finding red wine much harder to give up......

tania said...

I had the drugs that put you under, but that they can turn off at a moment's notice. Then when you wake up, you have amnesia for awhile. So when the embryologist lab guy came in I said "You should get a ferticam, so we can watch our eggs fertilizing over the internet." two seconds later "You should get a ferticam so we can watch our eggs fertilizing over the internet." I'm sure it was much funnier the 2nd time I said it. I guess I also asked about 27 times in a row how many eggs were retrieved. If you have had trouble with nausea associated with anesthesia in the past, they'll give you some anti-nausea drugs afterword. I was very exhausted afterward, but felt fine aside from the fact that my ovaries were gigantic (apparently that's what happens when you have 41 eggs)

Most of my egg quality was crappy, but my doctor said he wasn't sure if it was due to my having crappy eggs, or due to the fact that since I grew so many of them that their quality was compromised.

For the transfer they gave me valium - otherwise it was pretty similar to an IUI except he had me on this freaky table that spread my legs wide for the world to see rather than putting them in stirrups...

I finally got to the point where I just told my supervisor what I was going through. I had a decent enough relationship with her, and it made everything less stressful for me to just be able to tell her that I was having a procedure without freaking out about what to say or whether to make something up blah blah blah.

In my book if crack whores can have sex and have babies you can have a cup or two of caffeine a day while doing IVF. But I've never been very good at denying myself food. One of these days I keep telling myself I'm going to give it a whirl, but it hasn't happened to date.

p.s. loved your story about the Dude. Score on the soccer legs. Mine has cycling legs. Also quite nice (but sometimes a bummer if he's shaving and has smoother legs than me.)

statia said...

And I hated your bragging ass for a split second (but only because I was jealous that you got off so cheaply). Fuckin' IVF meds.

Molly said...

Letting wiser women answer. Just stopping in to make sure you haven't posted a picture of your cleavage -- don't want to miss anything.

mm said...

*I've had general for both of my retrievals. Didn't feel a thing and was only slightly crampy afterwards. I don't think I even took anything for the pain.

*I'm freelance so didn't have to make up a lie for my boss (there's a first).

*Egg quality: they won't be able to tell you anything about the eggs until they get them into the lab. The only thing you'll know when you leave the retrieval is how many eggs they got (NOT how many are mature, which is key). You'll probably get the info on your eggs when you get your fert report the day after.

*Coffee: Supposedly caffeine can inhibit implantation. I usually stop drinking it once I start stims. But then again, the one and only time I've ever been pg was when I was trying naturally (ie not trying at all and drinking wine and coffee like they were going out of style).

Good luck!!

fisher queen said...

Not there yet, but eagerly reading everyone's comments. Good luck!

Suz said...

* Retrieval - I had a general for mine, too. A little cramping, but not much else.

* Work - My favorite term in the world is "medical procedure." I used it over and over. Nobody dared ask.

* Coffee - Quit it the first IVF; stayed on it my second. It was the second one that worked. I drink one-two cups a coffee a day.

Mary Scarlet said...

I also had the twilight sleepy-time drugs for retrieval, great great stuff. Slept right through it and had about 20 minutes of groggy time in a recliner afterwards before being sent home. I was sort of sleepy for the rest of the day but not nauseated. First cycle, I had very little pain afterwards. Second cycle was much more painful, was still kind of sore when I went in on day 3 for the transfer.

I had saved up my vacation time so I was able to schedule a week and a half in advance. When I had a m/c, however, I did use your vague outpatient procedure thing and noone asked twice.

I don't know about the egg quality thing, my eggs suck apparently but that was discussed before and well after retrieval, not any time around the time of that procedure.

Transfer is a piece of cake. The worst part was having to pee so so bad and having to hold super still while they were doing the actual transfer.

Good luck!

Anonymous said...

Yay, the oily bohunk! Love that movie.

May your IVF experiences turn out to be the equivalent of the $200 mechanic's bill. They probably won't be easy, but hopefully they'll be much more dealable than your worst expectations. Good luck with it all.

Manuela said...

Good luck, Pru... looking forward to sharing our stories in person in D.C...


elle said...

I have no pearls of wisdom to share - just the hope that all goes well w/ no more bills. Good luck, Pru!

pixi said...

No useful insights in that arena, but please know that I wish you well with all that's coming.

DeadBug said...

For my two procedures, the ER was done under a light general that was extremely pleasant (the IV kind that can be immediately turned off). No nausea, no disorientation, nada--just a general sense of wellbeing. The first time, they had to move my right ovary during the procedure and I ended up in a lot of pain for about five days afterward. It was OK when lying still but getting up and especially using the toilet was excruciating. Second retrieval, when my ovaries behaved and stayed in their proper location, it was a piece of cake, even though first retrieval was of four and second was of seventeen. Didn't even take the Tylenol.

Transfer hurt a bit for me, but not much more than an IUI. When the catheter brushes against the inner lining of the uterus, it can cause a pretty strong cramp, but it's over very quickly. Definitely nothing to worry about. And it was incredibly cool to see the embryos being deposited.

As for work, I used the "surgical procedure" line with my client and there were absolutely no questions asked. I took off a fews days from work (day before retrieval through the end of the requisite post-transfer bedrest) and that didn't seem to raise any eyebrows.

Regarding egg quality: I was a "poor responder" (produced too few eggs, which is usually assumed to reflect poor egg quality, too) on cycle #1; on cycle #2, with a different drug regimen, I produced 21 mature follicles, 17 eggs and ended up pregnant with triplets. So, even if it the initial egg news isn't great, know that it's most likely the regimen and not YOU. Especially at your age.

Are you guys doing a standard fert or ICSI? Will you be doing assisted hatching? Just being nosy!

Rooting for you,


Lori said...

Not yet at the IVF stage, so I'll refrain from any assvice.
However, I loved your car analogy. You've got me wondering if I'm an '85 Thunderbird named "Bessie", as in Bessie the 'Bird. I loved her dearly but I too thought a $200 mechanics bill was getting off cheap!

laura said...

(1) ER made me the most nervous, which wasn't necessary, now that I look back. They hooked me up to an IV, and gave me a small 'cocktail' of the good drugs, to see how I handled them. When all went well, they gave me the big dose. They said it was 'twilight', but as soon as they rolled me into the procedure room, slapped my legs up in the stirrups, and adjusted the 'modesty drape' I was out like a light. When I woke up in the recovery room, I said "Okay, when are we going to start?"

Recovery-wise, I stayed in bed for two full days afterwards...I wa very sore, and took full advatace of the prescription painkillers.

(2) Transfer was a breeze. Much like an IUI, just with an incubator of your embryos and much more serious people. Again, I erred on the side of caution, and I spend three full days in bed.

(3) Work ... I own a business, so no explainations necessary. But I do think that "surgical procedure" should cover it.

(4) Caffine - I gave it up totally about a month before ER. I needed to do it anyway, since my diet coke habit was bankrupting me, and I'll assume it was a good thng!

Good luck!

Pamplemousse said...

Old rock here! I think the thought of retrieval is worse than the reality but everyone is different. My first one was great and I thought what is everyone going on about? Once the sedation wore off, I felt like I had been kicked in the fanny (British version) by a mule.

At my NHS clinic, you are offered twilight sedation or conscious sedation which you control, and you can watch what is happening. WTF? You would have to be a sadist to choose that.

My 2nd retrieval was v. different. My ovary was hiding and apparently it was a real bugger to get into. I was convinced that I woke up during the retrieval but Mr P swears no. In both cases, the first couple of days after ret. were pretty sore and all I wanted to do was sleep and take painkillers.

I stocked up on loads of food for MR P so he would not starve whilst he was serving me hand and foot. I think the euphoria of how many fertilise and the prospect of transfer help to dissipate any pain but I did not have those joys.

Feel free to e-mail for more gory details but honestly, it was worse pain when I had 2 wisdom teeth out.

Cass said...

I'm not there yet with anything except the work excuse - I told my boss that I'm having a minor surgical procedure, and I'll be out for about a week between the procedure and recovery. I was prepared for further questioning, and had planned to make some vague comments to reassure him that it was nothing serious, and to try to imply that it had to do with my girly bits, but he didn't ask so I didn't offer. (It will actually be the week of Thanksgiving, but I wanted him to know it was medical and not just me going on vacation that would require additional days off - but to everyone else it'll just look like I've taken a long holiday. Oh well.)

And I'm a bit freaked out at the prospect of the retrieval, too, and following along with all the advice you're getting.

Kim said...

Good questions. Thanks for the education.

Kimmer said...

2 different procedures and 2 different clincs for me.
ER #1- IV sedated(conscious but didn't really know what was going on) got a nice shot of pain medicine when it was over. Felt very good at the time due to the drugs. 3 hours later it was a different story. I had severve pain for about 3 days after the ER. I almost passed out from pain after ER when I attempted to use bathroom later that evening(just peeing mind you) and swore I would never attempt IVF again.

ER# 2- Different clinic! No going under with "concsious sedating." Just a nice shot in the bootie before ER, 2 really nice pain pills(forgot the name), and a valuim. I was very aware of what was going on and even got to watch my eggs being aspirated on a monitor. Really neat. It hurt afterwards for an hour. Went home and slept like a log(12 hours or more). No pain the following day and was good to go. Really, I could have went back to work the following day.

Regarding work- I am my own employer so don't know what to tell you. I had to answer to my clients and just told them I was going to be out for a simple medical procedure. That shut some of them up.

Transfer- Cake walk if you have a nice cervix. I've heard it can be hell for some. For me it was like pap smear. Period craps on and off during the 2ww which really drove me crazy. Did it work? Is my period coming?

Bedrest- I did the bedrest thing with the first cycle for several days. Second time around I just took it very easy until second day. Just take it easy and go with what your RE suggest, they all vary with that.

Coffee- I always switch to decaf.

Good luck!The hardest part of the IVF process(for me) is the 2 week wait. Keep busy so you can attempt to take your mind off things.

MC said...

I've had 4 ER's and had a general each time, but light enough so my husband can be with me. In recovery it doesn't take long to be ok to get out of bed. Last time I had very bad cramping in my ovaries, this went as they gave me pain killers through the iv. I find I need to sleep it off the rest of the day. I'm usually sore the next day and my DR gives me that off work as well.

I haven't told work about IVF, I just say I have a minor medical procedure and as long as I give them a certificate they are fine.

Egg quality I don't know about, I've always got plenty, but only had one successful implantation out of 8 transfers (16 embryos). It could be my age or the male factor? They don't seem to know.

Good luck with everything.