graphic details of josh and i making a baby...

good news, i don't have hiv or any other infectious diseases and my cystic fibrosis screening was negative. i was confused when i previously posted that we could start whenever we want, it actually does depend on my cycle. so, we have to wait approximately three weeks before we begin. i was bummed for a minute but now think it will be nice to have a few more weeks to prepare. i have posted the ivf calender from my doctor below, i am not sure if it will make things more or less confusing but its there for anyone who would like to take a look. omg, i am officially nervous.

IVF Calendar


• We often plan this calendar based on an estimated period start date. If your period is a few days early or late (and sometimes even a week early or late), this calendar will not change. We will let you know if it changes.

Getting “started!” Period start date: ~3-25
• Call or email your IVF coordinator with your period start date to confirm IVF cycle dates, schedule labs, etc.
•If you start on a weekend, please wait to call until the next business day.
•Please do not call the physician after normal office hours with a period start date!
• If you are considering PGD (embryo biopsy/genetic testing)…or Attain IVF through Integramed, you MUST let us know at this point. You CANNOT add it later in your cycle, it must be planned from the beginning.
• Take a home pregnancy test. Yes, we’re serious! It is actually quite common to mistake early pregnancy bleeding for a period. Unless you’ve had your tubes tied or removed, or your husband has had a vasectomy…humor us and take one before you start any medications. Thank you!
• You and your husband should start the Z-Paks (antibiotics): 2 days before HSG. Your husband’s prescription will be under his name at the pharmacy.
• Use a non-spermicidal condom throughout your IVF cycle to prevent accidental pregnancy (not necessary for tubal ligation or vasectomy patients).
• Continue taking or start taking a prenatal vitamin daily. It is also acceptable to take an over-the-counter multivitamin with 1-2 additional folic acid tablets.

Begin birth control pills:
• Please start birth control pills on day 1, 2, or 3 of your cycle; it doesn’t matter which day.
• Take one active pill daily until the stop date listed below. It doesn’t matter if you take them morning or night.
• Warning! You will likely take an odd number of pills; it may be more or less than one pack. You already have refills on your prescription at the pharmacy. Make sure you take only the ACTIVE pills, do NOT take the placebo / sugar pills! If you are scheduled for more than one pack, take the first 21 pills and then go straight into a new pack.
• Breakthrough bleeding is annoying but normal.
• If you have any questions about how to take pills, please let us know.


Uterus evaluation appointment: Mar 29, 31, or Apr 5 or 7, email Brandi to schedule
• Trial embryo catheter measurement
• HSG (hysterosalpingogram or dye x-ray)
• Check in at the main entrance of Overland Park Regional Medical Center at 7:00am. You can park at the main entrance...or you can also park at our building and just walk down the hall. It's not far from our office. Your doctor will then meet you in radiology to do the HSG and embryo catheter measurement (very crampy, but quick). Please eat something for breakfast, and take 800mg of ibuprofen at about 6:30am.


Getting closer! Begin the following medications on: 4-8
• Aspirin --Take one low-dose 80 or 81mg aspirin tablet once daily until 20 weeks of pregnancy. It does not matter what time of day you take it. Avoid additional aspirin-type products like ibuprofen, Excedrin, and Aleve. Tylenol products are OK to take for headaches or muscle aches.
• Dexamethasone --Take one dexamethasone tablet daily at bedtime, until your coordinator tells you to stop. It will be approximately 1 month.
• Lupron --Start taking Lupron (leuprolide acetate) injections daily.
• Draw up 10 units on the syringe.
• Administer in the abdomen or thigh.
• Give injection at the same time every evening (between 5-11pm).
• Do NOT stop taking Lupron until your coordinator tells you stop. It will be approximately 1 month.
• Even though the box says “14 days” and it looks like a tiny amount in the bottle…it will last for your
whole IVF cycle. You will need more needles than are in the box; the pharmacy should have given
them to you.
• Make sure you follow these instructions and NOT the dosing instructions on the box.
$ If you are doing Attain IVF through Integramed, your payment of _________is due TO Integramed by today.

Take your LAST birth control pill on: 4-13
• You will likely have another period in 2-6 days. You do not have to call.

Halfway there! Suppression appointment: 4-20 or 4-21 or 4-22
• This appointment will take approximately 1 hour. Your husband does not have to be present unless you choose.
• Report to the lab (Suite 125) for blood draw FIRST.
• You will then have an ultrasound (suppression scan) to confirm the ovaries are suppressed.
• Notarized consent forms are due. You have 2 stapled sets of consent forms, one set for IVF, one set for frozen/cryopreserved embryos. You must fill them both out, even if you don’t end up with any embryos to freeze. You can take them to a bank notary, or any notary that you know; or we usually have a notary here in our office and we can witness them if your spouse is with you today. The forms MUST be signed in front of a notary.
• Your IVF coordinator will review the next phase of your protocol, give you lots of new instructions, and order your injectable medications from a specialty mail-order pharmacy. The meds are usually shipped overnight and will arrive in time to begin stimulation. You should also receive a needle box from the pharmacy; you can return it to our office for disposal at the end of your cycle.
$ Payment is required today. MultiCycle Plan ___________, or Attain ___________ , or insurance __________.
Call or email Toni or Carol (Carol@RRC.com) with financial questions.

Time to make eggs!
• Stimulation shots (Gonal F, Follistim, other) to make eggs will begin approx: 4-25
• You will need blood draw in the morning to check estradiol (estrogen) level on approx: 4-27
• First office visit for a morning blood draw and scan to check the ovaries on:4-30.
• You will have ~1-3 additional scans to monitor follicle growth the following week. Usually on Monday and/or Tuesday: 5-3 / 5-4. These scans will determine the retrieval date.

Retrieve the eggs!
• Egg retrieval will be tentatively: 5-6 (give or take a day depending on follicle growth)
$ You will be instructed when it is time to pre-register and make payment to the hospital ($1000) and anesthesia ($440), or file to insurance per Carol’s instruction, if applicable.
• If you live more than 1 hour from our office, we ask that you stay in Kansas City the night before your retrieval (if you are late to retrieval due to traffic or weather, you could ovulate, and the eggs will be gone).

Embryo transfer!
• Embryo transfer will be 5 days after retrieval, tentatively: 5-11 (give or take a day based on retrieval date)
$ If you did PGD (genetic testing on the embryos, $1500 payment is due today, shipping will be billed to you later).
• You will need 2 days off work, the day of transfer and the day after, at home resting.
• Pregnancy test will be the week following embryo transfer (approx 8 LONG days later)!!


Good luck! Please follow these instructions very carefully.
Do not hesitate to ask questions…we are with you all the way!

the facts of life, continued...

since i know i didn't post enough information last night i thought i would continue today:) the doctor ordered 5 blood tests yesterday to check my fsh (follicle stimulating hormone) level, estrogen level, thyroid, cystic fibrosis and infectious diseases. the nurse called today to inform me that they have the results for the fsh, estrogen, and thyroid and they are all normal which is terrific news, one more hurdled passed. we will have the cystic fibrosis and infectious disease results next week.

i tried to cover the process of in vitro in last night's post so today i thought i would pass along some less scientific info. the multiple rates at rrc are much lower than the national average which is great. i am pretty sure anything above twins and i am losing some friends:) there is a one in three chance that we will have twins, less than 2% chance of triplets and they have never had quads or above. let's hope i don't become the exception. for real. if it is twins the majority of the time they are fraternal, so if everyone could pray for a boy and a girl we would greatly appreciate it. two for the price of one, ya know? i was pleased to learn that i am allowed 2 diet cokes per day (cans not sonic route 44's) which is not only good for me but for anyone who has to be around me as well. we have to double check about the vino situation. i am pretty sure she said i could have a glass of wine per evening but josh swears she said only 5 drinks per week. i plan on double checking. seriously? they want me to relax but they take my wine away?? absurd. i said i would do whatever they ask but i don't have to be happy about it. as for acupuncture, they were pretty indifferent. there isn't any real medical proof that it does or does not help so they feel like it is best left up to the individual. basically, if it relaxes me to do it then i should but if not no need. i think i will be seeing enough needles in my near future and have decided at this point it is unnecessary for me.

the side effects sound like quite a vacation. my ovaries go from being the size of a walnut to the size of a baseball which causes bloating, cramping, shortness of breath, insomnia, etc. combine that will all the hormones they will be pumping me with and it sounds like i will be a real treat to be around. i will apologize in advance for my behavior in the next few months. you might want to start sending sympathy cards to josh pronto.

so, there you have it. most days it is still hard to believe that this is the path we have to go down. however, every time i think of the day josh and i finally get to welcome our baby to this crazy, bizarre, mixed-up world i am reminded of the reason for all of it. whatever it takes. we will let everyone know the instant we decide to proceed and hope for it to be in the very near future. again, we have had to rely on the support of so many and are eternally grateful for all of you.

you take the good, you take the bad, you take them both and there you have...

i am on a bit of an information overload right now but feel it is best to try to get all of these facts down while they are still lurking around in my brain. we were at rrc for 4 hours today meeting with the the nurse, doctor, scientific director, financial counselor followed by having 4 viles of blood drawn and an exam that i will not be able to talk about without mucho vino. i know i said i was going to put it all out there but you have to draw the line somewhere and the pelvic ultrasound is the line. no doubt. in a nutshell, what we have is an abundance of information and now we have to try to dissect it and decide where to go from here. we can start the process whenever we like, it is not as i originally thought based on my cycle. when we decide it is go-time they will first have me begin to take birth control pills. i know, didn't sound right to me either. i spent the last, well the number is not important, so many years trying not to get pregnant and now you want me to start taking birth control to try to conceive? apparently the birth control pills is a way to tell your body to stop ovulating and allows the doctors to come in with hormone injections and various medications and take over. so, i am going to try to describe the process to the best of my ability.

here goes. for argument's sake, let's say we are going to start this process tomorrow. i would begin taking birth control pills and lupron for the first half of the in vitro cycle to suppress my body's production of hormones that cause stimulation and ovulation. i should probably point out that an in vitro cycle lasts approximately 2 months. once suppression is confirmed by ultrasound and blood tests, i will begin gonadotropin injections which should stimulate the ovaries to produce eggs. these injections will be administered by josh once or twice daily and last about 8-10 days. the nurse actually said after informing us of this "man he looks like he wants to bend you over and throw it at you like a dart." i am assuming you can picture "the look" josh got after that. from here, i will have 2-3 ultrasounds and blood draws to monitor the follicle development. when the doctor has determined that the eggs are ready to be retrieved, josh will administer a "trigger shot" aka "the big one" to mature eggs for retrieval.

the eggs are retrieved approximately 36 hours after taking the trigger shot. i will check in at overland park regional center where an anesthesiologist will sedate me and proceed to suction the fluid from the ovarian follicles with a needle. the eggs come out with the fluid. this was the part that i apparently skipped in all of my research. it is apparently more painful than i had imagined and i will be on bed rest (only able to get up to go to the bathroom) for the two days following. if there is a silver lining it is that i will get some good pain meds:)

the follicular fluid will immediately be examined in the ivf lab, and the eggs will be counted and placed into culture dishes. they will tell us at this time the number of eggs retrieved. the embryologists will attempt to fertilize all mature eggs. they will call us each day with an embryo count. they like to retrieve 12 eggs on average with at least 70% of them continuing to mature.

assuming at least one, and hopefully two (i will have more on this later) mature, they will be transferred to the uterus through a long flexible tube. josh will be there with me and we will be able to see our embryo(s) on the monitor prior to the transfer. the transfer is a simple (their words, not mine), relatively painless procedure that takes only a few minutes. they said "relatively painless" and "comparable to a contraction" in the same sentence. i was fortunate enough to be in the room for the birth of my niece and nephew and witnessed first hand my sister's head spin around in one of those "relatively painless contractions" but i guess i will take their word on it. from here, i remain resting for 15 minutes after the procedure followed by another 2 days of bed rest. they stated, and i have it in writing, "no cooking, cleaning, chores, projects, or errands, for 48 hours." just thought i better put that out there as it is a pretty valuable piece of information. i will return to rrc 8 days later where they will draw blood to determine if i am pregnant and they will call us that afternoon to let us know. if positive, they will repeat the blood test a couple of times over the course of 3 weeks followed by 1-2 ultrasounds to confirm the heartbeat or heartbeats and make sure it is not ectopic and then my regular ob takes over from there.

whoo, if you think you are exhausted imagine having it regurgitated to you over four hours and then asked to write a nearly $700 check and be on your way. so, those are the basics, although there seems to be nothing basic about it. now, i don't want to cover it but feel it needs to be...where things can go wrong. during my pelvic ultrasound they found that one of my ovaries is much smaller than the other. while it is not something to be extremely alarmed about at this point it is certainly nothing to jump for joy about. apparently the bigger the ovaries the more the eggs and obviously the more the eggs...you get it. plenty of woman have had babies with only one ovary so at this point we have no reason to believe this will be a major obstacle. it is imperative that we have embryo's left over that can be frozen for future use for two reasons. one, if it doesn't work the first time (which it doesn't for 60% of women in my age group) then to try again we just have to thaw one or two out and implant it and can skip over a lot of the invasive stuff it took to create the embryos. two, it would cost a lot less to to do it that way, if we have to start over again we will have to pay full price, which is nearly $15,000 per try. obviously, there are a number of things out of our control that are no different than pregnancies created in the bedroom so there is no reason to worry about that.

so, in a nutshell, we have no idea where we are going from here. we could start tomorrow if we wanted but we have to have $11,000 up front 4 weeks after we start and that doesn't even cover the whole process. so unless we or one of our super generous friends or family hits the powerball tonight we have a lot of figuring out to do. we are both remaining positive, we just need some time to let it all soak in. i will update tomorrow when the doctor calls with the results of our blood tests. oh yeah, the blood tests, i don't believe i explained what that is all about...i promise to do so tomorrow.

doctor, doctor give me the news.

just received a letter from dr. brabec detailing our appointment next wednesday. it clears up a lot of the questions regarding what will take place. i have copied an excerpt below...

Your consultation will be structured as follows: you and your partner will first meet with the nurse. She will review your history and prepare you for your visit. You will then meet with Dr. Brabec. During your visit, you will have a consultation and physical examination including a pelvic ultrasound. Dr. Brabec will review the results of your history, examination, labs and ultrasound with you, and make treatment recommendations. Your nurse will review new prescriptions and schedule any necessary procedures or tests (bloodwork may be performed including infectious diseases screening which is a requirement prior to treatment). A financial counselor will be available to discuss costs and insurance with you.

we were pleased to learn that we haven't waited four long weeks to get a 15 minute appointment. it also states in the letter that we will be there for several hours so i thought i should give those of you who will be anxiously waiting news a heads up.

we are very excited about getting this process started and are doing everything we can to prepare. barb gave me a a couple of guided imagery cd's that has guided meditations to help with fertility. for those of you less familiar, guided imagery is a popular form of directed daydreaming, a very simple way of meditating that is very easy, and actually quite relaxing. I have also recently started doing fertility yoga which has been very nice. we have found mixed opinions regarding acupuncture so we are going to wait to see what advice the doctor gives us. so, that is all for now. i assume we can count on everyone sending positive vibes our way next week. i believe if i get a clean bill of health the process should move along pretty quick. as always, we will keep you posted, ad nauseam:)

Things that make you go hmm...

Eve Ensler, author of The Vagina Monologues, wrote a serious of monologues and stories inspired by girls she has visited around the globe titled I Am An Emotional Creature: The Secret Life of Girls Around the World. While the book is intended primarily for teenagers and young adults I found this particular monologue very interesting and thought I would share! It is quite lengthly, but well worth the time in my opinion. I hope you enjoy it as much as I did...

YOU TELL ME HOW TO BE A GIRL IN 2010

Questions, doubt, ambiguity, and dissent
have somehow become very unmasculine.
Authoritarian maniacs are
premiers, czars, and presidents.
Each one is more righteous than the next.
Each town they bomb
each human they kill
is done for "humanitarian" purposes.

People don't own the water in their own village
and they certainly don't own the diamonds or gold.
Millions are forced to make dinner out of garbage and dust
while Russian businessmen and movie stars
are buying 500-million-euro villas on Cote Sud.

Bees have stopped making honey.
People are drilling in all the wrong places.
The U.S., Russia, Canada, Denmark and Norway all claim the Arctic
but none of them seem to care that the polar bears are drowning.

They are fingerprinting, photographing our licenses and teeth.
Big Brother is now in our phones, our pods, our PCs.
Not one of us feels even a little safer.
New age mental health providers turn
out to be former war torturers with beards.
And the pope in a dress showing off his
ermine trim and cuffs
is telling everyone that
people kissing people they love is the greatest evil.
A woman running for U.S. vice president
believes in creationism
but not global warming.

Why is everyone so much more afraid of sex
than SCUD missiles?
And who decided God wasn't into pleasure?
And if the hetero nuclear family is so great
how come everyone is fleeing it
or paying their life savings just
to sit in a room with a stranger and cry about it?

The Iraq war cost nearly $3 trillion.
I can't even count that high
but I know
that money could have
would have
ended poverty in general
which would have canceled terrorism.
How come we have money to kill
but no money to feed or heal?
How come we have money to destroy
but no money for art and schools?

The fundamentalists now have
billion-dollar private armies.
The Taliban is back
but never went away.
Women are burned, raped, bludgeoned, sold,
starved, and buried alive
and still don't know they are the majority.

Water is clearly nearly running out
but even in the desert where there's serious drought
the golf courses are green and lush
and the swimming pools are full of water
for the twelve rich people who might decide to come.

Special people adopt hand-picked babies in faraway lands.
Their flights there cost more
than the babies' parents made
this year.
Why don't they just give it to them?
Slavery is back
but never went away.
Just ask anyone who has been whipped
how deep the legacy.
Six million dead in the Congo
and they never made the news,
and don't tell me it doesn't have
to do with color
and minerals.

Poor folks are dying first
From hurricanes
Shame
Tsunamis
Radiation
Pollution
Floods
And neglect.
Rich folks
just put up fancier super-electrified gates
on their private perfect cities.

Everyone's having "benefits"
and throwing fancy parties
with lots of swag
so the rich people feel good about giving
away the tiny little bit of the whole lot they have.
But no one really wants to change anything.
If you really want it
you have to give something up
like everything
and then those that have, wouldn't,
and then who would they be?
And that's too complicated
so they write checks
and keep doing the same old things.
Selling change.
Making revolution profitable.
Corporations own everything anyway
even our hippie jeans, memory cells, and rain.
Why do so many women leaders look like Margaret Thatcher
and act even meaner?
Why doesn't anyone remember anything?
And how come rich bad people
get paid lots of money to give speeches
and poor bad people are tortured
and in prisons?
Is there anyone in charge?
Or is this whole thing spinning until it explodes
or dissolves?
And if there is something we can do
why aren't we doing it?
What happened to fury?
What happened to accuracy
or accountability?
What happened to not showing off your wealth?
What happened to kindness?
What happened to teenagers rebelling
instead of buying and selling?
What happened to teenagers kissing
instead of blogging or dissing?
What happened to teenagers marching
and refusing
instead of exploiting and using?

I want to touch you in real time
not find you on YouTube.
I want to walk next to you in the mountains
not friend you on Facebook.
Give me one thing I can believe in
that isn't a brand name.

I'm lonely.
I'm scared.
Girls younger than me are giving blowjobs
in homeroom
and they don't even know it's sex.
They just want to be popular
and get some respect.
Most girls my age are taking pills
or not getting out of bed
or eating or starving
or getting nose jobs or implants
or getting cut
or twittering away
or covering themselves
or desperate for a way
to be awake without faking
to be alive without freaking
to be serious
to be true
to even think of loving someone
when we're already doomed.

You tell me how to be a girl in 2010

I say let's go for it
if it's all coming down.
I say let's speak it
let's fight it
let's right it
there's nothing to hold on to
if it's already gone.
They left it to us.
It sucks but it's true.
It's you and me baby.

attack of the whatifs...

long night last night thinking about the whatifs. unfortunately, some nights i am unable to shut my thinker off. ugh! anyway, it made me think of a poem from my childhood and i thought i would share.

Whatif by Shel Silverstein

Last night, while I lay thinking here,
some Whatifs crawled inside my ear
and pranced and partied all night long
and sang their same old Whatif song:
Whatif I'm dumb in school?
Whatif they've closed the swimming pool?
Whatif I get beat up?
Whatif there's poison in my cup?
Whatif I start to cry?
Whatif I get sick and die?
Whatif I flunk that test?
Whatif green hair grows on my chest?
Whatif nobody likes me?
Whatif a bolt of lightning strikes me?
Whatif I don't grow tall?
Whatif my head starts getting smaller?
Whatif the fish won't bite?
Whatif the wind tears up my kite?
Whatif they start a war?
Whatif my parents get divorced?
Whatif the bus is late?
Whatif my teeth don't grow in straight?
Whatif I tear my pants?
Whatif I never learn to dance?
Everything seems well, and then
the nighttime Whatifs strike again!

t minus four weeks

well, it's official, we have an appointment! exactly four weeks from today we go see dr. brabec about getting the in vitro fertilization process started! whoo whoo! i realize to some it may seem odd to be so thrilled about having to go through in vitro, but i think after all we have been through in the past couple of months and fearing the possibility that there would be no possibility, we are just stoked to have a shot at a baby of our own. i know everyone has a lot of questions/concerns about the process as do we, but i just can't tell you anything for sure about time frame/procedure until we meet with the doctor. believe me, i wish i could!

josh is recovering well from his biopsy, in fact the stitches are almost gone. of course we have already started bickering about names, baby room decor, etc. but it is so nice to talk about having a child without so much stress and anxiety tied to it. we are relishing in the excitement now because we know in a month things are going to get real again. we found out that josh might have to give me the hormone injections, it just depends on the clinic. i will tell you, he is far more excited about the possibility than i am.

on another note, i had my semi-annual melanoma check up today and all is well. i am officially two years cancer free which feels awesome. after five years the chances of it recurring decreases dramatically so two down, three more to go! speaking of cancer, terrible, nasty, awful, disgusting cancer, i would like to make mention of a very dear friend who's father is now battling cancer for the second time. i can't even begin to understand why this terrible thing has happened to such a wonderful family, not only once, but twice. what i do know, is that they are strong beyond their own comprehension and will get through it whatever the outcome may be.

anyway, just wanted to get this out there to anyone who might be paying attention:) i will try to make a post on march 3rd after our appointment but it might be the 4th before i get to it. the avett brothers are playing in columbia and i think josh and i are going to try to go. we think it is a good sign they are playing on our big day!

one more thing...just want to say, cause i probably don't do so enough, that we are so grateful for everyone's support. it is because of our friends and family that we are able to get through these trying times. our cup runeth over...