Sunday, 30 June 2013

6dp3dt - Hope is transient

I woke up bright and happy to see my TCM doctor on 4dp3dt.  Relished any chance of getting out of the house, especially now that I am feeling a lot better.  She shared bad news that 胎不稳,不是很好。 It seems that the embryos are not holding up very well and she advised more rest.  She prescribed cordyceps, eucommia bark and other herbs, mainly to 按胎。

Her words kept ringing in my head non-stop.  And I was a little in shock.  Deep down, I feared the worst.  Everything seems to tell me to prepare myself for the imminent.  My OHSS symptoms have gotten better (which is supposed to worsen if implantation was successful).  I am starting to feel menstrual-like cramps.  My bust feeling a little tender which is a sign that my period is coming.

I tried to rest more, prayed more, distract myself more.  Now the days feel long again, though for a different set of reasons.  After resting for a day, I decided to throw caution to the wind and we went out the next 2 days.  At least it kept my mind busy.

Backaches seemed to have crept up on me as well and I drank a huge cup of lemongrass tea.  It usually hits the spot for me.  And I just learnt that lemongrass may induce miscarriage.  BIG oopsie for me.  I immediately contacted my TCM doc.  Well, she advised me to have black chicken soup with eucommia bark.  Honestly, I did feel a lack of support from the hospital.  On reflection, it would be good for them to have scheduled a visit during 2ww, especially when I had OHSS symptoms.  This would really have helped.

Reflecting on the last 6 days since the Egg Transfer, I find that Hope is something really transient.  Sometimes I feels that Hope is all around me, giving me strength to face the adversaries.  Yet Hope can vanish equally fast into the darkness, plunging me into the realms of my nightmare.  I am also conscious that Hope in its extreme, can blind me to all the realities and I only see what I want, ignoring the truth.  That is just me, being a little melancholic.  Or just the hormones talking.  No matter what the struggles are, I will continue grasping tightly to my hope; however tiny however small.

Thursday, 27 June 2013

Appetite after Egg Transfer

Since young, I am a big fan of meals.  To me, life is about eating.  I love to indulge in a nice meal when I am happy.  I must indulge in a nice meal when I am sad.  I would indulge in a nice meal when I am stressed.  Give me any reason to have nice food.  To beat the Monday blues, my colleagues and I will have lunch in a simple restuarant instead of hawker fare.  To welcome the weekend, Friday lunches could be at a nice place also.  Nice meals are not expensive fine dining, it just have to be nice.  Food that I like!

I used to tell my hubby.  It is easy to keep me contented - 吃足长乐 - which means I am always happy when I can get my food.  My hubby is just opposite.  He eats to live.  He can eat the same meal every day as long as it fills his tummy.  On the contrary, nice food is what I live for. 

Since Egg Transfer (ET), I have an appetite of a baby.  Because of the bloatedness and nausea, I could not stomach anything more than half a small bowl of food for each meal.  I have this for breakfast, lunch and dinner.  This is the most I could do. 

Some may think, well at least you will lose weight.  I wish.  Instead, I have put on weight because of the bloatedness.  Thought about it for very long whether to pose this compromising photo, but decided to go ahead.  This is how bloated I am - looks like a mid-term pregnancy.  It is all liquid inside; hard and hurts when you press.


Luckily, nausea has reduced and appetite has resumed a little since 2dp3dt.  Tummy is still as bloated and I still can't handle anything more than half a tiny bowl of macaroni.  But I do feel hungry every 3 hours now and I have progressed to eating 5 bowls at macaroni in a day - breakfast, brunch, lunch, tea and dinner.  I do feel hungry and want to eat, it just that there isn't any space for it.

Hopefully, really hopefully, I will get to enjoy my love for food once again =)

Wednesday, 26 June 2013

Summary of Stimulation Phrase and Symptoms After Egg Retrieval

Summary of Condition:
I am turning 33 years old with irregular periods.  Diagnosed with PCOS.  Have been trying to conceive naturally for 5 years.  Tried TCM for the last 18months.  Husband sperm is generally ok, with slight sperm morphology but no big concerns at all.

Tables below summarises the treatment plan during stimulation phrase and the symptoms that arose after Egg Retrieval:
 

Outcome of Egg Fertilization on Day 3:
  1. 23 eggs retrieved
  2. 9 eggs ripe and suitable for fertilization.
  3. 2 eggs successful fertilized - One is a compacting embryo while the other is a grade 2.
Both eggs were transferred on Day 3.

2dp3dt

The gastric attacks the night before steeled my resolve to visit my TCM doctor yesterday.  She prescribed me some medicine to balance the acidity in my stomach.  I also decided to try this whey protein, Immunocal which came highly recommended by the people in the forums.

So what is the outcome of 3 packs of chinese medicine + 3 packs of Immunocal + a family prayer?
I woke up this morning feeling still bloated.  My tummy was still huge and hard.  BUT I was able to sleep on my side without wanting to burp or puke.  I did wake up whenever I wanted to toss and turn.  But I did get better sleep.  And there was also no gastric attacks, which I was very thankful for.

So I am more refreshed.  Each step is still painful for me; I still wobbly like a duck.  But at least there were some relief, and mentally a little stronger and positive.  I did, however, come down with a sore throat though.  It is still the morning of 3dp3dt and everything feels tad much better already.  Hooray and I give thanks to the Lord for putting his helping hand on me!


Bad sleep after Egg Retrieval

Not sure if it is a coincidence, but I haven't had a good night's sleep until Egg Retrieval on Day 12.  It had been 3 nights. The first 2 nights were plagued with nightmares and morbid images of coffin, dead people imprinted in my mind.

Subsequently, suffering the symptoms of Ovarian Hyperstimulation Syndrome (OHSS) was really no joke.  This is what I feel all the time throughout the day, which will worsen in the night.
  1. Constant bloatedness.  It felt like I swallowed a whole giant watermelon - big and hard.
  2. Nausea and puking.  I couldn't lie down or lean back on a chair.  Even messaging on the phone made me giddy.
  3. Lower abdominal cramps.  Every step I wake was a torture.  I walked at the speed of a tortoise, wobbling side by side like a duck. 
  4. Sharp gastric attack.  This comes and goes.  When it does, all you can is to bend over and hug your tummy until the pain subsides.
  5. Lack of appetite.  I was constantly full.  Every drop of water or morsel of food makes me feel as if my tummy was going to explode
  6. Backache.  Feels like my bones are breaking from inside.
  7. Shortness of breath.  Possibly caused by the weight of the bloating tummy, I would feel short of breath.  Nothing painful, just that I would have to take more breaths to finish 1 sentence.
  8. Lack of sleep.  The above symptoms worsen at night.  I could also try to sleep sitting upright, but when the pain suddenly kick in, I am helpless once again just waiting for the pain to subside.

On the 3rd night, I kept burping and there was a burning sensation up my throat when I burp.   I tried to lie down but it would trigger the burping.  So I resorted to napping while sitting down.  The night felt like eternity.  It was such a delight to see the skies brightening. It brought hope to my discomfort. Like I was not alone anymore.

On the 4th night, I felt so bloated that I could not even lie down.  And it made me even more breathless.  That was not the worst.  I started to have gastric and nausea again and it kept me awake most of the time.  I eventually puked til all the bile juice came out.  It gave me a respite and a nap of about 1 hour before I was suddenly jolted up with a sharp gastric pain.  It was so painful that I couldn't stand up.  I managed to stumble my way to the toilet and somehow peeing managed to relieve the pain.  Seriously, I would have rushed myself to the hospital at that point.
 
Fingers crossed that I would have a better sleep soon.

Day 15 aka Egg Transfer (0dp3dt)

A bit of update on yesterday symptoms before I touch on Egg Transplant. I started to bloat and tummy was as hard and round as a watermelon.  Gastric was gone but still cramping at the lower abdominal area. A visit to the church resulted in spotting and I spent the whole day in bed subsequently. Luckily the spotting subsided.

At the hospital, I described my symptoms to the nurses. I was warned that I might not be able to have my Egg Transfer.  Blood test was done and after 90minutes, we went to meet my doc. While it was not mentioned, it was clear that I had OHSS (Ovarian Hyperstimulation Syndrome) and going ahead with Egg Transfer may worsen the symptoms.

My doc only asked me 2 questions: Can I drink? Can I pee? Since I am able to do both, he proceeded with the Egg Transfer. I think I understood his intentions subsequently though he didn't elaborate on it.

A total of 23 eggs were retrieved,  9 were ripe and able to be fertilised. Of the 9 eggs, 4 were successful in being embryos but 2 had abnormalities, leaving only 2 suitable eggs for implant. And of these 2 suitable embryos, 1 was growing normally while another 1 was slower at grade 2 on Day 3 of cultivation.  But given my limited choice, a grade 2 embryo is equally precious.

Why I had to go ahead despite OHSS? I am guessing is that the alternative would be to freeze the embryos for the next cycle. However they may not survive the freezing and unfreezing. And I could be left with no embryos.  So it was quite clear for me. I got to survive the OHSS symptoms, no matter how hard it would be.

Today is 0dp3dt which means 0 day past 3 day transfer. Below is the photo of my embryos. I named the right one Cayenne and the left one Cayman. Both are models of Porsche cars so that they will be blessed with the power to zoom ahead and grow at astounding speed. Also the names also hint of twins - my secret wish to have a boy and a girl.

So today is the start of 2 week wait (2ww) but honestly, I am feeling absolutely terrible. Bits of gastric, abdominal pain when I walk, bloatedness that is robbing my smile, a nagging constant feeling of wanting to vomit and my nemesis - the aching backpain that is slowly creeping in.  It is going to be a loooooong night.....

Saturday, 22 June 2013

IVF Day 13

Seems to be a long time since my last post.  The last few days have been quite hectic - possibly something that every working women undergoing IVF would have to go through.

A blood test was done on the morning of Day 10 before I could go back in the evening for the trigger jab.  Honestly, it was quite a painful jab.  For me, it really hurt from the moment the needle went in until the whole jab was done.  The 'bruised' feeling lasted throughout the Day 11 e.g. when sitting down or tossing and turning in bed.

Day 11 was a whirlwind - trying my best to handover my work as I would be hospitalisation leave for at least 17 days.

Finally, Egg Retrieval on Day 12.  Honestly, I really didn't know what I was getting myself into.  Hahaha!  Reported at the hospital real early at 730am.  Waited in the recovery lounge for my name to be called.  Family members were not allowed in the recovery lounge.  So it was just me, lonely and scared.  First call for my name was for the insertion of the plug on my hand to facilitate the injections and drip later on.  In full honesty, it was painful.  Until now, my hand is still feeling a little bruised.

Second call for my name was to enter into the operating theatre.  There was a bed in the middle of a big room with many round lights above the bed.  I was told to wait there for my doctor.  Nurses were around but the wait felt like eternity.

Another thing that scared me - while I was supposed to be sedated for Egg Retrieval, it is not a heavy dose of medicine.  So I was told that I might still hear conversations and feel some discomfort.  Luckily, I was completely knocked out for the next 10 mins during the operation.  I started to regain my conscious as the nurses wheeled me out of the operating theatre.  Good news - I didn't feel any pain or discomfort.  Got to lie there for about 2 hours with a drip and constant monitoring of blood pressure before the nurses came with a cup of milo.

There were some spotting below but nurses explained that it was normal.  Hubby came to fetch me and off we went for a delicious lunch.  After all, I was super hungry after a 12-hr no food no drink fast. And I was totally oblivious on what was coming!

About 6hours after the operation, I started to feel lower abdominal cramps.  Then gastric hit me.  By evening, I could only prawn in bed.

Symptoms have subsided a little today.  But I still have to prawn in bed.  Taking 1 step is still painful - as if each step causes the womb to wobble.  Hoping that it would be better tomorrow.

For those curious folks out there, a total of 23 eggs were retrieved.  Egg Transplant is arranged on Day 3 as Day 2 is a weekend =P  Before Egg Transplant, got to let the nurse suck some blood from me to test for Ovarian Hyper Stimulation Syndrome.

Tuesday, 18 June 2013

IVF Day 9

This can be quite a roller coaster experience, which I am trying my best to enjoy the ride and not sweat too much about it.  Today is Day 9 and I am back at the hospital waiting for my scan.  I was initially hopeful that I could have my Egg Retrieval on Thursday! 

However, the scan showed that my follicles are kinda growing slower than expected.  Today, lining is 11mm and there are 20 follicles ranging from 9-17mm.  Growth was only 1mm in a day.  Out of the 20 follicles, only 2 of them were above 16mm and ready for retrieval.

Doc had quite a dilemma - Should he arrange for Egg Retrieval on Thursday?  Should he extend stimulation by 1 more day and if yes, at what dosage of Puregon.  Eventually, it was decided:
  • Today Day 9 - I get a jab of 200units of Puregon
  • Tomorrow Day 10 - I would be back at the hospital for a blood test in the morning and the trigger shot at night. Time of trigger - not confirmed yet.
  • Egg Retrieval on Day 12 with Egg Transfer 3 days later
Updating the table, it now looks like this:



Monday, 17 June 2013

IVF Day 8

Today's scan gave us good news.  My follicles are reacting well to the increased dose of Puregon.  Lining is 11.5mm and there are about 18 follicles ranging from 8-16mm.  The doctor is estimating that the egg retrieval would be on Thursday or Friday.  Another scan is scheduled for tomorrow!  Fingers crossed!

Sunday, 16 June 2013

IVF and TCM

We were knocking on doors of various TCM doctors but none were able to help us conceive naturally.  In any case, my current TCM doctor, who came strongly recommended by my mother, is a family doctor for one of her close friends.  If I had learn 1 thing from my 3 years of seeking help from various TCM doctors, it would be to just follow what your parents recommend.  If not, they will keep buzzing the same message -  your current TCM doctor is not good.  I eventually relented and now everyone has a peace of mind.

But having said that, I do click very well with my current TCM doctor.  Every visit had been a breeze for the last 10 months.  I get medicine in individual packs of powder - 2 packs a day.  Acupuncture is administered occasionally (about 3-4 times in 1 month) during key periods e.g. to encourage ovulation or regularise my period.

The TCM treatment during my IVF treatment - quite routine like previous visits.  I was given medicine before my period.  No medicine during the period and started another set of medicine once period stops.  The table below summaries the current plan:



IVF Day 6

We got up real early to be at the hospital for the scan.  Deep down, I was hoping for good news that things were better than expected and we could possibly shorten the stimulation.  The scan showed that lining was 8.5mm with 14 follicles ranging from 5-12mm.

Unfortunately the doc said that the growth of the follicles had slowed down significantly.  Puregon would have to be increased from 150units to 200units.  Next scan would be on Day 8.  Kinda sad to hear this news, but we are comforted that there is still progress.  Heehee!

IVF Day 4

After 3 days of puregon, we went back for a scan on Day 4. It was quite silly that I had to empty my bladder just before the scan and was told to load up on water right after. That is because I had to do an ovulation test in the next 30mins before I see the doc. And so I downed 5 cups of water and waited.

Never been happier to pee. Hahaha! The doc on duty shared that there were 10 follicles (5-10mm). Not too sure if this is considered good, bad or average. But my gynae did warn us earlier - these numbers mean nothing in our case. That's cos I have PCOS and even with a substantial number of follicles, many could be just empty without eggs. And people with PCOS tend not have good fertilization records too.

On a separate note, I did overheard the nurse saying that lining was 5.5mm. Quite worried about lining as I don't have heavy periods. It would be in and over within 3 days. In any case, today - aka day 4 of stimulation - we are going to add on the genirelix injection. So it is going to be 2 injections from today onwards. Can't wait for the next scan on Day 6!

Friday, 14 June 2013

Injections - Puregon

One of the most common questions - how are you feeling? Honestly and luckily, pretty fine. I have a phobia of needles and injections. Good thing that my mother live with us and she is my personal IVF nurse. Generally on a scale of 1-10, the injections possibly rank on the scale of 2-3 depending on which part of the tummy. After the jab, there is a bit of pulling/crampy at the tummy area which takes about 1-2 hours to disappear. I realise that if the injection is done nearer to the belly button, the injection pain is more intense but results in much shorter cramping at the tummy subsequently. Occasionally I would feel a little light-headed as if I am on a cruise ship. Tends to get very sleepy between 4-7pm. And gets hungry easier which results in 2 incidents of gastric within the first 3 days.

IVF Day 1

The feeling is almost surreal. I cannot believe that we have finally started our IVF journey. It was 3 years ago when we first heard the doctor suggest that we do IVF. We fought hard and resisted against it. We tried everything possible - chinese medicine, acupuncture, ovulation strips etc. Three years on, we finally gave in - because age was a better runner than we are. Age has caught up with us. We were put on an antagonist cycle aka short protocol. It was an arduous wait for my period to come and we resorted to taking medicine. It finally came on 8 June. Up bright and early on 11 June, we headed to the hospital and started on first puregon jab at 150units. Honestly, I hate injections. But sometimes we just have to do what we have to do. Until now, I can't say we love kids and we must have kids. I still have reservations about being good parents. But the golden window for IVF is closing on us soon. It was now or never. So here it goes..