13) Surgery & Meds

The journey is officially underway!  I after a little hiccup, I've started meds and am preparing for an embryo transfer in January.






In October I was finally able to have the hysteroscopy and polypectomy.  Wednesday afternoon I had my pre-op appointment with my OB, then arrived bright and early for the surgery the next morning.  I had to arrive two hours before the surgery was scheduled, with nothing to eat or drink after midnight.  Through the week, I had a bit of a cold and the day prior was still pretty congested.  I was worried that because of the anesthesia involved they wouldn’t let me go through with it.  Luckily it wasn’t so bad as to have to postpone, although my anesthesiologist presented it as an option.  Aside from my four pregnancies, I’ve never been admitted to the hospital, so this was a new experience for me.  More so, I’ve never had general anesthesia and was a little nervous about being knocked out.  A couple weeks earlier I had a terrible terrible nightmare about Donald Trump.  I dreamed I was at a political rally while I told him, honestly yet as politely as possible, what I thought about him.  After the rally I went into my bedroom to go into my bathroom, but crouched in the corner was Donald Trump, who leapt out at me, placed his hand over my mouth, and began to throw me on my bed.  I jolted awake, sweating, more scared than I have ever been in my life.  My biggest fear on the day of the surgery was that while knocked out I would have another dream about Donald Trump—while the doctor was grabbing my pussy—and I wouldn’t be able to wake up.

While waiting, I mostly sat around on the hospital bed playing on my phone.  I tried to read my book, but the nurses interrupt so often I wasn’t able to actually focus on it and settled instead on trying to beat my high score in 2048 (currently 15,892).  When it was finally time to go back to the operating room—35 minutes after my scheduled time—I put everything away and they wheeled me back.  The anesthesiologist placed the mask over my face and I was out.  Moments later I woke up, looking at the nurse and asked “are we ready to start?” 

“We’re already done!” she replied. 

Oh.  Apparently it was more like an hour than moments.  So it was that quick and easy, and a couple pea-sized polyps were now removed. 

My recovery was equally as easy.  I spent a couple hours hanging out at the hospital rocking my purple gown, IV, and leg compressors.  There was a little cramping the next day, but not even as much as I have during my regular period. 

                                        

 

Two weeks later I went back to Portland for a follow up appointment.  I was pretty excited to fly up for the day so I could spend five minutes talking with my doctor—three of those minutes on topics not even related to the surgery.  I’m not exactly sure why that appointment couldn’t have been done over the phone—saving me twelve hours and my IFs a few hundred dollars, but it is what it is. 

The following week I was able to have my repeat SIS ultrasound and was so entirely relieved when it showed a nice smooth uterus. 

As we’ve now officially began our journey, I’m starting to think more about the level of communication we’ll have.  This is something that’s talked about prior to matching, and we’ve all agreed for them to be an active part of the pregnancy journey.  However…my first IFs said that as well and the communication was much less than I had anticipated or wanted.  Regardless of preconceived expectations, the communication aspect can be confusing to navigate.  How much is too much?  How much is not enough?  How can you balance needing to be supported while not being clingy?  How can you communicate the unplesentaries without coming off as complaining?  Where is the line between commenting and whining? 

With my own pregnancies, there’s a level of complaining and whining that’s necessary—I mean, here I am growing a baby for our family, while my husband sits there all comfortable like in regular clothes eating unheated lunch meat and drinking a beer.  Complaining is my way of making him suffer along with me.  My favorite phrase when pregnant with my own three was some version of "This is all your fault!"  I can't really use that excuse this time around.  When you’re doing this as a premeditated—not to mention compensated—act, your complaining threshold is minimized.  At the same time, I want to be open an honest about what’s happening with the medications and pregnancy, which is bound to include some level of pain and annoyance. 

My general rule of thumb is this: Were it my own pregnancy, is it something either abnormal or amazing that I would bother my husband with at work—not just wait to talk about it when we were home?  If the answer is yes, then communicate it.  If the answer is no, it's probably not something I need to share.  It should go without saying, this automatically includes any concerns I would communicate with my doctor.

First Trimester examples, based on four prior pregnancies:

·      Throwing up before and possibly after breakfast every day from week 6 to week 12: Normal, don’t communicate unless asked.

·      Throwing up dinner more than three times a week during week 9 to 12, or not being able to keep down anything at all for longer than two days: Abnormal, may need stronger interventions, communicate.

·      Not throwing up all day even with three full meals for the first time in six weeks: Amazing!  Communicate!

*Side note, J& A, if you’re reading this, now is the time to tell me that’s too much and to never communicate any information regarding vomit at all, ever. 

A few weeks ago I received a box of meds—a huge box of meds—which I promptly opened, verified, checked expiration dates of, and sorted into drawers and a tackle box.

           

I had planned on using a make-up organizing box, but while browsing Sportsmans Warehouse one afternoon with my husband, I saw a selection of children’s tackle boxes; basically the same thing I’d looked at in make-up boxes, but at one third of the price.  So now my weekly meds are stored in a lovely Frozen Tackle Box (which my daughters have claimed as their own as soon as I’m done) with the overflow in small plastic three-drawer organizer. 

          

The way a normal cycle works is that a woman’s body releases an egg which then travels down the fallopian tube looking to be fertilized.  Meanwhile, the uterine lining is building itself up all fluffy-like.  If the egg is fertilized, it attempts to attach itself to the nice thick uterine lining—finding difficulty in doing so if the lining is thin.  If the egg isn’t fertilized, the uterine lining is shed a la menses.  The med protocol I have includes birth control for a period, Lupron, delestrogen, and progesterone.  The purpose of the birth control is to manipulate your cycle to be able to know exactly where you are, since although the standard is a 28 day cycle, every woman is different, and even within one woman’s cycle there are variations.  The Lupron suppresses your ovaries from producing eggs because, although the purpose is to get pregnant, it’s not to get pregnant with your own.  But, since your ovaries aren’t doing their normal job, you have to artificially produce the other hormones you’ve told your body not to produce and do the things you’ve told it not to do—like build up the uterine lining for the embryo to nestle into. 

Good thing about this particular med protocol:

1)   It eases you into the meds.  Birth control pill, then add Lupron every day—a tiny needle injected into the stomach—then stop BCP, then add delestrogen—an intermuscular shot given with a two-inch needle in the butt—two days a week, then stop Lupron and add progesterone—another IM shot given with a two-inch needle in the butt—every day, then eventually add progesterone suppositories—tablets inserted vaginally three times daily. 

2)   Nightly meds is a family affair.  My middle daughter wants to be a doctor and all three of them get in on helping give me shots, pushing in the syringe and pulling out the needle.  Even two weeks in, every time we do a shot my three-year-old says “Now do you have a baby in your tummy?”  The first time my five-year-old replied, “No, silly.  This just gets her ready for the baby.  Then they take a little tiny baby and put it in her uterus.  I guess they like, cut open her tummy and put it in there or something.”  I proceeded to explain how the embryo is transferred into the uterus through the cervix (no cutting necessary, thankfully!), and love that my children are learning the biology of how babies are made. 

Right: Lupron needle goes in the stomach.
Left: Delstrogen needles.  Pink is to draw out the medicine, blue is inserted into the butt muscle.

Bad things about this particular med protocol:

1)   You’re surging your body with hormones with huge needles shoved in your ass. Even on my second journey and knowing it’s not that painful, I still wince every time I look at one of those needles.  While the shot itself doesn’t hurt very much, the muscle soreness that follows can be terrible.  Twice a week isn’t too bad.  You put on a heating pad right after and by the next morning it’s just a little tenderness.  But when you do it Every. Single. Day.  the muscle pain can become increasingly unbearable. 

2)   No alcohol and no sexual activity.  I don’t really drink very often, and with full time jobs and three kids, my husband and I probably engage in sexual activities less often than the average married couple.  But there’s something about being told you can’t drink and you can’t have sex that makes you really want to drink and have sex.  I’ve now stopped BCP—which in itself is a natural birth control by making just the idea of sex absolutely repulsive—and I actually want have sex but I can’t.  My instructions were unclear last time and I was only informed to not have intercourse, but allowed other activities.  This time it was made very clear that there is No Sexual Activity At All.  Nothing.  My only saving grace is thinking how awesome it’s going to be when we’re finally given the go-ahead again.  Meanwhile, my IFs are posting pictures of the festive drinks they’re making for Christmas and I’m over here bringing sparkling cider to my staff party, coming home to a kid-free house to…watch This is Us, I guess.

3)   Progesterone tablets.  Inserted into the vagina.  Three times a day.  These pills dissolve into the vagina wall.  Except what doesn’t which then leaks all over.  Which is why you invest in some classic Hanes briefs and panty liners.  Side note: if you are one of the lucky ones who is still allowed to engage in sexual activity while on meds and are resorting to more creative means because you can’t have intercourse, please take note of the disgusting taste of these tablets.  And no, it doesn’t matter if you took it in the morning and are waiting until after canoodling to insert the second dose.  It’s still disgusting. 

Meds is easily the worst part of this entire process.  Which of course makes the end result all the more amazing.  Next up: embryo transfer and the agonizing decision all surrogates and IPs must make: to take a home pregnancy test or not??