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That first needle

February 8, 2012

Finally, in February 2010, we were ready to go! We were thrilled to have been matched with our perfect donor and in awe of her generosity and kindness. Now, we had to begin the process of “synching” to each other. The process for a donor is similar to what most women follow during IVF treatments; the process for the recipient birth mother is to be controlled hormonally to be ready to be implanted with the fertilized embryo or embryos at the right moment.

To learn about the process, I had to attend a session with the R.N. at CRWC who oversees the recipients from this point forward. Enter “Nurse X,” who I won’t identify any further to spare her embarrassment or hurt feelings. She was an extremely capable nurse, and I have no complaints about her professionally except to say that she is my least favorite type of medical professional–a giggler. No matter what I asked her, no matter how serious and sincere, she giggled her response. For example, as she taught us (another recipient was in this session with me) how to inject ourselves every night, I asked her about air bubbles in the syringe and if that could cause problems. She giggled and said, “Yes, of course, that would cause a big problem, tee hee hee heee heeeeeeee.” Of course, it was obviously just a nervous tic on her part, or maybe she really does get a huge kick out of pulmonary embolism? I’ve never figured it out.

Nurse X was also very, very pretty and quite stylish. While all the other nurses, doctors, and technicians wore scrubs, she wore a white lab coat open over a series of stunning outfits complete with what looked like Manohlos or similar spike heels. I’ve been told by other nurses I know that you can “spot” these two distinct types: the nurses who do all the work and the are nurses who walk around with the charts looking important. I pegged Nurse X as a chart walker. Over the course of the nearly year I spent in this part of the process, I was to get to know Nurse X fairly well, and I realize now that I transferred a lot of my frustrations (rather unfairly) onto her. But sometimes she just pissed me off so much I wanted to reach across the table and smack the giggle out of her. Then again, it might have been the hormones.

During this session I learned that in order to get the donor and me in “sync,” we would first have to inject ourselves with a drug called Lupron which, quite counter-intuitively, induces menopause. The side effects include all the classic side effects of menopause: hot flashes, mood swings, weight gain, and headaches. As a 49-year-old woman, this didn’t sound too much different than just your average day to me. For the 20-something donor, this must really be daunting and gross.

Once the injections begin (on a precise date determined by a blood test done at 7:30 in the morning on a specific date), the donor and I (separately, never at the same time or in the same area of the clinic) would come in for morning blood work to monitor our progress. Also, at these morning sessions, I would have a internal pelvic sonogram to monitor my ovaries for cysts. As far as the donor’s process, I’m not as familiar with her daily and weekly routines. After almost 3 weeks, the Lupron injections are tapered off and I would start taking estrogen and then later progesterone. The donor would begin injecting hormones to make her ovulate while I would be kept in this “holding pattern” of getting ready to receive the embryo.

Once the donor was ready to ovulate, D’s part of the process would start. I’ll spare everyone the silly obvious jokes, we’ve all seen the sitcoms, and yes, ejaculation is funny, but let’s try to be adults about it. Apparently everyone at CWRC feels the same way, because we were given a list of instructions for D’s appointment. He was to show up at the appointed time, he was to approach the desk and tell the receptionist that he was there for “sperm retrieval for fertilization,” he was NOT to make any jokes or try to engage anyone in any further conversation. Additionally, to protect the donor’s identity, I had to agree not to accompany him to the appointment. The donor would be in the building at the same time in an operating room on another floor having the eggs retrieved, but if you really wanted to violate the rules and try to discover your donor’s identity, this would be your opportunity.

During the session, Nurse X gave us syringes and saline solution in a vial to practice with. We had to learn how to draw the Lupron into the syringe, and we talked through the injection procedure. I immediately tried to imitate all the shows I’ve ever watched on TV and Nurse X giggled and guffawed and tee-hee’d at me each time I drew a barrel full of air bubbles. Hilarious! At the end of the session I asked her what to do if something went wrong. She wanted to know what I thought could possibly go wrong. I don’t know, could I break a needle off in my thigh? Could I pump myself full of air bubbles and die? (Again, hypochondriac meets the tiniest little bit of knowledge, but come on, these are legitimate concerns, right?) Nurse X laughed and laughed until I was ready to reach across the table and hit her in the neck with my bubbly syringe full of saline. All she had to tell me was that in her experience, everyone is able to handle these injections pretty easily. That’s all I needed to hear.

Now off to buy the hormones. There was only one pharmacy near me on the whole island of Manhattan that carried the Lupron and everything else needed. The pharmacist and the assistant there were lovely; they obviously could tell from the prescriptions what I undertaking, and they both wished me luck. Of course, my insurance company balked at paying for the Lupron ($400 for a two week supply), so I paid for it on a credit card and decided to fight it out with them later. I was just so anxious to get started, and nothing was going to bring me down.

Armed with my kit of hormones, syringes, and pills, I had nothing to do now but wait for a phone call from Nurse X telling me it was time to start the injections. That call came in early March 2010. That night, any time between 4pm and midnight, I was to give myself the first 20 units of Lupron, and I was to do this at roughly the same time every night for about 3 weeks. Have I mentioned that along with being a hypochondriac, I’m also a pretty big coward? This needle we are talking about, it’s the same tiny little needle used by diabetic children to give themselves insulin a few times every day. I only had to jab myself once a day for a very finite length of time. I would not have to get the awful and painful progestone injections, either. The donors do, but the recipients are allowed to take the progesterone orally or by inserting the pill vaginally. Those progesterone injections, I’ve heard, are the worst, and I was going to be spared that part. Still, I put off the injection all night until about 10pm, and then I knew I had to get it over with. D sat next to me the whole time, and I admit, I was crying. I wasn’t afraid of the jab itself, but I really was afraid of doing something wrong like injecting myself with an air bubble. D rubbed my back as I decided which thigh to jab first (you alternate every night, or you can jab yourself in the abdomen, but that did not appeal to me at all) and finally I worked up the nerve and injected myself. The needle honestly hurt a little, but nothing I coudn’t handle. But, I spent the next hour waiting for the crushing chest pain that would indicate the air bubbles had hit my heart or lungs…….dramatic much? It never happened, of course and thank goodness. I kept telling myslelf, another 4 to 5 weeks of injections and pills, and we’d be pregnant!

Next time: Just when we thought this was going to be a breeze……

From → IVF Treatments

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