Spring in Seattle

Dave says: Spring has come early to Seattle which is a good thing. We've seen temperatures in the 50s pretty consistently and a decent number of sunny days in the last two weeks. A number of trees and flowers are already in bloom here. Last weekend, we hit the trails with Chris, Keith, Sarah, and Pauline. It was a nice day on Duthie/Grand Ridge with only a little mud.

On the final Saturday in February, we woke up on a crisp sunny morning and made it out for our first "big" hike of the season up Mailbox Peak. We went up the old trail and down the new trail which is a great way to do it because the old trail is crazy steep and gets you to the top in half the distance but might not be as fun going down. On the way up we gained 4,000 ft. of elevation in just 3 miles. Alisha still likes to put the hurt on going uphill! We hit the snow line near the top and ascended through boulders in some pretty fresh powder to reach the famous mailbox at the top along with 360 degree views. On Sunday, we rode the HT29s around Lake Union for an easy spin and it was beautiful. It has been a busy couple of weeks at the university and I just gave a presentation to the faculty on Friday but now the quarter is almost at an end. I've really enjoyed teaching but I'm also looking forward to the break.

IVF Part 3: Waiting

Alisha says:
Friday, February 13, 2015

Now we are just in the another waiting time in which I have been on birth control for a few weeks while my body recovers and then I will be taken off them and will start a new set of injections in order to grow the endometrium lining for the transfer. My new box of meds/injections arrived and this time the shots are delestrogen and progesterone in oil and have to be given intramuscular (in the muscle)in the back of the hip area which requires a much bigger and longer needle that I had to use for the stimulating medications. The needles are  1 ½ inch long and are a little intimidating. I had injection training yesterday at the clinic, they said that you can give them yourself but it is easier if someone else does so we will see if I can talk Dave into doing it, he wasn’t too excited about the idea. After that I had to have another saline sonogram to make sure that no cysts or polyps had developed in the uterus. It is a simple procedure but they had a hard time feeding the catheter in and it ended up taking almost an hour and several attempts. Eventually they even had to use a tenaculum. Because of the trouble they had with the SHG they decided that it would be best to do a mock transfer to figure things out before the actual transfer.  The mock transfer was scheduled for the next day so back to the clinic I went, luckily it went smoothly and they have some notes and measurements for when they do the real embryo transfer.

February, 25, 2015

Yesterday we had a meeting with Dr. Johnson to discuss some lab results. Because I have technically had two miscarriages I had to get a panel of blood tests done to see if a blood lipid thing could be part of the problem. My results came back border line for one of the lipid and usually the treatment is to be on injections of heparin two times a day for the first trimester. I wasn’t sure if this was something that I wanted to do since the result was only border line and after a good discussion Dr. Johnson left the decision up to us and we decided that we are not going to use heparin this time.

 That night I was supposed to begin my delestrogen injections so while I was at the clinic I had them draw some target circles on my backside for where to aim. I decided that I would give myself the injections and spare Dave the experience. I thought I would be totally brave and just be able to do it but I have to admit that it was a little intimidating. I drew up the injection and then just stared at the needle thinking that it was big. I had to psyche myself up and then I just did it and the actual injection really wasn’t that bad. It made me a little sore but not too bad. I have to give this injection every third day up until the transfer when I will stop these shots and switch to progesterone injections which I hear really do make your derriere sore.

More meds to get ready for the transfer/post transfer. I ended up giving myself at least 115 injections and going through 22 vials of progesterone.

Going Underground

Alisha says:  When I looked at the extended forecast on February 1st all it showed was straight rain for the next 10 days. So the first week of February was a little rough for us. Still wanting to do something fun on Saturday we decided that a great rainy day activity would be to use a groupon that I had purchased for a Beneath the Streets Tour of the historic part of downtown Seattle. We learned some interesting history of Seattle and go to go to a few of the underground areas.

Here is a brief recap:
Seattle was originally built on a tidal mud flat and buildings were made out of wood. What this meant for the city was that twice a day the tide would come in and cause problems with flooding and the sewage. In 1889 there was a great fire where 31 blocks of the city burned. When starting to rebuild the city it was decided that in order to try to fix the tide/flooding problem they would raise the streets, all new buildings had to be constructed of fire safe materials and at least three stories tall. A retaining wall would be build surrounding each city block and then the place where the street was would be filled with dirt. Once the streets were filled with dirt a new sidewalk would be built and what used to be the 2nd floor of the buildings was now the entry level. For a time before the new sidewalks were built that were level with the new street you would exit a building by the original 1st floor, be greeted by a big retaining wall on which the new street rested, walk to the corner, climb up a 12-30 foot ladder, cross the street and climb down another ladder. Not one person died in the big fire but apparently several died and lots were injured using the ladders.

Once the new sidewalks were built the now underground levels went through several stages where they played host to many shady dealings before they were eventually condemned. Some of the underground areas have been restored and are in use and others look terrible. It was neat to see the pieces of old glass that worked as skylights.

The underground, the current sidewalk is on top of the ceiling

The original sky lights that you can still see if you walk around

 This is what the skylights look like from underground

 After our tour we went and checked out West Seattle and Alki Beach. You get a great view of the Seattle skyline across the water. And the fun day continued in the evening with a session at the climbing gym and dinner with Sarah and Chris.

John Wayne Rail Trail

Alisha says: Today we took our hard tail 29 mountain bikes and rode them on the John Wayne rail trail off of I-90. It was a cool but clear day and we had a really enjoyable time riding on the trail past waterfalls and over trestles.

As an athlete at Southern Utah University we traveled to compete at the Husky Invitational Indoor track meet in Seattle a few times so I looked up the accepted entries to the meet and sure enough there was once again going to be a contingent of SUU athletes attending. Dave and I walked down to the meet from our house and I looked around for Coach Houle until I found him and then I casually walked past to see if he would recognize or notice me. Luckily he did and was surprised to see me because he didn't know I was living in Seattle. Coach Houle is so great and it was really fun to catch up and reminisce about my college days.

IVF Part 2: Egg Retrieval

Alisha says: My egg retrieval surgery was scheduled for Tuesday, January 20^th in the afternoon so in order to pass some time we went for a little walk at Magnusun Park. I had checked traffic and had planned out the time that we needed to leave but as we got in the car to go it wouldn’t start. I got super anxious and couldn’t believe that this was the time that the car battery decided to die. Dave as usual stayed very calm and decided to put the car in neutral and back it out of the driveway so that we could access the other car. Thankfully we have two. The problem with parking on our street is that it is only two hour parking and so I was sure that we were going to get a ticket while we were away. Dave wrote a note about the battery being dead and that we would move it ASAP, left it on the windshield and we hoped for the best.

 

After arriving at the clinic I was taken back and changed into the glamorous gown complete with a hair net and then Doctor Johnson came and talked to us, then the anesthesiologist and finally Jo. Jo is such a great nurse, she really knows her stuff. When it was time she took me into the room where after laying down I got my IV put in. At the time it was just the anesthesiologist and the medical assistant in the room. I asked a few questions then the anesthesiologist said she was going to give me a some medication and I would start to feel like I had had a few drinks, I laughed and said that I didn’t know what that was like because I don’t drink. I vaguely remember a few more people coming in and me trying to lift up my leg, but that’s the end of it. The next thing I know someone was talking to me and it was like I was trying to wake up from a really deep sleep. I felt a little groggy and fought my way to consciousness. The anesthesiologist said that I did great. Then Jo came and checked on me and put an extra blanket on me. By this time Dave was brought back and sat with me while I recovered for a little bit. Dr. Johnson told Dave that they were still counting the eggs but that they were already over 30 and they would let us know the next day how many had fertilized.  I felt really crampy and tired but happy that it was over. After a while I got dressed and Dave helped me out to the car.

Recovery was so much worse that I had anticipated. I had read countless things online that ranged from people going being just fine to much worse but figured I would be fine in a day or so but I was wrong. The first 24 hours were the worst.  My whole abdomen ached and I felt really bloated. It was hard to stand up straight so I sat in the recliner while Dave took great care of me. Whenever I had to get up to use the restroom I almost passed out, a feeling that continued every time I stood up for about two days. The first night sleeping was awful, I could only stay in one position and it hurt to even breathe and the second night I threw up a couple of times.  Over the next few days I slowly improved. We had been invited by Chris and Sarah to go stay the weekend in a cabin by Mt. Baker and do some skiing. I thought about canceling but Dave convinced me that I could just hang out in the cabin and that it would be good to get out so on Friday afternoon they picked us up. My big improvement came the first night at the cabin when I was able to sleep for short periods of time on my stomach. Lucky for me the weather was really rainy on Saturday so they were unable to go skiing and instead we went for a short hike which was a good test for me and I felt mostly good and then relaxed most of the day. By Sunday morning I decided I was feeling good enough to try skiing with everyone and I am so glad that I did, we had a great time and it took my mind off of everything for a little bit.

Backing up a little bit, so the day after the egg retrieval the embryologist called to let us know that they retrieved 37 eggs (that is partly why my recovery was so bad, lots of eggs are good but also means more trauma during surgery.  Average egg retrieval numbers are 8-15), of my 37 eggs 27 were mature enough to try to fertilize. Of the 27, 18 fertilized and that they would continue to monitor their development until day 5/6 when only the ones that had developed into healthy blastocysts would be frozen. Monday afternoon I got the call that I had been waiting for and was very surprised when I was told that we had 14 great looking embryos in the freezer. It is a relief to know that we have a good number to work with as we continue our journey to having a family.

Ski Trip

Dave says: January hasn't been too bad this year in Seattle. We've had a few dark drizzly days (including the last couple of Saturdays) but also some nice days mixed in. The temperatures haven't been too cold either with most days in the mid 40s or 50s. Chris and Sarah invited us up to Mt. Baker for the weekend and we had a great trip. 

We drove up to a rented cabin on Friday evening and cooked some dinner. On Saturday morning, it was raining pretty heavily but we took Chris' Subaru up through some wet roads and a bit of ice to a trailhead for some hiking. We made it several miles but couldn't quite make it to the end due to a creek that had turned into a raging river due to all the rain. The cabin's hot tub was a nice way to relax afterwards and the stove in the cabin worked so well that it was like a sweat lodge in the evening.

The next day, we awoke to sunny skies and warm temperatures that made it feel like "Juneuary." We drove up to Mt. Baker and hit the slopes. The snow was soft and pretty slushy but not too bad although it was definitely getting a bit thin in places. We started with some easy greens but worked our way up to blues and by lunch time were enjoying some of the blacks quite a bit. The views off the top of the mountain were incredible. We also saw a boy who missed getting off the lift get rescued in a half-hour operation that involved us sitting on the chairlift for a long time until he was roped down. Overall, it was a great weekend getaway with some fun friends.

IVF Part 1: Waiting, Miscarriage, IUI, and Finally IVF

Alisha says: Dave and I have wanted to have a baby for several years now. After we didn’t become pregnant after a while I started using clomid to see if that would help. I did get pregnant on clomid but had a blighted ovum and miscarried at eight weeks.  I thought that I would get pregnant soon after the miscarriage but as the months passed, even on increasing doses of clomid and nothing I knew it was time to see someone. When moving to Seattle we knew it was time to see a specialist to get some help. I am so glad that I found the clinic that I did. I choose to go to Overlake Reproductive Health. They have been great, a bit expensive, but great. I have been there so many times that I basically know the name of everyone who works there. My doctor, Dr. Rehman, is really knowledgeable and good at taking his time to get to know you and explain things. The receptionists Melissa and Teesha are awesome; they are always good for a laugh. The medical assistants are great and the two nurses who you actually see the most, Jo and Julie are exceptional.

Overlake Reproductive Health Staff

I had to do a bunch of baseline blood tests, diagnostic blood tests, ultrasounds, HSG, SGH before having a re conference with Dr. Rehman. Basically all of the tests confirmed what I had suspected and that was that I had Poly Cystic Ovarian Syndrome or PCOS. PCOS makes it hard to get pregnant because your hormones are out of balance resulting in many small cysts on the ovaries and not ovulating on a regular basis. Because I had already done many months of clomid cycles and still nothing, we decided to move forward to the next step and try a few rounds of intrauterine insemination or IUI. I was hopeful that this would work for us but after two rounds we were still not pregnant. We actually could have done one more round of IUI but around early December Dave accepted a position at the University of Arizona and we knew that we would then be moving in June. We were anxious to be pregnant before moving and I wanted to hopefully finish the process at Overlake because I had been going there since we moved to Seattle, they had done all my testing, I knew everyone and was comfortable and I didn’t want to have to search for a new fertility clinic in Phoenix and was afraid of the delay that there would be in finding a new clinic and then how long it would take before things got rolling at a new clinic so we made a huge decision and decided to move forward with in vitro fertilization or IVF in January. IVF is an extremely expensive procedure (on top of all that we had already spent) but we both felt good about it. The way that they do it at this clinic it is a three month process from the start to embryo transfer. At this clinic they freeze all of the embryos after egg retrieval and then wait until the next cycle before transferring them back. They are finding that this is safer for both the mom and the baby because they aren’t transferring the embryos directly back after you have used all of the stimulating medications.

Getting ready for IVF is a bit overwhelming. I received a giant box of medication that made me almost cry when I opened it. However my clinic is awesome and they do an injection training where they go through each medication and show you how to use it. They also provide very detailed instructions so that you are giving the right meds in the right dose at the right time.  Friday, January 9^th I gave myself my first injection. Luckily the needles are tiny and it really wasn’t too bad. I did get a few bruises and my stomach was tender around the injection sites.  A typical day was follistim injection in the morning followed in the evening by a menopur injection. After a few days another injection called ganerelix was also given in the evening. The menopur left a stinging/burning sensation that I found was almost eliminated if I iced the area for a few minutes before giving the injection.

Lots of expensive medication

After a few days of injections I began going to the clinic daily for a blood draw/ultrasound so that they could monitor my response to the meds and monitor the development of the eggs. After my second blood draw/ultrasound my estrogen was extremely high and I was responding a little too well to the meds so they cut my already low dose of follistim down even more.  I already know almost everyone at the clinic really well but after going there every day that week I took some cookies to those who had to work on Saturday. At my appointment on Sunday Jo, my nurse/ivf coordinator, said that I was ready to do the ovulation trigger medication and that my retrieval would be scheduled for Tuesday. Because I stimulated so well I was at risk for OHSS so they triggered me for ovulation with a medication called Lupron. It is given in two doses exactly 36 and 24 hours prior to retrieval so my first dose I had to get up and inject at 1:15 am in the morning. Monday I had to go in just for some blood work and then Dave and I went to Snoqualmie to ride our hardtail mountain bikes on a path. We planned to be back to the car in time for me to give my 2^nd trigger injection but I took it with me just in case which turned out to be a good thing. First of all we got rained on really hard for a little bit but then it stopped and we had a nice ride for a while. On the way back to the car I got a flat tire and so there we were on the side of the path with Dave fixing my tire and me giving myself my injection.  I felt pretty good through the stimulation phase, I was worried that all the hormones would make me a crazy person but emotionally I felt fine. Physically, as time went on I began to feel a bit different but generally okay. I still stayed active but just toned it down and listened to my body, I ran the first few days but stopped when the jarring of running became uncomfortable then we did a few bike rides and some walks. In total I gave myself 37 injections, had 11 blood draws (19 vials), 6 ultrasounds and 1 egg retrieval.