The Space Between

Brennen: “You have one whale of a blog post to write.”

Me: “No kidding.”


So I started writing, and I wrote a lot.  There was so much to say and so many updates to give.  As Brennen explained in his blog post, our transfer on November 15th went as smoothly as it could have.  We had a good looking embryo and all my hormone levels were in check.  All that was left to do was wait out the next few days until my first hCG blood test.

Now, for the post-transfer breakdown.

Days 1-5

For the first few days after the transfer, I hung out in a hotel room with my mom in Memphis.  It was miserable.  Not because of my mother, no, but because it was a hotel room. And I was having some pretty intense post-transfer symptoms.  I knew from the day after the transfer that this one was different than Round 1.  I ran a low-grade fever off and on from Wednesday to Saturday and experienced much more cramping than I did after our first transfer.  My hips were also not adjusting well to the progesterone injections either.  They were so sore which is not ideal when you’re basically sitting in a bed all day.  Oddly enough, when we switched to some larger needles from our first transfer, the hip pain got much better.  I never imagined that I would be thrilled to see a larger needle!  After Memphis, we spent the weekend at my parents’ house for some much needed distraction.  And just like that, half of our 10-day wait was over, and by Sunday, I was feeling a little more like myself.

Day 6

One of the first things they tell you is to not take an at-home pregnancy test.  And I promised myself that this time around, I would wait on the blood test.  But Monday morning, before I knew it, I found myself peeing on a stick at 6am.  Brennen claimed he didn’t see anything so he went back to bed, and I hopped in the shower.  When I got out, I saw an ever-so-faint line.  My heart skipped a beat.  I collected myself, hid the test in my make-up bag, and went about the rest of my day.  Well, I tried to at least.  I could not wait to get back home and take another peek at that test.  I blew through the door at 5:00, unzipped the bag, pulled out the test, and said, “Oh, shit!” Not the words I expected to come out of my mouth, but it was a good “Oh shit!”  I was looking at a dark pink line, almost as dark as the control line.  Now, I know there is such a thing as an evaporation line and not to trust a test past a certain amount of time yeah, yeah, yeah.  But I have used my fair share of ovulation test strips and pregnancy tests to know that a line like that doesn’t appear for nothing.  Without a doubt, there was some hCG in my system at 6 days post transfer.  I tested again.  Another pink line – not as dark, but evening urine is much less concentrated than morning urine.  I called Brennen and asked him to meet me at a local mall for their Christmas open house.  I was happy and hopeful and just wanted to spend some time with my husband.  After all, there was a possibility that it would only be just Brennen and me for a few more months.  Once we met up, I showed him the lighter test, the one from that evening.  He said, “Holy crap!” – the PG version of my reaction.  We promised ourselves not to get overly excited and to proceed with cautious optimism. We still had a few days to go until the blood test. We planned to celebrate and distract ourselves by shopping (my idea), but work and the evening’s excitement had exhausted me.  Plus, the cramping was getting to me so much that it hurt to button my pants.  So rather than risk anything by walking around the mall with my pants undone, we went back home.  I rested – husband’s orders.

Then, that night around 9:30 I developed a rash all over my body.  Actually, it’s not fair to call it a rash because it wasn’t raised or bumpy.  It itched but mainly because it made my skin warm.  It was more like my entire body was blushing in splotches.  Lucky for me, Benadryl was safe to take.  It eased the itching AND helped me sleep.

Day 7

I didn’t take a test that morning. Believe it or not! But it’s because I thought I didn’t have any.  So, what did I do after work? I bought some.  I tested when I got home and saw a faint pink line.  I was still feeling pretty good.  This time, I didn’t tell Brennen.  His reaction was so precious in the parking lot of the mall the night before that I wanted to capture it the next time I showed him a pink line.

Day 8

After work, Brennen and I met at my best friend’s house for her to take our Christmas card pictures.  And I figured that while we were there, I would use an extra test she had at her house. Convenient, right?  I also wanted her to capture Brennen’s reaction which she did…beautifully.  There was without a doubt a pink line.  The problem was…it was lighter than the lines I had been seeing.  Brennen chalked it up to a different type of test, a cheaper one; and after Christmas card pictures we grabbed a bite at one of our favorite restaurants to celebrate.  When I told the waiter I would just be having water, I saw Brennen grin.  He was so excited.  But I wasn’t quite there.  I was nervous about the lighter pink line.  He kept telling me to “Be happy,” but when I explained how overwhelmed I was and how I needed to see a blood test before I would let myself get too excited, he understood.  He calls me the pessimist of the relationship.  I’d say I’m more of a realist.  Still, we talked about baby names, grandparent names, and the whole timeline of the pregnancy over dinner.  Like Brennen said, “We’ve talked about this stuff before, but this time it’s real.  How crazy is that!”

Day 9

Happy Thanksgiving!  I took another test that morning.  Still a line! It was light, but it was there!  We coasted through Thanksgiving Day in default mode, unable to really think of anything other than the blood test I would take that night.  Even the turkey wasn’t enough to distract us!  That evening, I had my blood drawn for my first hCG test.  The 20-minute wait for the results was the longest 20 minutes of my life.  We filled the time with talks of Black Friday sales and the food we ate that day.  And finally, a number – 17.87.  It was low, but it was above a 5 which was good!  We FaceTimed Brennen’s parents who squealed with excitement then drove on to my parents’ house.  The rest of the evening was spent sharing the news of our positive with my family members still in town for Thanksgiving.  We weren’t expecting to share so quickly since the number was low and another test was due in 48 hours to verify an increase, but when it’s Thanksgiving and you’re a part of my family, secrets don’t stay secrets for long.  We were excited.  Our families were excited.  And even though there was still doubt in my mind because of the low number and light pink lines, we had never been this far before and shared the news anyway.  Still, the words “I’m pregnant” didn’t quite roll off my tongue.  It didn’t seem real.  I opted for the safer, “We got a positive!”

I held my belly as I went to sleep that night and prayed so hard that our growing embryo would become our baby.

Day 10

I tested again Friday morning before I called the clinic to report my hCG level from the night before. The line was still a light pink, which was worrisome.  The on-call nurse didn’t seem concerned that the number was low.  The most important thing was how it increased over the next few days.  She instructed me to do another hCG test Saturday night, 48 hours from the first.  The rest of the day was a blur, but I’m sure there was some football and leftovers in there somewhere.

Day 11

As if it were a full time job for me now, I peed on a stick that morning.  The line was barely there.  At that point, our moods shifted, and we had this nagging feeling that something wasn’t right.  With nothing else to do except sleep, I crawled back in bed, apologized to God for the things I was about to say, and vented to Him about the unfairness of this all, questioning “Why us?”

By that evening before my blood test, we had accepted that the level had either decreased or showed little change.  Results came back – 19.54.  At that point, we went ahead and let our families know that the pregnancy didn’t seem promising and that the number had not doubled or even come close to doubling over the 48 period as it should have.  We were preparing them, and more so ourselves, for the worst.

Day 12

I didn’t even bother with a urine test.  In fact, the one the morning before would be my last for a while. I  reported my number to the nurse who didn’t seem optimistic but asked me to continue my medications and test again in 48 hours – Monday.  That day I tried to do my best Googling to learn about low, slow-rising hCG levels.  Unfortunately “low” and “slow rising” are pretty vague search terms.  Some message boards had women worried about their 58 hCG.  I read where women were concerned because their hCG hadn’t doubled but had gone from 180 to 300 in 48 hours.  Looking at my report that read 19.54, I thought, “Cry me a river.”  Brennen did his fair share of Googling too, and on the drive home from my parents’ house we found ourselves dwelling on the uncertainties of this transfer and any transfers to come.

Day 13

In a torrential thunderstorm, we made our way to the hospital Monday night for the third blood test.  At this point, we were going through the motions.  We didn’t have much hope for the embryo that was inside of me and figured it was only hanging on because my hormones were being controlled with pills and injections.  To our surprise, we saw the biggest increase we had seen in my hCG level so far – 28.38, about a 40% increase from Saturday.  Still, a 28 at this point was not great, but there was still a shred of hope that we could hang on to. We drove back home in a steady mist of rain, and suddenly, I didn’t want to talk about it anymore. I became angry. I didn’t want to keep spinning our wheels and exhausting ourselves on assumptions.  We didn’t know why my hCG wasn’t rising like it should.  We didn’t know what the doctor would say or do next.  We didn’t know when the next transfer would be or if there would even need to be one.  We just didn’t know.  Then, I remembered something I learned after Round 1.  You have to let go of the things you can’t control.  There was nothing we could control at that point other than progesterone injections and Estrace pills.  Everything else needed to be let go.  So before we crossed the Madison County line, we agreed to do just that.

Day 14

I reported the 28 hCG to the clinic this morning.  The nurse agreed that the level wasn’t rising as it should and wasn’t as high as it should be.  We expected that our doctor would tell us to stop all medications, but we guessed wrong.  My doctor called yesterday evening and told me he wasn’t ready to throw in the towel as long as the hCG was still rising.  He recommended another hCG test the next day and hoped that the 28 would evolve into a 50, or there about.  We chatted for about 30 minutes about my symptoms since the transfer – the fever, the rash, the cramping – and discussed what to do next.  If anything, continuing to measure my hCG may give us some insight into what’s going on and how it could affect the protocol of future transfers.

Day 15

My hCG doubled. Finally! 56! Still low for this stage, but it doubled! What the heck?! That’s really all we can say.  We don’t know what’s going on.  Our emotions are in total limbo.  We’re thrilled with the increase but understand that the number is still low, so we’re guarding ourselves.  I don’t mean for it to sound so crass, but I can’t let myself get too attached just yet.  It’s a defense mechanism…because all of this can be so hard to deal with.

We never expected to be here.  We thought we would have a positive or a negative at this point, not the in-between.  Sunday night as we were lying in bed, I told Brennen, “I never even considered being at this point – the space between.”  Naturally, he responded with the chorus from Dave Matthews’ The Space Between, and in no time we were both singing the song in our best Dave impressions.  We didn’t know all the lyrics, and we don’t even know what the song means, but we found comfort in the line “The hope that keeps us safe from pain.”  That’s what this embryo has given us.  We had never seen a positive pregnancy test in all our years of trying until this embryo.  We weren’t even sure implantation was possible until this embryo.  And a few months ago, we didn’t even think we could make a high-grade embryo, and this little guy is a 4AB.  Still, we don’t know what is ahead.  But this little embryo, even in its short existence so far, has already given us more hope than we’ve ever had – the hope that keeps us safe from pain.

 

 

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Transfer #2 – A Second Chance

Last time Breanne posted an update, she was shouting from the rooftops about her thick uterine lining (a phrase I never thought I would type).  Now, she’s hunkered down in a hotel room in Memphis on bedrest, so I’m handling this update on our transfer.

Monday evening after work, acupuncture, and a progesterone injection, Breanne and I hit the road to Memphis.  She had a suitcase packed with nothing but pajamas, a box of gluten-free cupcakes courtesy of my parents (Thanks, Mom and Dad), and plenty of Christmas music on her iPhone to pass the time. For those of you that know Breanne, you know that she loves Christmas.  And I don’t mean the normal kind of love.  I mean the already-has-all-of-her-Christmas-shopping-done-in-mid-November kind of love.  So with “Let it Snow” playing in the background and the air conditioner on full blast, we made our way up I-55.  Like a pitcher on a hot streak, we didn’t want to change up our pre-game routine, so we ate a late dinner at Memphis Barbecue Company on our way.  We’ve stopped there every time we’ve come up to Memphis for IVF.  If this round works, I bet it was the BBQ.

The morning of the transfer before we left the hotel is a bit of a blur, and I didn’t realize it was a blur until I started writing this post.  It’s almost like we were on auto-pilot.  I think we both had so many emotions running through us that morning – anticipation, excitement, hope, fear – and they all somehow cancelled each other out, leaving us numb and just going through our pre-transfer checklist.

We arrived at the clinic at 10:00 so that Breanne could have her blood drawn for a progesterone check; then, we spent the next thirty minutes in the waiting room where Breanne chugged water.  Evidently, a full bladder helps the doctor view the uterus on the ultrasound monitor so he can guide the catheter.  So there Breanne was, playing a chess match with her bladder all morning, trying to decide when to take her last pee before the procedure.  Checkmate: Bladder.

The transfer is a much less invasive procedure than the retrieval.  For the retrieval, Breanne was put under anesthesia; for the transfer, she only got a Valium.  The transfer basically involves the doctor guiding a catheter into her uterus and then injecting a solution holding the embryo right up next to the uterine lining.  That way, when the embryo hatches from its shell, it’s close enough to the lining that it can implant and begin to grow into a baby.  Because the procedure is less invasive, I was allowed to be in the room with Bre.  I just had to throw on a lunch lady hairnet and some massively oversized scrubs.  But when you’re 5’7, just about everything is oversized.

When the doctor finally came in for the procedure, he gave us a picture of the embryo we had been dying to see. Suddenly, we weren’t numb to our emotions anymore.  We were overwhelmed with hope.  Right away we could tell that this little guy was a higher quality embryo than the one we transferred in our first round.  It was more advanced and, without getting too scientific, had better cell differentiation.  The embryologist gave it a grade of 4AB.  The “4” indicates how far along the embryo is in its development.  At stage 4, it’s considered an “expanded blastocyst,” which is exactly where you want it to be for transfer.  The first letter in the grade represents the quality of the “inner-cell mass,” the group of cells that will eventually form the fetus.  This part of our embryo got an A!  It takes after its dad.  The second letter in the grade is the quality of the outer cells that will develop into the placenta.  This was a B.  Not perfect, but still pretty darn good!  For reference, the one embryo we had and transferred after our first round was a 2BC, so we knew we were already ahead of our first round.

The doctor left us alone for a few minutes while they prepped the procedure room, and we stared at our embryo.  It’s hard not to get emotional looking at the little clump of cells that could grow into our precious little boy or girl that we have fought so hard for. And I’ll be honest, I teared up.  Not many people get to see their children at this stage.  Going through this infertility struggle has been unbelievably difficult for both of us.  I bottle a lot up inside trying to be strong for Breanne, and my emotions wind up coming out when I least expect it.  I actually broke down in our Customer Service Manager’s office a few weeks ago (sorry Bennie!).  But getting to see this little 5-day old embryo before it hopefully grows into our beautiful baby made us feel so lucky…and me so emotional.

Next, they walked us into the procedure room and strapped Breezer in.  The nurse looked through our chart to once again verify who we were (a lot of verification goes on during the transfer process which is very much appreciated).  She laughed at how our names were so close, and Breanne, in her Valium-induced state of relaxation said, “Oh, it gets better!” and proceeded to explain how her maiden name is also Hancock.  The nurse jokingly asked if we were sure we weren’t related, so to break the tension I said, “Well, if this baby comes out with a third arm, we’ll have our answer.” Hard to tell if that joke landed or not.

The procedure went about as smoothly as it possibly could have.  Our doctor was incredible – he walked us through every step of the process so we could follow along on the ultrasound monitor.  And being able to both be in the room meant so much to us.  Breanne has had to fight so much of this battle on her own.  She’s the one getting poked and prodded almost every day.  She’s the one who has endured multiple surgeries in order to give us a fighting chance at a child together.  But in that moment, getting to hold her hand through this precious piece of the process, I’m not sure I’ve ever felt so connected to one person in my entire life.  As the doctor transferred the embryo, we could see a little glow appear on the screen.  The embryo is microscopic, but the solution it was in could easily be seen on the monitor.  And when we saw that glow, we both teared up (again).

After laying flat for 30 minutes following the transfer, Breanne was finally allowed to empty her bladder (hallelujah!)  She told the nurse it was the greatest pee of her life. The doctor gave us our post-transfer instructions, which involved a lot of bed rest for Breanne.  Once doc was finished with us, I went to go get the car to pick Breanne up.  About halfway to the car, I heard a woman’s voice calling for my help.  Once I walked over to her, I saw her and her husband trying to get a stroller to fold up so they could load it in their car – I’m guessing it was their grandchild’s stroller.  The woman said, “You look young – I bet you have kids.  How do you get one of these strollers to fold up?”  Not wanting to share our whole infertility story with a stranger in the parking lot, I awkwardly laughed and tried to help.  When I couldn’t figure it out, she said, “Well I thought you’d be more helpful – you look like you have a couple kids, don’t you?”  Guess I need to work on my dad bod…  After I swung by the hospital entrance to pick Bre up, we had to stop to let two very pregnant women walk across the street.  It was as if the universe was taunting us, but we laughed it off.  No negative vibes for our little embryo on board!

In order to make sure she followed the doctor’s instructions (and to allow me to get back to work), Breanne’s mom met us up in Memphis and is currently staying there with Breanne until tomorrow morning, then they are heading home.  Thanks, Connie!  If anyone can keep her in line, it’s you.

I’m not gonna lie – it’s been really hard being away from Bre over the last few days.  Knowing (and praying) that our embryo could be implanting as I write this is crazy to think about. Yet being 200 miles away from each other sucks. I’m just ready for tomorrow evening when we can start spending the rest of this 10-day wait together.

Thanks so much to the dozens of you who have messaged us, encouraged us, and prayed for us over the past few days.  If that little embryo can sense the love y’all have sent our way, he/she will definitely want to stick around!

 

We Set a Date and Took a Shot

I HAVE A THICK UTERINE LINING, and I want to shout it from the roof tops!  My monitoring appointment yesterday confirmed a lining of approximately 9mm, which means my body, more specifically my uterus, is ready to take on an embryo.  And with that news, we were able to set a date for our frozen embryo transfer.  Drum roll please…Tuesday, November 15th!

But first, progesterone.

For the past two weeks, I have been on an estrogen regimen – 6mg of Estrace daily – to keep me from ovulating and to support the growth of my lining.  Good job, Estrace.  I forgive you for the mood swings and heart burn.  I’ll continue to take Estrace through the transfer, but to ensure that my lining doesn’t get too thick I have to add my little friend PIO (progesterone in oil) to the mix.  PIO is an intramuscular injection, which means big needle in the hip.  And our first injection was tonight. In fact, as I write this, I’m sitting in the car with my right cheek pressed firmly against my heated seat on our way to a steak dinner.

This is the first time in this entire process, including Round 1, that I was shaking from nervousness.  I knew too well what was ahead.  When Brennen walked through the door, I tried to mask my nerves and bravely said, “Ok, I’m ready. Progesterone, now.” It didn’t help when he started mumbling, “Oh my gosh we’re really doing this.”  Then, I hear the voice of a stranger in my house.  A lady on YouTube was giving Brennen instructions on how to give a PIO injection.  Her voice…not so comforting at the time.

As Brennen reached for the Sharpie to temporarily tattoo my backside with injection targets, he said “Now, where exactly do I inject?” Brennen called my uncle (a nurse) for advice.  I heard the words “6 inches from the top of the butt crack…” and saw Brennen go for the tape measure.  This just kept getting better.  He drew the first circle, put an X through it, and drew another.  Finally, we were ready, and gave and took that progesterone like total champs.  When the needle was out, Brennen asked me how it was.  Tears filled my eyes.  They weren’t sad tears.  They weren’t happy tears.  They were just tears…because here we are…5 days from transfer…and wanting this to work so badly.

So, the plan is to continue PIO until I take a pregnancy test; further instructions will follow depending on the results.  I’ll also take an antibiotic and a steroid, Prednisone, for a few days for transfer prep.  The antibiotic is to help ward off any infections from the procedure, and the Prednisone is administered to address any inflammation that may result from implantation.  Aside from medicine, our hotel is booked, and our bags will be packed by the end of the weekend.  I’ll have to be on bed rest for a couple days following the transfer, so I’ve opted to just stay in Memphis.  My mom will be babysitting me so that Brennen can get back to work.  And that means for those few days we’re in Memphis, she’ll be the one injecting me with PIO. That should be interesting…

Well, that’s about it for now!  My tears have dried up. My butt is starting to feel better. And I have a steak dinner waiting on me. We like to celebrate.  Let the countdown to November 15th begin!