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Tuesday, September 17, 2013

the no good, very bad stim check


 This is going to be a quick update because I'm devoid of all energy and emotionally drained. Today's stim check at my local clinic did not go well. Actually, that's an understatement...it could not have gone worse. 

I was a little nervous going into this appointment because it's the point where my last cycle got cancelled. But I feel like the meds have been working so I wasn't too concerned. Dr. SA performed my ultrasound and relayed the following information.

You have a 10mm and 9mm plus two small follicles on the right. 
After looking around a bit on the left and measuring nothing, he stated that there are 3 tiny antral follicles but they are so tiny he wouldn't even call them follicles.
Me: That doesn't sound good.
Him: No, it's not. I'm not sure what your doctor will say. But I don't want to give you false hope. 
Me: Do you think my cycle will get cancelled?
Him: Shrug. It doesn't look good.
I proceed to hold in tears while I get myself dressed. The flood gates open as soon as I get in my car. In my mind, that's it...it is done. Dr. S is going to call me and cancel the cycle. And since I'm on the most aggressive protocol already, I'm hearing "donor eggs" and I cry harder.

I don't tell A anything because I don't want to ruin his day. He's at work, sleep-deprived and has been on a fire for the last 18 hours. Instead, I wait for the call from CCRM for almost 6 hours and think about life without children. I cry and work. And cry and work some more. At the end of the day, I get a call from nurse sweet pea. She says in her up beat tone "I'm calling to give you instructions for your next dose of meds."

Huh? You mean my cycle isn't cancelled. 
I inform her about my appointment with the local clinic. Here's what she had to say.
 "We do not agree with that asset of the situation at all. Yes, you only had 7 follicles but that's all we expected and they are growing. They aren't where we'd like to see them but that's why we are upping your dose of follistim. The worse news I have for you is that you're going to need to order a couple thousand dollars more in meds because you're going to run out. I'm so sorry that doctor got you so upset."
I was shocked. 
Then we discussed my estrogen level. 
Mine is 80. They'd like it at 200 today but the minimum they want is 50. So, I'm by no means a rockstar but certainly not benched either.

In terms of my follicles, here's what they see. And they don't even weigh this very heavily because they don't trust other clinics' ultrasounds. 
Right: 10mm, 7.4mm, 5.7mm, 5.5mm
Left: 5.8mm, 5.4mm, 4.8mm

She said the small ones are only about a day behind. They increased my follistim from 300IU per night to 450IU per night. Then she said the cutest thing, "this is going to sound crazy but talk to them (my follicles) and tell them to grow. And tell that 10mm to slow down". 
I think I love her.

Reflecting back, I'm certain that my cycle would've been cancelled had I stayed at my local clinic based on their reaction today. And it makes me wonder if that is because they want to keep their stats up. Their percent of cancelled cycles is much higher than CCRMs. 

 My local clinic wants to see E2 levels between 250-700 on day 5 of stims. CCRM just needs me above 50 with 200 being ideal. It is a different kind of clinic for people who are not easy, typical patients. 
It's for people like me. 

Win, lose or draw. 
I do believe I'm in the best hands at CCRM. Finally, I feel like the money we are spending is well worth it. Words of wisdom for anyone seeking outside monitoring....do not listen to your local doctor's assessment of your situation. After reflecting further, I'm so thankful I switched clinics. 


51 comments:

Finley S said...

That nurse sounds like the most wonderful lady and the fact that she cares like that is such a blessing for you!

I can tell how hard it would be for you and all I can say is its okay to feel sad about this whole process and I love the honesty you have with sharing it - very brave of you!

Good luck, hold on to your prayer and I am seriously praying with you! Go follicles go!!!

Mrs B. said...

I am so sorry it didn't go well this morning. Great to see them upping your dose and being so caring at CCRM. Nurse sweet pea sounds lovely although not too sure about the doctor that did your scan!

Joanna Clarke said...

I cried when reading the beginning of your post. I felt every ounce of pain and despair that you felt. I wish I could have hugged you in that moment.

As I continued to read, I can't even explain the joy I fely that your day completely turned around. Your sweet pea nurse sounds wonderful and so genuinely caring of patients. This whole process is both a psychological and physical struggle. She is right, talk to your follicles! Visualize it. Listen to calming music and meditate on it.

I will be praying that your follicles grow steadily and that you continue on this path with nothing but positivity!



-Joanna

jenn said...

UGH, I hate those bad news appointments. Such a mood-killer. But I am so glad that you're still in the game. Fingers crossed the extra meds push it in the right direction, and things start looking up soon x

Mandy said...

Jessica, keep the faith, good things come to people who wait! Enjoy life's moments, take the good with the bad, and find something positive to stamp on each day. You & your husband's strength speaks volumes..your courage and bravery is inspiring..and I have no doubt you'll achieve your hearts desire. Thinking of you and keeping you in my prayers tonight!

lo @ crazy ever after said...

How wonderful that you're at the clinic you're suppose to be at. Feeling so hopeful for you.

Mrs Green Grass said...

That's awesome that you got good news from CCRM! I'm sorry you had to freak out all day. :( I think it makes a lot of sense that slow and steady would be just fine. I hope they continue to grow nicely! Wishing you the best. Hugs.

Charity said...

Praying for you! All hope is not lost.

Anonymous said...

Your follicles sizes are perfect. There are at least 6 there and they are about the same size. No lead follicle. Fantastic! You should have been started on 450 IU from the beginning if you are DOR. You would have had over 10mm follicles by now on a higher dose and much higher estrogen levels. This is all good news!! You will see much better progress by your next U/S.

jAllen said...

So glad to hear you're still in the game and you happy about the choices you made to go to CCRM!

Court said...

Oh I'm so glad you're still in the game! Grow follies grow!!

Endo_Life said...

I am so glad you have sweet pea she sounds like an angel. I know how draining it is but you are doing great so far. Looking forward to good news xx

Emily said...

I've often wondered how that all works out....doing IVF elsewhere with the local monitoring. I'm so glad it's nearly as bleak as you first thought. I think things are looking pretty good considering you have follicles and they're growing fairly steadily as far as close in sizing. I bet that increase in meds will get them going a little more. Oh, I do love that nurse too. She is simply awesome! And so are you lady! You have a lot to be hopeful for!

Amanda said...

This, my friend, is EXACTLY why you go to CCRM! They know what a lost cause really is and they don't think you're it! I'm sorry the day was so emotional; the roller coaster ride is so hard! Hoping that your next ultrasound goes better and that you get some great news! Hugs to you, Jessah!

Catherine said...

Grow follies, grow! I agree, it sounds like you are in the best possible care. I just know the outcome will be great! Prayers!

Amie said...

Oh I'm so sorry you had to endure such a rough day but am thankful that your day ended on a much higher note. Keeping you in my prayers on this tough journey :)

Kristin J said...

I am so glad it ended up better than you thought! You are right that you need to trust the clinic you are going through and not the one doing the testing necessarily! So glad you found the place that is right for you!

shay said...

So glad your cycle isn't cancelled! I'll keep praying that those follies grow grow grow!!

Just T said...

It really looks like you made the right decision by going to CCRM. That nurses suggestion on talking to your follicles is just awesome. I am so glad they gave you hope and I am sending your little follies growing dust!

Caroline said...

So glad that you are confident in your situation and despite what the doctor said, the cycle will continue. God's word TRUMPS what any doctor says - put your faith in Him! Keep believing Girl!! I am with you :)

JJ said...

Have you tried accupuncture at all? I know it sounds crazy, but I have DOR as well, and did not respond as well as my clinic would have liked. I saw my acupuncturist and the next day I was ready to trigger because everything grew like crazy!

Katie @ Loverly She said...

I am so sorry you had that experience, Jessah. What a roller coaster. I really admire you for your fortitude in this whole process - what a strong lady you will be on the other side of this. Continuing to think of you and pray for the outcome you've longed for.

Ashley said...

So glad it turned out to be okay!! I hear ya on how scary it is to be on the verge of being cancelled. I've been cancelled and it sucked!! That why I ended up doing the long micro flare protocol, so my stims could take longer to grow and I was allergic to the med in the "easier" protocol. I did talk to my follicles - not crazy at all, or if it is, I'm crazy haha.

Suzanne said...

There's certainly a reason people go there from all over!! Glad to hear that they are still confident and things are a go!! Are you heading east soon for the remainder of your monitoring? I'll start saying little cheers for your little follies, hopefully that helps. :)

Mel said...

Hang in there....thats why we went to CCRM for our entire cycle because we didnt trust our home clinic...We were out there for almost 2 weeks during stims/ret but totally worth it to us... as my meds got adjusted on day 4 after our first ultrasound/labs with them...and without that our cycle would have been a bust. Love what your nurse said.

Keep the faith! Praying for you.

bellehavendrive said...

Wow, Jess. Talk about a rollercoaster. I'm so sorry yesterday started out like it did. Thank God for Nurse Sweet Pea and CCRM, huh? And you're right, you are exactly where you need to be - receiving treatment from CCRM. They are quite impressive. I'm so glad you are on track according to the experts' standards. :)

Laura Crosby said...

Yahhh! for qualified professionals. Local clinics must make a killing by making people cancel their cycles and start all over again. All that medicine and testing....

Kelly said...

It sounds like you made the right choice to change clinics. We moved to another clinic after the 1st RE only found 2 follis on the 2nd ultrasound during our 2nd IUI. We met with a new RE the next week and he saw 4. That was concerning to us the 1st RE only mentioned 2. Hang in there!

Natalie | Mrs. Janney | said...

I'm so glad that switching seems to be the best decision. And I'm hoping your follicles grow to be NICE and HEALTHY. :)

Aislinn said...

I'm sorry you had such an emotional roller coaster of a day, but I'm thrilled that CCRM is allowing you to move on with your cycle. My fingers are crossed that those follicles will catch up and everything will work out!

Lena Amstutz said...

You are definitely working with the right clinic for you! I am so glad that your cycle wasn't canceled! Good luck!

Always Maylee said...

I'm so happy your cycle wasn't cancelled! And nurse sweet pea sounds like she is exactly what you need. Good luck with the rest of the cycle and talk to those follies! :)

xo, Yi-chia

Infertile625 said...

I am so happy that your very special nurse is keeping you calm and bringing you hope. I love her! Best wishes that more follistim does the trick. Xoxoxo

Jennifer T said...

What great news that your cycle is not cancelled! I also am sorry that that doctor got you so upset. You don't need any extra stress! So glad you have someone who truly cares and treats you for you and not some set standard guidelines. Good luck! Hoping this cycle continues to go well :)

JoJo said...

Oh my...can't believe ur local RE implied that things weren't looking good. I truly believe u are in the best of hands with CCRM an ur nurse sounds like a total sweet pea. Elated that you have her through this roller coaster. Praying for you and sending positive vibes ur way. Start talking to those follicles, woman!!!

Aubrey said...

AMAZING news! I LOVE Sweet Pea. What a sweet, sweet woman! I knew it that CCRM would see this situation differently :) Keep me posted, girlie! xox

Sarah Jafari said...

Hi Jess
You have me in tears right now!!!! So thankful for sweet pea. Please do talk to your follicles and tell them to grow! Ahhh, I'm sitting in the seat behind you on this roller coaster...I think it just made a dip, a turn, and a jolt...now with my stomach in knots and my heart racing...I'm hoping we can take the straight path to finish! I'm on this ride with you Jess to the finish. I love you and tell your body not give up!!!! Xoxoxo
Sarah

Aramis said...

I know CCRM deals with a larger number of "hard" cases, so maybe that's why they're a bit more forgiving with the numbers before cancelling. I don't know if this helps but I always stim pretty slow myself, it can take up to day 5 or 7 to really see anything growing well so hopefully yours just need a bit more time too! You're not out of this yet. Sending lots of positive vibes.

Mrs. E said...

Hooray for not being out of the game!! I know we have very different diagnoses/protocols, but on Day 8 of stims, my E2 was only 81. Again, I know our situations were really different (I have a tendency to overstim because I start out with 20+ natural follicles, so I was on very low doses of Menopur), but just saying that it's still early, and it sounds like you're in excellent hands! Sending lots of baby dust your way!!

Amber said...

Okay, so you are still in the game. I am praying extra hard for you Jessah!

Marcy said...

Wow, it is amazing how important it is to find a doctor that is the right fit. I'm so happy that CCRM is treating you right.

Sally said...

Glad you are happy with your decision to go with CCRM. Thinking of you!!

John + Bethany said...

I hope your cycle is continuing to progress. My clinic (Boston IVF) does not have a min E2 requirement, only that it is going up. Sure, there is what is "ideal" or "average" but you and your cycle should be considered on an individual basis. My E2 after 4 days of stims was only like 49. It kept going up and was doubling every 48 hours and then every 24 hours. I'm glad CCRM knows to stick it out. FX for you!

Nessa osuna said...

I think I love her too! Praying for you! Xoxo Nessa Osuna

Alie said...

Such a rollercoaster - so hard when one doctor says one thing and a second says something different. But I think it's best to go along with whoever has the most positive attitude... solutions are only found when you're willing to work with what you have, not when you write things off. So try to be happy with Nurse Sweet Pea's assessment -- I hope it all works out!! :)

Sarah said...

**Letting out a sigh of relief!**Phewwww! I was nervous for a minute there! I am SO glad you went to this new clinic. Sounds like you are in the best hands. Praying as always xo And yes Nurse Sweet Pea has the right idea...talk to them! :) xo

Janna Renee said...

CCRM sounds like they take MUCH better care of you, and it's stupid that the clinic doesn't want to give you "false hope". There is no such thing as false hope, because hope cannot be false. It is the driving force that keeps our spirits up and our goals within reach. You just keep your chin up and sing to those follicles if you have to. I'll write you a song, haha.

Lerissa said...

That's a great update! I am thrilled that they aren't cancelling this cycle. It's about time this blog turned into a pregnancy blog!!

Good Luck!

Non Sequitur Chica said...

Hooray for CCRM and yay for Nurse Sweet Pea! Grow follicles grow!

conceptionallychallenged said...

Phew. That does sound exhausting. I'm glad you feel in good hands at CCRM. It sure sounds like they are able to handle the wide range of diversity among patients and reactions quite well.
Also, despite being a scientist and all, I did talk to my follicles. Good luck!! I'm sending many good thoughts your way.

Whitney B. said...

Such happy news. I know that must have been so scary for you, glad it turned out all right. I love keeping up with you on Instagram and pray for your miracle to join your family soon!

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