How Much Have I Changed?

I found this at Raising WEG. Plain text results, because I don’t think WordPress likes the fancy stuff (with Java)

***You’ve Changed 56% in 10 Years***

You’ve done a good job changing with the times, but deep down, you’re still the same person.
Your clothes, job, and friends may have changed some - but it hasn’t changed you.

How Much Have You Changed in 10 Years?

(I had to edit a your/you’re error in the two-sentence description. Looks like Jody did too. Argh.)
I thought it would come out with a higher number, given the difference between being a poor, celibate, graduate student in New York state vs. a married associate professor in the Republic of X.

I couldn’t remember if I had my hair dyed 10 years ago, but it was never “completely different,” just auburn over the brown. They should have asked about hair length-grad school corresponded in part to my 10-year experiment with short hair, but it’s all long again now (don’t get me started on the history of my hair, because I’m fairly sure it interests only me).

Jody mentioned her shoes. Both pairs of boots I own (one pair Gore-Tex hiking boots, one pair lined leather boots) are more than 10 years old, bought to deal with Grad School Town winters. The rest have had to be replaced after being much-repaired. None of the clothes I had then fit me now, except the scarves, and one oversized sweater.

The big difference is that ten years ago at this time of year, I was realizing that my optimism about going off anti-depressants had been premature, and my psychiatrist and I were beginning a long (entire academic year) process of trying to find new meds that would work.  (There were various reasons for not going back to the previous ones.)

I didn’t get much work done on my dissertation that year, between the depression and teaching in a new department (my first experience teaching a language of which I was not a native speaker).

I’m much happier now. Three years ago I went of the antidepressants again, with no problems. I do pay close attention to news about antidepressants and pregnancy/breast feeding, but I haven’t delved into PubMed just yet.

Compare and Contrast

I have had four ultrasounds at my ob-gyn’s office: two by my ob-gyn during an annual exam and two by the sonagraphers (day 3 of this cycle, and the 5-week ultrasound I had today).

I have had, of course, innumerable ultrasounds at Alma Mater Clinic. Who am I kidding? I have had eighteen transvaginal ultrasounds in the big city.

Alma Mater Clinic is so named for being associated with my graduate alma mater. I think of my ob-gyn’s office in My Fair City as the Fancy Ob-gyn Office, because it is so much posher than the office of my previous ob-gyn in the much smaller Spring City. One of the fancy things about it is the presence of on-site laboratory, sonography, and mammography.

Fancy Office’s sonography and exam rooms have no window., whereas some of Alma Mater Clinic’s rooms have scenic New York views.

Alma Mater clinic’s ultrasound rooms are free of personal photos, posters (except for a BMI matrix on the scale in the rooms with a scale), and xerox copies of cute cartoons. Fancy Clinic’s sonographers have all of the above, but no scale. My favorite: “Unattended children will be given a cup of espresso and a free puppy.” If you are going to be averse to children, at least have a sense of humor. Fancy Office is so averse to children in the sonogram rooms that they also have a 2-page handout explaining why. I was wondering why I would ever want a child under thirteen (if I had one) in the exam room with me, but then I remembered that most normal pregnancy ultrasounds do not use the dildo-cam.

The Fancy Ob-Gyn Office sonographer had a box of “probe sheathes” which were a bunch of unwrapped rolled up condoms, but the Alma Mater Clinic uses actual brand-name individually wrapped condoms, and in at least one room, individual packets of lubricant. A waiting patient is more likely to be tempted into theft of supplies at Alma Mater clinic.

My sonographer today was not as slow getting started as Julie’s doctor, but she took so long to find the sac that I was getting very worried about no news equalling bad news (”there’s your ovary,” (WHO CARES?) “let’s measure your fibroid,” (IT’S BEEN DONE!), there’s the sac (THANK YOU!).)

At Alma Mater Clinic, the doctor or fellow doing the ultrasound always has a nurse to sheath the probe, apply the goo, etc. My ob-gyn does too. The sonagraphers at Fancy Office are strong, independent professional women who do it all themselves.

At Alma Mater Clinic, the good doctors and fellows will turn the monitor so that the patient can see it too. And if they don’t, the patient can train them to do so by maneuvering herself and/or the monitor into a better position. At Fancy Office, the monitor was less grab-able, but they have an additional flat screen monitor high up on the wall that the patient can watch in comfort while lying on her back with feet in stirrups.
Nothing at Alma Mater Clinic is covered by my insurance. But maybe, just maybe, I have gotten pregnant enough that today’s ultrasound will be.

UPDATED: With accurate numbers, because I am all about keeping track of my stats.*

* At first, I only remembered having one during  regular exams; it’s just that the second is more memorable because I cried when he said my fibroid might need to be taken care of before doing ivf. The RE measured it differently and disagreed, saying the less messing with the uterus before transfer the better. Maybe the first one was abdominal and hence less memorable.

Sac

Ultrasound this morning found a sac. That’s good.

I had a long discussion yesterday with my dietician (hey, she’s also a LMSW) about my apparent need to think pessimistically about this I-can’t-believe-it’s-a-pregnancy and other things. I blame blogs. Anyway,  today I plan to be all positive all the time. As long as I get my naps.

Household Hints

I don’t have any hints, I just need some.

I’ve seen a couple of posts about the virtual book tour of The Complete Organic Pregnancy, by Deidre Dolan and Alexandra Zissu. Once I decide that thinking beyond week 7 will not jinx the pregnancy, I will probably buy it.

Even though I will feel like a fraud. Because I use bleach.

I got by on vinegar and baking soda for most of my cleaning for more than a decade (all of graduate school and the years I lived in Spring Town, where my university is located). A little generic windex when I moved into an apartment with mirrors in Spring Town. And some Seventh Generation toilet cleaner when I started worrying about the baking soda scratching the toilet. I can’t remember what I used in Old Colony-probably the local version of Comet, since that’s what I grew up with.

Then I moved in with Mr. Luo, into an apartment with tiles and grout in the shower. [Updated to add: I mean, we both moved into a new place, together. So the shower started out clean, which would not have been the case if I had moved into his place.]

Keep in mind that I am allergic to a couple different kinds of mold. Also, I am bourgeois enough that I want the shower to be and look clean.

So how do I get the mildew/mold and stains off the grout without using bleach?

Do not bother to suggest (because they don’t work):

baking soda and vinegar, my old standbys

Seventh generation shower cleaner, a waste of money, though I keep buying it because I feel guilty about the bleach.

tile grout stain eraser (”chemical free cleaning / quickly removes stains”) from Target

Also, forget the idea of spraying the shower walls after every shower. Nice idea, but it isn’t going to happen.

At least it’s not toxic mold. Where I live, this is a concern.

One night when I was getting paranoid, I looked at government sites about mold. The CDC downplayed the health concerns but said to use bleach to get rid of mold. The EPA said there were definite health concerns but advocated non-bleach methods of removal. I found this more revealing of the two agencies’ differning concerns than particularly helpful.

Cats

I am working on another pgd post, but I want to increase the ratio of rational argument to ranting, so I’ll stick with a lighter topic for now.

Meet the Luo family cats. Both of them are Mr. Luo’s cats from before we knew each other (of course he wasn’t Mr. Luo then, just the guy from dancing who asked me out one night). I had wanted a cat, but a combination of lease restrictions and worry about my travel schedule interfering with cat care had prevented me from getting one. (Oh, it was fear of commitment–and you wonder why I didn’t try to have kids sooner?)

In keeping with the pseudonymous nature of this blog, I’ll call the younger cat the Princess (because I call her that half the time anyway) and the older one the Goddess.

I know comparisons of children and cats are odious, but I will admit that when I started dating Mr. Luo and spending time at his house, I thought of the 1 1/2 year old cat as the eager-to-please affectionate kindergartner and the twelve-year old one as the surly teenager who reacted to every overture with hissing and scratching. This was at a time in my life when I realized I was meeting more women who were stepparents are fewer who had them.

We’re all a little older now. The Goddess rarely hisses at or scratches me. She likes to sit on my lap, or my stomach when I’m lying down. She has failing kidneys, hence the need for me to give her subcutaneous injections of fluids. (And if it took somebody four needle pricks to get half the fluids in me that I was supposed to get, I’d feel like hissing.)

The Princess has destroyed big patches of the carpet and most of the leather on the the pretty second-hand couch and chair I scored a year ago, because the scratching posts just aren’t good enough for her. She had ten teeth pulled this summer because we were too clueless to realize they were decaying until the Mr. Luo asked the vet to do a dental exam the last time she was there. We had boarded the cats at the vet when we were out of the country for a conference. As part of justifying the expensive procedure (”you win the prize for highest bill this week!” said the receptionist), the vet assured me that the Princess’s teeth had been causing her a great deal of pain for a while. So, if your cat has bad breath, don’t forget to get her teeth checked, or you too will feel like a complete cad.

She is still quite affectionate, and gives me constant affection from the moment I open my eyes in the morning, so as to ensure that I do not forget to feed her. Then she doesn’t like to eat much unless I brush her coat while she nibbles. She won’t sit on laps; she prefers to curl up with her back touching someone.

Our landlady, who lives next door, also has an old cat and a young cat: the Diva and the Dynamo. Ours are indoor cats; hers are indoor/outdoor. The Dynamo and the Princess like to entertain us by attacking each other from inside/outside our living room windows.

Negotiate with the Pharmacy

This may be of use to those of you whose insurance does not cover your ivf medications.

I have not gone to far afield for the meds, instead using pharmacies in New York that specialize in ivf meds and that also have overnight shipping. That way, I can get the meds I need before leaving home and then, once I’m in NYC, I can pick them up or get them delivered to the hotel the same day (I had to pick them up in ivf1, when I was staying in Queens).

Both pharmacies ship for free when the order is over a certain amount ($450 for the one I was dealing with today), which most ivf meds are. The problem is after coming back home, when I need a refill of PIO that doesn’t cost as much. (I tried to avoid the problem this time by getting two vials of PIO at the start, but then I got a positive beta, so I am taking it for longer than in the past. Of course the refill also turned out to be two vials, so if the ultrasound on Friday turns out to be bad news, I will have a lot of extra PIO.)

Twice I have had to point out to the pharmacy the rather large total amount I have spent over the cycle and ask them to waive the shipping  charge for the PIO delivery. And they have. But I had to ask and insist. You should too, if you are in my position.

The shipping charge isn’t much, compared to the cost of an ivf cycle, but it will save you enough to buy two small containers of Sable’s lobster salad.

Disability Paperwork

I like Mr. Luo’s doctor. I knew he was well-respected in the field of TFD, but what impressed me the most at our first visit was the respect he showed to Mr. Luo. A disease that causes involuntary movements and slurred speech can lead to condescension and even the dreaded talk-to-the-companion-as-if-the-person-weren’t-there behaviour, even (especially) from doctors, even though Mr. Luo’s symptoms are mild. We were quite happy that this specialist had set up a once-a-month clinic in Our Fair City for people with TFD.
Dr. Respectful and his office have been very helpful with the paperwork for the private short-term and long-term disability insurance. When I got home on Saturday night, amongst the stack of mail and papers on the table was a letter suggesting that the enclosed long-term disability paperwork should be filed by yesterday (9/26). Since Mr. Luo had an appointment scheduled for Monday as part of the clinical trial, we took the papers with us, figuring that the doctor would take them back to his main office a couple hundred miles away, have his assistant fill them out, and fax them sometime soon. Instead he filled them out and faxed them while we were in the waiting room waiting for 15 minutes to make sure Mr. Luo wasn’t fatally allergic to the first dose of clinical study drug (or the placebo).

So, Dr. Respectful is wonderful. But did he have to put “FATAL” in all caps and underline it in his description of TFD on the disability form? Because it makes the denial a little harder to maintain.

Waves of Depression (A Long Time Ago)

Don’t worry. I’m not depressed now.

This is inspired by comments on another blog, but since that blog is password protected, I am not linking to it.

When I was very depressed and fighting off a lot of “suicidal ideation,” I often felt like I was standing on the beach getting slammed by waves. (I grew up next to the Pacific, so you have to imagine real waves here, not idyllic Caribbean ripples. I just lost any reader who’s lived through a Caribbean huricane, including Mr. Luo…) All I could do was stand there and hope to be strong enough not to fall over and drown.

It was only when I was hospitalized that one of the nurses helped me realize that I did not have to be passive in the face of those thoughts. We talked about specific easily-remembered strategies for how to think and what to do in response to suicidal thoughts.

To me, it was like suddenly remembering that I didn’t have to stand in the surf getting smashed by the waves. I could step away to a place where the waves couldn’t reach me.

The person on the pw-protected blog is getting hit by a lot of waves these days. Her waves are cravings, not suicidal thoughts, but it is self-harm either way. It seems like she has the support available to help her get away from the waves, and I wish her well.

I just wanted to say that it took a long time, but the waves hardly bother me anymore, and when they do, it is more like a reminder (”oh, that’s how I used to feel under stress”) than a danger.

I’m So Relaxed

I talked to my RE yesterday. The five-week ultrasound is because he likes to have an early scan, not because of any special concern in my case. The u/s is scheduled for Friday morning at my ob-gyn’s office. He kept telling me there is nothing concerning (his words) about my numbers, so I will choose to believe him and relax the rest of the week away.

As happy as I am to be home sweet home, I wish I were in NYC so my RE could do the ultrasounds. After the initial consultation and the hysteroscopy, I didn’t get to see him much (three retrievals and three transfers, and he was not the attending in the OR on any of those days, although I had Dr. Uncommunicative three times and Dr. Reassuring twice). Now I will probably never see him again, though we will be talking on Friday at the very least.

He was happy to hear I have had no spotting or bleeding. I myself don’t see this as particularly significant, because in the first two cycles, except for a bit of spotting after retrieval, I had nothing until I got my period four days after stopping the progesterone. My cycles are normally shorter than 28 days, so in my first ivf, I was convinced that if the cycle didn’t work, my period would start before the beta, as happened to Barren Mare around the same time. But no. If nothing else, the PIO shots keep me from bleeding. So far.

To add to the ample information out there in the blogosphere confirming that symptoms tell you nothing about whether you are pregnant, my symptoms so far have been almost exactly the same as my post-retrieval symptoms in the two failed cycles. Fatigue. Early waking. Need for multiple naps per day. Twinges-to-mild pain in the ovaries. Occasional mild cramps that feel disturbingly pre-menstrual. Added this time: crying more than I remember during previous 2-week waits, a spot of light-headedness now and then, smiling a lot after the betas.

This paragraph is for those getting their medical degrees from Google Medical School: My RE’s strategy was to trigger earlier in the hopes that the eggs/embryos would turn out stronger. That seems to have worked so far. I triggered after 7 days of stims, compared to 9 days in ivf2 and 8 days in ivf1. All 6 eggs were mature and got fertilized with ICSI, compared to 12 retrieved, 11 mature, 9 fertilized with ICSI in ivf2 and 10 retrieved, 8 mature, 6 fertilized with ICSI in ivf1. I’m not sure about ivf1 (when we transferred 2 blastocysts), but in ivf2, one of the four embryos that passed pgd did not make it to transfer. This time, all three that passed got transferred, and one of them seems to be sticking around.

I hope that I am done with roller coasters and merry-go-rounds. I suspect that I have simply graduated to new worries. And I am happy to be here.

PIO Updates: Does This Progesterone Make My Butt Look Fat?

First, in my previous perusal of Julie’s archives for posts I remembered and wanted to link to, I missed her post on Stupid PIO Tricks. Lots of suggestions in the comments.
I spoke too soon about my freedom from knots in the rear. This time, I noticed that I seemed to have bulges in the ol’ upper outer quadrants. About the size of my open hand. The problem is that I don’t have buns of steel, so I thought the bulges could have been there all along. I had to wait till I got home on Saturday to ask my husband. He affirmed that a. my butt is as beautiful as always and b. the bulges are new. A little reminiscent of the water bulge that Old Goddess Cat gets after her subcutaneous fluid injections, but less mobile.

JUST FOR THE RECORD: Practice giving oneself subcutaneous injections does not translate into facilty giving them to the cat.

Also, I do not know if I have just hit a bad batch of needles or if my skin is hardening after two weeks + of injections, but it has been harder for the needle to puncture my skin the past couple of days.