The Treatment Diaries: Aftermath & anxiety, June-July 2001

Monday, June 4, 2001: Negative, of course. :( What's more, my ultrasound showed a few large echogenic follicles. "He wants you to come back in a few weeks (Monday, June 18th) to monitor those large follicles and make sure they're going down," office manager K. said in a phone call to me later in the day. By late that afternoon, I was bleeding heavily -- the heaviest cycle I'd had in a few years. In 8 hours, I soaked through five maxipads, and was leaving large clots in the toilet.

I paged Dr. RE: "Is this normal??"

"I wouldn't say it's completely normal, but it's not unexpected," Dr. RE said when he called me back awhile later. "Your estrogen levels were very high, and your lining was quite thick." He told me I could take ibuprofen. He started talking about things we could do "the next time," but I told him we would probably be taking a break for awhile. (Maybe permanently.)

Tuesday, June 5th happened to be my annual physical with my family dr. I was 10 lbs heavier than I had been the previous year. :p

Later that night, I called my mother. She chose that evening, of all nights, to tell me about someone she knew who had adopted two children through the same agency two of my girlfriends had used. And now they had just gotten a third child, after a wait of just three weeks! "I just thought I'd mention it," she said brightly. "Your sister told me to leave you alone, but we DID sort of talk about adoption once, didn't we?"

My replies were monosyllabic. When I finally got off the phone, I burst into sobs & cried for more than an hour. My sister was right -- I knew my mother meant well -- she wanted grandchildren, and she had no idea the lengths we were going to, trying to get her at least one. But geez Mom, what rotten timing!! Dh was furious -- with my mother, for bringing it up, and with me, for not telling her what was going on. That didn't help matters.

The next morning, Wednesday, June 6th, I wrote in my diary:

I look like a mess -- woke up this morning, eyes sunken with huge bags underneath. I feel lousy, like I was hit by a truck. Eyes feel sunken (could hardly put in contacts), hard to even walk (a little short of breath?). I am so out of shape it's not funny (although I suspect some of this is psychological -- also compounded by general end of cycle/period fatigue).

My life is a mess. Dh is right -- we need a break from all this.

I didn't take my temps this morning.

Friday, June 8th:

I have been winded all week. Today, I noticed my ankles are swollen. Weight is up slightly, but it's evening, & I usually weigh myself in the morning. Health encyclopedia says symptoms of pulmonary edema/congestive heart failure. OHSS?? OH. GOD.

You can see I was beginning to work myself into quite a state. I called Dr. RE (again). He pointed out that OHSS symptoms usually show up within a week to 10 days after an IUI, and it had been almost three weeks now. "I would be very surprised if it showed up this late, unrelated to other symptoms." He pointed out that the weather had changed, that the body tended to retain fluids in hot weather. Also, I had just had a very heavy period, and my body might be trying to compensate by retaining fluids.

Then he added, "I guess we could have pushed you a little too hard with the drugs, so your kidneys & heart aren't working very well." Exactly the WRONG thing to say to a hypochondriac who had kidney & bladder problems as a child (and one kidney slightly smaller than the other) and a diagnosed heart murmur (albeit a very minor one).

I mentioned I had been to my family dr for a checkup. The blood results weren't back yet, but my EKG had been normal. "If there was anything abnormal, I'm sure he would have picked it up," Dr. RE said, but then reiterated, "You may have underlying problems that have been exacerbated by the drugs... you should get that assessed. You might be unique." Oh, I'm friggin' unique, all right... :p

He wound up by saying, "Don't be frightened... but don't dismiss things either. If you're really concerned, get to the nearest hospital. And call me, so the drs there get the full picture."

My next few journal entries obsess over the daily state of my ankles. :p They looked better, but I still wasn't sleeping very well.

Sunday, June 10th was our pg loss support group's annual picnic and butterfly release. It was a highly emotional day.

Monday, June 11th, I got up at 4 a.m. & got ready to take the early train into the city. Then I remembered -- I wasn't due back at the clinic until NEXT Monday, June 18th. I decided to take the early train anyway & head straight for the office.

I had a lunch date at a restaurant downstairs in my office tower with my college roommate -- she'd had a birthday recently & it was my treat. All morning long, I'd felt a certain tightness & discomfort in my chest. My bra felt tight, & before I went to meet her, I went into the washroom, took it off & stuffed it into my purse.

In my journal, I wrote (and I have no idea why I was writing in present tense...!):

As I settle into my seat, I think, "This is a mistake." But I chat, I laugh, I eat -- lightly -- tomato basil soup, salad, roll and Perrier. I do have a good time -- for awhile.

About the time the tea comes (1 p.m.-ish), I start feeling really funny. I nod and laugh, but I'm no longer listening. My chest is feeling tighter, my shoulders feel sore, I start to feel warm from the chest up, but my hands feel cold & clammy & weak. I reach for the leather folder to slip in my money, but I have to try three times before it opens. I try to take a sip of water, but I can't lift the glass.

"I'm not feeling very well," I tell my friend. I try to take a deep breath, but it's hard. She asks if I feel sick, asks me questions. Tears fill my eyes. "It's scary," I whisper.

She asks if I'd like to call my dr. on her cellphone. She tries to dial, but the phone doesn't work inside the restaurant. Somehow, I find the strength to rise slowly and leave. We go sit on a bench in the concourse outside. I call Dr. RE & the receptionist answers. I tell her I'm not feeling very well. She gets K. on the line and I tearfully tell her how I'm feeling. She asks me questions. Nausea? (No.) Bleeding? (No.) Cramps? (No.) She asks me to call back in five minutes.

When I do, I'm still not feeling great. Maybe I'm having a panic attack? I suggest. "Could be," she says. It's too far past the profasi shot for it to be OHSS, she says, "but you should get checked out at your family dr's or the emergency room." Gee, thanks. :p

I call dh & tell him what's going on & where I am. Decide not to call Family Dr., just go there. I call my boss & leave a message, saying I'm not feeling well and am going to my dr's. We slowly make our way to the escalator. Outside, there's a cab waiting -- thank God! I hug my roomie and thank her. She offers me her cellphone but I decline...

Not sure which is scarier, the way I'm feeling or the way the cabbie is driving. I feel like I'm going to pass out. I struggle to remain calm and take deep breaths. Dh squeezes my hand reassuringly and smile. I am so proud of him.

We pull up in front of the dr's office. Dh pays the cabbie and we go in. There's a delivery guy with the receptionist and the nurse (who is also the dr's wife), but no one in the waiting room.

"I'm sorry I didn't call," I sob, "but I'm not feeling very well." Within seconds, I'm led into an empty room and told to lie down. Dh uses my cardigan to make me a pillow. The nurse slaps a blood pressure cuff on me and pumps it up. She shakes her head -- it's high. She asks me how I feel -- chest pain? (Tightness, no pain.) Nausea? (No.) Headache? (No.) etc. etc.

I tell her about the fertility treatments, about Friday. I had actually called there just before lunch about my bloodwork. My thyroid was high (6.64, normal is 0.5-5.5), & hemoglobin a tad low (116 -- should be 120-160) but everything else, including my ECG, was fine.

The nurse takes my blood pressure again (and again). Still high, but falling each time, until it reaches a high normal range of 130/90.

The dr finally comes in. Same conversation as with the nurse. He listens to my chest & lungs and pronounces them fine. To ease my mind, he does another ECG. It's fine.... He also takes some blood to test for cardiac enzymes (it comes back the next day negative). He tells me it looks like a panic attack to him.

He leaves briefly and comes back with a little bottle. He shakes out a tiny white pill and offers it to me. "What is it?" I ask. He tells me it's anti-anxiety medication & will help calm me down. (He later tells me it's the receptionist's!) He writes me a prescription for the same thing, "just in case," only a lower dose.

I'm finally calming down. They send us on our way feeling better (the drugs are working!).

We go to a nearby drugstore to fill the prescription. Stop at a payphone to call people. Dh calls his partner at work, I call my best friend at work and then my boss, then my roomie (voice mail), then Dr RE's office (talk to K.). We take the subway to the train station & take the next train home (by now, it's almost our usual time to leave anyway). I lay on the couch most of the evening & go to bed at 8:30. I sleep soundly for the first time in ages. Dh stays awake until 2 a.m., listening to me breathe!!

Over the next few days & weeks, I experience what I think of as "aftershocks." The next day I was attending a training workshop out of the office. All was going well until about 3:30 p.m., when I got what I described in my journal as "a funny cold feeling... a little tingle/numb feeling going up the right side of my face that started to turn warm. Great, now I'm having a stroke??" I struggled through the rest of the session, wound up taking another pill and going to bed early again.

Wednesday, June 13th, I called the infertility counsellor we had visited prior to embarking on injectables & IUIs. She remembered me instantly, and we set up an appointment to meet Monday after work. The next day, I returned to Family Dr's for a followup blood test for my thyroid. "Well, you're looking MUCH better!" they all told me. He checked my blood pressure and listened to my heart while I was there, and all was well.

Eight years earlier, Family Dr had thought he detected a mild heart murmur. He sent me to consult a cardiologist, who ordered an echocardiogram. At that time, he said he saw absolutely nothing that concerned him -- on a scale of 1 to 6, my murmur ranked at about 0.5 -- but he added I might want to repeat the test in another 10 years just to check things out. Family Dr asked if a repeat echocardiogram would make me feel better, and I said yes, so he booked one for me. "I don't want to dismiss your concerns," he said, "but this sort of thing is almost always emotionally based and you've been under a lot of stress lately."

Monday, June 18th, I was back at Dr. RE's for ultrasound & bloodwork. The echogenic follicles were still there, but they weren't as big.

Later that evening, we met with the infertility counsellor again & told her everything that had happened since we last saw her. We acknowledged that we had said "three cycles" -- and we'd done three cycles. Were we ready to stop treatment? To stop ttc altogether?

Dh said he was ready -- he felt we had done all we could, and he was worried about my health, the stress on both of us, the possibility of multiples. He said we could continue to try on our own for awhile, but acknowledged he wasn't getting any younger.

I said I was 85-90% of the way there. "I know we could do more -- more IUIs, IVF -- but emotionally, physically, mentally, I'm not sure I can do it anymore. I said I still wanted to keep the door open crack. And I said I needed a holiday!!

The counsellor recommended that we take a break -- put away the thermometer. think about the surgery. "If you're going to do one more cycle, set a time limit, say, your 41st birthday in January." She recommended that, once we decided we were ready to stop, we should consider birth control (!!). "I know it sounds nutty," she acknowledged, "but then you won't be constantly hoping in the back of your mind." She also recommended performing some kind of ritual to acknowledge & mourn the end of this phase of our lives.

She also asked us, "What would it mean to give up on that dream?"

In my journal, I summarized my response: "I know in my heart we can have a good life with just the two of us. But I will always feel like I missed out on something special."

She asked us what we did for fun, to relax. I said, "You know what? I had fun tonight! We stayed downtown, had dinner, wandered around a bit until it was time for our appointment. Usually we just head for the train, go home and flop on the couch in front of the TV set."

"You had a DATE!" the counsellor grinned. "I'm going to prescribe a regular date night for you two. You should take turns planning it. Something different, not the same thing all the time."

[I loved date night. Dh was less enthusiastic. He confessed he was usually too tired at the end of the day & wanted to just go home & flop on that couch. So it didn't last long, but it was fun while it did, and it helped get us over that initial post-treatment hump.]

Besides a date night, she recommended yoga for stress relief. I did eventually start taking a weekly yoga class, which I loved. I also started getting regular mini-massages at a walk-in storefront massage clinic near work, on my lunch hour. "You're very tight," one of the girls there remarked as she worked on me.

Monday, June 23rd, day 23, I was back at the clinic. K. called me later in the day. "Looks like you're starting to surge," she said, advising timed intercourse -- every two days for the next week.

I returned Tuesday, July 3rd (day 31) I was back for bloodwork. K. called me later to say my beta was negative, and my results suggested I was having an anovulatory cycle.

I returned a week later on July 10th (day 38), My homone levels were still fluctuating wildly, & I was offered Provera to induce my period. I was almost ready to go on vacation. What would happen if I didn't take the Provera? K said there was no medical risk; it was just a way to end a "really long" cycle & wipe the slate clean. 38 days was not that unusually long for me, so I said I'd prefer to wait things out.

"Call us when you get back," K. said. "And have a good vacation."

I never returned.