Medical Mystery Tour!

Oh, the crippling pain. I am walking as though I were morbidly obese. Or a 90-year-old WWII vet who never got around to getting that hip replaced. I groan when I get up from chairs. I whimper when I gingerly climb into the car. I am a mess. Why, you ask? A massive allergic reaction to my progesterone in oil (PIO) shots, that’s all. What the what. At my RE clinic, it is routine to receive a progesterone shot immediately following your egg retrieval. I had the shot last time, ended up in a fair amount of pain, and figured the nurse must have accidentally hit a nerve. It happens. This time around, I decided that instead of using Endometrin suppositories (white, chalky progesterone tablets 3 x day up the old hoohah), I would give myself a once daily PIO shot. With Endometrin (and other types of progesterone suppositories), you are forced to wear a pantie liner at all times and sit in a pool of vagi-pharmaceutical byproduct. Yes, I change the liners but unless you plan to live in the bathroom, you can expect frequent damp, icky moments. I explained it to J like this: imagine you had to live in tighty-whiteys filled with pudding.  I think that pretty much sums it up. I am such a lady. You can see why he fell for me. I leave just a bit to the imagination…

Retrieval went just fine. They got all 8 eggs. We later learned that of the 8, 7 were mature and 6 fertilized. Much better numbers than last time. For IVF #1, we got 11 eggs, 7 were mature and 5 fertilized. The theory of quality over quantity already seemed to be playing out. 

Saturday. Thus starts day 1 of crap.  After retrieval and my PIO shot, J and I had brunch with his parents and did a little light strolling. We hit up a farmers market and toured around Graceland Cemetery. I progressively felt more and more meh. J took me home and I tried to sleep off the last breaths of the anesthesia. When I woke up, I felt incredibly nauseous. TMI starts now, kids. You are more than welcome to shut down your browser and do something more pleasant than read about my horrid bodily functions.  I took my temperature and found that it was 100. Also, constipation. Fun. Per my handy-dandy post-op instructions, I called the doctor on call. She advised that I try to drink a lot of fluids, take a stool softener, and call her if anything got worse. I promised to call in the morning to follow up. Begging off of dinner with the in-laws, I asked J to run and grab me a stool softener and some Gatorade from the pharmacy. That poor man.  I should have thrown in a tube of Monistat for good measure.

While J was out, I gave myself my second PIO shot. Uneventful.  Later that night, after J was back from dinner but out walking the dogs, I realized that the time had come for some long awaited bowel movement. The party was about to start. As I sat down, I was hit by waves of extreme nausea and broke out in a head to toe sweat. After I finished my business, shaking with my hair and clothes soaked with sweat, I staggered out of the bathroom and collapsed on the living room floor. My thoughts: I’m going to die. We’ve got to get this carpet professionally cleaned.  J came in seconds/hours (not a clue) later – freaked out for a moment – and then scooped me up and carried me into the air-conditioned bedroom. I was able to drink some water, calmed down and insisted there was no need for a trip to the hospital. Freak incidence, all probably due to a bad reaction to the anesthesia. I slept fitfully that night.

Sunday, day 2 of crap. I speak to the on-call doctor to follow up as promised. Yes, I’m still nauseous. Yes, I’m drinking fluids and keeping them down. Yes, I still have a low-grade fever. She was about to let me off the phone when she asked about the state of my bowels (I am so sorry you people are reading this literal shit). I told her, with very little detail, about the rather dramatic movements of the night before. “You need to come in to see me. I don’t like this. I’m not sure what’s causing you to be sick but I want to check you out for myself.” J and I cancelled our plans and hit the road. At the clinic, they ran every test to confirm that I didn’t have OHSS (ovarian hyper stimulation syndrome). I didn’t. I didn’t have any signs of it with the exception of the fever.  They took blood, did a urinalysis and all that came up was a slightly elevated white blood cell count. I was told that this is typical for post retrieval and if you’re fighting off an illness. I mentioned the severe pain I was developing at my PIO injection sites. She checked them and noted that they looked ok and that muscle soreness was unfortunately par for the course. The doctor then scheduled me to come back the next afternoon so that I didn’t “slip through the cracks.” 3 hours after we arrived, I got to go home and take a freaking nap. Sick and tired. That night, I administered my third PIO shot. Afterward I walked around, sat on a heating pad and massaged the area the best I could given how much it already hurt from the first shot.  As the night wore on, the last injection site became more and more painful. By 1:30 AM, I was lying on my stomach crying while J iced my blazing red ass cheek. Whoever told you that fertility treatments weren’t romantic had no imagination! J ran out to get Tylenol (no Ibuprofen for the IVFers) and I eventually was able to drift asleep at about 3 AM while watching Dexter murder people. I love that show.     

Monday, day 3 of crap. Holy mother of pain. Monday is when shit got comical. I could barely walk. My ass had a hot, red, raised pad the size of my palm on the upper left cheek (lucky 2 injection side) and a small, hot patch on the right side. I was more nauseous than ever and decently dizzy. My skin hurt. I took off my jeans and t-shirt because they hurt.  I changed in to my most muumuu-like maxi dress only because nudity wasn’t an option. I took my temp. Still at 100. I went back to the clinic and this time was greeted than none other than Dr. Robot. She is the shining star that told me, after revealing that there was no heartbeat, that there was “still stuff in my uterus.” In her defense, Dr. Robot was very thorough. She ran all of my tests again. Same results. Nothing obviously wrong. Once again, I mentioned to her and the nurse how incredibly painful my injection sites were. This time they told me to stop the PIO shots and to switch to suppositories.  I’m sure they were just trying to give me one less discomfort but that allowance saved the day. Before I left, I told Dr. Robot that I was concerned about doing a transfer (scheduled for the next day) while I was feeling so sick. She agreed and said that she would recommend freezing all of the embryos and doing a frozen transfer on a later cycle.  OH HELLS NO. No. It’s not that I assume that cycle would undoubtedly work. It’s that I at least need a shot. I need to know that we’re at least trying – you know, how other couples do when they have unprotected sex. Like that. Here’s the other piece of that shitcake: my clinic has very good success rates with fresh embryo transfer. Not so much with frozen. Dismal. I’m sure that says unfortunate things about the lab. Regardless, for now I’ll go for the good rates with the fresh transfer. I’d rather transfer 2 fresh embryos into my sick body than frozen ones with little to no chance. Seeing the horror on my face (really, I meant could we push to a 5-day transfer?), she suggested I come back tomorrow an hour before my scheduled transfer and see the doctor to make a game day decision. Fine.

While waiting for my test results to come in, I took the time to Google side effects of the PIO shots. Nausea? Check. Dizziness? Check. Fever? Check. Severe pain, swelling and redness at injection site? Check. Difficulty sleeping? Well yes, due to constant pain. Gradually, I became more convinced that the stupid shots were the source of all my troubles. After I left the clinic, I went to the pharmacy and picked up some Benadryl. When I got home, I took 2 Benadryl and took a nap. When I woke up the nausea and dizziness had significantly subsided. I ate a real meal for the first time since Saturday morning.  No PIO shot and another dose of Benadryl before bed, and I woke up this morning feeling much, much better. No more nausea or dizziness, no more fever.

Tuesday, not so crappy. I saw yet another doctor this morning who quickly ascribed my symptoms to the PIO shots. After checking my temperature and my blood pressure he pronounced me “just fine.”  I told him that Dr. Robot had been concerned enough to suggest that I freeze all the embryos and abort mission. “We’d only do that if you had OHSS which you clearly don’t.” Right, clearly. He assured me that my freak allergic reaction would not affect the success of my transfer.  I’d like to believe that. I don’t think he knows that for sure. Cleared for transfer, I went in where Dr. M, my primary RE performed the procedure. He too seemed very familiar with adverse reactions to PIO like the one I had. Why don’t they warn about these things? The reaction, I should clarify, is to the sesame oil that the progesterone is suspended in, not the progesterone itself. He said that some patients still have swelling months after stopping the injections. Shoot me.

We transferred two embryos. One was a fabulous 8-cell (ideal) with no fragmentation and good symmetry. The other was a 6-cell with no fragmentation and decent symmetry. Another B student. I was very excited to have an 8-cell embryo. Last time, not a single one was at 8-cell by day 3. Again, quality over quantity. Of the remaining embryos, 3 were 6-cell and 1 was a 5-cell. Dr. M predicted none of these would make it to freeze. For some reason I think he’s wrong. I’ll find out on Friday.

So to summarize this incredibly long, rambling, whiney post: I am a medical mystery. I can't walk and am crazy sick. Nobody knows why. I figure out that it's an allergic reaction. Medical professionals agree. Day 3 embryo transfer.
TTFN. Off to lie on the couch and watch bad television. Also, long live the royal he-baby. Whatever his name is.