Monday, September 19, 2011

So Thankful....


NOTE: This is a VERY long post! And if phrases like ovarian follicles, frozen sperm, and intramuscular injections bother you, you may want to have someone else give you the summary. :)

Happy Monday, everyone! Last Friday was a big BIG day for me and for the babies. I'm officially 28 weeks now and still pregnant. And at the ultrasound last Wednesday in Omaha, we learned that the babies are over 2.5 pounds each and that they are still strong and healthy. In fact, they are both around 55th percentile in growth for a singleton pregnancy. Amazing!!!! Kevin and I held hands on the car ride home and just took in the sunshine and that glorious news. :) The doctor looked like he wanted to do a back flip when he entered the room. He said we are now reaching the point of "sunshine and roses," where if the babies were to come today they would not only have a fighting chance to live but also a chance to develop normally and with few complications. *DEEP exhalation* And my cervix, while still very VERY minimal, has not changed since they last checked it 4 weeks ago. Whoo-Hoo!!!! So each morning I'm now breathing a whole lot easier (but not literally) and continuing to truly enjoy each little kick coming from my tummy. I am overwhelmed. I'm so grateful. I feel so undeserving of such divine intervention for my little ones. I am thankful. I am THANKFUL......

So today I'm going to celebrate by finally writing about my little ones and how they came to us. I want to write their story before all the craziness begins in the next little while. My goal is still to make it to Halloween, which would put me at 34 weeks. For the first time ever, I think my doctors are starting to think that this is possible. So we're going to think positive and hope for another 5 or 6 weeks of baby-growing bliss.

Our sweet babies are here because of in vitro fertilization, and with the help of some truly amazing doctors and nurses at the Utah Center for Reproductive Medicine in Salt Lake City. If you happen to know our infertility history, you remember that Kevin and I have attempted IVF twice before in the summer of 2009 in Chicago. You can read about it HERE. IVF has been one of the craziest, most thrilling, most emotionally trying experiences of my life. Through the whole process, which can take about a month or so, and with every shot and every blood test and ultrasound, you still look in the mirror and wonder if there will even be a baby in the picture when it's all over. And for us, there never has been. Until this April. :)

Kevin and I weren't sure if we would be able to do IVF again or if it was the right thing to do. By last July we'd been approved for our next adoption and on the LDSFS website for 18 months. We'd done our best to spread the word that we were hoping to adopt again. We ordered pass along cards and sent them with Christmas cards and gave them to well-wishers. We felt good about the possibility of adopting again. But I just wasn't ready to let go of the possibility of becoming pregnant and adding to our family that way as well. My sister Jaime knew of an amazing doctor in Salt Lake City and once I heard about him and his clinic, I just couldn't get it out of my head (usually a sign). Then we planned a trip to Utah for a family reunion last August. Kevin and I decided to go meet with this doctor for an IVF consultation and just see how we felt about it. We made the appointment and set all the paperwork and medical records into motion months in advance.

Still, walking into the clinic I was unsure. I wanted it to be the right thing so badly. But it would mean so much sacrifice for us and for those who offered to help us try once again. The "what if's" stayed in my mind all that morning. What if it doesn't work again? What if it's just another waste of time and money? What if it's not meant to happen? What if my body doesn't respond the way we hope? Well, the "what if's" still lingered as we walked out of the clinic later that day. But I didn't care. I had just met the most AMAZING IVF doctor and his team and I felt so calm about it. I felt encouraged and knew that it was the right thing to do. We had to try just one last time. This doctor used completely different meds than I had been given before, and just looking at the records of our past cycles, he pointed out so many things that had bothered me about my previous meds or procedures before I even asked about them. If anyone was going to help us, it would be him. And there were so many changes that had taken place since our last heartbreaking attempts the summer before. Since then, I had had surgery to clean up my endometriosis and remove several painful cysts. My doctor made the right call to put me on six months of Depot Lupron injections immediately after the surgery so that my body could heal even further. When the awesome IVF doctor learned that I had just finished a regimen of Lupron, he did an ultrasound on me expecting to find shriveled little raisins for ovaries (a side effect of the drug). But he found that my ovaries were stellar, full-sized and ready to go with 5 follicles on my right side and 3 on my left. My body wanted to be pregnant. It was great to hear!

So Kevin and I set up our last IVF cycle for March 2011. Dr. Awesome didn't want me to attempt a cycle until at least early November because of the Lupron, and I didn't want to drive across Nebraska and Wyoming in the winter. So we decided to wait until spring. I gave myself plenty of flexibility for arriving in Utah just in case the weather didn't cooperate. And BOY did it NOT! You all probably remember the crazy snow storms and blizzards that hit the whole country this last January and February???? Yeah, I was trying to get to Utah to start this last adventure and I don't think that I've watched the weather so closely! I would set a date to leave and then another storm would blow through and dump over a foot of snow in Cheyenne and Evanston. Bah! Then it was like the skies cleared and the roads dried out for a 36 hour window and I took off. Noah, Abbie, and I sailed through Wyoming under clear blue skies and perfect roads and made it to our destination without a worry. And later that night, Evanston received another foot of snow. That was our very first miracle during this adventure.

My puppy, my little boy, and I literally moved in with my super awesome brother Sean and his sweet family for the month of March. I was SOOOOOO grateful for their hospitality and love. I had a comfortable place to stay and my son had his boy cousins to play with while I was distracted. My sister Jaime played an amazing role in this process too. She offered her home to us as well, and she gave me the emotional support and medical expertise that I needed to get through my meds. Kevin stayed in Nebraska and worked until the last part of the process when we hoped that we would have an embryo transfer. Since we were using his frozen sperm that we had transferred from Chicago to Salt Lake, he didn't really need to come any sooner and use all of his time off. Fortunately, my sweet mother flew out to be with us and to help take care of Noah and Abbie while I did the cycle.

Where all the magic happened:


Dr. Awesome did my baseline ultrasound on Monday, March 7th and found that my ovaries were at just the right point to begin. He had timed it perfectly so that my body was at the very beginning of a "normal" menstrual cycle, so it was the right time to start meds to stimulate as many ovarian follicles as possible in the next 2 weeks. I began my shots on March 9th.

The meds arrive in the mail:


My stimulation involved giving myself subcutaneous injections (in my belly) for 8 to 12 days. I was monitored very closely by ultrasound and blood work during that time and especially towards the end. They would count the number of follicles and how big they were each time. Once some of my ovarian follicles reached a certain size, it would be time to retrieve the eggs. It's amazing. It's all timed just right and then everyone hopes that each of those big follicles will contain a mature egg that may become a chance for a baby. I started out with 3 shots per day for 4 days. Then I had a total of 4 shots per day for the next 2 days. And then back to 3 shots per day for the last 4 days. It sounds a lot more complicated than it really was! Basically, I gave myself 3 meds that tried to stimulate as many ovarian follicles as possible. Then, on day 5, some of my follicles were big enough that I had to start giving myself an "antagonist." A med that would stop my body from ovulating any eggs that were forming at that point. In a nut shell, I had over 20+ follicles filling with fluid in my ovaries and the meds were making it so that they just kept getting bigger and bigger until Dr. Awesome could go in and collect the fluid and eggs. It got to the point where I felt like I had 2 sensitive water balloons inside me! I couldn't move very easily and within about 20 minutes of giving myself the shots I could feel them start to "zing" me, or send little sharp sparks while they grew. It's a crazy feeling that any woman who's gone through IVF could describe to you.

Days 1-4:


Days 5-10:


What my belly looked like on Day 3...


On day 10 of my stimulation, I was ready for my egg retrieval. It was time for my "trigger shot." This is an injection of pure HCG that needs to be given exactly 36 hours before they retrieve the eggs. So I stayed the night at my sister Jaime's home the night of March 18th and she gave me the intramuscular injection at just the right time (8:30pm). 36 hours later, on March 20th, I was at the clinic for my egg retrieval, praying that the results would be so much different than the last 2 times. From our previous 2 attempts, they had only been able to retrieve 6 and 5 eggs. So bitterly disappointing, considering that for us creating embryos is not enough. Our little ones have to be tested for cystic fibrosis before they will consider transferring them (just another hoop that Kevin and I had to jump through in order to make it work). The more eggs retrieved, the more embryos that may be created and tested. And the greater the chances that there will be 1 or 2 that will be healthy and will give us hope for a baby. My mother came with me to the clinic, and I was so glad to have her there with me. Everything went well, and as I was waking up from the AWESOME drugs that they give you for a procedure like that, I heard the doctor say the most beautiful number EVER. 16 eggs!!!!!! I couldn't believe it. 16 beautiful, perfect little chances.

I went back home to sleep off everything, and waited for the phone calls that would come over the next 5 days from the embryology lab. This is where numbers play such a big part of everything. The next day (Day 1 of life for our little embryos), we were told that out of our 16 eggs, 8 were mature and were fertilized using Kevin's "little soldiers" (that's how we referred to his frozen sperm... Remember that you have to keep a sense of humor when doing IVF or you'll go crazy!) I just couldn't believe that we had 8 little embryos! It was a dream come true. By Day 2, one of the embryos had "arrested" or stopped growing. So they began the genetic testing on the remaining 7. I kept my fingers crossed and prayed like crazy.

Meanwhile, on March 22nd, Kevin flew to Salt Lake City and joined us for the remainder of the time. It was so comforting to finally have him there as a part of everything. I'd missed him so much. The test results wouldn't be ready until the morning of March 25th, when the embryos were 5 days old. We were to receive a call letting us know how many of our embryos were healthy, if any, and if there would actually be an embryo transfer later that day. When the call came, we learned that 4 of our little ones had been affected by cystic fibrosis and weren't able to be transferred. It's so heartbreaking to lose more than half... Just like that. Just like last time. But we had 3 perfectly healthy little ones ready for us. We felt so very blessed. It was a chance. :) Kevin and I headed to the clinic right away.

2 of our little ones were so stellar, the doctors rated them as 11's out of 10's. They were "textbook perfect." Here's the picture that they took of them right before they did the transfer:


They were "hatching," where all the cells that had been forming up to that point were coming out of the egg and getting ready to attach to the uterine lining. The one on top they estimated to be around 100 cells, and the lower one to be about 60 cells. It was a beautiful sight! They were ready to go. In fact, they were so incredible that the doctors told us that if we transferred them both that our chances of having twins went from 25% to 50%. We know how THAT went! And our chances of triplets (should one of the embryos split) went from 3% to 10%. We were overwhelmed by that thought, but knew that it would be a blessing no matter what. It would be the way it was supposed to be. After all, through the whole process, we had to leave the science in the hands of capable doctors, and the outcome of every part of it in the hands of a loving Father in Heaven.

Kevin and I signed the necessary forms and then they gave me some valium. The doctor joked and said that Kevin could have some valium when I delivered twins. Little did he know.... :) We watched on a TV screen while the embryologist in the lab next door collected our 2 stellar little embryos into a catheter, and then he walked into our room and handed everything to the doctor. The transfer took about 10 seconds, and then I stayed laying down for almost an hour with a pillow under my knees for comfort. Then Kevin and I were ready to go home, and I was put on bed rest for 4 days. They would call us the next day and tell us how our last little one was doing in the lab. At that point, it was doing just okay. They didn't really know what would happen, but we hoped for the best. If it started to do better and showed promise, then they would go ahead and freeze it for us for the future. We knew that if neither of the perfect little ones now inside me didn't stay, our last little embryo still safe in the lab would truly be our last chance.

On our way home after the transfer:


The lab called the next morning during breakfast and told us that our last little one had arrested during the night. I just broke down and cried for the first time in the whole process. I had stayed strong for all the shots and all the "what ifs" and all the tests and procedures. But that was my breaking point. I lost it, and grieved for my 6 little embryos that didn't make it through to the end. I let go of them as I wept on Kevin's shoulder. For better or for worse, our hopes had been transferred back inside me the day before, and I prayed that they were still there. They were all we had left.

Kevin, Noah, Abbie, and I packed up all of our stuff and headed back home to Nebraska 5 days later on March 30th. We stopped for the night in Logan to see my grandparents and it was so much fun! We ate some of Grandma Stephie's homemade turkey noodle soup and bread, and Noah donned his full Darth Vader and Spiderman outfits for them. It was the perfect relaxing end to one of the craziest months of my life.

The end of an IVF cycle is by far the most emotionally trying part. There's something called the "2 week wait," and anyone who's been through it can tell you it is absolutely excruciating. Everything is over and done. Now you just have to WAIT until the day when you go and get your blood drawn to find out if you are, in fact, pregnant. Every little twinge your body makes, every little change or lack of. Everything makes you wonder... Am I really? Is it possible? The doctors wanted me to start intramuscular progesterone in oil injections the night of my egg retrieval and continue until I had my pregnancy test on April 6th. THIS was really the emotional and physical mountain that I had to climb for this last IVF attempt. I had always done subcutaneous shots before, and I just didn't know if I could give myself these shots. In my own hip. Yikes. But I was really inspired by several women who posted about their experiences, and by one woman in particular that put a video of herself doing this on YouTube. I watched her do it and I said to myself, "I can do that... for the baby." I will put her video at the end of this post so you can see what I mean. And Jaime was with me when I did my first one, just in case I needed her and in case I FREAKED out (which I did NOT). I knew that she or Kevin would help give them to me if I needed them to. But I was determined to do it myself, as the last bit of control that I had over the outcome of everything. Anyway...back to the story. I had been giving myself progesterone shots for over 2 weeks when I took my blood test. I FELT very pregnant at that point. But I didn't know if it was because of the meds, or if I really was.... I couldn't say it out loud.

Progesterone in Oil:


I was at the hospital lab here in Lincoln by 7:00am on the morning of April 6th. I had my blood draw lab slip in my hand and I felt so overwhelmed. They took my blood and said they would fax the results to the doctor in Salt Lake City. That morning kind of seemed like a blur. I remember that Kevin stayed home from work so that we could receive the news together. Lunchtime came and I finally sat down to eat with my boys. I had just taken a bite of PB&J when my phone rang. Of course!!! I scrambled to drink some milk while Kevin answered my phone. It was Dr. Awesome from Salt Lake City. The minute I got on the phone, my heart was overjoyed. They had me on speaker phone with all the other doctors and nurses who had been part of the experience. And they all told me at the same time.... "Congratulations... You're pregnant!!!!!" I think I was in shock. I remember laughing and looking over at Kevin who was beaming. And on the other end of the phone they were clapping and telling me my due date. December 9th. " How wonderful! You'll have a baby by the end of the year."

How wonderful.... We were so THANKFUL.

I continued my progesterone shots until I was 13 weeks along, and then I was done. We had an ultrasound on April 26th to see HOW MANY babies were there. We knew there was at least one, and that was all that mattered. When we saw both babies on the monitor, we learned that BOTH of our special little ones had stayed this time. Our prayers answered... Our dreams reality. Our babies were there and they were real. Just a few months before that day, I had wondered if I would ever know that kind of joy on this earth. It is so much more beautiful than I imagined. And knowing that joy also makes me so much more grateful (if that's possible!) for my little Noah and how he came to us. We are THANKFUL. :)

I actually took some videos of me giving myself my progesterone shot, just so I could document it and so I could look back someday and remember that I actually did it! Here they are, if you want to see them. Don't worry, you don't see my back side. :)

The injection prep:

video

Injection time:

video



Here's the YouTube video that inspired me so much:



So that's the story of how our babies came to us... And soon, but hopefully not TOO soon, I will be writing the story of their birth and the day that our Noah officially became a big brother. :)

I'll leave you with a last little treasure of IVF humor. A few weeks ago I was on the phone with my brother Sean while Mom and Kevin were in the room. I just thanked Sean for everything that he and his beautiful wife Maren had done for us while we were there with them and for all their love and support. I was so glad that they could be a part of it with us. Then Sean said,

"Yeah, Maren and I are so glad that we were there when the babies were conceived..." TOTALLY joking....

I burst out laughing and told Mom and Kevin what Sean said. They laughed and then Kevin said,

" I wish I could have been there!"

Yeah, good times. Sorry if you find that offensive, but having been through everything, we thought it was pretty funny. :)

Love to you all and hope you are having an amazing September, full of little and BIG miracles.

Nicole
@>->--


11 comments:

All Yappers said...

Seriously, I laughed, cried and read this post like it was on the #1 National best selling list. Amazing.

Kim said...

I am seriously so thrilled for you guys!! Can't even tell you!! I absolutely love your humor!! and loved reading this! Go babies Smith!!

Clay and Brittany Drown said...

I love this and have been looking forward to it for awhile! I'll be honest, I shed a few tears toward the end when they told you that you were pregnant. I can only imagine how ecstatic and surreal that moment had to be for you both. I am so excited for you guys and can't wait to meet these two miracles!

brinnandramona said...

I loved reading this, it brought back so many memories of our invitro experiences. The next time you come to the intermountain west area we need to get together to swap stories, and see your precious twins!!!

Kim said...

SO happy for you guys. Thanks for sharing this Nic, it made my day. Much love!

Jeff and aimie said...

SOOOO happy for you!!! I cant wait to meet the little ones... but not too soon!!! We love you and are overjoyed with this wonderful miracle that you both deserve!!!!

chaela said...

Amazing Nicole.

LOVE Sean's comment at the end.

I feel so much love and excitement for you and your beautiful family!!

Jaime Dubois said...

That is the best story EVER!!! :) So much love, perseverance, sacrifice, and strength to get two little miracles here. They don't have any idea how much they are loved already by so many! Keep being thankful! Love you guys!

DK said...

Nicole, I really enjoyed your invitro story, it's very interesting, thanks for sharing it with us. We are SO happy for you, Kevin and Noah. Diane Kiipp

The Porter Family said...

wow--those videos were amazing...I don't know if I could do that...you are inspiring!

TOJJ said...

I am just reading your story of the twins now, Nicole, and I am so glad to have such wonderful role models in how to deal with infertility. You are an amazing mother and I am so glad I got to meet Noah at Heather's wedding 4 years ago and hang out with all the Smiths. Crazy to think it's been that long! I miss you guys and wish we were closer in distance.