The Lupron Depot Report

Today was the day. I switched from daily subcutaneous lupron to intermuscular lupron depot that lasts 1 month. About two months ago, I got a box in the mail from my pharmacy that looked like this:

Lupron depot box

Hmm, I’m imagining those old movies with the giant nefarious Victorian era syringes…

It said it should be stored at room temperature, so I kept it in a box in front of the AC unit all summer. I was concerned that it got too hot, bit the nurse wasn’t concerned so I guess it was all good.

Nurse? I’m an expert at this by now. I’ve done four rounds of progesterone in oil. Apparently, this drug is required to be administered in a doctor’s office. Maybe because you only have one shot not to screw it up.

Anyway, here’s the nurse telling me she doesn’t recommend looking at the needle:

It looks waaay more scary than it is. I proceeded to turn around and bare my ass. (I have no sense of privacy left after four years of infertility treatments.) I barely felt it go in. There was pressure and some pain from the medication going in, but not as much as the flu shot that I got last week. They did warn me that side effects might start in about a week, and that they might be more intense than on the daily lupron. (Now you tell me.)

So, that was it. I put my skirt back on and ran off to a meeting.

#MicroblogMondays: This is not a blog about being perfect

Going into the end of week four on daily Lupron following laparoscopy and it is kicking my ass. I was worried about getting super depressed on it, but I’m just hyper irritable and anxious, which frankly makes me come off as a total bitch. My partner is a real trouper.

So this is me seven and a half weeks post surgery and 27 days into the lupron. (Just keeping it real here.)

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I’m bloated from the daily injections and am starting to get a localized rash from it each morning. That said, my surgery scars a way smaller than I thought they’d be and it hasn’t been as bad as the stim period of a fresh cycle. I’ve been thinking about working the scars into a tattoo when this is all over. Any ideas, Reader? I’m scheduled for the month long depot injection this coming Wednesday, so we’ll see how that goes….

In the meantime, I’m keeping myself busy with work (way too busy). I’m trying to figure out how to lower my stress level and relax a bit, but that’s not a talent of mine. I’m also trying to avoid moments of weakness like this morning when I added a bunch of onesies to my ThinkGeek wishlist.

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(One of them was a Star Trek Next Gen engineering uniform! Am I right?) Anyway they’re perpetually out of stock and apparently so am I.

This post inspired by the the Stirrup Queens #MicroblogMondays. Hop on over to check out more blogs.

On Jealousy

I am not shy about my baby envy, and it is ugly. I have the urge to punch women with babies in the subway. Instead, I sometimes am my worst self and give them a nasty look for no reason, and at other times I’m a not as bad self and I look away and turn up my podcast. I’ve made excuses to leave the room when co-workers bring in their newborns. I’ve skipped baby showers, and I unabashedly unfollow every single person that posts a pregnancy announcement on Facebook.

Then something new happened. A friend,  more than a friend, a person who is part of my chosen family, texted to let me know she was pregnant. Yes, I had one good cry in one of the soundproof telephone boxes at my office. But, strangely, although I was jealous and sad for myself, I was so happy for her. I was so happy that I called to share her joy and get every single detail. Instead of the urge to pull away, I wanted to take part in this joy. After that call, the jealousy melted away. It would have been ok if it didn’t, but it did. I wanted to be part of this process for this person that means so much to me, even though I knew it might be painful at times.

Then a week later, I got another text. She miscarried. I was so sad. I wanted to be there to support her in her grief (we live in different cities). But I also had a new anxiety unfold during my evening commute. I know that miscarriages are common, and most women who have them go on to have healthy pregnancies. But all I could think about was the beginning of our journey. You start out so hopeful. Then one thing goes wrong, one fairly normal thing. For us, it was just that we didn’t get pregnant month after month. You don’t know that you’re one of the ones who will have to struggle toward parenthood. Not yet. It slowly dawns on you piece by piece after tests and treatments and months slip by. My friend will probably get pregnant again soon, and I can’t wait to celebrate with her when it happens.

I don’t believe that there is a purpose when bad things happen (other than the purpose we create for ourselves). I don’t believe that life is fair or somehow cosmically balanced.  But on the evening commute all I could think about was, don’t let this turn into anything else for them. I’m already going through this struggle. I’m handling it (barely), just let me keep handling it, and spare my friend. I know the universe doesn’t work that way, so I’ll rely instead on the numbers (probability and statistics) and on the hope that I carry for myself and for her.

Week three of Leuprolide

I want to give a short update about how things are going on my Leuprolide Acetate (Lupron) protocol. First a quick note: In this blog, I will talk in detail about medications and protocols prescribed to me. This is never meant as advice for anyone else. Our bodies and circumstances are all different. The only thing that I recommend is talking to your doctors, doing internet research with a healthy dose of skepticism, and practicing self-advocacy.

I am almost done with my second week of subcutaneous Leuprolide injections. I am doing a protocol in which I take Leuprolide for 2-3 months to suppress endometriosis followed by a frozen embryo transfer. (Research shows that the benefits of this protocol are inconclusive, but that is where I am at desperation-wise right now.)

Since depression is a common side effect of Leuprolide and I have a history of all sorts of depression and anxiety, I opted to try daily injections first before moving to a monthly one. That way we can pull the plug on the treatment quickly if anything goes wrong. My reproductive psychiatrist also kept me on an SSRI in addition to my regular medication and I’ve been taking another anti-anxiety medication on top of that. Sucks to be on more drugs, but it’s getting me through with less emotional side effects.

I started the injections in the morning before I realized that most women do them in the evening to avoid the side-effects being worse during the day. The injections themselves aren’t bad. I can barely feel the needle and it doesn’t burn going in like some of the injections that you take to stim during a fresh cycle. The worst side effect for me so far is problems with short term memory. It basically makes me super ditsy, so I write down or record EVERYTHING or I will forget it. It’s also embarrassing to frequently stop mid sentence during meetings because I can’t remember what I started to say.

So that’s where I’m at: holding pattern, trying to not let it affect work too much, keeping a close eye on my mood. Waiting is the worst!

The Catch-up Post (Only for the curious)

Since I began with the middle, this is the post, reader, in which I bring you up to speed on my long struggle.

Preface (a little bit of rant on my soapbox… because I can): 

I do not support the Suffering Olympics (aka. competing to see whose infertility story involves the most suffering). Everyone’s journey is their own. Every infertility sucks. Period. I simply share mine here for context and so that readers with questions can reach out. 

2014:

  • Context: I’ve been on birth control since puberty for irregular periods and pain. I take medication to manage severe anxiety and occasional bouts of depression.  I’ve had all sorts of chronic pain most of my life. I’ve never been pregnant. Partner and I are both 31.
  • I taper off my anxiety medication and have my IUD removed (Yay! We’re going to have a baby!)
  • We try for six months using ovulation test kits right out of the gate. (I’m really impatient so we were going to get this thing done as efficiently as possible.)
  • Nothing happens, so my gyno throws my first infertility drug into the mix. Clomid + timed intercourse (Yes, this is the point when sex becomes “intercourse,” ugh.)

2015:

  • We see an Reproductive Endocrinologist (RE) for the first time.
  • Lots of testing: (Blood tests timed to cycle, Ultrasounds timed to cycle, HSG, Saline Sono, Genetic panels for myself & partner, Sperm analysis for partner)
  • No cause for infertility found (Maybe a partially blocked tube?) “I’m almost certain you’ll have a baby within three months,” says the RE
  • Three IUIs (Clomid + trigger) = Nothing
  • IVF #1: Fresh cycle = 4 embryos, 2 transferred = Nothing
  • IVF # 2: Fresh cycle = 4 embryos, 2 transferred = Nothing

2016

  • Now we’re broke, so lots of waiting (grrrr) while we pay off our IVF debt.
  • More tests: Abdominal ultrasound, Karyotype testing for partner and me
  • So much waiting
  • FET #1: 2 transferred. FIRST POSITIVE EVER!!! The nurse warns me that it my beta is very low and unlikely to be viable.
  • FET ends in a chemical pregnancy a week later.
  • I go back on my anxiety medication, but plan to go off of it again for the next transfer.

2017

  • IVF # 3: Fresh Cycle only = 1 embryo
  • PGS (pre-implantation genetic screening) of the 1 fresh + 2 banked embryos reveals that all three are genetically normal.
  • Back to the drawing board: we switch to a new clinic
  • My new RE thinks I have endometriosis and that it is the cause of our infertility. (Someone took my pain seriously, and we might have answers? What!!)
  • Lots of tests: More comprehensive genetic panel for partner and self, genetic counseling, uterine biopsies, hysteroscopy, abdominal MRI “with gel” (NOT recommended)
  • IVF # 4: Fresh Cycle only = 7 embryos, PGS shows 6 are genetically normal
  • Start birth control pill to prep for surgery
  • Depressive episode, add a new medication to my current anxiety med, diagnosed with Premenstrual Dysphoria Disorder (PMDD) (Just add it to the list).
  • Laproscopic Surgery: confirmed and removed endometriosis, found and removed small uterine septum, third procedure to relieve painful bladder syndrome.
  • 4 weeks of estrogen and 1 week of progesterone to support recovery from surgery

Current & Upcoming (It’s still 2017? Whew!)

  • Current:
    • daily luprolide acetate injections to suppress endometriosis growth (it also puts me into a menopausal state)
    • Taking two daily medications, plus one as needed (to help with anxiety and depression while they’re messing about with my hormones)
  • Upcoming:
    • Switch to monthly lupron injection
    • Just one more test….: 3D ultrasound
    • FET #2 is coming (November?)

It’s Not Me, It’s the Hormones

tired dog

So I had a post-surgery appointment today. The good news is that I’m doing great! Healing quickly, in less pain than ever before in my life. The bad news is that the exhaustion that I thought was my body recovering from surgery is most likely actually from all the post-surgery and pre-IVF hormones and the anti-depressant/anti-anxiety medications that I’m taking. I think that this blog will be most helpful to you, reader, if I keep things real. So, in addition to talking about infertility, I will also be talking about what it’s like to go through infertility (and hopefully pregnancy and beyond) with a pre-existing anxiety disorder and history of depression. As you likely know first-hand if you are also struggling toward parenthood, there are all kinds of scary statistics out there about the level of stress that going through infertility causes. OK, I’m getting off topic. We will geek out about infertility and stress in a later post, complete with scholarly references. For now, let’s just leave it at my anxiety medication and hormones for infertility treatment are not playing nice. I’m exhausted all the time, and I now realize that this state of affairs won’t go away with one more week of rest. I have to find a way to cope and get work done while I’m this exhausted, possibly for months on end. I’m not sure what I’m going to do to cope yet. In the past I’ve broken my work up into small, doable chunks and rewarded myself for completing each chunk. I’ve also used the ideas of self-compassion and self-care. Now that I’m aware of the cause, I’m confident that I will find ways to slog through: one small step at a time.

Resources that I’ve found helpful:

Gamify Your Infertility (because why not): SuperBetter

Get support and, if you need it, help from an expert:

Recovering from Surgery When You Are Impatient

Have I mentioned that I am impatient? Well it’s no exaggeration. In preschool other 4 year olds used to scold me by singing the “Be Patient” song to me. I haven’t improved much over the years. For impatient people, recovering from surgery is a bitch. If are dealing with infertility, you probably already know about getting caught in the Infertility Time Warp where ever single cycle feels like slowly creeping years, especially cycles when you are not undergoing any sort of “active” treatment. Yes, giving myself daily injections is unpleasant, but it does make time move slightly faster.

Before I underwent my laproscopy, I wondered what the recovery would be like. Of course, everyone is different. For me, the pain went away quickly. I even felt less pain than before the surgery, likely due to the endometriosis that was removed. The part that is still kicking my ass two and a half weeks later is the exhaustion. It takes energy to repair your body after surgery. (I also had two other procedures done in addition to removing the endo; more on that later.) So I feel good, but I get tired after doing even small tasks. If I rally for a whole day and say work from home, which for me involves sitting on the couch while I write or talk with people on the phone, then the next day I’m wiped and have to take multiple naps. It’s frustrating to feel good, but not be able to do very much, even when it’s good for me.

Another aspect of the frustration is feeling like I’m so close, but having to wait. I’m doing a medication protocol for three months while I recover leading up to a frozen embryo transfer in mid-November. “You’ve already been on this road for three and a half years, so what’s three more months?” A rational person might ask me. Well, impatience is not rational. As my hope gets renewed, the waiting gets harder.