Sunday, January 31, 2010

Scans, Plans and Specimens

(Yeah, yeah - pronounce it 'specimans' for the rhyme.)

It's too much to say we're used to our surroundings but I suppose, with all the distraction that comes with our focus on surrogacy, we've already reached a little equilibrium. Wake up at 7:30am so Shannon can take her meds, shower and get dressed, head down to the excellent breakfast buffet, take a little walk and/or sit around the pool, and then wait for our driver while responding to emails, writing for our blog and the like. We know before bed when and where we'll be needed the following day - we get a call from the doctors on the cell phone they supplied - so it's easy for us to plan appropriately. And happily, jet lag hasn't really been an issue. Seems the significant time difference between India and the US east coast (India is 10.5 hours ahead) is more easily accommodated than a more moderate five or six hour change that comes with travel to Europe. (Shannon and I both have had some rough jet lag after European trips.) It also helps that we spend at least part of each morning in the sun, letting our bodies understand that yes, normally, this hour is midnight, but right now it's 10:30 in the morning.

On our third full day we visited Lilavati Hospital so Shannon could have a second pelvic exam as well as an anesthesia workup while I get to make a little donation. The pelvic exam allows Dr. Yash to monitor the size of the follicles in Shannon's ovaries, ensuring they're growing properly and helping her to determine when the trigger shot and egg retrieval should be scheduled. The anesthesia workup is a little more important than typical because, unlike in most cases when egg retrieval is conducted vaginally, the high placement of Shannon's left ovary (due to the congential condition that brought us to surrogacy in the first place) requires the retrieval be performed laparoscopically. This means a slightly longer application of general anesthesia. We're told it'll be a 10 to 15 minute procedure instead of a 5 minute procedure so, in the scheme of things, not a big change. On the other hand, it does mean Shannon gets to go home with a couple of other souvenirs - tiny incision marks.

The hospital is a fairly modern building located in an upscale part of Mumbai named Bandra, about 30 minutes of traffic south of our hotel. Inside we were met by Dr. Sudhir and Heena, the assistant who met us at Hiranandani Hospital yesterday. A few moments later we were joined by Dr. Yash who took Shannon away for her pelvic exam. Shannon tells me the setting for this second test - though better than the one in the clinic up north - still failed to meet the standards we've come to expect in the States. She gritted and bore up to the test and random visitors who passed through the test suite. Upon return, Dr. Yash informed the two of us that the follicles were developing well and we were going to perform the retrieval Wednesday morning. This meant a trigger shot Monday night at 11:30pm (1pm Boston-time). Dr. Yash asked us to come by for another pelvic exam sometime Monday morning for a sanity check but things seemed to be in order.

The two of us were then led to an office for a detailed discussion with an anesthesiologist about Shannon's allergies, past history with surgery and the like. Looks like things will be a piece of cake for her. Then, to complete this day trip to the hospital, I had to produce a sample. (A sample of what, you may ask? I'm not telling.) This tattered room wasn't conducive to producing samples of anything but I did find a newspaper in the room I could use to catch up on local news if I got bored. Needless to say, I eventually held up my end of the whole surrogacy bargain.

Back to the hotel. This late in the procedure, Shannon's feeling more than your usual fatigue, capped with headaches, bloating and lots of other fun symptoms. We're just going to take the rest of the afternoon off. I've actually witnessed Shannon nap two days in a row. This woman does not nap, her energy's boundless, so I've learned she has a weakness - three weeks of body-altering drugs and long flights east. Good to know.

Saturday, January 30, 2010

Parting Shots

If you haven’t read them by now, Geoff posted two entries just last night so please check them out (First Impressions and Breaking the Ice).  I wanted to give folks an update on my shots and what our next medical steps will be.  Tomorrow (Monday) is my last day of Lupron and Gonal-F shots.  YIPPPEEEE!  They’ve left me bloated and a little tired with some firmness in my abdomen since that is the only part of my body I used for the injections. The injections themselves really haven’t been THAT bad but the anxiety just before I’m about to inject is something I can definitely live without.  I usually prep both needles and get the injection site ready.  If I hesitate when injecting at all, I’m a goner and that is what throws me off.  Yesterday was a piece of cake but today, not so much.  Even though the needles aren’t that big, to stand there holding a sharp weapon a half inch from my stomach isn’t as inviting as one would think.  The hesitation brings on a few hot flashes of adrenaline, weak knees and shaky hands. What fun!  I know what you’re thinking…why can’t Geoff give them to you?  Well, I suppose he could, but I’m an intelligent, strong woman in my thirties and I’ll be damned if I can’t get through this.  For me, it would be a blow to my dignity if I couldn’t administer these shots on my own.

Tomorrow day, I return to Lilavati Hospital for a third pelvic scan and in the evening, I inject the “trigger shot” (HCG), which tells my ovaries to let go of my plumped up eggs and get this party started!  I am ecstatic to say that like the two other shots I’ve been administering, this will be a subcutaneous injection (1/2” under the skin) vs. an intramuscular injection (under the skin and into the muscle) that many are familiar with.  All this means Wednesday will be the day of our egg retrieval. Wednesday is E-Day!

The Meeting

Our second full day here in Mumbai is a day that Geoff and I will remember for the rest of our lives.  After breakfast and a stroll on Juhu Beach we got ready for the big moment – meeting our surrogate. Our driver picked us up and we sat in typical Indian traffic for roughly 45 minutes before arriving at a different hotel where another SI couple was staying. Together we then visited Hiranandani Hospital, the birthing hospital we will be utilizing if we are lucky enough to get pregnant. Heena, another SI assistant, met us there and introduced us to a doctor who took us on a behind-the-scenes tour of the birthing facilities. To appearances it’s different from the state-the-art hospitals we’re accustomed to, but I’m thrilled to report it’s clean and closer to the standards we are used to. While there we had the great pleasure of meeting another SI couple who are here to pick up their twin boys! Congrats Todd and Alper and best wishes to you both!

After visiting Hiranandani Hospital, we eagerly headed back to the SI offices.  Soon after arrival, we proceeded into a semiprivate room where our carrier, “R” was seated with her husband and an attorney named Amit who would facilitate the contract signing. We anxiously shook hands and offered the most sincere smile two people could offer. Amit explained the contract and then tried his best to cut the nervous tension by joking with Geoff and me about how this signing process is similar to a house closing as in both instances you sign a slew of papers. The formal signing took only a few minutes after which Amit opened it up to all of us to communicate. R was shy, extremely soft spoken and reserved. Beautiful is an understatement, with eyes and a smile as innocent and sincere as you can imagine.  She was dressed in a traditional Indian sari and wore gold chandelier earrings, a matching necklace and a small piercing in her nose. (Apparently, in most of India, women prefer to wear gold jewelry - with the exception of an Indian state named Rajasthan where silver is preferred.)  Her left hand was delicately decorated with Indian henna tattoos which I meant to comment on but just couldn’t remember in the thick of it.  Her husband understood some English, supposedly unusual for a lower caste family, and in true Indian culture showed more eye contact then she.  He appeared to be very supportive, aware of the implications of this process and very much a part of it. We were extremely happy for confirmation that R would not be on her own.

The process was a bit awkward but incredibly exciting and inspirational. The emotions of gratitude that we felt in her presence were beyond overwhelming. We are meeting the woman who will hopefully, very soon, be carrying our child – oh my god! I was so nervous. My legs were shaking uncontrollably and my heart pounded so loudly I thought for sure R would hear it. With my hormones at their height coupled with the intensity of meeting her, I couldn’t help but cry. I tried to hold back, but simply couldn’t. The SI assistants standing at the ready quickly came to my rescue with tissues and bottled water, patting my hands. Amit hugged me and told me it’s okay to cry. He explained to R and her husband that they were tears of joy and relief as we’ve waited a long time to finally meet them.

Through translation, we wanted them to know that her well being and health is our main concern. Their head nodding confirmed they understood. Aside from answering a few of our questions and asking us what nationalities we are, they didn’t have much to say. R's timidness didn’t go unnoticed and we didn’t want it to be any more uncomfortable then it already was, so as directed, we quickly moved back into the space where Doctors Sudhir and Yash were waiting for all of us. The doctors were very happy for us to finally be in this moment, to be sitting with our surrogate and moving forward with the process.

The doctors translated a few questions we had for R and let her and her husband know that we would always consider them part of our extended family. Geoff and I did struggle to express our thanks. This simple couple from the streets of Mumbai would be tied to us for the rest of our lives through this amazing act of sacrifice. What can you say? To complete our visit we gave them some gifts we’d brought along for them and their two sons. We had purchased a Lego set for each son and some Playdough.  We gave the husband a foam baseball and bat for use with the boys and much to our surprise, he knew what they were. Funny thing….as Dr. Sudhir was explaining to him that baseball is a very popular sport in America, the husband nodded and in the middle of his native response, we heard him say “ESPN”.  Not sure where he’d seen it, but he was spot on. (Gift selection was challenging, particularly for the father. What would be suitable for a low caste Indian father? We settled on something he could use with his children thinking, well, baseball is a lot like cricket – which is popular in India - but novel enough to be unique in their neighborhood.) Except for the baseball and bat, all of the gifts were in pretty gift bags with coordinating tissue paper and ribbon.  Geoff thought it might be awkward for the couple to walk home with these technicolor bags but in my family, gift presentation deserves its own attention. R’s gifts were in a hot pink, polka dot bag (of course!) and her eyes lit up in amazement.  Understandably, she preferred to wait until she got home to open it, but inside was a pretty necklace and matching bracelet for her, some girly things (eye shadow, lip gloss and nail polish), a body cream set and a journal for her to write her thoughts in while she’s carrying for us. We’re hoping they will enjoy the gifts and were pleased with our selections. They collected their gifts, shook hands with us once more and then went on their way.

Prior to our leaving the clinic another SI couple arrived to say hello. Stan and his wife were two days away from going home to New York with their new daughter Daniella. (Geoff had actually spoken with Stan on the phone more than once as we researched our India clinic options. He was a fantastic resource.) We held the adorable newborn for a few stolen moments and then said our goodbyes through hugs and handshakes. Congrats to the happy couple!

That evening, the doctors took Geoff and I out to dinner at the restaurant Jamavar in the amazing five star Leela Hotel, where we enjoyed authentic Indian cuisine from both Northern and Southern India. It was a fun night and a great privilege to have one-on-one time with the doctors, getting to know one another beyond the x’s and o’s of surrogacy. It was a great night after a full day. We collapsed into bed once we got back to our room.

Breaking the Ice

In my previous post I shared some of our initial impressions about India. In this post we'll get to the whole reason we flew these 7500 miles.

On Day One our surrogacy responsibility was to visit our doctors’ clinic for a meet and greet and then to perform some quick tests – me a blood test and Shannon a blood test & pelvic ultrasound.

The drive lived up to the billing I mentioned in the previous post, taking about 50 minutes to cover a mere 10 miles. Our hotel was selected due to its proximity to a hospital south of us in which Shannon’s eggs will be retrieved – Lilavati Hospital. The surrogacy clinic, on the other hand, is located north and placed in a location conducive to travel for the surrogates – the lower classes can reach it easily. This was a wise business decision as it ensures a high volunteer rate for our clinic while other surrogacy clinics, located in more posh parts of town, have greater recruitment difficulties because they’re hard to reach. (We had 16 surrogates to choose from on day one; in other clinics, new couples sometimes have to wait days to weeks before getting even one to choose from.) The side effect of this location is that it looks absolutely like the wrong place for our destination. The driver must be lost. This is where our wonderful, kind doctors commute to every day? This is where we’ve been sending our money and placing our hopes for building a family? We didn’t even want to get out of the car. Is this a scam?

I’m sure by Indian standards the location was perfectly fine and perhaps my characterization is a little insulting, but I’m judging it using my Western expectations of medical cleanliness. The building was cramped, three dingy stories lodged between other rickety shops and shoddy advertisements. We walked across the dusty second floor landing, led by our trusty driver Ajit, stepping over the discarded sandals of visitors as we approached a smoky glass door. Behind it – the comforting, warm smiles of Dr. Sudhir and Dr. Yash. Here was our second oasis in India. Assisting the doctors are Ghopa and Gia, two very well dressed Indian women also equipped with endless smiles and sensitivity to our plight. The drive, the location, were quickly forgotten.

We hugged, exchanged niceties and then caught each other up – how have the shots gone, how’s the jet lag, that sort of thing. We learned that other couples were in Mumbai, two of whom were here to pick up their newly born babies. Yes, the greatest affirmation we could hear – successful couples that have sat in the same office and driven the same streets have babies to take home. (Shannon will tell you more about them in the next post.) These couples certainly weren’t the first successes of our clinic but these were people we could see and touch. Even better, they were people we had met virtually, through the Internet and on the phone. It would be a family reunion!

Shannon was taken away for her pelvic ultrasound, that invasive probing you read so much about. Regrettably, the location for the ultrasound matched the surroundings and frankly it was not a good experience for Shannon. The cleanliness does not live up to Western standards nor does the level of formality as people came and went with little consideration for modesty. The machine was top notch, the instruments sterile, the skill beyond reproach. But try dropping your drawers and throwing your legs wide in the basement of a building in India one day after arrival, with virtual strangers putting you through a very uncomfortable test while your husband remains upstairs. Sorry, no sugar coating, this was rough for Shannon. Lesson for everyone, including us – there are sacrifices in going to India for surrogacy. The process absolutely works and works well, not in little part due to the professionalism and care of the two doctors and their staff. It is simply clear that one must be ready to compromise some of the little things to make the big thing possible.

[We were a little hesitant to speak of ill experiences such as these for fear of implying that the clinic itself is any less than everything one could ask for. In the end, we decided the blog is useless if not honest - we will just try to be specific so as not to indict through association. To date the doctors and their attention to our care have been superb. Frankly, much of the criticism really stems from cultural differences and is arguably the fault of our own perception and preconception more than anything else.]

Our blood was taken one at a time in what looked like a waiting room. Many very petite women sitting on a bench – prettily attired but definitely lower class – stared at you (the big, white guy) as the needle was inserted and blood drawn by another prettily attired, extremely tiny woman. Not knowing protocol I decided I should divert my eyes and not make eye contact. When it was over I smiled and attempted to say thank you – shukria – eliciting laughs from everyone in the room. Apparently, Indian humor gets a kick out of hearing ‘shukria’ pronounced with a New York accent. (Hey, it's everyone else with the accent - not us!) Shannon asked Ghopa how long she was to sit in this waiting room before being taken to the phlebotomy room to which Ghopa replied, “What’s a waiting room?” Ok, she didn’t say that but she might as well have. Ghopa was wonderful though, standing with each of us, holding Shannon's hand, and keeping things light.

That completed our first trip to our clinic's office. We were given cell phones so we could easily contact the doctors and the driver, as well as be contacted, without paying crazy international rates. (The doctors have thought of everything.) Tomorrow we would be visiting the birthing hospital for a tour and then returning to the clinic to sign the legal contract after meeting our surrogate. Wait, what? Holy crap, tomorrow we meet the woman who will be carrying our baby!

Ajit helped us across the street and to his car, then drove the 10 miles over 90 minutes back to our hotel. One full day in India – done. The process has begun.

Mumbai - First Impressions

Picture a school of fish, a boiling mass of fish swelling and contracting but always connected, maintaining shape and a sense of order amongst the roiling chaos.Up close, these fish endlessly change positions, narrowly angling towards the inside and outside of the cloud, flying past one other, never satisfied with where they are, always striving ahead. From far away, however, the shifting mass has a sense of order and direction. Somehow, it works.

Now picture each one of those fish with a cute sounding horn. And lights they can flash. Watch them use their horns and flash their lights every time they want to change position. Note how they're all talking on cell phones. Now picture cows standing in the way of those fish clouds, big, horned cows that won’t budge or even take notice of the commotion. And then, everywhere along edges of the cloud, watch as sea horses (pedestrians – stay with me as I really overdo this analogy) fearlessly dart across and through the cloud, seemingly ignorant of the speed and the narrow separation from crazy fish and the horns and the lights, intent on getting to the other side of the cloud. And every once in a while, the cloud completely loses all forward motion as it collides with identical looking clouds coming from other directions. The horns and the lights and the ringing cell phones never stop.

That is driving in India.

We’ve been driven to various destinations during our stay and I find myself torn by an eager desire for the entertainment of near-death experiences counterbalanced by a deep desire to avoid further witness to the destitution and poverty found everywhere. The poverty is absolutely everywhere. Try this on for size. There are 1 billion people in India. The country is smaller than Australia and yet has more people in just the city of Mumbai (18 million) than in the entire land down under. Approximately 50% of the Indian population is illiterate and one third of the world’s poor is found in this country. India has admirably matured as a young democracy – gaining its independence from Britain in just 1947 – with a GDP that ranks 11th in the world. However, income distribution is highly skewed. 42% of tax revenue is generated by the city of Mumbai alone. Yes, almost 50% of all Indian tax revenue comes from this dot on the west coast of India, home to the country’s finance industry. Population density is crazy high, income is very low – any surprise at these roadside sights? This country just can’t raise the revenue to help and can’t sweep the poor out of sight to pretend otherwise. There’s just no room.

Jarringly, even the most destitute wear brightly colored – and to my male, Western eyes – beautiful saris. But these saris are worn by women squatting in filth, many holding babies, making do with next to nothing in tar paper shacks located on every sidewalk and beneath every overpass. It’s so overwhelming that perhaps it’s no surprise how the other Indian classes seem to ignore the destitution so completely. They just don’t pay attention when walking through and among it (it’s unavoidable to walk otherwise). They acknowledge it, they bemoan it, but there is a what-can-you-do attitude accepting each person’s lot in life. Even the lowest castes appear to accept their lot. I could be wrong but during our short stay I have the impression there is no ambition amongst those lower classes. They’re born as beggars and that’s fine, that’s what I was born to do, could you spare a rupee? Shannon has had trouble accepting this acceptance but I have begun to resign myself to the reality.

All this is viewed through a car window. In person, the Indians have been extremely friendly, quick with a smile and a “Hello, sir” or “Hello, sir. Hello, madame.” (Never just a “Hello, madame”. There’s still an undercurrent of chauvinism that recognizes men as being in charge. You know, maybe I could get used to this place…..) All of the top hotels are fronted with security who check automobiles for explosives or contraband and asks every visitor to place their bags on an x-ray belt, just like at the airport. Mumbai has known terrorism so the security is welcome and reassuring. Once in the hotel, as Shannon already shared, we’re in an oasis on the Arabian sea. Great views from our room window and surprisingly good food. Not that I expected bad food but we don’t find ourselves compromising in the name of overseas travel. The food’s good! We wimped out our first full night here and ate Italian food at an in-hotel restaurant. You know what? The Indians can do Italian!

Oh, by the way, we’re here for Surrogacy. We look around and think cripes, we've done it. We're in India...

I’ll share our first full day in the next post, Shannon the day after that.

Thursday, January 28, 2010

Namaste from Mumbai

Hello (Namaste) from Mumbai!  After a long day and night of travel, we finally made it here safe and sound.  As predicted, the flight from Boston to New Jersey ran late.  Knowing this flight is notoriously delayed, we built a long layover into our flight itinerary so we were fine.  After some ridiculously overpriced and not-so-tasty food in Newark, our Mumbai flight boarded on time and we were on our way.  The flight was full but not to capacity so we had our own row to spread out across and I did just that, thank you very much.  Wouldn’t you know, there were over 200+ movies to choose from! That sure helped the time pass.

I will admit, I was a little nervous for the Mumbai airport because so many people have shared their experiences - both good and bad - and I just wasn’t sure what to expect.  Customs was a breeze and before we knew it, we were pulling our bags off the luggage belt. It is kind of a free-for-all at the baggage claim but as long as you get to the belt before the rest of the crowds, you’re in good shape.  We walked outside to a huge corral of hundreds of people held back by 4’ high partitions.  Most were holding signs and others were eagerly awaiting the arrival of loved ones.

We found our driver in no time and made it to the Novotel Juhu Beach in roughly twenty minutes.  I’m fairly positive our driver works for NASCAR because although I was trying to take in the sights, I found myself mainly looking down at my shoes and crushing Geoff’s hand because it’s frightening how quickly and how close cars come to each other and passersby.  Cars, rickshaws, bicycles, cows, motorcycles, pedestrians, dogs and cows were all over the road – no exaggeration. Did I mention there are cows? Cows here are sacred and are left alone to do as they please.

I have to say, there is a certain smell in the air that some may find very unpleasant.  We’re told it’s from the smog and it’s always worse in the winter.  I’ve been trying to figure out what it smells like and the only thing I can relate it to is a smell that some may recognize while walking the streets of Manhattan – extremely burnt peanuts (from the street vendors) mixed with subway exhaust.  Fortunately,  as you enter our hotel, it smells like fresh cucumber water and the lobby waterfall helps you to forget the heartbreaking sights of deep poverty witnessed during our ride from the airport. The security at our hotel is great and the staff have gone above and beyond to ensure we are content, all of which makes us very happy.  In our room now sits a lovely flower arrangement that the very thoughtful Dr. Sudhir and Dr. Yash sent to welcome us.  Our original room overlooked the Arabian Sea and some neighboring buildings, including slums.  After walking around the grounds of the hotel, we found that the rooms on the other side of the building overlooked both the sea AND the pool while facing away from the harsh reality of slums.  The Novotel pool area is quite beautiful and that combined with the beach and sea is a much more pleasant view.  We shmoozed the front desk and won ourselves a room on that better side. We're "home".

There is lots more to talk about but bedtime awaits. Talk to you tomorrow!

Tuesday, January 26, 2010

It Takes Two

[T-minus two hours 'til our flight to Mumbai.....]

Although Shannon always has the grace and tact to use 'we' when discussing our surrogacy pursuit, the fact is - as with any pregnancy - she has to do all the heavy lifting. Yes, I'm playing my part in the planning process, but only Shannon has to self-inject twice a-day and then wrestle with the hormonal side-effects. (In my weaker moments maybe I'd say we BOTH have to deal with her hormonal side-effects, but this is where I show my own bottomless reserve of tact.) Add to this the almost mystical draw women have to motherhood and I'm quite sure I'm having a much easier go of it.

To date I've been fulfilling the role of supportive husband, key to which is denying how nerve wracking this entire procedure is, how I'm about to go ON A PLANE TO INDIA TO MAKE A FAMILY. It can be absolutely overwhelming if I let it but the denial is crucial because it lets me provide my wife with a safe harbor as she prepares for poking, prodding and baby making in a foreign land with people we've never even met.

As I get older I'm realizing that the old saw about women being tougher than men is probably true. Not in the takes-a-whack-to-the-shin kind of way, I mean the ability to weather adversity and move on. They cry, maybe wallow, talk it through, come to terms and forge ahead. Men deny, bury, stew and then have a heart attack. In a way, my denial might not be the healthiest choice though worth the sacrifice for Shannon. Let me give you a frank example...

I had my first proctological exam a couple months ago (yes, I just went there), a single digit affair that left me scared to drive and possibly scarred for life. If I can even muster the strength to speak of it, I get this far away look in my eye like a war vet reliving the storming of Normandy. Remember, this was one finger for, I'm guessing, two seconds. Shannon, meanwhile, (as mentioned in her last post) had to give way to an angry, foot long probe in her nether region for over 10 minutes - that's a year for guys. She cried a couple tears, sure, but you know what - five minutes later she's talking about more packing ideas and wondering if I'd be ok with her buying a sixth pair of shoes for India. Could I have moved on so well? No, sir.

Shannon wears her heart on her sleeve and cares, sometimes too much, for the welfare of others. She is also one of the toughest women I've ever known. I don't think that combination is a coincidence. On the outside maybe I'm the shoulder she cries on, but getting ourselves to India would never have happened without her.


The tragedy in Haiti brings with it a harsh perspective on our family aspirations. In a land where losing only one parent, sibling or child is a blessing, our struggles to start a family - though sympathetic - tend to pale. We have health, security, means and a future. Hopefully, we can maintain the proper perspective as we move into this new stage of our journey, remaining humble and thankful for what we already have. That said, pray like hell for us! ;-)

Thursday, January 21, 2010

A Spoonful of IVF

Let's just take a minute and acknowledge the fact that I've been successfully self-injecting Lupron for ten days now!  The purpose of Lupron, for those that may not know, is to suppress ovulation - or, as I like to think of it, putting my ovaries to sleep.  We want my ovaries on a clock set by the doctors, not the biological clock that's been ticking the 23 years I've been alive (shut up, I'm on drugs, let me be 23). Today, in addition to Lupron, I'll now be injecting Gonal-F. Gonal-F tells my ovaries it's time to go, start making eggs. It's fertilizer with rocket fuel. I'll be taking both Lupron and Gonal-F together for the next eleven days. At about that time I take one butt-directed booster shot of a drug called HCG and then, approximately two days later, it's egg harvest time. 

But how do we really know when to do the HCG thing? That's where today's glorious morning comes in. I had the pleasure of a lovely test called a Transvaginal Ultrasound. (I also had a blood test - an estradiol test - but as a needle pro I'm way past worrying about this.)  I agree, the sound of a Transvaginal Ultrasound alone is just awful and I can promise you, the test itself is worse.  I'll spare you the details and the ridonkulous size of the probe and just cut to the chase.  A transvaginal Ultrasound is an internal pelvic ultrasound used for multiple purposes.  For women going through IVF it's used to monitor the size of the follicles in their ovaries (each follicle makes one egg). As eggs mature, the follicles grow in size - seems there's a target size that says the eggs are ripe and ready to meet their match. We'll use today's ultrasound and blood test to determine my baseline and when I'm ready for that booster shot.  Am I an expert or what?  Not even close and I must give props to one of my favorite books thus far - The Couple's Guide to In Vitro Fertilization by Liza Charlesworth.  Great book for anyone going through IVF.

Before I sign off, I'll just add that this will be my last post before we leave (Geoff tells me he's got one on the way so keep an eye open), but we'll blog while we're away and keep everyone posted.  Only four days to go and come Tuesday, we're on our way to Mumbai!  This weekend, we're running some errands, packing and enjoying the comforts of our home while we still can.  We're going out with our "gang" on Saturday night (gang of closest friends that is) and then after a spa day with the women in my family on Sunday, we'll have a farewell dinner at my mom and stepdad's on Sunday night.  Please continue to send your well wishes, good thoughts, blog comments, emails, love, prayers and support because we need all that we can get! xo

Wednesday, January 13, 2010

Big Shot

That's right. That's me - because tonight I conquered the needle and gave myself my first injection. Thanks to all for the support and good wishes! Now that the anticipation and anxiety are over, I'm going to faint and then go to bed. xo

Tuesday, January 12, 2010

Emotions, Drugs & Hormones

Well, we are fourteen days away from leaving for our big trip and everything appears to be in place. (Phew!) I am 2.5 weeks into taking the birth control pill and I can honestly say it hasn't affected me too much. I understand there can be some unpleasant side effects but truthfully, with the exception of an occasional headache, hot flash or funky dream, I'm feeling great. That is, aside from the hurricane of emotions I would expect when only two weeks from a 7,500 mile trip and the next big step in starting a family through surrogacy. I'm sure those feelings will be stirred up even more once we begin our IVF meds, which arrived safely last week. I officially look like a drug dealer, as there is a mountain of syringes, alcohol swabs and drugs on our kitchen island (and in the fridge).

I begin the Lupron shots (a.k.a. Leuprolide Acetate) this Wednesday - that's right, this Wednesday, as in tomorrow - and I'm not sure whether I should say hooray or eeekk! The Gonal-F shots (a.k.a. Follitropin Alfa) begin about 10 days later. Ordering our meds wasn't too difficult and here is how it worked for us.....

Turns out that because our SI doctors only practice medicine in India, they can not register with the U.S. Drug Enforcement Agency and thus are unable to prescribe medicine in the U.S. Instead, Dr. Sudhir sent us the order and our local fertility doctor prescribed it through his office. (We got it through Freedom Fertility Pharmacy, a common source for IVF drugs.) Although our local fertility doctor will be monitoring me during our cycle while we are in the States, we obviously will not be working with him for all of it. Unfortunately, our medical insurance through Harvard Pilgrim Health Care only covers complete IVF cycles, not bits and pieces. As a result, none of our U.S.-based treatments and medications are covered. Bummer, I know, but we are moving forward with filing a “member claim” to hopefully have some of it paid for and we shall see what happens. For the record, the out of pocket cost for the IVF meds prescribed for us was approximately $2000.

In addition, because we will not be working with our fertility doctor here for a full IVF cycle, his office cannot legally walk me through how to administer the shots. They pointed us to a bunch of very helpful online videos posted by Freedom Fertility Pharmacy, but lucky-me has a stepsister (much more like a sister) who is a nurse. We had a private practice lesson in shot administration tonight and after successfully turning a banana into a pin cushion, I'm confident I will be good to go for tomorrow. In all seriousness, I'm not nervous about the actual shot, I'm nervous about mixing up the dosage, but she assures me, I'll be fine. Let's hope that's the case and thank you, Ad!

Many have asked how I feel about everything that's happening this month and I figured I'd address that while I'm writing about the three things that are keeping me up at night - emotions, meds and hormones. I am very excited and can't wait to meet R (our surrogate), our doctors and any of the people we've been interacting with during the process (along with any other IPs!). I'd be lying if I didn't say I am also scared, nervous, anxious, stressed and a bit apprehensive. I have been fortunate enough to travel a fair amount in my life both domestically and internationally, but never to a country in the developing world such as India. I know there will be a culture shock and everyone who knows we're going has said something to the effect of, prepare yourself, the culture shock is alarming. I feel as though I'm pretty open minded, but I must admit, with all of the warnings, I am nervous! To help prepare me for our trip, Geoff bought me a great book that I'm enjoying called Wanderlust and Lipstick: For Women Traveling to India. The book is perfect for women as it gives really practical advice on the culture, dressing appropriately, areas to visit and avoid, keeping personal belongings safe and a cool thing is that it includes fun anecdotes and advice from women travelers. I highly recommend it!

I continue to believe my emotions are still "in check" though my husband may disagree. (I like to randomly hurl insults at him and then scream, “That’s not me, it’s the pill talking!”) I understand there are hormones racing through my body right now but even still, I was feeling emotional prior to starting any meds because I am an emotional person and because this is such a sensitive subject. It's a bit hard to explain, but there are times when I'm excited and smiling and cheery because the hopeful outcome of this journey is a positive one. I also know that there could potentially be a negative outcome and I would be heartless if I didn't worry about that. Also, this is the first time we've ever tried to have a baby and I do feel responsible for what goes on in my body. To elaborate, I have been taking my prenatals and birth control pills regularly, I have been eating healthy, I haven't been drinking (not that I drank much anyway), I haven't been consuming caffeine and I've just been trying to be healthy, thinking that would help the process. But, what if I'm not as healthy as I can be or what if I'm slightly off on the meds and that throws things off? I know, I know, there are a lot of what-ifs! So I will just try my best to take deep breaths and embrace it all as it comes.