Thursday, November 19, 2009

Getting Started

(Gory detail warning - I do talk about some of the testing procedures they did on me below so read with caution!)

Now that we have settled on a doctor, it is time to get started doing all of the pre-screening work, and getting the PGD test set up. First off, we called the PGD lab and got the paperwork filled out to start building our test (or as they call it, “probe”) for detecting MCADD in embryos. They were super nice and very easy to work with. The forms were simple enough, and I have now sent them both Chris’s and my genetic test results along with Noah’s over to them. This part is pretty crazy. They collect DNA samples from us using toothbrushes. They are mailing them to us as we speak, and we will scrub the insides of our mouth with them and mail them back. I thought this was amazing. Everyone that I have told about it since learning this all seem to watch CSI and SVU and all those crime dramas, and are like “oh yeah…toothbrushes…” in a nonchalant way. Guess I am not up on the latest medical technologies! Anyhow, they also want our parents to do the toothbrush thing too so that they can be as detailed as possible in making our unique test for us.

Something we are strongly considering doing is we can have them do an extra leg of the test where they look for whole panel of things like down syndrome, spina bifida, cystic fibrosis, etc. It is a little bit more money, but after having been 1 in 15,000 for a disease, I think about the odds of cystic fibrosis being 1 in 2,000, and my stomach flops over. I would hate to spend all this time, effort, energy, and money preventing one disease and overlooking some more obvious ones. I am already going to be a bit of a paranoid mother having lost a child already. To have a sick one after this would just be the end of me. It’s the whole point of why we are doing in vitro to begin with. We can add that on at the last minute. There is nothing special to build for it. It is a canned test that they have ready to go.

So where we stand right now on the PDG test is, they have all of our records. They are sending us the toothbrushes, which will come in the mail early next week. Chris and I and our parents will swab with them and send them back. We will then have to watch a DVD on the whole PGD process that they are sending us and will do a phone consultation with their doctor after that, and get a final projected time it will take them to build our test. We hear it can be anywhere between 4 and 10 weeks. With the holiday season, it may be on the longer end of that, however, they are very familiar with MCADD in this lab and build these sorts of probes all the time, so it could be sooner. We just don’t know. We are fine to be patient though, because we want it done right.

Today we went to the fertility doctor to finish up the pre-screening tests they wanted us to do. Everything we do with them has to be planned around where I am in my menstrual cycles. It does make these visits somewhat inconvenient, because I don’t have much warning (maybe a few days) of when I need to go. There is lots of counting days and guesswork as to where I might be in my bodily processes, but they are pretty adept at guessing right.

I have been pounding the pavement, trying to get my medical records from the other clinics I have seen transferred over in anticipation of this. I must take a moment and say that, holy cow, did I choose the right doctor! I had done a pre-screening test with Doctor #1 (see post called “Breakthrough” below) and he was by far the worst in terms of getting things transferred over in a timely manner. Those of you that know me know that I am crazy organized and have the ability to be like Chinese water torture when something needs to get done, and let me tell you I was on them. I called multiple times, and if the person I needed wasn’t available, I insisted on waiting. I talked to their records person twice yesterday, and she swore to me she would get my records faxed over. Did she? No. Someone else over there mentioned that she is transferring a lot of patient’s records to other clinics right now (rats leaving a sinking ship?). My new doctor called over there today to see if they could fax my records this morning, and they hung up on her. We had no choice but to make do. As I mentioned earlier, everything is so timed as to when you can do stuff, and I don’t want to wait until next month, so we may have repeated a test or two thanks to them. Maybe that is just one more way of them trying to stick it to me for leaving. Who knows. Either way, not impressed, and really feeling even more glad I switched.

When you work with one of these clinics, they all insist on doing some pre-screening work to make sure that everything looks ok. They look at my uterus to check for any abnormalities, along with my ovaries, using an ultrasound. They check my hormone levels through blood work. In vitro is a big deal, and they want to make sure that before they implant anything, that there is nothing weird that could cause problems. Chris got checked out too. As modest a person as he is, I won’t say any more than that! Both of us checked out to be perfectly healthy. There are no issues. We are both very fertile people. They were very pleased to see that, and said that their only concern will be the medications they put me on. Some women respond too well to the hormones they use and their ovaries can be over stimulated, and cause you to drop crazy amounts of eggs. I think the norm is anywhere between 10-24 eggs for a healthy woman. They mentioned that this happened to a patient once where she dropped 40. It won’t kill me, but it is unhealthy. They will be watching me like a hawk to try to avoid that.

They also did a mock implantation to make sure they could get a catheter up into my uterus with no problems. (When they do it for real, they will use the catheter to implant our embryos.) They injected some solution up there and watched to see what happened, making sure nothing fell out and such. It went beautifully with no problems. It was good to know what it felt like and what to expect. It was very quick. It only took about 5 minutes. Granted, when they are actually injecting the real thing into me, it might take longer. It didn’t hurt at all. They used other equipment that was pretty uncomfortable. (Think of a pap smear on steroids ladies.) I remembered my Bradley Method training, and Chris was right there next to me and helped me remember my breathing, and as soon as I relaxed a little bit, it was totally not a big deal. That will probably help with the actual implantation too – being as relaxed as possible, so it is easier for the doctors to do what they need to do. I am going to try to remember that. I have very mild cramps now that it is over. Hardly even worth mentioning, they are that mild. I feel perfectly normal otherwise.

There is maybe one more blood test they might do on me, but otherwise I am done until we are ready to get going with the injections and implantation. I wanted to do this – to get the pre-screening stuff done early so we can just relax and move forward with the real deal when we are ready for it. We won’t be in a position down the road where we are ready, but we have months of work to do before we can get started.

This is so exciting! We have both had big goofy smiles on our faces this morning. It is awesome when you hear you are good at something, and also, again the confirmation that this is not the end of our story is such a comfort. I wore the necklace that Chris and Noah got me for Mother’s Day last year through the whole thing. I wanted a little piece of him there with me, along with the burning hope that there will be Mother’s Days to come in the future. So, here we go! It is on its way.

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