I’m not even really sure where to begin. The last several tortuous months have been filled with confusion and disappointment. To make this seriously convoluted story a bit less complex, I’ll try to be brief…. Eh, that’s probably not going to happen. Here it is anyway.
Some relevant context: On July 16th, I had a not-so-successful egg retrieval because my ovaries were positioned a little higher than usual and “hiding” behind my uterus. They were difficult to reach so we were only able to obtain 7 eggs out of nearly 40. I had a long recovery from this retrieval because I had developed fluid in the surrounding cavity. Additional fluid compounded the problem when I had some cysts (over-large follicles) burst on July 22nd. Slowly but surely I was on the mend. I thought I was healing, and so did my doctor. Everything was looking as if it were in order and I was starting to feel normal again.
We started the process of preparing my uterus lining for my FET (frozen embryo transfer) on September 4th. We scheduled our transfer for the 24th and were just thrilled.
I had to inject Lupron every day (a shot that suppresses FSH and LH, so that the body can create estrogen to grow the lining in the uterus). This is an “easy” subcutaneous injection. No biggie. I also had to use estrogen patches—two of them, every other day, for the entire cycle. The estrogen is something else! Talk about emotionally unstable… I could cry for any reason at any time. A few days into the patches, a co-worker asked me how I was doing and just the thought of answering that question made the waterworks flow. Just ridiculous. I cried listening to Beyoncé sing, I nearly bawled when asked “why I became a teacher,” I became misty upon seeing my dance team’s new professional team photo, I sobbed when I found out a fellow IVF friend became pregnant, and lost my damn mind when Vanilla Ice got all choked up on Dancing with the Stars. The only other meds on the schedule were nothing too intense and were all familiar to me from previous treatments– progesterone inserts, baby aspirin, prenatals, a small dose of steroid, and a mild antibiotic for when the transfer drew near. Besides getting all emotional, the side-effects were minimal. I did, however, have some intense back/side pain in the same region I had pain when my cysts burst. It had been pestering me for quite some time, weeks maybe, but it wasn’t anything significant. I only had the pain at night while lying down trying to fall asleep. I thought it was muscle-related and nothing to worry about too much. I was wrong.
Six days before my scheduled embryo transfer, I got out of bed and immediately thought I was dying. When I sat up I had severe stabbing pain in my right side that traveled up to my chest. It was the same pain I had at night while trying to fall asleep, but it never traveled up to my chest before. I tried not to freak out and hoped that it would just dissipate. It didn’t. I was soon having difficulty breathing. I chocked this up to asthma and tried to treat this by using my inhaler. That did nothing. I was freaking out a little because I was alone. Jacob was at his Sunday morning softball double-header and I didn’t know what I should do. Google to the rescue. I began looking at the side effects of my cycle meds, any matching symptoms, and possible drug-interactions. And there it was. Pulmonary Embolism (related to estrogen hormone supplementation). The symptoms matched: shortness of breath and chest pain (typically worse when bending, stooping, or lying down). I called my doctor’s office and the nurse told me to go to the emergency room. I was preparing to drive myself to the ER, but Jacob walked in just in the nick of time.
The ER doesn’t mess around with chest pain. Within minutes, I was hooked up to an EKG. Nothing looked out of the ordinary and I wasn’t, apparently, having a heart attack. Good news. My oxygen was good, blood pressure was just fine (maybe slightly elevated due to the pain), and so they began my typical ER routine—IV fluids, solumedrol (IV prednisone), and breathing treatments. I didn’t have to wait too long before they took me in for a CAT scan of my chest. The results were in—no pulmonary embolism—it looked like I had developed pneumonia. This made no sense to me because I hadn’t had any severe cold or respiratory infections lately, but if they saw it on my lungs, that had to be the case, right? Well, needless to say, I was admitted and in my own room before the day was through. How could this be? I was seemingly fine one minute and the next I was being admitted to the hospital. As a teacher this is worrisome. It is more work to be out for a day or two than it is to actually go to work! I had to scramble to make plans for a substitute and I was freaking out a bit because I was scheduled to be formally observed at work the very next day. Everyone at work was so helpful and understanding, so I didn’t have to worry about any of that for too long. With this on my mind and with people in and out of the room all night, I didn’t sleep much at all.
The next morning, bright and early, a team of doctors came in to tell me that I didn’t actually have pneumonia. A general attending physician, a pulmonologist, and a cardiologist all visited my room to discuss what as happening. The cloudiness around my lungs on the scans was actually fluid gathering on the outside of my lungs and heart. They were extremely concerned and puzzled because I was too young to have pleural and pericardial effusion. I didn’t have pneumonia. I wasn’t experiencing congestive heart failure, I didn’t have liver disease or lupus, and I didn’t have cancer. Geeesh. I didn’t even know that was on the table! They informed me they would have to perform a bunch of tests.
Hearing this news made neurons and synapses fire off connections in my brain. I remembered back to when I had my egg retrieval and I was given a medical consent form that was comprised of a laundry list of possible side effects from the procedure. I distinctly remembered reading that if enough fluid collected in the cavities, it could cause pleural effusion—fluid around the lungs! My friend Gina, who is studying to become a nurse practitioner, backed me up on this. She sent me scholarly articles from a medical journal that named OHSS (ovarian hyper-stimulation syndrome) as one of the causes of pleural effusion.
This idea was a hard sell to my doctors. They were unfamiliar with OHSS and have never experienced a patient with pleural effusion caused by something other than the norm. I explained everything to them as best I could and persisted until they agreed to let me have a consult with an attending OB/GYN. Even so, they would still continue with their battery of testing to determine the cause. They also scheduled a thoracentesis to remove the excessive amount of fluid on my right side pleural cavity. That, my friends, is no fun.
Imagine the thickest, scariest needle possible. Imagine that needle pressing firmly into your back, through the skin and muscle in between your ribs, and what feels like right into your lung. All of a sudden you feel like the air is being sucked out of your body through that needle and into a catheter. When that sensation stops you look to your side to see a giant glass jar filling with amber-colored fluid! Ahhhh! So strange, and so gross, but I had to watch. That wasn’t even the worst part. When it was over, my lung was working extra hard to expand back to its normal size. I couldn’t breathe at all. I felt like I was hyperventilating and having a severe asthma attack at the same time. I could feel stuff moving around in there! I was wheezing like I’ve never wheezed before, I was short of breath, and my heart was racing. The pain from the day before was back in full effect. Needless to say I was extremely disappointed that, of course, I was not going to be the patient that feels immediate relief from removing the fluid. Of course I wasn’t. I wouldn’t get the results from testing the fluid for days, so I had to hang tight.
Before and after the thoracentesis I had chest X-rays. I also had ultrasounds done on both legs to check for blood clots, what felt like millions of blood tests, an echocardiogram, and like five pages worth of other tests (seriously, the list is five pages long). All of this to figure out what I had known since my first full day in the hospital…. OHSS was the culprit and I had been living with this excessive fluid in my body (causing me nightly pain) for two months, and finally it had spread/shifted to affect my breathing and my heart.
The icing on the cake? My frozen embryo transfer on the 24th was cancelled. While I knew it was for the best, I was devastated. A whole month of preparing my body for a baby was wasted. All of the (expensive) meds, all of the emotions, all of the hope built up for what could finally get that little embryo growing inside of me…. All of it was wasted. And all I could do was sit around in a hospital bed thinking about it. I tried to keep myself occupied, but it wasn’t easy. I cried a lot—again I was mourning the loss of something that never was. But Jacob stayed with me the whole time and that helped. While it may seem that I’ve been down in my luck lately, I sure did luck out with him.
A couple days went by and the doctors were still unable to pinpoint the cause of the fluid. I was finally given the consult with the OB/GYN. After explaining everything to him about my fertility treatments and procedures, he believed that it all fit together and assured me that OHSS can most definitely cause pleural effusion. On Thursday, 5 full days after rushing off to the ER, I was finally sent packing.
I tried to go to work the next day and immediately regretted that decision. By the time I walked from my car to my classroom, I knew I made a mistake and tried to do too much too soon. My skin, from the medicines, was hot and bright red, I was having a hard time breathing, and the pain in my back/right side was screaming. I was a little dizzy and my legs were like jello. I had to go home and take things a little slower. I was going to be missing yet another day with my students, the homecoming pep assembly performance (this big performance that my team, assistant coach, and I had been working so hard for), the parade, the game… everything. I was not a happy camper, but I knew I was just not ready. Thankfully, I had support from so many wonderful people and was able to take the weekend to recuperate from my long hospital stay.
The next week I was much more myself, even though I was still experiencing some pain. I went back to the doctor for a follow up X-ray and was told I looked and sounded like a completely different person—almost unrecognizably so. And even now, this past week I felt even better. It has taken some time, but I am back in the swing of things and I am finally feeling healed.
I have been cleared to start another month of preparing for FET. In fact, I’ve continued the Lupron and have already begun using the estrogen patches. I was apprehensive to start all of this again. I didn’t want to push it just to be told we’d have to cancel. However, after being monitored last week by the fertility center and by the same doctor who saw me in the hospital, I feel confident that I am ready. I just hope everyone around me is ready for another month of weepy, emotional Nicole because she’s just around the corner!
While it’s not even close to being over, by any means, this has been a ridiculously complicated and trying time in my life. I’m not a quitter, though. I know that I want to be a mother some day. I know that I want to have a baby with the man I love so dearly. I wouldn’t be able to live with myself knowing that I didn’t do everything I possibly could.
I’m telling you guys…. I hope Baby Sonne turns out to be one grateful and appreciative child!