• Kat

Shots, Shots, Shots & Pills: Aka Stim Phase and the Grand Egg Hunt Preparation

Updated: Jun 5, 2020

At a certain point in your life, people will feel the dire need to start warning you that 30 is out there, ready to pounce. They caution you that when your 3rd decade of life hits, it’ll hit you like a brick wall. BAM! And just like that, your youth will disappear. It always used to amuse me the warnings I got as I neared 30. Warnings about my metabolism, crow’s feet, how hard getting up off the floor would soon be and endless questions about my procreation choices from the most unexpected people. Now, for the record, you can have a kid (or not have a kid) whenever you damn well please. I am not here for societies cookie cutter expectations of when women should bring life into this world. It’s your body and your choice. That being said, we did start trying to have a child in my 20’s because it was what we wanted (and my dog was getting really sick of me dressing him up in baby clothes due to my incurable baby fever)! We tried and tried and tried. And then 30 arrived, but it by no means snuck up on me. I had my eye on it for quite a while because as anyone balancing infertility issues will tell you, 30 holds an entirely different meaning for us. We don’t give a crap about crow’s feet. All we can think about are our ovaries and egg counts. There aren’t a lot of warnings out there about what 30 will be like when you’ve been diagnosed with infertility (because until recent years, women have been ashamed to openly talk about the subject). It doesn’t hit like a brick wall or a surprise, because again, you’ve seen it coming. You’ve seen it lurking around the corner like the evil witch in Snow White… but instead of holding a poison apple she holds in her withered old hand a giant ticking time clock doused in anti-youth serum. Sure, with all the advances in science and the medical industry, 30 doesn’t mean quite what it used to, but it is still a very large milestone in the fertility world. You still have plenty of time to get pregnant in your 30’s, but when you enter that new decade of your life already labeled with infertility issues, it just sucks a little harder. Which brings us back to our main topic. What DOES infertility in your 30’s look like?

I could write an entire blog entry quoting others, spouting facts from the internet and the hundreds of pamphlets I’ve been given throughout the years. But instead, I realized this is the perfect opportunity to put my almost 32-year-old ovaries on a pedestal and present you with the raw, unfiltered, often humorous, true story of how I spent my 31st year of life shooting up Menopur and dropping my pants on command for a room full of people (and paying THEM for it). The true story of what led me, and my husband, to making a baby with Science and an inside look at what all that entails. Everyone’s story is different, but this is our storked up version!

We have been trying to get pregnant for 4ish years. Tried every trick in the book. Special fertility diets, charted temperatures and cervical mucus like science project champs, swallowed vitamins like they were religion, and tried (aka gagged down) fertility teas, tried workout regimens, ovulation sticks, ovulation apps, fertility book after book, ALL OF GOOGLE, and even old wives' tales. Our lack of children is NOT for a lack of trying. My husband has ADHD and I am often the queen of procrastination but I have never seen two people more determined or focused on a common goal. Nothing could distract us from what we wanted, nothing could discourage us. We have wanted to have a family since the beginning of us. To give you an idea of how badly we have wanted this… Josh and I started talking about kids on our 3rd date. As my roommates at the time would tell you, we walked in the door to my apartment at the end of that date talking about what we would name our children! NOT EVEN KIDDING! My roommates gave me so much crap for that and cracked up at the fact that I was naming babies with the brown-eyed, brown haired boy I had JUST started dating who I refused to even call boyfriend yet! But that’s how things have always been for Josh and I. We met at my sister’s 21stbirthday party. He was one of the roommates who lived at the house where the party was being held in the backyard. When we showed up that night (to the Peter Pan/Fairy themed party in full fairy attire), and after walking around a few times (I knew NO ONE because I was visiting from Kansas and I was the DD) I found a chair and plopped down (as much as one can plop wearing a full-set of fairy wings and a crushed green velvet mini-skirt). A few minutes later a little fuzz ball of a dog covered in glitter jumped up in my lap, spun around a few times, looked me straight in the eyes like he was staring into my soul, gave me a quick approving kiss, and then laid down like he had always known me and went to sleep! I was fine with this, because I loved dogs, and it gave me something to do because socializing with a backyard full of drunk strangers was not my strong suit! Just a frazzled fairy from Kansas and an unknown puppy kicking it in the corner. An introvert’s dream! But a little later, a brown-eyed boy walked up to me and said “oh there he is!” And that is how we met. Bruce, our 10-pound Maltese was our tiny matchmaker! Josh and I spent that entire party sitting and talking while Bruce snoozed in my lap and drunk fairies and woodland creatures stumbled around spilling the contents of their solo cups and leaving trails of glitter all around us. But we didn’t care. All I really remember from that night is that boy and that dog and that feeling it gave me. It was magic in its own way. But then the sun came up and the weekend flew by and I didn’t really get to spend any time with Josh for 8 months after that because I wasn’t moving there until that summer. However, thanks to modern technology called Facebook (yeah, you Tik Tok hipsters, I’m old) we found each other and spent many the nights talking and stalking each other on the internet! I finally moved to Tallahassee June of 2010, and he moved back into town for the new school semester on July 28th. I know this date by heart, because this was the day he finally asked

for my phone number and texted me only 4 hours later asking me to go out for dinner that very same night, and we have been hanging out ever since (I wore a mini-skirt on that date too, but left the fairy wings at home)! Several years, many dates, and a beach proposal and diamond ring later, Gerald (the minister who was going to officiate our wedding) asked us when we knew we wanted to spend the rest of our lives together… and neither of us had a solid answer. Not because we didn’t know… but because he and I have always been “he and I” since the second we met. It was simply how it was supposed to be. There was no shining moment when I had a lightbulb go off or the thought of “holy crap, this might be the one!” He just… always was. So much so, that yeah, on date 3, we named our future daughter. So fast forward 6ish years later… when pee stick after pee stick came back with a solid no. When suddenly 4 years had passed, and it was still Josh, me and Bruce…as much as we love our little family of 3, something… someone… was missing. There was still a giant hole in our hearts where our child belonged. Many have asked us why we waited 3ish years before pursuing fertility help. It was a combination of thinking time and time again, “ok we’ll just try one more time,” and “can we really afford to get help?” But there was also an extra layer of complication because unlike babies, I make tumors like a champ! I have 31+ tumors in my breasts, aka fibroadenomas. I have been balancing this weird super power since I was 17 and have had multiple surgeries to maintain the weird collection of blobs I tote around. While they are not cancer, they are extremely painful and grow at a constant rate. I have lived with this unique talent and chronic pain for the better part of a decade, and to be honest, have gotten quite used to it. But, in addition to not being raised right, I also have a very strong family background of breast cancer (genetics has not been my friend); and because of this, plus a few other factors, I spend many the hours spread out on a table every year (sometimes every 6 months) while my boobs get a 2 to 3 hour, very expensive, not so glamorous photoshoot of each individual tumor with biopsy follow-ups, and sometimes surgery. We have discovered that my tumors STRONGLY react to hormones which… when it came child bearing time, was a fun conversation. Before we even started to try and conceive naturally we had to have countless tests to make sure my tumors would be ok for 9 months of pregnancy (you know, back when we thought we would be pregnant within a few months of date night fun)! So, when the conversation of IVF came a knocking, it took an additional YEAR to get the green light from my entourage of doctors to pursue a fertility treatment that would very likely include injecting myself MULTIPLE TIMES A DAY with stimulation meds and countless hormones. Not everyone was a fan of my choice as it almost doubles my chances of one day getting cancer. But at the end of the day, it was my choice, and I want to be a mom, and if at all possible, I want to carry my own child. There is a tug in my heart to do this that is so strong that there are sometimes not words for it. When people hear about your fertility issues, many are quick to say “why don’t you adopt?! There are so many kids out there.” And I agree. There are so many kids out there that need a home. And someday, we would love to adopt. Adoption is beautiful. And one day, I’ll write an entire blog about chosen family…. about MY chosen family. But for now, I want to send the message to every girl who has ever been shamed for persisting in wanting to create her own baby, to at least try with all her might to bring her own genetic child into this universe… don’t you feel bad. Don’t you dare feel bad. When I heard the risks, all I saw them as were hurdles I could jump. That’s how badly I wanted to meet the baby I named with my husband on our 3rd date. So, we moved forward once we got the green light and I spent 6 months getting my body ready for the process, lost 30-pounds, gave up coffee, doubled down on

therapy sessions and saved every penny we could and when we finally got the green light that’s when, through an entirely unexpected series of events (and a story for another day), we ended up at New Directions Fertility Center in Phoenix. It’s where, after 4 years of trying naturally, our infertility treatment journey began, and the exact moment we no longer needed Fairy Dust, but desperately needed some Baby Dust!

When we started at the clinic, I was prepared for all kinds of worse case scenarios! There is, after all, a reason we had been led to step foot into that type of clinic. I prepared myself for bad news about my ovaries, bad news about my husband sperm, bad news about anything under the belt! What I did not expect to hear during our very first consultation was that I had another tumor… this one in my noggin on my pituitary gland. My initial reaction was to make an ill-timed joke that left the room of doctors dead silent and unsure as to whether or not it was ok to laugh as they had just told me I had a mass in my brain. But what you have to understand is that I have been battling storms bigger than me my entire life. This year being no exception. So, while it took a hot minute to process that I had created yet another tumor, but in a new and creative place, I quickly fell into handle it mode. People have asked me time and time again how I have handled all of this, how I have handled the last year of my life (what I have shared on this blog and the mass amounts of things I haven’t), and my answer is always… “because I didn’t have a choice.” I have had to operate in handle-it mode. And for me (with the exception of July – November of 2019) that includes doing it with humor. Humor, determination and a lot of coffee! To give you an idea, after finding out I had a tumor, when we got out to the car, my husband asked me what I wanted to do. And I calmly said, “I want to go see Santa.” And that is what we did. It was that time of year when Santa’s Village had JUST been set up in the mall, so we went, got in line, and when I got up to see the guy in the jolly red hat… I probably caught him way off guard. I sat down, and told him I wanted a baby. Then we headed out and spent the 2-hour ride home planning. I immediately started treatment upon hearing the news (the SAME day actually), and after an MRI and waiting a little bit to see if the tumor responded to the meds (it did), I was given the choice to wait on pursuing fertility treatments or to move forward. We chose to move forward. We had already waited four years to get to this point, my heart couldn’t take another round of waiting. So, we headed out on our new journey, squishing tumors and making science babies at the same time!

The first few months at the clinic strongly consisted of test after test and piles upon piles of information and consent forms. Endless blood tests (to monitor the tumor, to check my thyroid (which the tumor caused to go on the fritz), carrier tests, etc, etc, etc)! One appointment I went home with 8 or 9 different holes in my arm looking like an ad for the Band-Aid brand! I had an Hysterosalpingography (HSG) to check on my tubes. A procedure where a thin tube is placed through your vagina and cervix and a contrast material is injected through it while an X-ray is taken to see if either of your tubes are blocked. My left was free-flowing, and my right had a slight delay. The results were not bad at all, and that specific test has shown to slightly increase your odds of getting pregnant for a few months after taking it as it can sometimes clear out your tubes, so we had our fingers crossed, but it didn’t work.

We tried Femara (also used to treat certain types of Breast Cancer) which is an oral pill that fertility docs sometimes use instead of Clomid. But that didn’t work either and between that medication and the one being used to treat my tumor, this was the part of our journey where my hair started coming out in handfuls and my immune system crashed HARD. With so many meds in my system and the giant shift in my hormones with all the different treatments, we had a very rough month where I got very sick and it was incredibly disheartening. But we kept moving forward, trying a whole new world of options as months passed by quickly and we fiddled around with various science experiments, until one day... our options dwindled and we landed on IVF’s doorstep. It was just time. And we knew it was.

The first thing that happened when we decided it was time to pursue IVF was pure irony. They stuck me on BIRTH CONTROL! It caught me so completely off guard because… well… REALLY?! But the objective was to shrink all of my follicles to the same size before we entered the stim phase. We were given a very detailed calendar of dates, and a checklist of things that had to happen before certain dates, and a MASSIVE bill (because in the state of Arizona, jobs are not required to provide Insurance that covers IVF). To date, the ONLY medication my insurance has covered through this entire process…. has been my birth control. Don’t even get me started on this. Just don’t. (Or do… but we’ll save that for a different blog post)!

There were several tests we had to complete before we could start the Stim Phase (aka the phase where you have to inject yourself multiple times a day with medication meant to stimulate your ovaries into a high functioning egg factory)! Typically, in a nature cycle, one follicle takes the lead and produces one egg each cycle. But for IVF they want to stimulate EVERY follicle you have down there into making as MANY EGGS as possible. Basically… it quickly becomes a process that makes you feel like you are a cracked-out Easter Bunny during go time in the weeks leading up to Easter with one goal in mind, TO MAKE ALL THE EGGS! When we were first handed the schedule all I could think was “this…is…going…to…take…forever!” Boy was I wrong. The time between the OCP (birth control) phase and Stim Start FLYS by because you have to complete everything on their list and completely overhaul your life to prepare for what is ahead of you. If I can give you any advice, it’s to cherish those in-between moments and find a way to utilize that time to get your shit together! Simplify your life, deep-clean your house, let your closest friends and family know what is about to happen, make sure you don’t have any big events or big things planned during the same time as the upcoming cycle and if you do, cancel them now and make a game plan including finding help in any way you can get it. It was recommended to me that I create a medication station that could be permanently set up in my house during IVF and this is possibly some of the best advice I received. When STIM phase begins, you will have an incredible amount of vitamin pill bottles, vials of stim meds, extra needles, your follistim pen kit, alcohol wipes, sharps container, and so many other items that you will need on a daily basis, multiple times a day. I cannot imagine pulling that stuff out and putting it back after every round! I set up a book case that was out of the way of high traffic areas, out of direct sunlight, and up high enough that no visiting children or my dog could get to the items. I purchased cheap plastic organizing bins from Target to help organize the supplies, and a small trash can just for that area (in addition to your sharps container which you will need for all your needles, DON’T throw your needles in the normal trash). I set this all up in an area that I also had wall space to put up a massive calendar/dry erase board because you also need to be prepared to be the most organized you’ve ever been in your life. You’re about to embark on a journey that will often require daily appointments, multiple med times throughout the day (that you cannot fudge up or miss), and some serious chaos coordinating. You do not want to wing this! Find a system that works for YOU and (if applicable) your spouse and one that helps get you on the same page with all the appointments, deadlines and requirements. Keep a close eye on your med stash because often, your specialty meds have to be ordered and shipped because most of these meds aren’t available at your average pharmacy and missing just one shot can throw the entire process off track. To help us, in addition to the wall of organization, we also had a notebook where all important information from the clinic went, a group calendar we shared via an app, and a dedicated place where the medical bills went (no… not the paper grinder…but some days, ha)! Pulling this all together, including all the other stuff I am sure I am forgetting at this point, made the month of prep time vanish quickly and just like that, we found ourselves at the final appointment before the STIM Phase started. I passed my bloodwork test, including my tumor check-up, and everything checked out ok at the Down Regulation Ultrasound appointment. My lining looked good, there were no cysts, my follicles had all shrunk down and we made our way down the checklist just in time to get the green light. Which led us to the start of Stim Phase.

I will be the first to admit that I was not the best student in high-school/college. I got A’s and B’s but I did not enjoy being stuck in class. However, when it came to IVF, they had my undivided attention and I absorbed everything they threw at me like a sponge; I took notes, and studied hard! But on the day they sent me home to start Stim Phase and stick MYSELF with needles… all I could think was “NO WAY IN HELL AM I QUALIFIED ENOUGH TO DO THIS?!” The anxiety I felt leading up to that first day of shots was a record high. I don’t just have a normal fear of needles; I was not, in any way, raised right. It’s a long story, but, needles are straight up a trigger for me. But without these meds, there is no someday…there is no baby. The night before the big day, I couldn’t sleep. I tossed, I turned… ALL I could think about was what was going to happen at 8:30 a.m. the next morning and all I could do was watch the minutes tick away on the clock. I gave up trying to force myself to sleep and took to wandering through our home, eventually walking in to where we had my med-desk set up. I sat there looking over our IVF calendar, leafing through the pages of med-teaching materials, and finally, pulled out the box of needles, instantly causing the familiar blanket of panic to fall over me. We had a plan in place for the next day, but despite having gone over it a million times, I suddenly recognized a different feeling in the mix. You will feel so many things when you face infertility head on… from highs to lows and everything in-between…but of all the things you will experience, the one thing you will not often feel… is in control. I always thought I would have to have someone else give me my injections, but in this moment, I realized it had to be me. As much as they scared me, I had to be in control of this. In control of the needle. In control of the meds being put into my system. I had to be the one to do it. And while the thought of this scared me completely, it also gave me a unique sense of calm that got me to sleep that night. This was happening. But I controlled it.

The next morning, after a rough night of insomnia, I shuffled into the kitchen with my new mission in mind and over to my med station. I pulled out all of the supplies, read the how-to charts one more time, making sure I knew what I was doing before mixing the saline solution into the vial of Menopur powder (and I say this with a smirk on my face because the truth is,

it doesn’t matter how many times you read those pieces of paper or watch the tutorial videos online, that very first time, you won’t ever feel ready or qualified to be shoving a needle into your tummy, it’s just the IVF newbie jitters. OH, and also the fact that you didn’t go to med school and this was never a skill-set you thought you’d be adding to your resume). I clumsily filled the main syringe with the mixed meds, attached the needle and (after OBSESSIVELY checking for bubbles and wiping the injection site with an alcohol wipe) pinched my stomach as instructed and went to inject myself………and FROZE. 32 minutes. I spent 32 minutes with that needle hovering over my belly. Hand shaking, heart pounding, and tears streaming down my face. Those 32 minutes felt like hours. Every minute that ticked off felt worse than the last and I panicked a little more with each one because these shots are time sensitive (and I also needed to get to work). I thought the minutes leading up to having your blood drawn or getting a flu shot from a damn professional was hard… but I’ll never think that again! Those 32 minutes were their own kind of hell. But then I yelled at Alexa to play “Be My Baby” by the Ronettes, took a deep breath, imagined what my someday babies little eyes would look like looking back at me, what his/her little head would smell like, what it would feel like to love them for every minute of their entire lives, and never let go. I imagine what it would feel like to be a someday mom. I re-routed my panic and focused on the tug in my heart that had led me to this moment, facing one of my biggest fears, and I took another shaky breathe and cringed as I popped the little silver dart of a needle into my belly, pushing down on the syringe to inject the meds, and then finally yanked it out and set it on the table before sinking to the ground into a puddle of tears. I did it. But I didn’t even care in that moment. This wasn’t the plan. This wasn’t how I imagined we would create our child, how their story would begin. I didn’t choose this. No one chooses infertility, no one chooses to do IVF. But when you’ve spent your whole life wanting to be a mom, and things get storked up, this is what you do. You give up your laid back, Starbuck’s filled mornings for an anxiety riddled game of nurse. I sat in that puddle of tears, already exhausted, mascara running down my face, when my alarm went off telling me it was time to swallow the first 12 pills of the day AND I realized that if that alarm was going off, I was incredibly late for work. So, I frantically wiped the mis-placed makeup from my cheeks with no time to fix it, grabbed my stuff and booked it to work swallowing pills at every stop-light along the way so I could hit the ground running when I arrived at work… all the while not showing that an entire life had happened before ever showing up to open the doors and “start the day.” Life doesn’t stop for IVF. It wasn’t until hours later when I had a moment in between clients at work where I realized, I did it! I gave MYSELF a shot! And for a few minutes, I felt like a bad-ass… until I

quickly remembered I had to go home and do it all over again in a few hours, and my heart sunk; but I swallowed another 6 pills, ignored the funky feelings that were beginning to wash over me from the meds, and moved on with my day. Thus, began the rollercoaster that is Stim Phase!

Everyone’s treatment program varies depending on your age, the obstacles your body has given you, and your doctors’ methods. For us we started out with Menopur by morning (which I eventually learned is made from post-menopausal women’s urine… google it, I’m so

not kidding on this one), and Follistim by night (still an injection, but delivered in the form of an injection pen into which you insert a vial and then turn the dial to your proper dosage). Then we introduced Gonopher which brought me up to 3 shots a day in addition to an incredible amount of vitamins and my other meds. To give you an idea, I carried around THREE giant pill cases in my purse at all times and had over 10 alarms set on my phone each day to help remind me when to swallow things and when to inject things. Remember when I told you that organization would be your best friend? This starts straight out of the gate and THEN… the appointments begin...

Just about the time you get used to the insane medication schedule it’s time to add in your ultrasound and bloodwork appointments. Mid Stim Phase you start out going to the clinic every other day, but in the last weekish, you start going EVERY single morning. The last week I was going in each morning for a transvaginal ultrasound and bloodwork to make sure my follicles were progressing as they should and to make sure my ovaries were not over-stimulated (aka Hyper Ovarian Stimulation). Because our clinic is a 2-hours away from us this meant getting up at about 4 a.m. most mornings to get ready and hit the road. And by hit the road, I mean bundle myself up in everything shy of bubble wrap because during Stim Phase you are in a period they call the “No Bump Zone” which my IVF Nurse jokingly called the “No Shake No Bake Zone!” Your body is hard at work creating as MANY eggs as it possibly can…and your ONE job is to protect those eggs. Therefore, during this time, you can’t participate in any activities that shake, jiggle or bump you too hard. And yes, that includes sex (trust me, you won’t want to anyways)! But it also means no exercising shy of lite and very limited walks, no long hikes, no going over vicious speed bumps with careless abandon, no jumping around playing interactive WII or Nintendo games. This period of time also means you cannot be near an oven (no baking, no cooking) or do anything that raises your internal temp…aka no baths, no heating pads, and no blasting the heater in your car. The list is endless, but you get the idea. All of this is to protect the eggs you are creating and, towards the end, not trigger them to ovulate too soon. But it is also to protect you and your ovaries in general as there are so many meds/hormones rushing through your body that you are walking a fine edge between the egg-making machine of the Easter Bunny’s dreams, and a lovely nightmare called HOSD (Hyper Ovarian Stimulation Disorder). The best thing you can do is to NOT google this obsessively (like I did) and instead take this time to relax and enjoy letting others take care of you (here’s to hoping your spouse knows how to cook… otherwise, UberEats and DoorDash are very helpful)! Find other ways to practice selfcare… binge watch that show you have been wanting to watch… take up sewing… or start a Pinterest board and start looking at nursery ideas and get the power of positive thinking going and go to bed early! Sleep is your friend, and in those last few days… a comfy chair that leans back, fuzzy blankets and a few days off… is your BEST FRIEND. You won’t feel like being around a lot of people because at this point in the process your vagina feels like Platform 9 ¾ just before the start of a new semester at Hogwarts. And by that, I mean THERE ARE SO MANY WANDS INVOLVED! And instead of magic, there’s just a whole lot of science. For me, it didn’t really hurt. I did feel slightly uncomfortable and I did have to whip out my baggy thanksgiving pants, but mostly my ovaries just felt like potatoes and occasionally felt a little pinchy (clearly a technical term). I was very lucky that I never really felt any pain pre-egg retrieval… just an overall weirdness and I had a cute little egg pouches appear in the last part of the final week (which is my cute way of saying yeah, I got a little fatter but it didn’t bug me… I just told myself the poofier I got the more eggs were down there for the Grand Egg Hunt)!

All in all, the Stim Phase wasn’t as hard as I thought it would be as far as discomfort went.

The biggest challenges were facing my fear of needles and getting used to juggling a crazy schedule. Jugging all of this and a full-time job… that was the REAL challenge. To be clear, we’d be up at 4 a.m. each morning, headed to Phoenix by about 5 a.m. and, after going to the appointment and driving back…. I’d stop home briefly to rip off my Band-Aids, and book it to work! All in all, the Stim Phase was exhausting but worth it. I just kept reminding myself what it was all for; and it all led up to tonight. The night we pull the Trigger Shot. At 8 p.m. we administer the final drug and exactly 36 hours from that, we will be going on the Easter Egg Hunt of a lifetime!

We don’t know what lies ahead of us. This is just the first big milestone in our journey to someday! But by the end of this weekend we will know how many eggs they are able to retrieve and in the days following, how many successfully fertilize and make it to the viable embryo stage, aka…. our embabies. This is a big weekend in the Keeling family, and there are SO many feelings bouncing around. But right now, we are packing our go-bags, filling up the car and checking our lists over and over because we will be leaving bright and early tomorrow morning for Phoenix to check into the hotel across from the clinic in preparation for the big event; and despite all the craziness of the last few weeks…we are just flat out EGG-cited at this point to be one step closer to someday! But first… we have a giant shot to administer! Our next blog entry will be post-egg hunt with updates regarding results and a behind the scenes look at the storked up things we do on our quests to become parents! Including this giant needle. Did I mention it's HUGE?!

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