Buckle Your Seat Belts; Turbulence Ahead

Picking up where I left off, we were solidly into Fall with littles getting excited about Halloween costumes and Trick-or-Treat adventures. In the last week of October, the bean was at 22 weeks, measuring just a little bigger on fundal height, and generally, growing like a weed. I had been feeling movement for several weeks, but around that point, he was getting much more forceful in his kicks and rolls, enough that Scott and the kids could feel it on the outside of my belly too. Everything was progressing nicely... until is wasn't.

I woke up on November 5 with that annoying pressure/pain feeling indicating that a UTI was setting in. It wasn't extremely painful, but I wanted to get on top of it before it got out of hand. I'd had a UTI get out of hand in my first pregnancy that landed me in the hospital on IV antibiotics due to the bacteria not growing on the culture medium and leaving the doctors working blindly to try to treat it. They weren't able to tell which antibiotics to use until we tried them and they didn't work, switch to a different one, lather, rinse, repeat. After a week of no relief, it had spread to a kidney and required IV antibiotics. It was a scary situation, and not one that I wanted to repeat. So at the first sign, I headed off to the office of Lovely Outgoing OB and Partner OB. I was in an awkward position, in that Lovely Outgoing OB had left 5 days prior, and I hadn't ever had an appointment with Partner OB. Regardless, I peed in the obligatory cup, which was very cloudy with an abundance of white blood cells, Partner OB called in an antibiotic and we went on with our day. I was swamped with procedures and meetings over the next 2 days, so I gave little attention to the fact that the pain was not subsiding. By the middle of the day on the 7th, however, I was startled to see blood in my urine to add to the pain/pressure. I called the after hours line for Partner OB (it was Saturday by this time) and she quickly called me back. She told me that she was out in the wilderness with her family, so she couldn't look up the culture results, but that I should go somewhere to be seen that day given that it wasn't getting any better with the current antibiotic. So Scott chauffeured me to a great little stand-alone ER that we have close to our house. More obligatory peeing in a cup. Urine looked clear, as it should after 2 days on an antibiotic, but presumably, the infectious bacteria was resistant because symptoms were getting worse. That meant that this poor ER doc was going to be working blindly to treat, much like the first pregnancy UTI debacle. ER Doc #1 was great though; very thorough, attentive and conscientious. He gave me some Azo to alleviate the urethral pain that was increasing, then tried a new antibiotic IV. I headed out the door, hopeful that we had tackled it with the new antibiotic and ready to watch my favorite college football team domina.... er... take it in the shorts.

By Sunday morning, the pain was increasing and Scott felt that we needed to take a more direct approach. We talked about it at great length and decided that we needed to go to an ER that had a vast network of specialists because we may need a urologist at this point. We decided on the hospital that Partner OB is affiliated with so that we could ensure some continuity of care and information sharing. Admittedly, I was aware that Partner OB was still out in the wilderness with her family, but hoping that this strategy would allow the other professionals ease of access to my history, notes and results. ER Doc #2 was a stark contrast to ER Doc #1 in that she was much more direct and a bit brash, but she was very intellectual and her approach to solving the problem was very outside-the-box. Yet another cup of urine was collected, and again, it was as clear as one would expect after 3 days on antibiotics. This made ER Doc #2 think that the problem wasn't an infection, but rather a bladder spasm. Interesting... At that point, I was open to any thoughts/suggestions/treatments, because the pain was getting too intense to handle on my own. ER Doc #2 called Partner OB who said "As long as she's not having contractions, it's pretty much out of my field." So ER Doc #2 called the on-call urologist who said "Not really anything we can do for it. Just give her some pain meds and send her home." On that note, we left with bed rest instructions and an order to see Partner OB two days later to follow up.

Throughout the day on Monday was more of the same, but the pain meds took the edge off, so I was just trying to make it to the follow-up appointment on Tuesday at 1:00 pm. Instead, I woke up at 3:30 am with contractions that were regular and 5-10 minutes apart. In addition to managing the pain, I was lying in bed thinking that we really needed to *not* have a 24 week 2 day baby! I called the OB's office, drank a ton of water, laid down on my left side and thankfully, the contractions subsided within an hour. Partner OB's nurse called me and told me to come in at 11:00 am which was as soon as she would be out of surgery. Going in, I was so eager to finally get some relief and find an effective treatment after 5 solid days of this. Unfortunately, I didn't get anything like that. This was my first time ever meeting Partner OB in person, and I was shocked to see a twenty-something walk through the door. This made her accomplishments and awards all the more impressive, given that she's obviously only been working in her field a short time. She quickly ordered a fetal fibronectin test and ultrasound view of my cervix to rule out preterm labor. Both looked perfect (cervix length was a solid 4 cm), so she was pleased and told me I was good to go. I was caught a bit off guard when I asked about the pain and she shrugged her shoulders and told me she was baffled by it. She suggested I see the urologist, with the first available appointment being Wednesday at 10:00 am. Ok. On to day 6, again, eager for this physician to finally help resolve this situation.

I arrived at the urologist's office well ahead of the scheduled appointment time (did I mention I was eager??), with my best friend, Jamie, in tow. Scott was at work and I didn't think that he needed to keep taking half days off just to chauffeur me around. The medical assistant that called me back was very soft-spoken and sweet. She directed me to empty my bladder then took me to a patient room where she started to do a bladder ultrasound to determine how effective my emptying was. As she approached me, she said "Have you had an hysterectomy?" I said "No, in fact, there's currently a fetus taking up residence in my uterus." Clearly thrown for a loop (apparently didn't read the referral notes from Partner OB??), she quickly excused herself from the room without doing the ultrasound. At this point, Jamie started to question why we've been struggling with this issue for 6 days and no one, neither ER Doc #2 nor Partner OB, thought to visualize the bladder via ultrasound. Who knows, as she noted, maybe there's a stone in there irritating it or something. Certainly taking a look could be worth the time and effort. But that was definitely not in Uro Doc's plan either.

Uro Doc charges into the exam room 30 minutes past appointment time and says "You know, there's not a whole lot we can do with you while you're pregnant. You should really come see me after you have the baby." I'm sitting there silently, a bit confused. Is she saying that this pain is going to outlast the pregnancy?! Because I am absolutely certain at this point that I *cannot* do this for another 15.5 weeks! I told her that my goals for this appointment were to identify a cause of the pain and to discuss what options we have for treating it. She scoffed "Yeah, that's not going to happen." I literally laughed out loud when she said it. Sometimes I have a nervous laugh when I'm so stunned by how brazen someone is with what comes out of their mouth. This was one of those moments. She then tells me to drop my pants and proceeds to give me the most awkward, jabbing, pinching examination of my lady parts that I have ever experienced. At the conclusion, she says "Well, there's nothing that I can do for you surgically, so although you're experiencing some discomfort, it looks like you're going to have to just ride it out." Did she just use the term "discomfort" to characterize the hell that I'd been living for 6 straight days?! Here's the moment where the pregnant lady can no longer hold in the tears of frustration. What, exactly, do you do when you have been battling pain strong enough to cause contractions for 6 days, and every doctor that you see says "I'm not sure what it is, but it's not my problem." I couldn't even look this abrasive woman in the eyes anymore. Instead I fixated on the cabinets in the corner of the room while she continued to tell me that maybe the pain wasn't even real, just a figment of my imagination. She briefly stepped out to call Partner OB, then came back to say that they had decided it was bladder spasms and they would prescribe a muscle relaxer.

I went home feeling completely defeated, miserable, and somewhat out of options. I took the muscle relaxers as directed, and promptly slept through the entire day on Thursday; a side-effect of the medication that I simultaneously loathed and appreciated. Waking up on Friday morning (day 8), things had taken a serious turn overnight and I now had excruciating back pain on the left side. There was no relief and I told Scott that we had to do something, go somewhere, find someone that would actually *do* something. After a bit of tense back and forth on what to do, he buckled me in to head to a different, full-service hospital ER  close to our house. By the time I got there, it was difficult to walk and I was a blubbering mess trying to relay to the ER nurse what was going on. Once I mentioned the pregnancy, they wheeled me on up to L&D for monitoring and for the OB on call to handle the case. There was yet another round of pee-in-a-cup, but this time, this lab did something none of the previous ones had: They actually assessed the bacteria load in the sample. They didn't just look for white blood cells, blood, color, clarity, etc.. They came back and told me that there was a very heavy bacteria load, which they would not expect to see after a week on antibiotics. They were also monitoring the baby's heart rate and contractions while they ran a few more tests. While the contractions weren't strong enough for me to time them, they noted that my uterus was very irritable. I couldn't blame it... pretty much all of me was getting to the point of 'very irritable' by day 8! In the meantime, Sensible OB thought it would be a good idea to review some of my records to see what antibiotics had worked in the past. She picked one (again, working blind to what bacteria it actually was), and within 4 hours the pain was nearly gone. I seriously could have kissed her! She sent me home with a prescription to continue that antibiotic, and by the next morning, I felt like a brand new woman. I jumped out of bed feeling like I could do anything!

Throughout the 8 days of UTI hell, I was very careful in how much I relayed to Mandy and Wes about my pain. Without them being there, I knew that they would be very concerned, and I didn't want them to get worried when there wasn't anything that they could do about the situation. I made sure to let them know with each passing day that little belly buddy was doing great and that the doctors were still working on finding a treatment that would work. Mandy was so sweet and checked each day to see if I was feeling better, but I just couldn't lay the weight of my daily struggle and frustration on them. Still, we all shared the immense sense of relief when it was finally resolved. Mandy then broached the subject of questioning the treatment choices of the previous physicians, including Partner OB. I had been thinking the same thing, so it was nice to see that we were on the same page. We agreed to find a different OB for the remainder of the pregnancy, and who better than Sensible OB that looked at the situation and thought "If it walks like an infection and talks like an infection, chances are, it's an infection." She saved us from being admitted for IV antibiotic treatment by catching it as we were on the brink of a serious kidney infection due to the spread. So it was a logical choice to schedule our next appointment with her and cancel the end of November appointment with Partner OB. As the scheduling gods would have it, our first appointment with Sensible OB would fall on the same morning as the 3D/4D ultrasound in the first week of December.

And We're Off, Like a Herd of Turtles

It's that time again: Another month has passed, and the blog needs an update. If you've read any of the older entries, you'll notice a pattern of posting where there's a longer pause between updates during these contract and preparation periods, and more of a flutter of blog activity as we get into some of the more exciting surrogacy events. There are two main reasons for this. First, the contract and preparation periods are tediously long and rather boring. Second, as you may know by now from this blog, I am not a patient person, so I don't take the long, slow waiting as well as one might hope. More frequent updates from me during this period may come out as "Still no *@^$*# contract yet," and no one wants to read my constant Debbie Downer frustrations without some good news to help wash it down. With that said, brace yourself for a flurry of blog excitement on the horizon.

Exactly a month ago, I closed with "Here's hoping we have a signed contract next week. If so, we'll be right on track for a transfer in the last week of May." And then the gods laughed and laughed. T'was not meant to be for an end of May transfer. We experienced two major hiccups to the plan. First was that Wes and Mandy's attorney *must* get paid by the hour. I can't think of any other explanation for why someone would hold onto this document for days and weeks on end without signaling forward progress. Holy buckets! I have never seen someone work so slowly in my life. Working with her has led to me the conclusion that if I ever find myself in the situation of doing another stork contract and the IPs select her as their attorney, it's an automatic deal breaker for me. I have also decided that I would rather be subjected to an angry hoard of starving fire ants with no route of escape than to wrap myself up in another several month long contract negotiation, especially with that attorney or any others like her. But I digress. There was a secondary hold up as well.

Back in early April when we all visited the RE, Mandy and Wes also had to have blood drawn to meet FDA testing requirements for transferring the embryos to a third party (me!). Normally, IPs will have this done at the time of egg retrieval and/or sperm collection, but Mandy and Wes did not intend to use a surrogate at the time of their embryo creation, so the RE had no reason to run those tests at that time. Now that we're getting ready to start cycling, they need those results on file before we can get started. It was about two weeks after the results for Mandy, me, and Scott had come back that everyone started to question where Wes' results were. After some digging into it, the answer was that the lab lost his blood sample. This is quite problematic, as Wes is working an out-of-country job assignment, so he doesn't have access to lab to get another sample drawn quickly. It took about a week to get another sample drawn and submitted, but alas, the contract still wasn't done, so we waited patiently for the results. About a week ago, as we were all trying our hardest to pry the final draft of the contract out of the attorney's death grip, we got an email from the clinic saying that one of the infectious disease markers on Wes' blood panel came back positive, and that we would need to do some additional steps before proceeding. The positive result was for a relatively inconsequential virus and indicated a very old exposure that Wes had fully recovered from. Still, I had to have an antibody titer done to assess my immunity to it, meet with an infectious disease specialist to talk about the risk of contracting the virus from the embryo (highly improbable) and sign an FDA form stating that I assume that risk in moving forward with the transfer. Amazingly, I was able to whip through all of that in two days AND put some ink on the signature line of the contract last Tuesday. It was like some kind of post-Mother's Day miracle! Still holding the wet pages with a look of shock and awe on my face, the box of medications arrived on Saturday in order for me to start my first Lupron injection today.

We're cooking with gas now! We may still be a month away from transferring, but we have some dates to look forward to in that time span. I'll start Lupron tonight and my first monitoring appointment will be May 26, with two more monitoring appointments on June 2 and June 5. Then I'll fly out to the clinic on the 11th for our frozen single embryo transfer on June 12. This stork is officially no longer on standby; let the oven pre-heat begin!

To Be or Not To Be

That is the question on this very important day. Today is July 23rd; the last business day before July 24th, the all-important first day of cycle medications. This is the day that all paperwork must be completed by in order to be on schedule for the transfer on August 26. For all of you out there making bets on whether it would really get done and signed in time, the final answer is.... kind of.

A full 9 days ago, I optimistically hoped it would be done in 48 hours... and then the gods laughed and laughed and laughed. It was a week of little to no news, pacing, nail biting, calendar watching stress. The nurse coordinator from the IVF clinic emailed me yesterday nervously asking if it was done yet, and I passed along the anxiety in kind to my attorney to see if she had heard anything from Ellie and Matt's attorney yet. While there was no official response, the nurse coordinator went ahead with sending the medications, and we all slept uneasily on it for another night. This morning I received a somewhat panicked email from Ellie and Matt that they had received the final version of the contract and were ready to sign it, but the one and only representative from the surrogacy agency that has to witness their signing and notarize the contract, unexpectedly went out of town and won't be back until Monday the 28th. Did I mention that dealing with this agency makes my teeth itch? Regardless, we have the finished contract in hand, and that's a win all on it's own. In the meantime, Ellie and I came up with a plan where my husband and I will sign and notarize the contract today, send it back to the attorneys this afternoon, and then Ellie and Matt will have it in their possession while waiting on the agency rep to return, allowing them to execute their portion. This was agreeable to the nurse coordinator in terms of starting the medications tomorrow and will keep us on schedule. As I said 23 days ago: coo coo cachoo, we have a completed contract... kind of.

Now comes the fun (?) part. I'll be giving myself an injection of Lupron in the abdomen once per day starting tomorrow for the next 28 days. I've rationalized that it's a tiny little insulin needle, and I've built up a nice "protective layer" over my abs, so this shouldn't hurt a bit. I'll let you know how that goes. The Lupron is very important though, as it will quiet my ovaries and prevent me from releasing an egg of my own during this process. We want to be VERY sure that the only little storkie in this adventure is Ellie and Matt's! So tomorrow is day 1, the beginning of an exciting and highly anticipated stork adventure. Let's do it!

Don't Stop... Believin'...

I'm tired. Exhausted, really. It seems crazy; the process hasn't even really begun yet, but I'm totally wiped out. My work schedule has been particularly hectic in the past 6 weeks, and the paperwork of the stork adventure has continued to steadily roll in. I keep remembering how tired I get in the first trimester of pregnancy and thinking that I can't imagine adding that onto how worn out I am at this point. Luckily, the projects I have at work are dwindling down again, and we're close to the summit of Mt. Paper-manjaro, so hopefully I'll be able to catch up on some rest before I start incubating the storkie.

Here we are, two weeks since my last post, and we don't yet have a signed contract in place. That sweet, 10-day cushion that I boasted about is wearing a wee bit thin, but it looks like we're on the brink of success. Ellie, Matt and I have been through the first draft of the gestational agreement, conferences (very. long. conferences.) with our respective attorneys, and a fun little game of 'telephone' between our attorneys. I think we're lucky: We had a great foundation to our relationship before the attorneys were involved, and we worked through every contractual point that we could think of before sending it over for the attorney to draft. Still, the process has been mind-numbingly tedious. I can't even begin to imagine what it must be like for intended parents and surrogates that have had very little communication. Needless to say, we're looking forward to applying some ink to those pages and putting this part of the process behind us. I'm cautiously optimistic that we'll be doing just that in the next 48 hours. I mean, really: Have my time estimates ever been wrong during this process? Wait... nevermind, don't answer that.

Rules of Engagement

It's been quite some time since my last update, but as things go in a stork adventure, there's a lot of slow and tedious work to do be done up front. I look forward to the entries that will tell you all about how the little storkie is growing and moving, kicking up a storm, and demanding bizarre treats at all hours of the day and night. With patience we will get there, but today it's all about contracts and legal procedure.

When we left off a month ago, Ellie and Matt had sent our contractual plans to the CFO of the agency, and we all waited for a contract draft to come our way. I can't speak for Ellie and Matt, but I had a great amount of patience in the first two weeks. Early on in the process, one of the agency directors had mentioned that the typical timeline of the contract phase was 2 weeks to draft the document, and 2-4 weeks of conferring with attorneys while requested changes are made and sent to each others' attorneys for review and further conference. Seems reasonable. So by week 3 I was starting to wonder how things were going (not that I would dare to check in with the agency!). I was counting weeks and days left until July 23 - the day that the contract has to be signed and notarized by all parties, in order to do the transfer on the date scheduled in August - and trying to not get impatient. Ellie emailed me at the 3 week point with great news: The draft would be sent to her within the next 3-5 days. We both went back to our day to day activities while we waited, and we were both completely swamped at work; sufficiently distracted. Five days later, Ellie's attorney contacted her to say that it would be another 4 days before the draft would be done, so back to the distraction of work we went. Life was bustling for both Ellie and I; besides work, all of my kids were out of school and in the full swing of summer activities. We can't even sit down for 10 minutes at our house without having to run out the door to the next activity. Again, it's nice to not be hovering over my email inbox waiting for it to ping. However, when we passed the 4 week mark, and got to the (second) date that the attorney promised the draft and there was still no draft, I was starting to lose my patience. Ellie's attorney sent her a message saying that it would be done early the following week. When it finally arrived in Ellie's inbox (after 4 weeks and 5 days), I have to admit that her attorney did a great job. It was VERY thorough (75 pages!) and sufficiently accurate. After taking a few days to read it over and make comments, Ellie, Matt and I Skyped to discuss our comments and thoughts. We were all quite happy with how it turned out and had only a handful of minor changes, so they were able to send it back to their attorney at the end of last week.

As of today, we're in great shape to finish the contract in time for our target transfer date in August. My attorney should be receiving the completed contract today or tomorrow, we'll have a conference call to review it on Monday, and coo coo cachoo: we'll have a completed contract! This, a full 10 days before we are scheduled to start meds for the transfer. And you were worried that our 9 week lead time wouldn't be enough. Pssshh, we just like living that close to the edge.

So it's time to roll up our sleeves and get to work on the really exciting part of this adventure. Let's make some scientific magic happen! We need to get everything prepped with an impressive, month-long medication protocol involving lupron, estrogen, and progesterone. The countdown is on: 24 days to the first injection. Did I mention that I'm needle-phobic?? I'll be back to let you all know how this goes.