Tumbling Through the Rabbit Hole...
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An injectable cycle in Endoland

Posted by Haisla Sunday, 10 August 2014

Warning: another long post. I seem to be suffering from verbal diarrhoea.

I have started spotting so AF should be here any moment now.

I have started getting really quite bad vaginal itching just before my period (so, so sorry for the TMI, but if I don't share it here, where will I - on a coffee break with my colleagues?) and this has happened a couple of months in a row. I was getting really quite concerned, until I googled it and found out that it is perfectly normal and due to the lowering of Oestrogen levels. Great, so another source of discomfort to add to the great injury that is AF each month! Gahh.

Before we went on holiday we'd had our doc's consult and a brief meeting with Nurse Nelly to discuss our next injectible IUI cycle. From that conversation I'd understood that it would be pretty much like the Clomid cycle except with added needles. I.e. ring Nelly on CD 1 to book a scan, start injecting on CD2, do so every other day and depending on the scan results stop injecting at some point.

So, dear M. went to pick up the meds from the hospital earlier this week, only to find out that needles weren't included when he got home. So I asked if he could go back after work the next day (he works much nearer and finishes normally by 4pm so can make it there in time, unlike me), get the needles from Nelly and just double check that we'd understood the instructions correctly. I even wrote down some questions (like whether we should inject morning or evening, and what to do if my period starts over the weekend) to ask Nelly so that M. could bring home the answers.

Well, M. came back without the needles and with this cryptic message from Nelly:  "a) Injections from CD 2 every other day, preferably morning (so far so clear),  b) if your period starts between now and Monday, call and leave a message saying that you'll be coming on Monday morning and I will inject you".

But, but, I thought we would be doing the injections ourselves..? And no one had told me about Monday morning before then, what if I'd arranged appointments with my clients or something!? (I hadn't but still, this sloppy and inconsistent communication is really starting to get to me - this was now Thursday evening). So I rang Nelly on Friday morning. Unsurprisingly couldn't get hold of her. So I just left a message saying I still felt confused about the cycle and asked her to ring my mobile or work numbers (thinking she would try one and then if she couldn't get hold of me would try the other) so we could talk it through. At 5.15pm I noticed that there was a message on my mobile phone (now this is where I have to take part of the blame myself. As it had been a really busy day I hadn't checked my phone regularly, thinking that Nelly would ring me on my work phone and had therefore missed her call). Basically she re-iterated that I should come in on Monday and I could ask my questions then.

I'm really quite livid and still in the dark as to how this will all pan out and how it will affect my work. What if my period doesn't start by Monday - do I still go and see her, or just ring her on CD1? I mean I could spot for days. My periods are pretty regular but I have the odd wonky cycle. Will I have to go there every morning for the injections, or does she just want to show me the first one (I really hope the latter)? Will the scans then be every other day or not; what does this all mean!!??

I just kind of feel like this is such routine to them (the staff at the clinic), that they don't even realise that us patients are completely left in the dark by their vagueness. Surely this is not good enough, even from the NHS!?!? I mean, will they be like this when it comes to the IVF cycle ("oh yes, just have a few injections and uhm.. a few scans and then we'll 'book you in'.."). I mean, I like to be well-organised and informed and prepared. And not only that I like being that way, but I have to, BECAUSE I HAVE A JOB!!! Aaaggghhh. I am sorry, but this just frustrates me so much.. And I am so envious of some of you, who receive such excellent care and actual time-lined plans etc. I am just scared that I am in the hands of some morons, and this is really pretty serious stuff here that I can't afford to be messed around with.

Anyway, having now analysed all the vague data Nelly has given me, I think this is what is supposed happen:
I will ring Nelly as near to CD1 as possible (even the weekend and leave a message if I need to). I will then go and have the first injection done by her (perhaps I'll also have a scan, perhaps they'll have to check for cysts etc - I'm just guessing here, because nobody's told me), she'll show me how to do it and then will give me the needles for the rest of the shots. I will go for scans every other day as I did with the Clomid cycle and stop injecting myself when they tell me. Then it's HCG trigger time and then the IUI. This would be the best case scenario and hopefully the more likely.

The worst case scenario - Nelly wants to do all the shots herself and I will have to go to the hospital nearly every day until the IUI (unlikely though, because surely that would be a complete waste of their resources.) So in order to keep myself sane, I will pretend that scenario one is true and be open to be told otherwise on Monday and completely change my plans.

I am starting to get a little worried though. Am I bringing this all on myself by not being assertive enough? Is this the way this clinic generally operates (I genuinely feel like I've slipped into some kind of Wonderland - who ever thought this blog's name would prove so apt)? Will added assertiveness make a difference or just put their backs up and make them treat me less favourably? What is a girl to do?!

I'm really hoping that when we get to the IVF it'll be done by some other people (even by the fierce head of the department - let's call her Dr Queen, who did my lap -  at least she seems competent, unlike the rest of her bumbling clinic staff).

Ooh, the joys of NHS.

Oh, oh and just one more thing since I've got started. How come I only learnt that my uterine lining was on the thin side during my last IUI afterwards and by accident through a letter that I received which had been sent to my GP (I have insisted that I am cc'd to all their correspondence, and thank God for that)? How come this was never mentioned to me during the cycle and how come nothing was done to actually thicken it!!?? These are the questions I will ask the RE (who is yet unnamed) when I next see her. I mean ggrraahh!!

Well, one thing's for sure. If I happen to get pregnant during any of these ART cycles, it certainly won't be thanks to the competence of the NHS but down to a pure, unadulterated miracle. So, maybe all this nonsense will prove to serve some purpose by strengthening my faith..


JCH4DCU said...

I truly can't imagine she'll want to do the shots for you. They're not hard to do at all, I promise.
At my clinic (we're in different countries obviously but maybe it will help make the process understandable) I call when I start my period and they fit you in right away.

An ultrasound is done to make sure there are no cysts and you're told you can start the injections. My doctor told me injections have to be started by CD4. I think last cycle I started on CD3.

I did the first follie check ultrasound a few days later and then after that it was about every 2-3 days. I had blood work done every time. They're checking for Estrogen and LH which are being monitored along with your follies. I would always have to have a morning appointment so they could get the blood work results back the same day.

If you have any questions, feel free to ask! I'll keep my fingers crossed for you!

Haisla said...

Thanks, that's really helpful!

I thought there may be a pre-injection scan required as I read in the meds leaflet that cysts are a no-no.

Am still waiting for AF to start and it is obviously now taking its sweet time.. x

Anonymous said...

I haven't got any input on the NHS--I know that most of the bloggers who receive their care from the NHS have issues with the system, but in the end things seem to work out, maybe not seamlessly though. I was never actually taught how to do an injection for my medicated IUI's, but I got direction from youtube videos online--if you're ever unsure you can always look for tutorial videos online. Good luck! XO

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