Just woke up from a nap with Javi and Mark. We drove to Ann Arbor through a "wintry mix" this morning for the egg retrieval procedure. I once again opted out of the Versed that was offered, which might have actually made the nurses more nervous that I was. One nurse said, "why would you do that?" and another said that she'd never worked with someone who opted out of it. I feel pretty clear at this point that pain medications like Fentanyl in combination with breathing exercises are more than adequate for me when undergoing painful medical procedures. The benefits of opting out include being more alert and functional after the procedures, being able to remember how the procedure worked, and I have to admit a sense of pride that I'm able to get through the experience without relying on additional medication with potential side effects. I totally get how another person would see there being more benefits than downsides to taking Versed for a procedure like this, and the nurse actually amended my consent form to say that I understood the risks of opting out- stated as risks of "discomfort" and "memory." Considering that Versed comes from the family of date-rape drugs, I feel that not having a memory of the procedure could be a bigger risk to my overall well being.
So here's my memory of the morning's procedure. We arrived around 7:30am and didn't have to wait long until I was called back into the procedure room. I was under the impression that Mark was going to be able to sit with me during the procedure, and we found out that this wasn't the case at that point. I was a bit angry about the change in our plans, but I let it go pretty quickly so that I'd be in a calm state (also helpful for convincing the nurse that I didn't require Versed). I changed into a gown and thin blue booties, visited the restroom, and walked through a door to the room where the procedure was going to take place. The sedation nurse got me set up with heart and blood pressure monitors, warm blankets, and answers to many of my questions. She then placed the IV with little effort- I was concerned that this might take a while since I'm not too easy to get an IV in when I've been fasting. Things moved along pretty fast from there. She administered some anti-nausea drugs while we waited for the doctors to be ready. Several of the staff had experienced power-outages at home that morning due to the snow/rainstorm and downed trees so that was a main topic of conversation. Once the two doctors and the med student were ready to go, the first dose of Fentanyl was administered through the IV and it kicked in pretty quickly. They used the ultra sound to get a look at the state of my ovaries, and then added the needle attachment to the probe which would be used to retrieve the eggs and the fluid in each follicle. There was certainly some pain and discomfort with each poke of the needle through the tissue and into each follicle, but I just kept breathing and reminding myself that it would be over soon and that this was an important means to an important ends. At one point, a follicle was pierced by the needle and I reflexively gasped in response to the sharp pain. I asked for more Fentanyl at that point. So they aspirated all but one of the follicles with relative ease, having to push on my uterus from my belly to move it out of the way of the needle while working on the right ovary and having to thread the needle through some of the cervical tissue at that point as well. This was remarkably less comfortable than the left ovary aspirations. The final follicle was a bit stubborn- as they pushed the needle towards it, it moved away rather than being pierced with the needle. It turned out that there was a clot in the needle that needed to be cleared before they could aspirate the last follicle so it got to be pretty painful at that point. All of the aspirated eggs and fluid were suctioned through the needle into little vials which were sent to the lab next door as they were filled. All in all, I was given 250 mcg of Fentanyl.
The lab rapidly determined that nine eggs had been retrieved and then they sent for Mark to retrieve his contribution to the effort. He required no pain medications, but perhaps it was still an uncomfortable procedure for him in its own way. Once he was done, they put him in a protective suit and cap and he got to come in to see me in the procedure room. They were nice enough to let me be the one to tell him about the nine eggs and we sat there together for a few minutes while I drank water and gradually sat up. Those of the nine eggs that were deemed "mature" are being fertilized by the ICSI method this afternoon and we should hear sometime tomorrow about how many were successfully fertilized.
In the meantime, I will be getting an Echocardiogram tomorrow morning to make sure that my heart is in good shape to handle the upcoming chemotherapy infusions. Then I have a consultation with the oncologist where I hope to get details and a schedule for the chemo plan. So tomorrow is a big day for information and next steps. I expect that chemo will start within a week, so the reality of that is settling in a bit. I'm feeling strongly that I'm ready to get started and that I also want to spend some time researching supplementary treatments such as herbs, nutrition, and immunotherapy in general. I understand at this point that the chemo is necessary to kill the cancer cells, but I would like to have a solid plan to heal my body during this process which is not part of the current chemo plan. I continue to not have any cancer symptoms and my port incisions seem to have healed nicely.
We met with a financial counselor yesterday and at least have a general plan to deal with the costs of this condition, which is absolutely no fun to think about. I'm trying to trust that I won't be completely financially ruined by this, but also trying to detach from the emotions that come up around money and finances. I'm being told pretty clearly by service providers and caregivers that my first priority has to be getting healthy, and I'm grateful that I have people in my life who are there to support me. Next week is spring break at WMU, so it is well-timed with (hopefully) my first round of R-CHOP. I will still work part-time and I can use some of my normal class time to get caught up on assignments from the last two weeks. Really looking forward to not having to drive to Ann Arbor every other day. There may just be one drive left for a follow-up on Monday. I plan to update the blog again by this weekend with the info that I get tomorrow. Thanks for following along, and may you be well.
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