Tuesday, August 30, 2011

ODWU

I tossed and turned all night Thursday, barely sleeping at all.  Not sure if this was due to the bed at the hotel or anxiety about my CCCRM ODWU (One Day Work-up).  Thankfully, my energy stayed with me all day.

I tweeted updates all day, since there was down time between appointments.  And as my Twitter friends can attest, I even tweeted half the evening, having dinner at the bar of a restaurant by myself (excellent people watching).

7:30am  New Patient Orientation
The day started with a New Patient Orientation.  This was basically a review of the coveted Binder each couple is given at the start of the day (I know I'm single, but for ease of communication I'm going to use the word couple to reference the others going through their ODWU).  There were 5 couples having their ODWU on Friday.  They generally take 5 couples a day through the ODWU, Monday through Friday.  WOW!

8:30am  Fertility Labs of CO (FLC) Consent Review
FLC is a separate entity from CCRM although they are co-mingled as an operation. I spent about 10 minutes going over embryology related consent forms with the representative (I should have captured all of the names).  

It was a quick review for two reasons  1)  I've been through IVF before - so I understand the consents  2) I didn't have to debate disposition of embryo options with a partner, specifically the options that have to be specified for the event of a divorce.


10am  CCRM Business Office
This was a financial review of cycle related costs.  This also took about 10 minutes.  When you have been through IVF before you already understand the costs/breakdown, so it was just going over the specifics.

10:30  New Patient Consult (with your doctor)
First the nurse took my vitals then took me to a small consult room.  This was my first Face-to-Face with Dr. Surry.  He was running about 20 minutes late.

He's very nice, quite personable and, of course, SMART.  The consult seemed to be pretty quick and to-the-point (although we talked 20 - 30 minutes).  He said that he knows what protocol he wants to use for me, barring any changes based on the results from the testing we're doing, along with my ultrasound results.  I'll share more on all of this once things move along a little further.

Since Dr. Surry was late, I missed my 30 minute lunch break that was scheduled on my calendar.

11:30am  Psychologist - Donor Sperm Consult
CCRM requires a consult for anyone using donor sperm.  This meeting lasted about 35 minutes, as the psychologist realized that I understand what I'm getting into with Donor Sperm given I've been at this so long.

Thankfully, since my psychologist appointment was brief I had 20 minutes to grab lunch at their kiosk in the back lobby.  They have fresh salads, sandwiches, soda, water, juice, coffee, etc.  Of course, I'd been eying the cold Diet Coke all day but couldn't have it yet... not until after my ultrasound.

12:30pm  Baseline Ultrasound & Doppler
This was the coolest vaggie ultrasound I've ever experienced (and I've had a LOT of them).  This is probably a post in and of itself.

Overall, my uterus looks healthy.  She measured the length, width of both my uterus & ovaries.  They have a flat screen on the wall specifically for the patient to watch during the Wandy session.  She measured the lining (triple stripe) and all sorts of other things.  Then she turned on the doppler to measure the blood flow on the left & right side of the uterus.  I heard the "heartbeat"... of my uterus (bittersweet).  I did text my acupuncturist afterwards because the bloodflow in my uterus is perfect (if it's not, they require patients do acupuncture).  The ultrasound tech said that she's never had a patient who regularly does acupuncture have poor uterine bloodflow.  The only thing is... I have to keep it up (which I was planning to do) to make sure the bloodflow stays perfect!

She then went to count my follicles.  I had 3 on the right and 2 on the left.  A small number overall... that was the most disappointing part of the report.

You are asked to refrain from caffeine/chocolate for three days leading up to your ODWU because caffeine can skew the results of the uterine bloodflow measurement taken during the u/s.  So after my u/s, I went straight to the kiosk for my Diet Coke fix!

1pm  Primary IVF Nurse Consult
At this appointment I met my primary nurse, Tonie.   She's cute as a button and sweet as can be (and very sharp too).  We covered the remaining IVF consent forms and other administrative details, along with an overview of their CCS (Comprehensive Chromosomal Screening of embryos).  I don't mean to gloss over this, because this took an hour, but it was a lot of small details (i.e. next steps, instructions about local testing, etc).

2:15pm  Labs
They took 4 vials of blood for all sorts of testing.  Hint:  Drink LOTS of water leading up to your ODWU and through the day (altitude can dehydrate).  I had a ton of water for a few days leading up to this so my 4 vials were quick!

Another Hint:  Don't go to the bathroom right before your Labs, because they want a urine sample too.  Although I had been drinking a TON of water, I couldn't give a sufficient sample so I had to down more water and try again after my hysteroscopy.

3pm  Hysteroscopy with Dr. Surry
My last appointment of the day was a hysteroscopy.  The purpose of this was for a more thorough look at the uterus, different than the ultrasound provides.  The nurse had given me ibuprofen during our earlier meeting to prepare for the discomfort.

It starts with the speculum.  Then comes oxygen.  It stings a bit, but it's an overall, general sting, not terrible.  And it's quick.  Everything looked great.

Dr. Surry mentioned that based on my low follicle count, he would lean to probably doing a CCS-Polar Body Biopsy (PBB - this is when they test the egg after retrieval, before fertilization) and a Day 3 freeze, rather than trying to go to Day 5 for CCS- Blast.  This will show me if my eggs are chromosomal normal (rather than the embryos overall).

I'm comfortable with this approach because one of my biggest questions is whether I have 'normal' eggs.  This will help give me answers.

CCRM Lobby

Next Steps...
This cycle, 9 -11 days after a +LH surge (OPK) I'll have an endo biopsy which will be sent out to be tested for the presence of a Beta 3 Integin.  The lack of this protein in the uterine lining leads to implantation problems.  My local Resolve friend who is now 20 weeks along with twins was missing this protein.  She was treated prior to FET (with Lupron and I'm not sure what else) and had great success!


When my next cycle begins, I'll have Day 3 labs drawn and shipped to FLC (the CCRM lab) for testing there.

I also have to have some additional bloodwork testing run, probably by my primary care physician.  So I'll be managing my cycle and making appointments.

I did email with my local RE nurse today and asked her if I could have the endo biopsy and D3 bloodwork done there.  She said it was fine as long as I had written orders for the tests, which I do.  It was a little awkward to ask my local nurse/RE to help me with my CCRM orders, but I'm trying to stay open about this... since this will either lead to success or answers for me.

Tentative schedule... I would start estrogen priming after ovulation from my September cycle (expected cycle start 9/17).  The following cycle would start my stims.  After local monitoring, I'd go to Denver somewhere around CD6 for a week - 10 days for monitoring/retrieval.  A transfer would be, at best 8 - 10 weeks later. It's not a fast process, and I've accepted that.  It's a long process but it's my best shot!

Long post, I know... even though I really only gave the high level overview.  I really liked Dr. Surry.  The whole staff was really great, nice, friendly.  I REALLY liked the nurses I met!

As I mentioned, I tweeted most of the day on Friday.  It was a bitter sweet day in the Twitter IF community.  Cassie gave birth to her beautiful son Gabe.  Like Ellen2 heard her baby's heartbeat for the first time.  And Dipitie learned that her baby lost its heartbeat at 9 weeks.

Infertility is so unfair!

17 comments:

  1. Wow, thanks for a detailed run down on what to expect. I've heard great things about CCRM and am keeping it in the back of my mind.

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  2. Wow - busy day! Sounds like everything went great and your cycle is right around the corner. Dr. Surrey did my retrieval - seems like a very nice guy! Best of luck to you.

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  3. CCRM is clearly the place to be, thanks for sharing! Wonderful, I'm praying for you.

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  4. Fascinating! Thanks for sharing so specifically-- I've been curious about what the process at CCRM is like. Good luck!! I'll be keeping my fingers crossed for you.

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  5. I am so impressed with how organized they are! No surprise they are the best in the country. Thank you for bringing us along on your journey. I really believe it's your fresh start, and will bring you your dream.

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  6. Wow. It sounds so positive. I can't wait to hear more!

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  7. Thank you for this post - it was well worth waiting for! BTW I know it's not supposed to, but egg count Can change - I had total 5 one time then after co Q 10, (which I think helped) a few cycles later, 13!

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  8. Sounds like a great day overall. I'm glad you mentioned accupuncture because I've been continuing mine and was wondering what the point is. Now I know.

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  9. Wow!!! I feel tired after reading about it all. :-) Are you on your way home or will you be there longer?

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  10. Thanks for the overview! I've been wondering if I should get a consult from them. xoxo hope it all works out for you!!

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  11. I love your blog! We are looking into CCRM after our failed IVF cycle and have a phone consult w them end of september!!! best of luck to you!

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  12. I can see why CCRM is the best in the country. They are so detailed... You are in great hands. Thank you for sharing.

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  13. WOW!! CCRM doesn't miss a thing. No wonder they are so successful (and expensive!) But they are dotting all their "I's" and crossing all their "T's" which should lead to success for you!

    I'm so happy you get the opportunity to go there! I know this will be it for you!

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  14. Very interesting to read and made me wish for big bucks so I could go there too. You're on the way! All good things will happen now, I'm certain.

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  15. Holy Moly! What a workup! Definitely sounds like you're in the right hands.

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  16. Yay for having that behind you! Now comes the fun part :) I'm glad they met all of your expectations and you're excited about continuing with them!

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  17. So glad your ODWU went nice and smooth, now let the madness begin! May I ask if your Resolve friend had previous failed IVF's? I just need a little hope :-)

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