Frequently Asked Questions

One of the biggest blessings throughout my cancer journey was that we were located in the Austin, Texas area when my diagnosis happened. Austin is a notoriously high young adult population area and is also home to the LIVESTRONG Foundation and several other great oncology treatment, research  and advocacy organizations. I really found that I had a lot of age appropriate resources and information available to me, that many of my counterparts in other areas did not. Access to fertility preservation resources is probably one of the most important issues that differentiates the young adult cancer community from everyone else. For those that do not know, many types of chemotherapy and radiation treatment can negatively affect the body’s reproductive organs in both men and women. Ever since I announced that I was having twins, I received a lot of questions from people about how I got pregnant, how long it took me, whether my twins were fraternal, whether they were “natural,” whether twins run in the family, etc. While a lot of these questions come with the territory of having twins, because I am a cancer survivor and discussed my fertility journey publicly I think it attracts even more questions. Which is why I thought it was the time to revisit the topic of fertility and pregnancy from a cancer survivor’s perspective. I personally do not mind these questions (depending on the setting, use common sense people) because I made a choice to discuss these issues very publicly when I was going through cancer. I also know that people’s intentions are usually not malicious and I also want to make sure people who are going through infertility issues feel like they talk to me and ask me questions if they need to. However, I will preface this by saying most parents of multiples do not feel the same way, so I don’t encourage anyone to bring this up with others unless they have expressed a willingness to discuss it (and there are about 5 million blog posts out there about why you shouldn’t.)

I have discussed my fertility preservation experience quite a bit on my blog, and also spoke about it at a Leukemia & Lymphoma Society fertility forum a couple of years ago (see June 2012 and March 2013.) To recap, I underwent embryo preservation through invitro-fertilization prior to having chemo in June 2013. I also took lupron shots for the remainder of my chemotherapy and radiation treatment, which shut down my ovaries during that time period. Although originally designed for men undergoing treatment for prostate cancer, lupron use in women undergoing cancer treatments actually can help preserve ovarian function. I actually would like to segue here and just say one of the reasons I don’t get into the whole “which disease deserves the most research funding debate” is because of things like this. Many therapies designed for one purpose, can actually have unintended benefits for other purposes as well. The human body is extremely complex and amazing and I won’t pretend like I know better than someone else by saying what research we should and should not support.

Anyway, long story short, lupron worked for me. I was given the “green light” to start trying for a child six months after I ended radiation treatment. From what my oncologists told me, this was a pretty short time-frame and that one year is a more standard recommendation for people in remission from Hodgkin’s Lymphoma to wait before trying to conceive. I was very blessed my diagnosis was caught early, so I had much lower chemotherapy and radiation exposure than the average Hodgkin’s patient, which is why we were able to start trying sooner. However, many people are advised to wait much longer, or even forever, before trying to conceive. How treatment affects fertility is really very dependent on the diagnosis, the treatment received, the length of treatment or even just how that particular individual responds. Also, the damage done to the body during treatment can be so extreme that they physical cannot conceive and even if they are able to conceive, they are advised not to due to a variety of possible health concerns. And some of it is still a mystery, there’s just not a ton of research in this area yet.

I found out I was pregnant about six months after receiving the “green light,” which was just long enough for me to get extremely anxious and concerned. I think its common for survivors to feel like they are waiting for “the other shoe to drop” and I would think to myself that maybe this was it. I wouldn’t be able to get pregnant. The month I found out I was pregnant I went in for a check-up with my fertility specialist who insisted everything looked great. A few days later I found out I was pregnant. When I found out it was twins 10 weeks into my pregnancy, I was incredibly happy but also extremely shocked. As I mentioned in my blog previously, a psychic I went to at Voodoo Fest in 2006 predicted I would have twins and I would occasionally joke about having twins after that, particularly after we went through IVF, but I never genuinely believed it would happen for us. It truly was one of the happiest days of my life. However, I will say amid the joy, there was also a lot of anxiety. One of my first thoughts was “Oh my gosh, now I have two of them to worry about!” You don’t have to be a cancer survivor to know that there is a lot of fear that comes with being pregnant. With twins they pretty much tell you upfront you are at higher risk for almost every possible complication. As a cancer survivor, I was at higher risk for even more complications. Whether it is statistically true or not, I felt like my chances of something going wrong were  infinitely higher than average, and I was extremely scared that something would happen to one or both of my babies, that we would find out my body was unexpectedly damaged from chemo and  wouldn’t be able to handle the stress, and about a thousand other doomsday scenarios ran through my head.

I also felt like I didn’t deserve so many amazing blessings, especially in such a short time period. I really look back on those early months and realize there was a lot of survivor guilt at play. Why am I still alive and others aren’t? Why was I fortunate enough to have great health insurance when others are hundreds of thousands of dollars in debt with medical bills? Why was I blessed enough to pay for IVF AND get pregnant without assistance? How is it fair I got pregnant so soon when others can’t? Why am I so lucky to have TWO healthy babies when so many people can’t have one? How is it fair I am already out of treatment and PREGNANT when people who were diagnosed before me are still in the middle of their fight? Why is it fair that I have a job? And benefits? etc.  There was also anger AT THE GUILT. I just want unadulterated happiness DAMMIT, why do I have to have all of these OTHER FEELINGS swirling around. So many paradoxical emotions existed and its really just hard to explain to someone unless they have been there too. All I can say is I gave it to God, and I got through it. I accepted that this was my journey whether it was fair or not.

At the end of the day, it is the way it is. I had an amazing twin pregnancy. My kids were full-term, healthy, had no nicu-time and I am still healthy. I did not have a stroke, I did not have a heart attack, I did not have a blood clot or preeclampsia or any other thing I was convinced would happen. I was lucky. I was blessed. And I am extremely happy.

So to answer some of those FAQs:

Are they identical or fraternal?

Fraternal.

Are they boys or girls?

Boys.

Did we use fertility assistance?

Obviously this whole post is the answer, but the short answer is no. However, I would not be surprised if the fact that I had been on lupron did  cause me to hyperovulate (release more than one egg) when my ovaries came back online. According to my doctors, my past treatment should not have played into affect, but its one of those things that not a lot of research exists for. My body went through a LOT in a short period of time, and there’s no telling how those experiences may have affected my ovaries. I have run into a lot of people who have had twins without assistance after prior fertility treatments, so it does happen, but current research says there is not a cause and effect relationship.

Do twins run in the family?

For the record, identical twins (according to current research) just happen randomly and do not run in the family. Since I have fraternal twins and they are cause by hyperovulations which can be passed down through the mother’s side of the family, it is possible there is a family connection. At the time I got pregnant, I actually thought that twins did not run in my family. However, recently we found out there were quite a few twins on my great-grandmother’s side of the family and for whatever reason, two other cousins from that branch have also had fraternal twins recently, even though twins haven’t occurred for several generations prior to our’s. So it is possible they “run in the family,” and I would have hyperovulated even if I never had cancer.

What are you going to do with the embryos?

I don’t get this question often, but it is the hardest one to answer. It’s honestly not something I can discuss at this point because we just don’t know yet, and honestly I might never want to discuss it publicly. Will we want more kids, will we not? Will I be able to get pregnant again? All these things remain to be seen. However, for anyone else who is in a similar situation, there is a great blog post on Twiniversity.com that discusses what the typical options are for people who no longer want to use embryos from IVF.

Finally, do you wish you had never done IVF prior to treatment since you got pregnant without assistance?

This is another tough question. Would it be nice to have that money back? Of course, it was a life-changing amount of money. Would it have been better to avoid daily shots, hormone therapy, surgery, etc. Of course. But the answer is no. I do not regret having IVF. For whatever reason, these were the kids I was meant to have at this point in my life, and I probably wouldn’t have had these specific kids if I had not gone through cancer and if I had not done IVF. We had to make a lot of difficult choices in a short amount of time and we did the best we could. I will never regret those choices. I have two amazing kids because of those experiences and I wouldn’t trade them in for the world.

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Six Months Cancer Free!!!

I wanted to let everyone know that I had my official follow-up with my oncologist yesterday and received the results from my PT scan, and I’m still cancer free!!! I’m so relieved, I can’t even express it. I know I seemed like a cool character last week, but I had pretty much convinced myself that every little itch/random pain was a direct result of returning cancer. Whew!

In even more good news, the PT scan detected “activity” in my left ovary that is “consistent” with ovulation. I didn’t even know PT scan could pick up on that, the more you know! As you might have read in my earlier entries, I went through fertility treatment leading up to my cancer treatment because there was concern that chemo/radiation would leave me infertile. Although we won’t know until we actually start trying to have kids how everything is operating in that department, at least there’s a good indication that things are on the right track!

Which brings me to another topic. I won’t be blogging for a a few days since I will be traveling to New Orleans for a good friend’s wedding. Coincidentally, I happened to be invited to speak at a Fertility Forum hosted by the Leukemia & Lymphoma Society and Stupid Cancer in New Orleans on Thursday as well. I will discuss my journey through fertility and IVF treatments in order to help other young adult cancer patients, parents and healthcare providers understand some of the problems young adults face when facing these choices. I’m super excited/nervous to have this opportunity to tell my story and help educate others. Wish me luck!

Inspirational Individuals on the Ides (ish) of November

So I had this whole idea for a regular monthly blog topic called Inspirational Individuals on the Ides (I^3). I totally thought the 15th was the “ides” of every month and apparently that’s not quite the case. You can find a neat little history lesson on how the ides of months are determined here. (And yes, I do know I sound like a dork. And no, I don’t care.)

I was being interviewed for the Manship School of Mass Communication’s (my alma mater) website a few days ago and one of the questions was “why did you decide to start the blog.” Part of it was to keep my friends & family in others state updated on what was happening regarding my cancer diagnosis. But I had already established a private blog that I could use for that purpose. I really just had this inner drive to document what was happening to me because I know as someone waiting to be (or newly) diagnosed, I was scoring the internet for any information of what other people in my situation had been through. For example, I wanted to make sure that any other army spouses out there trying to get TRICARE to pay for a wig could learn from my experience and avoid some of the pitfalls I encountered. For another, I really had no idea what to expect from radiation. No one told me I was going to have to be tattooed ahead of time, or that I’d have to wear a mask and stay absolutely stationary for long periods of time. I knew all of that because of the blogosphere and other people’s experiences, so I was prepared, but those issues easily could have thrown me through a loop. Knowing how much I benefitted from blogs in the days leading up to my diagnosis, made the decision to blog very natural.

I think another major influence is the fact that I have grown up and come of age in a time when so many inspiring individuals have bravely discussed their illnesses or disabilities very publicly in order to raise awareness and research funds, and to empower and educate others. I’ve already talked about quite of few of these individuals: Robin Roberts, Scott Hamilton, Lance Armstrong, Michael Douglas, Shannon Miller, etc. I’m sure I’ll spotlight quite a few of these characters and other well-known people in the future. But this month I want to take a few minutes to spotlight someone who did not grow up in a time when people were very vocal about their illnesses. When people couldn’t find information through a Google search. Survivorship issues didn’t really exist because most people didn’t survive. She was not wealthy or famous. In fact, her real name wasn’t even known for many years. She was instead referred to by the first two letters of her first and last name.

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November’s Inspirational Individual on the Ides is Henrietta Lacks. I first heard about Henrietta Lacks at the September meeting of BAG (Books are Glorious) Ladies, my monthly book club. We were trying to decide what books to read in the upcoming months and someone suggested “The Immortal Life of Henrietta Lacks” by Rebecca Sloot for November. As she was explaining the book to me I was immediately hooked.

Henrietta Lacks was a 30 year old African American woman and mother of five who was diagnosed with cervical cancer in 1951. She received medical care at a free clinic at Johns Hopkins. While she was unconscious for a procedure, they took two samples of her cervix, from both the healthy and affected areas. A physician at Johns Hopkins, George Otto Gey, used samples from the people that were brought into the free clinic regularly for medical research. It was not legally necessary at that time to ask living patients for their consent for these procedures, and it is unknown whether Henrietta ever knew the samples were taken. What is known, is that Henrietta forever changed the medical community.

Although Henrietta died from her cancer a mere eight months after this procedure, many of her cervical cancer cells are still alive today in the form of HeLa, the first ever line of immortal human cells. Since then, her cells have helped cure polio, create new cancer treatments, determine the number of human chromosomes, and countless other medical advancements. They even went into space to test the effects of zero gravity on human cells before any human made the journey. Before HeLa, scientists had no way to safely test human tissue. Her contribution to medicine and science is truly invaluable. And yet she lived in a time when African Americans were segregated in hospitals. When she had only one hospital to go to period, because it was the only one that served African Americans in her area. When even blood donations were segregated by race. Her surviving family never received any financial compensation for HeLa from the medical community. They couldn’t even afford the medical advancements the HeLa cell’s generated.

Just recently, Rebecca Skloot author of “The Immortal Life of Henrietta Lacks” has set up The Henrietta Lacks Foundation to help Henrietta’s descendants and others who have made contributions to medical research without financial gain of their own.

Henrietta, I want to say “thank you!” Thank you so much for your contribution to science. I have personally benefitted from it tremendously. Your cells helped develop and improve effective chemotherapy and radiation therapy treatments which saved my life. They also helped develop invitro fertilization, which has created four embryos that might one day be my children. Thank you thank you thank you from the bottom of my heart. I can’t imagine how scary things were for you. I’m so sorry that you were not fortunate enough to live in 2012 and benefit from the resources and research that I do because of you and others like you. I truly owe you my life.

You have given so many people the happy ending you so rightfully deserved.

Chemo Eve

So I admit I was overly cocky about the Novarel (HCG) shot. If you recall, I had said I would give the HCG shot to myself at “exactly 8 p.m.” on Saturday night. That didn’t quite happen. I had it prepped and all ready to go. I watched the how-to video several times, I even invited my friend (Pastor) Amy over for moral support. And I just couldn’t go through with it. At one point I had gone so far as to get the needle up to my skin, but since it was an intramusucal injection in my hiney as opposed to be subcutaneous (fatty) injections in my tummy that I was used to, the needle basically just bounced back. Despite watching the how-to video where it talks about using a fast “dart-like” motion, I was convinced I could just slowly put the needle in like I had done with my other shots. Knowing you have to inject yourself with a 1.5 inch needle and actually looking at it (and being in a very unnatural position while doing it) is all very different than watching the how-to video.

So Amy was a gem and started making phone calls to all the healthcare professionals she knew in the area. About an hour and a half later, she drove me to Florence (a town about 25 minutes away) to meet up with our friend, Jessica. Jessica is a nurse and was a friend from our former church in Copperas Cove in the Fort Hood-area. She basically had me drop trow in a church parking lot, while Amy stood guard, and was done in about two seconds. I could barely even feel it at all, but she was nice enough not to make me feel like a huge baby for not giving myself the injection. We were convinced we would get arrested for drug dealing or something, but luckily our late night church parking lot injection went unnoticed by the people of Florence.

I proceeded to freak out because at this point the shot was about 2 hours later than it was supposed to be, but I was convinced by the on-call nurses and my friend, Victoria, that it would be fine and wouldn’t affect the egg retrieval on Monday, and luckily it did not. All in all, the egg retrieval went pretty well. We had to be in day surgery by 6:30 a.m., so we opted to stay in Temple the night before so we didn’t have to worry about oversleeping, potentially hitting I-35 traffic, etc. I’m all about limiting stress as much as possible. Unfortunately TRICARE doesn’t reimburse travel unless its 100+ from your residence and the Temple hospital is only 48 miles away, but c’est la vie. I won’t complain since TRICARE covers so much compared to other insurances.

Thanks to everyone’s comments, I was very vocal about having adhesive allergies and they gave me paper tape this time instead of the regular bandages. I didn’t have any issues from the bandages this time, thankfully. They did, unfortunately, stick the IV in my hand. However, since I was very vocal about my distaste for hand IVs, the nurse numbed be up really well beforehand. So other than the initial shot, it wasn’t too bad. I’m learning that being vocal pays off!

They doped me up for this procedure more than any other. From the initial shot in the IV, I started feeling dizzy. I remember them wheeling me into the operating room and chatting with the nurses. I remember that one of them told me she was pregnant with twins, so I shared my story about the psychic and gave her baby name suggestions (Aidan spelled backwards is Nadia if anyone is interested). I remember moving off the gurney to the operating table and after that I was completely out. I woke up in the recovery room seemingly seconds later. After waking up, I continued to lose time quite a bit. I kept thinking I had gone back to sleep, and Rene would tell me that no, I was just talking to him 30 seconds before that. It was pretty humorous. The doctor came in a little while after the procedure and told me they had gotten 17 eggs! That I definitely remember.

On Tuesday, the embryologist called to tell me we had 7 embryos. Today we had 9, so that was very exciting news! According to the embryologist they were “tarty for the party!” It’s very likely we’ll lose a few over the next couple of days but that’s definitely a good number to start off with. Much more than we had hoped or dreamed we would have.

The recovery hasn’t been too bad. I was a nauseated the first day, but that was might have been my fault since I was overly confident in the anti-nausea medicine and decided to eat left over Chinese food. Again, I’m still learning. Now that we can cross IVF off our to-do list, I went to the dentist for my 6 month check up. Unfortunately you can’t have dental work done while you’re on chemo due to infection risk, so I wanted to get a good cleaning in beforehand. I also met with my oncologist to touch base yesterday. My chemo starts on Thursday and I think both Rene and I benefited from having a talk with her. Since we’d been so consumed with IVF, I hadn’t seen her since my bone marrow biopsy more than 2 weeks before, and Rene had never met her.

One of the most frustrating things about chemo is that I have to give up all raw foods, including fruits and vegetables. I can still have them canned, frozen, or cooked, but the risk for bacterial infection is too high with raw. That also means I can’t have any sushi, which is basically an entire food group in our family’s diet. So as part of a pre-Chemo celebration, Rene took me to Chik-Fil-A yesterday so I could enjoy my usual grilled chicken sandwich complete with lettuce and tomato one last time before chemo. We then went to Walmart to stock up on some chemo friendly snacks. That proved a bit too ambitious for me, and I got pretty cramped up on that trip, so I took it easy the rest of the evening and re-watched some of the episodes from True Blood last year to pump up for the new season.

Today, Rene went back to work and I mostly relaxed. One of my other favorite “meals” that I won’t be eating during chemo are the soft-taco supremes from Taco Bell, so I ventured out to get those at lunch. This also proved to be too ambitious, and from a combination of my recovery, the Texas heat and waiting too long to eat I got a bit dizzy and nauseous while I was out, and didn’t enjoy the meal as much as I wished.

While I was out, I also retrieved my prescriptions from the pharmacy. Luckily, I’ll be getting a numbing cream so I can prep the port area before chemo starts tomorrow. They also prescribed me a pain killer. While I’m on the chemo, I’ll be immuno-suppressed and they need to know about any kind of infection I might have, so I can’t take any Advil, Tylenol and basically any over the counter pain medication because they can mask fevers. They also gave me anti-nausea and anti-inflammatory medicine to help assuaged some of the other chemo symptoms as well.

I get asked a lot about what kind of side effects I’ll have. I’m honestly not sure because chemo is different from person to person, session to session. The main things to watch out for are fatigue, nausea, constipation, loss of appetite, lethargy, light sensitivity, proneness to bruising and infection. I will probably lose some of my hair, if not all.

People always seem really fascinated and horrified with the hair loss aspect. Losing my hair is honestly the least of my worries. I just got in a multi-pack of turbans I ordered from Amazon, and they seem like they’ll get the job done if/when I lose my hair. Part of me is really not sad at all about the prospect since I’ll get a break from bad hair days and expensive haircuts for awhile! I’ll also potentially lose body hair which means I’m not plucking my eyebrows until further notice. Why put myself through such torture if I’m just going to lose them anyway? I’m still shaving my legs because, I mean, a girl has to have some standards. But honestly, hair loss is not something that bothers me a whole lot. Watch me freak out in a few weeks when it does happen, but right now I feel okay with it.

From extensive Googling I also found out that TRICARE will pay for one wig. I called my primary care manager and she’s going to figure out how to navigate that system to get that paid for, so I’ll keep you posted on how that process is works. Right now I’m planning just to wear the wig for special occasions and maybe to work, otherwise I’m going to turban it up or go au natural. As an Alias fan, I’ve always had a penchant for wigs anyway, so I might just stock up on some cheap costume ones with bizarro colors just for funsies.

I’m the one in the bright red wig dressed up as Sydney Bristow from Alias in this Halloween 2005 photo.

I also learned from Victoria that I qualify for a temporary disability tag, so my PCM is also helping me out with that process as well. Apparently it has to go through the tax office and not DPS or the DMV, who knew? Victoria also told me about this amazing program called Cleaning for a Reason, where maid services volunteer to clean chemo patients houses for once a month for free. I’ve already been approved and have my first session coming up in mid-June. I’m super ecstatic about this, and my house, pets and husband will also benefit greatly!

The actual chemo process starts tomorrow morning. So Rene is taking me out tonight for sushi for a “chemo eve” date, and then we’ll be in the hospital for more than four hours tomorrow while I receive treatment. I’ll keep you posted on how that process goes!

Edit: I also can’t have fresh flowers due to chemo. Quite a few of you have been amazing and have ordered some for me the past few weeks. Starting now, I won’t be able to have them in the house. If for some reason you’ve already ordered some for me, don’t worry, I’ll have Rene get them to a nursing home or some other deserving purpose.

IVF with Cancer

Since my port placement, I haven’t had a lot of specifically “cancer stuff” happening. Rene and I enjoyed a nice, long weekend for Memorial Day last week. We did our fair share of laying around the house, and Rene’s parents also came down from Waco and we went to the zoo, played Fact or Crap, made a frozen yogurt trip, and ate at a German restaurant (the land of Rene’s & his mother’s births). I was able to go back to work on Tuesday for most of the week, and I have to say I was ready! Although I do enjoy my “cancer uniform” of sweats and over-sized button downs, it was nice to feel well enough to go to work and have somewhat of a routine for a few days.

What brings me to the topic of this post is that while I haven’t had any cancer-specific appointments since my port placement, I have been undergoing fertility treatments. Since I chose to blog so publicly, I waited awhile to make this entry because its such a sensitive topic to so many people, I wasn’t sure if/how I wanted to approach it. I also wanted to have as much information as possible to share with you, in case this blog turns into an early resource for someone who just found out their own diagnosis. Unfortunately, possible infertility is just one of the many harsh realities that both male and female patients have to deal with, and my goal with this blog is to be as open and honest about the experience as possible.

I was extremely fortunate that the possibility of infertility was brought up with me early on. From what I understand, not everyone is given that information beforehand and have since struggled to have children. The pulmonologist was the first doctor I saw after my diagnosis and he made sure to put it on my list of things to ask the oncologist about. The oncologist also made an appointment for me with a fertility specialist the same week I saw her. Fortunately, the fertility outlook for the form of chemo I’ll be taking is fairly positive, however, the chance was still high enough to be a concern. Rene and I always wanted to be parents, and although I’m open to adoption, having biological children isn’t a door I want to risk closing just yet. In addition to chemo, I’ll also be doing radiation during my treatment which also has its own set of risks. Since we can’t predict how well I’ll respond to the initial treatment, it’s always possible they could try something that might be less friendly to fertility as well.

Being in our mid-20s and only having been married about 2 years, Rene & I had never attempted to conceive before. My knowledge of ultrasounds was based on one surface ultrasound I had a couple years ago when someone suspected I had ovarian cysts, and I was told to have a full bladder so they could more easily read the ultrasound. So I went to my first fertility consultation appointment thus, and quickly discovered I would be having a vaginal ultrasound and a full-bladder is actually not a good thing to have. It was uncomfortable for me and the doctors kept complaining that my bladder was “in the way.” Just a head’s up for anyone going in for fertility counseling, but I digress…

Once they determined I was otherwise healthy and fertile, the doctor explained to me that there’s several options:

Egg harvesting: I take hormone shots that encouraged my body to release a large quantity of eggs and then the doctors go in and get them. Afterward they cryofreeze them until Rene & I are ready to have a baby, and then they thaw them, fertilize them and implant them.

In vitro fertilization (IVF): Egg harvesting + using sperm to actually fertilize the eggs and create embryos. The embryos are then frozen until we’re ready for them and then they’re implanted.

Lupron: A monthly shot that basically shuts down the ovaries. Studies indicate that women who are on lupron during treatment have a higher chance of fertility afterward.

My doctor recommended IVF because its the most reliable method, and also using lupron throughout my treatment. If any other Grey’s Anatomy fans recall, Izzy & Alex did IVF a couple of seasons ago for the same reason. (Maybe they’ll bring Izzy back for this potential plot line for the future?) Although egg harvesting and storage is now becoming more available, there’s just not a lot of research on how well those eggs fertilize after being cryofrozen for a time. A lot of women are in the process of freezing eggs, but not a lot of women have retrieved them yet. The research they do have indicates that embryos are more likely to result in viable  pregnancies than the eggs being fertilized after being frozen. However, a lot of people do choose egg harvesting because its more affordable and because many women are single and would rather save their egg’s for Prince Charming’s sperm rather than donor sperm. Whatever the situation, people choose different methods for different reasons.

I’d love to say we did a lot of research, soul searching and praying before making our decision, but that just wasn’t the case. Given the fact that I a) have cancer, and b) was about to start my menstrual cycle, we had to make a decision extremely quickly and we opted for IVF. It just felt like the “right” path for us. To allude to Hunger Games, the odds have NOT been in my favor thus far in the sense that I’ve been diagnosed with cancer at 25 period. We always wanted to be parents and I wanted to increase our odds at having little Rene’s and Laura’s in the future as much as possible. Unfortunately, IVF is not a cheap route to take and right now most American insurance companies don’t cover it– including TRICARE– which is the military insurance that I have because Rene is active-duty. IVF is generally between $10-15K per treatment, and our experience has fallen into that. Luckily, TRICARE will cover everything else related to my cancer treatment and we decided it was a cost that was worth it for us.

The nurse did refer me to several charity programs out there for people who are undergoing fertility treatments due to cancer though, so I definitely recommend anyone in a similar situation to check them out. Lance Armstrong’s LiveStrong Foundation (which happens to be based locally in Austin, TX) has a whole program dedicated to fertility called FertileHope.org. FertileHope works by offering a list of participating clinics that offer discounted fertility services. In addition to the FertileHope discount, we also qualified for a military discount, and the estimate we received for IVF at the Austin-area clinic was around $7,500. Coincidentally, my friend (Jersey City) Amy had connected me with her friend Victoria St. Martin who went through IVF last year due to breast cancer. She did IVF through another charitable program, the Sher Institute (HaveABaby.com) and referred me to their participating clinic in Dallas (about 3.5 hours away). If you’re interested in learning more about her journey, you can visit her website at breastcancerat30.com. She’s been an amazing resource for me throughout this experience.

The quote we received from the Dallas clinic was about $5,500. Unfortunately, the charitable programs weren’t able to offer long-term storage of the embryos and future implantation was going to be at least $3,000. In the end, we opted to stay with our physician at our current healthcare system since we already had a relationship built with them and they were able to offer us a payment plan on a package that included harvesting, storage and future implantation for about the same total price. We also were not up to driving to and from Dallas due to cost and time constraints. So although it was more money upfront, it will probably pay off for us in the future and be more convenient since we won’t have to travel as far. We still have to travel about 45 minutes north to our healthcare system’s headquarters. Again, this is just the route Rene & I chose, it’s really specific to the situation. I would say that if I had been single or didn’t have TRICARE to cover my additional expenses, or lived in Dallas, etc. I probably would have gone with the charitable organizations. I think it also was a great option for those interested in egg harvesting, which was around $1,000 or less. The additional resources page on FertileHope was also a tremendous help, http://www.fertilehope.org/financial-assistance/additional-programs.cfm. They also offer information about options for men going through cancer treatment as well.

Before I even left the office at my first consultation, we started the IVF process. They decided to go ahead and give me my first lupron shot. As mentioned earlier, women can receive this shot to help preserve fertility. Lupron also serves a purpose in IVF because it prevents early ovulation. The doctor decided to go ahead and give me the lupron shot because even if we opted against IVF, it would be good to have a lupron shot in my system for when I started chemo. The second step was my doctor personally wrote a letter himself to my husband’s commanding officer. The essential message of the letter was, “I need Rene’s sperm!” Not a topic your doctor usually has to discuss with your husband’s boss, but there’s the Army life for you. Rene was still in Kuwait at the time, and his leadership had been waiting for a treatment plan for my cancer before they decided if/when to send Rene home from deployment early. Luckily, the letter worked its magic and Rene was back home within 48 hours! I don’t think I’ve expressed enough gratitude to the Army for this, so thank you thank you thank you!

The next step was waiting for my period to start which was a couple days later (TMI, I know). They had my fertility meds shipped to me the next day. The meds really have been an adventure unto themselves. The primary med is Bravelle. Bravelle comes in a powder form that we then have to mix together with sodium chloride and administer the shot ourselves. Upon learning this, our first thought was, “Uhh…… are we qualified to do this?” FreedomPharmacy also sent us a how-to video that we watched the night before (and rewatched the day of the first shot) to help calm our nerves. Luckily I had Victoria as a resource to give me tips. We also called the nurse twice for reassurance that small air bubbles wouldn’t kill me, etc. The Bravelle comes in boxes with five vials to take a day. Fortunately, the nurse informed that I didn’t have to take five separate shots a day, but can mix the vials together for two shots a day. I take 150 iu (two vials) in the morning, and 225 iu (three vials) in the evening for a period of 10 days. They can either go in the fatty tissue of the stomach, or the thighs. My friend Victoria swears by the thigh, but I found that the tummy was easier. So again, it’s just a situational thing. Victoria found it easier to do the mixing herself and have her boyfriend do the shot. Since Rene felt qualified given his experience of administering a grand total of one IV for deployment training, we had initially planned to take this route as well. However, when push came to shove I preferred to do the shot myself. I liked having control of where it was going and when! I started last Thursday and today is my last day. Tonight at exactly 8 p.m. I have to give myself a shot of Novarel (HCG), which basically will tell my body its time to ovulate. I’m pretty intimidated by it as the needle is quite a bit longer, and I’ll have to use more solution, which means it’ll take longer to inject. Those milliseconds really seem like a long time when you’re giving yourself a shot!

My egg retrieval will be Monday morning. I’ll know that day how many eggs they’re able to retrieve, and by the end of the week we’ll know how many fertilized. Unfortunately, IVF is not an exact science. They might not be able to get every egg that is released, and not every egg will fertilize, and not every embryo will implant, etc. There’s also the tragic situation that I’ll ovulate early and they won’t be able to get any eggs. As my doctor explains, ovulation is one of mother nature’s greatest instincts and she doesn’t always like it when we try to mess around with her. However, all my tests and ultrasounds (of which I’ve had many the past two weeks), have been positive, so I’m very hopeful by this time next week I’ll be able to tell you how many embryos we have. We also made the decision that any embryos that we have that go unused will be donated to other couples. Although it will be weird to have biological children out there that we don’t even know about, I’d be happy knowing we may have been able to help another couple have a family. Again, it’s a personal decision people going through IVF might have to consider.

Interestingly. when I went to Voodoo Fest in New Orleans in 2006, a psychic told me I would have a set of fraternal boy/girl twins. At the time I rolled my eyes because no one in my family has ever had twins to my knowledge, but now I’m seeing how it might be a possibility since IVF increases the chance of multiples.

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Thanks to Facebook, I still have a photo of my 19-year-old self paying apt attention to the psychic who told me I would one day have twins at the 2006 Voodoo Festival in New Orleans.

Victoria was also told she would have twins by a different psychic. Maybe this is a go-to prediction psychics give young women? Who knows. The odds of that prediction being correct for most women are certainly not in their favor! Only time will tell I guess!