CD14: Between U/S's

LH surge happened night before last. My calendar said the LH surge should happen sometime starting today. When I saw that I knew they were OFF.

My full bladder at 5AM had me dashing to the bathroom and, while I was there, figured I ought to whip out the old OPK and give it a try. I had done an OPK before going to bed and it looked like my surge was on the way UP, but at 5AM it was on the way down. Could I have missed it? I pulled out a second OPK, different brand. Sure enough, different results. No matter, I called Dr. Moustache's office and left a message that my surge seemed to be happening and that I wanted to come in ASAP. I went to bed, thinking I'd be able to sleep, but I tossed and turned, fretful that the cycle was afoot.

They called at 7:45AM. Impressive. Often they take forever to call. Not this morning. Not when I could really use some sleep. Could I come in at 10AM? I looked at the clock, felt how nice and warm my bed was. "Sure, I'll be there." Threw myself out of bed, upset to leave my warm toasty bed, and I showered and dressed in a hurry. Mom cancelled her Kaiser doctor appointment to go with me. Totally not necessary but she wanted to go. Good thing she did. The freeways were jammed up and having her in the car so that I could use the carpool lane meant we got there in time to grab a bite to eat.

U/S showed that my left ovary had a follicle at 22.7mm. Big! Lining was at 11mm. Nice and thick. Dr. Moustache said the blood test would confirm where I was in my surge: on the way up, or on the way down. They called at about 3PM. LH was at 28, progesterone 1.1, and prolactin was at 26.5. Progesterone, if I recall correctly, starts to rise as the surge is over (maybe I've got that wrong), so I did see my surge finishing up on the OPK. Damned things are so inconsistent. I would highly advise anyone to buy more than one brand and use both. If I hadn't used both I would have likely missed my surge.

I did an NK test on Monday and the results came in yesterday. My NKs spiked from 8.7 to 21 at the 1:50, and to 14 on the 1:25 dilution. DB's assistant said to stop humira immediately (my last shot was Monday) as it was likely causing a flare. We probably didn't see the flare before because of the protective nature of the LIT treatment we did in Mexico. She said that I'd definitely need IVIg before transfer and that she'd call it in with 4 refills. I spent a couple of frustrating hours on the phone with Blue Cross yesterday trying to find 30 grams of gammunex or gammagard. It is still unknown whether they'll cover it or not, but I'm hopeful. 30 grams of either costs about $3000 off of the shelf through my insurance company. Through Columbia pharmacy in Illinois I can get it for about $62 a gram, or $1860. Big savings. I called Columbia and asked them to ship me 30 grams just in case my insurance fell flat on their faces.

To return to the test results: the prolactin at 26.5 seemed high to me being that I'm not on stims. First cycle it was at 19 or so. Second IVF it went to 31 as I had a lot of follicles. Why on earth was it at 26.5 when I'm not on stims? I wondered if that might have flared along with the NKs? I asked the immunology board whether this was possible, and it seems that women with cateogory 2 and 5 immunological issues can have higher than normal prolactin and that it can cause damage to the uterine lining. I immediately cracked open the parlodel last night and put in 1/2 a tab (1.25mg). I emailed Dr. Moustache and asked what he thought. He said he didn't think I needed parlodel. DB, on the other hand, treats any prolactin higher than 20, so I'm going with his treatment plan as it's more aggressive. Here I go self medicating again.

So tonight I do my HCG trigger, although I'm not sure why on earth I'm doing a trigger with a natural cycle. Progesterone suppositories start tonight, of course, with the parlodel french tickler. Tomorrow I've got a second U/S with Dr. Moustache at 9AM, IVIg with two friends from Nogales at 11:30AM.

I'm into the home stretch. Five full days to go and then transfer. I'm nervous as all hell, scared that this won't work (again) and that we'll be faced with decisions about what to do next.