Wednesday, November 09, 2005

Gatorade, how I loathe thee, or freaking "right the fuck out"

So, does anyone know what the difference is between "really overstimulated" and "hyperstimulation"? Is it a mild version of OHSS? Is it completely different? Is it

The R.E.'s nurse called yesterday afternoon and told me to start drinking Gatorade last night, and to drink as much as possible, and to stock up on extra strength tylenol. Apparently Aleeve, Advil and Ibuprofen (all of which I do have in the house) can interfere with ovulation, or something. Can I tell you how much I absolutely loathe gatorade? Seriously, I detest it. So, I relayed this information to Michael while we were out to dinner last night, and he freaked out - our conversation went something like - WE HAVE TO GO TO THE STORE RIGHT NOW! No, honey, seriously we can go tomorrow morning. GET THE CHECK - YOU'RE GOING TO DIE! No, seriously. I'm o.k. WE HAVE NO GATORADE AT HOME, HERE DRINK MY WATER! Ugh. Fine.

O.k., I admit it wasn't quite that dramatic, but the poor man is a *little* wigged out by this whole thing, and I'm trying to convince him that I do not have, and will not get OHSS, so anything you can tell me (or lie to me too - that's fine - as long as it's believable) to that effect would be great. We did however, go to the store after dinner and I am trying my best to choke down Gatorade "Frost" right now as we speak, or rather as I type I guess.

Last night, after I had gone to bed he came upstairs with a giant glass of water. Granted, I usually go to sleep every night with a small glass but this was enormous. I told him I couldn't drink it all - and he said just try, I'm really worried about you. You're really swollen already.

And indeed I am incredibly swollen. I could barely zip my "almost too lose to wear, without accidentally losing it on the street and having no clue that I am sashaying down the street with only panties on" skirt that I'm wearing today. This, my friends, is not good. How I'm going to get through the next few days, clothed - appropriately for work, is a mystery to me. I am not really in any pain, but I get full very fast, and I have a raging headache.

And I had horrible, unbelivable nightsweats last night. I soaked completely through the sheets - and this was after I ripped off my pjs.

And the trigger shot, yeah. I gave it to myself in the thigh. Hurt like a bitch this morning to walk downstairs. Michael was freaked out about it (he's skeeved out badly by needles - as if I'm not) but I decided that I'd much rather have the control of knowing what was going to happen, so I did it myself. Thinking about it is much worse than actually administering it.

Oh, and did you know that apparently follicles continue to grow 1-3 mm a day after your trigger and until ovulation (approximately 36 hours later)? I didn't. So, that means that assuming a 2 mm growth pattern, I've probably got on the left side: 23, 20, 15, 15, 14. On the right, I probably have 20, 20, 18, 17, 16, 14, 13. Do you know that eggs as small as 15mm could hypothetically contain fertilizable eggs? Um, and that could in theory mean NINE FUCKING EGGS? I haven't told you what my last name is, but I can guarandamntee you it's not McCaughey. I did read a scientific study this morning that said that typically HCG only will cause those follicles that are approximately the same size to release eggs. Which leads to my question - what is "approximately the same size"? Persephone was wonderful to calm me down and tell me that only those around 18mm or larger will go, but still, that's five.

Do you know how afraid I am? And how curious I am as to why I wasn't cancelled, or - as Thalia asked why I wasn't converted (or offered to be converted) to IVF? Because I am starting to freak right the fuck out [that's a technical term], in case you were wondering.

Last night at dinner, I told him, you know - maybe we just need a puppy instead. And for a brief moment, I was completely, dead on serious. And he looked at me, and said - well, you may end up with a litter.

And I came this close - (that's me showing you a very tiny space between my thumb and index finger) to projectile vomiting.

Oh, and I just realized that 14 days from the IUI is um, Thanksgiving Day. We're going to be in Dallas with my family, so I'm guessing that I won't have any bloodwork done - and will be relying on an HPT.


At 11:50 AM, Anonymous Jen said...

I'm sorry this is so darn freaky for you--that is a heckload of follicles, and I can understand the freakout.

And Gatorade does suck, though I found that if I drank it ice-cold, it was a lot easier to bear.

Good luck with the IUI--I will be thinking fertile, but not TOO fertile, thoughts for you!

At 12:12 PM, Anonymous Jennie said...

:stunned mullet look: so many follies for an IUI you are the foliculator!
gatorade is easier to drink if really super cold and raspberry flavoured, i hate the stuff but the red one is sort of ok.
wow woman that's a lot of follies you have there, fingers crossed you get a few but not too many releasing

At 12:16 PM, Anonymous Anonymous said...

I promise, things could be worse... and I'm not lying.

I had OHSS during my last injectible cycle, and I had over 50 measurable follies. You can check my blog if you don't believe me -- look in one of the August archives. I don't know where they decide what is a high risk hyperstim as opposed to a moderate overstim, but everyone was flipping out over my ovaries.

You aren't going to die, but you're going to be uncomfortable for a while. You need to drink the fluids because when you ovulate you're going to get even more bloated. The more you drink, the more you pee and the faster you'll get back to normal.

But I promise, you will be o.k.

The statistic I was told was that with IUI one generally conceives almost half of however many follies release. And it is true that generally only the follies that are around the same size will release (think a difference of 1 mm). You aren't being benched because at 5 follies that are close in size, but not identical in size, you have an increased risk for twins, and a slight risk for triplets.

I'm hoping only good things for you.

At 12:19 PM, Anonymous thalia said...


I can't help on the overstim vs OHSS, but re multiples I've copied the research I did for my IUI here. You can get most of these articles for free on pubmed. I have them printed out at home but not here at work so I can't look up your specific numbers, but you are clearly at risk of multiples. That doesn't mean you will get them, but it's an increased possibility. I suggest you talk with your doctor about the questions you have - it can't hurt, right? I'm not sure how old you are so can't interpret the results for you. Let me know if you want to chat further (more detail in my post of 7 August this year).

1. A multifollicular ovarian response to clomid/HMG (ie FSH) resulted in better treatment success than a monofollicular response. Other factors contributing to success included female age of less than 40, infertility duration of less than 6 years, and no evidence of endometriosis. Nuojua-Huttunen et al. Human reproduction 14.3, 698-703, 1999. *

2. Risk factors for higher order (ie more than twins) implantation after FSH stimulation and IUI are serum oestrodiol >=862 pg/mol, female age =<32, and total number of follicles. For a woman over 32, with 4-5 follicles and eostradiol >862, the risk is 13%. If oestrodiol is <862, the risk is 4.3%. I was in the latter category (although only just). Tur et al. Human Reproduction 16.10, 2124-2129, 2001*

3. More recently, Tur et al have applied the methodology indicated above to manage the cycles at their clinic. Application of these three variables has resulted in an 8% reduction in pregnancy, but a 290% reduction in higher order multiple pregnancies. Tur et al, Fertil. Steril. 2005 (don't have the rest of the info)

4. For patients 35 or older, pregnancy rates in hMG and clomid+hMG cycles doubled when six or more follicles were =>12mm, or E2 levels were >1000 pg/mol, but incidence of higher order multiples was not increased. In women under 35, the same conditions did increase the incidence of three or more implantations. Dickey et al. Fertil. Steril. 75.1, 424-426, 2001

At 12:27 PM, Blogger persephone said...

I'm a little confused about the difference between overstim and hyperstim too, so I can't help you there. But have you tried Powerade instead of Gatorade? It comes in a bunch of flavors - maybe you can get one of them down. I like the blue one, though some people find it too sweet - it tastes a bit like KoolAid.

At 12:36 PM, Blogger April said...

50?!?!?!?!?!? Teresa oh sweet heaven. That thud sound you just heard through the computer was me passing out in my office and slamming my head into my desk. You poor thing - oh it makes me nauseous just thinking about it.

And for the record, I'm a little freaked, but I definitely concede it could be a lot worse. I'm actually feeling o.k. - just really swollen.

And Jennie's "stunned mullet look" made me snort gatorade through my nose. And for the record, it's no more appetizing that way.

At 12:49 PM, Blogger April said...

According to the site that Thalia referenced, with my age (26) and the number of follicles I have greater than 10mm (at least 12), I have around a 20% chance of HOM.

Another study found the risk of high-order multiple implantation correlated significantly with increasing total number of follicles and was significantly increased in women with a serum oestradiol >862 pg/ml and aged < or =32 years. My serum estradiol yesterday was 1108.

At 12:50 PM, Anonymous Molly said...

Holy crap. Don't know much about this stuff, but HANG IN THERE, and keep us in the loop.

At 1:04 PM, Blogger Mrs. T said...

Don't know much about either, but wanted to let you know that I was thinking of you!

At 1:23 PM, Anonymous Dooneybug said...

Wow, you're a great responder! Good luck with it all, thinking of you!

At 2:49 PM, Blogger DD said...

Those little eggies are looking for survival of the fittest and may the fattest and most mature win. Stay focused on the prize and I'm sure everything will go picture perfect.

At 2:53 PM, Anonymous mm said...

I find that Gatorade tastes better with a bit of vodka mixed in. But seriously, sorry about the overstim. That has to be scary and uncomfortable. Hoping the very best for you!!

At 3:03 PM, Anonymous Alexa said...

My mind is boggling. No, really, I can feel it. Everyone seems to have the research covered, so I will just wish you the very best of luck, and tell you I am thinking of you.

At 4:39 PM, Blogger zhl said...

Follicles, follicles, follicles, what about the important stuff? Where are the pictures? The casket photo freaks me out.

Good luck. Sounds very uncomfortable. Hoping that one (or two?) good eggs get fertilized.

At 6:56 PM, Blogger Toni said...

With my injectable cycle that I got pregnant, I had 6 eggs go - and got pregnant with one. I was 24.

50 is a ton. And your cycle sounds more like an IVF cycle than a injectable cycle - but I'm guessing that's b/c you're an overachiever :)

Thinking sticky thoughts for one.

At 7:39 PM, Blogger Zarqa said...

When I was sort of over/hyper stimulated I drank vitamin water. (It was an IVF, they retrieved 33 follicles, and still tried to tell me I wasn't overstimulated)
Anyway, Vitamin Water is a little better than gatorade, not as sickly sweet. And those electrolytes do make a very big difference so drink up!

At 7:51 PM, Blogger DeadBug said...

Please do not freak. You may release five, but the odds are extremely strong against all five fertilizing and implanting. Four to five is generally considered ideal for an injectible IUI cycle. My former RE wrote a paper on the subject a while back and the numbers were solidly in favor of no more than twins resulting.

As for the Gatorade: I was instructed to chug the stuff, too, and I hate it. As an alternative, I was told I could drink fruit juice cut with 2/3 water as long as I was also taking in a decent amount of sodium in my diet (I'm a saltaholic, so that wasn't a problem). Perhaps you could ask about something like that?

Hoping this works out perfectly for you!

At 9:30 PM, Blogger daysgoby said...

April -

I'm hoping great things for you!

Oh, and my boy hates Gatorade too. We freeze it in popsicle molds. Much better.

Is there an amount of Gatorade you're supposed to be drinking? Could you cut each glass in half with water?

Good luck, funny girl.

At 10:47 PM, Blogger Lisa P. said...

I obviously don't have any advice about the stimming, but I like your technical term! Thinking good thoughts for the IUI.

At 11:23 PM, Anonymous Anonymous said...

I have absolutely nothing useful to contribute so I'll just say I'm thinking of you.

At 7:04 AM, Blogger Lola said...

Crikey. You're positively ovulicious. I hope you stop swelling before you start scaring animals and small children. Everything you're going through is foreign to me, so it's fascinating as hell to hear about it, but I hate to see anybody freaking out. Hope it all turns out exactly as you want!

At 8:19 AM, Blogger Vacant Uterus said...



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