Sunday, August 28, 2011

My OHSS - Mismanaged or "Normal"?

image from google images
During my OHSS ordeal, I spent the half the time I was calling out for help be told that this--all my symptoms, pain, weight gain--was "normal".  After five days, when I actually received an ultrasound, the entire office was spun into a frenzy.  Obviously, this was not normal.  But I still question whether this was a result of gross mismanagement or if this was a normal protocol that my body just decided to rebel  against severely.

Here are my numbers from the days I was monitored.  Any input on what you think may have happened would be very, very helpful.  This being our first injectable cycle and the response being so severe, we are not only new to this and the relative norm of such data but also worried about going forward.  After my liver enzymes were off, I also wonder if this is linked to the Metformin or OHSS.  Info you have on Metformin and if you get regular liver tests while on the drug would be helpful as well.  Thank you for all your input that will help us find our way!

Patient History:
 Meds: Metformin, basic fasting glucose test prior, no other test before or during
1 cycle on 50 mg Clomid -- no response, cycle canceled
1 cycle on 100mg Clomid -- no response, cycle canceled

This cycle:
Day 1 baseline ultrasound - quiet ovaries, cleared to begin
Clomid 100mg days 3-7
6 Gonal-F shots 150 iu days 8-13
Ovidrel Trigger day 14
IUI day 16 

Monitored Appointment Data
Right ovary follies:  14.5mm, 14mm, 12mm, 9mm
Left ovary follies:  2@13mm, 8mm
many smaller
E2:  824.6
Right ovary follies:  18mm, 14mm, 2@11mm, 10mm, 9mm
Left ovary follies:  2@17mm, 14mm, 13mm, 11mm
many smaller
E2:  3621
Right ovary follies:  20.5mm, 2@15mm, 2@14mm, 2@12mm
Left ovary follies:  18mm, 17.5mm, 2@15mm, 13.5mm
many smalller
E2:  3343
Trigger shot

40-60 forward moving/hpf

I am fairly blown away by some of these numbers, specifically the E2 jump by Monday.  Even more so when I read that normal E2 during the ovulatory phase is less than 500!  But, all in all, I am not an expert in fertility medicine.  I don't know the norm.  I don't know what data should really look like or what red flags would constitute the immediate canceling of a cycle.  I just know my gut feeling--that this wasn't right.  

Thanks for any and all input.  Every little bit will help us figure out where to go from here!

Saturday, August 27, 2011

My OHSS Story - Part V

. . . The tests that followed, the measuring, the weighing--all confirmed again that I was far beyond severely hyperstimulated.  Ovaries are supposed to be the size of eggs, about 2-3 cm.  Severe hyperstimulated ovaries are the size of grapefruits.  My largest ovary was, in hospital analogies, the size of an IV bag.  The largest measurement was 20.5 cm, with an estimated volume of 1170 mL.  The follicles, or cysts, we all know are ideally measured at 1.8-2.3 cm.  I had numerous cysts covering my ovaries, the largest measuring 5.5 cm.  Unbelievable.

The fluid had begun to move into my lungs, thus the trouble breathing.  Because of the fluid, my lungs weren't able to expand as much as they should.  So, when I was feeling like my breath was cut off half way through my inhalation, it was.  The lungs had hit a wall and could expand no further.

For the entire time I was in the hospital, my belly was measured and I was weighed daily.  Until the very last day, their long tape measure couldn't even come close to fitting around my hard, swollen belly.  The fluid was nearly all in between my ribs and my knees.  I felt huge.  I looked huge.  When I could finally get up one day and shower, it was a scary sight to see my body.  I had sent my husband out to get some nightgowns so I wouldn't have to wear those lovely hospital robes.  Though I would normally get smalls, I told him to be sure to get mediums for me with the swelling.   In mid shower, I was tearfully yelling out to my mother, "Please call!  Tell him to get large!  Tell him to get large!"

When all was said and done, in less than a week I gained 27 lbs, all falling between my ribs and knees.  It was scary.  So scary.

Now, I am on the other side of this nightmare.  My ovaries began to shrink on Monday.  Though there was still a significant amount of fluid affecting my lungs and my liver enzymes were off, they decided I could be released from the hospital with regular monitoring at the clinic.  The first day home was the hardest.  It was exciting to be home, be able to sleep in my own bed, but it was also misleading.  I was home, I could do more, right?  Wrong!

The night we got home, I started bawling on the sofa all because I wanted a water.  I had been getting up and down, getting drinks for a few hours and it had begun to take a tole on me.  Even getting situated was hard.  Here at home there were no nurses to bring you nice, cold drinks whenever you wanted, I couldn't pull a tray right up to my mouth in order to eat my food, there were no bars around to help me pull myself up, and (perhaps the most difficult) whatever I sat on was not mechanized for easy resituating!  So I went through a box of Kleenex and bawled my eyes out.  Even the glasses and plates that I had to lift at home to eat and drink were heavy and causing strain.  How pathetic!

It has been a struggle to learn how to deal with my still enlarged ovaries over the last week or so.  There are still times when my ovaries ache or seem to cramp up, though the sharp, debilitating pain is gone.  I have been walking slow and eating smaller portions, in order to not upset my insides.  Now, with movement coming easier, when I forget to take such precautions and take it slow, my insides rudely let me know!  I am still getting my stamina back.  Having just returned to work as a teacher, the days are very long and I usually head home for the lunch hour to nap.  It is a wonder I can get back up and get through those long meetings that follow.  But when I come home, I collapse again, literally sound asleep in less than 5 minutes.  Breathing is easier with the fluid subsiding and while I am still shrinking bit by bit, I have lost 22 of those 27 pounds I put on.  Follow-up ultrasounds show that the ovaries, though still grossly enlarged, can actually be told apart at this point and continue to shrink.  My liver enzymes are still a bit off, but continue to normalize.  My body is generally more sore all over as I can't stretch or exercise as I normally do.  Indeed, without my back exercises, my back is a mess and causing much pain!

Hubs says I am shut down until after Labor Day and while it is hard, I suppose I agree.  When I think about it, this will mean that I have really been "shut down" for the entire month of August.  I have missed out on so many fun plans this month with friends and family, but I know my health is the most important thing.  Normally, I would push myself far beyond what I should, but with the risks so high--torsion or rupturing of an ovary--I know that I can't.

I feel very lucky to be on the other side of this ordeal intact.  I know that OHSS can turn out so much worse.  With the size of the ovaries being so mind-boggingly huge, I am just as shocked that it did not get worse, that I am intact, and that more than likely there will be no real long-lasting residual effects.

The emotions are pouring out of me in so many ways, on so many fronts.  But for now, I am spent.  I will have to explore those emotions later and nap now!  Goodnight!

Thursday, August 25, 2011

My OHSS Story - Part IV

. . . Once in the ICU things started happening quickly.  It was a whirlwind.  I suppose they are used to having to do things at top speed in the ICU and they were true to form.  In no time at all I had an IV drip, sensors for EKG were slapped on me and I had machines monitoring my pulse, heart, and oxygen continually.  Maybe blood pressure too?  I can't remember.  I had x-rays and blood draws and another ultrasound in no time at all.  I was in between being panicked from the sense of immediacy and just thankful that I could finally get help.  I am not sure if this is how others feel, but when I was admitted I was just as fearful as I was relieved.

I was in the ICU until the following night.  The pain was still radiating and bodily functions still painful.  The staff there was good.  Different nurses and doctors would come and check on me, but it was there that I first started hearing the questions.  How did this happen to you?  Why is the treatment for this an IV?  Why are you swelling?  At that point, this was only from one whacky nurse, but really?
The night I was moved out of ICU though, I started having more complications.  As friends and family visited throughout the night, I reclined in my amazing mechanical bed feeling fairly fine.  The laughter hurt, but other than that, I was feeling decent.  But after everyone left and I got up to use the bathroom, I was shocked to find that the swelling had now moved down into my legs.  They were stiff and rock hard just like my abdomen and I could barely move them to walk.  Other parts were swollen as well.  So swollen.  A quite irreverent nurse put it the best as she examined me saying, "Oh, it's like you grew a pair, huh?"  So inappropriate, but so hilarious.  It was terrible and rivaled the moderate pain of my ovaries themselves.  In the middle of the night, I started having trouble breathing.  When my husband would pull me up or help me change positions, I couldn't breathe.  When I would try to take a breath, my windpipe seemed to be abruptly cut off half way through and I would be sent into a coughing fit.  I was scared.

The following days brought more frustration.  Though I felt good about being at a hospital in case something happened, my care really didn't seem consistent.  Having never been hospitalized, perhaps this is the norm, but I was surprised that my clinic sent a different OB to see me every day.  At the same time, they could treat me and my ovaries, but they could not treat the lung problems I was having.  Nor did they really seem to know much about how to treat my body chemistry that was completely off-balance.  It was frustrating and for good reason.  I will say that if you ever go through hyperstim, it is difficult because there is no treatment.  Still, you do have to be monitored and receive supportive therapy to ensure nothing does happen.  This can be frustrating because you really don't feel as if anyone is necessarily acting as your doctor.  Different doctors would come in, all with varying degrees of bed-side manners, ask how I was doing and then more or less leave.

One day, I just lost it.  Yet another OB doctor came in, asked how I was doing, and then proceeded to ask me what the plan was and if any other doctors were assigned to my case.  What?  You're asking me?  Isn't this stuff in my chart?  Didn't you just review it?  He, quite unprofessionally went on to question why I had an IV and asked who ordered it.  He discussed how he thought it was an overreaction to put me in the ICU.  He told me how the pulmonary specialist that had been seeing me in the ICU had been called after my breathing had worsened and had questioned why he should see me at all.  I wasn't his patient.  He didn't want to come down.  After this frustrating conversation, I laid down.  My heart was racing, my breath so short.  I was upset, but still relatively calm, so I didn't see any reason for this distress.  In a minute, I had called the nurses asking if my oxygen level could please just be monitored as I was having so much trouble breathing.  Enter OB doctor.  Cue respectful tirade which went something like this:

"I know that I've never been in a hospital or in this situation before and don't want to be disrespectful of how things work, but I'm not feeling comfortable here.  I see a different OB every day who asks me about my symptoms and then asks me about the treatment I'm receiving.  I can't answer the question of why I am on an IV.  I can't answer the question of why I was admitted to the ICU.  I can't answer the question of why I did not receive any attention while I was calling and even in clinic Sunday through Wednesday.  But I'm here and there are issues.  I understand that there isn't any treatment and I can only receive supportive therapy, but I feel as though I am receiving more questions from healthcare professionals than I am receiving answers.  I don't know if my ovaries have shrunk.  I don't know what my lungs look like.  I haven't had an ultrasound nor a chest X-ray since Thursday.  Again, I don't want to be disrespectful, but consistency would definitely make me feel a little more at ease here.  Or even to feel like someone knew my case and cared to look over my chart and see me.  I'm having issues breathing, I need to see a doctor for that.  After everything that has happened over the last week and the lack of response from the clinic, we are feeling so vulnerable right now.  We want to put our trust in the healthcare professionals here, but don't really know who that is."

Within about 5 minutes, I was hooked up to a box that monitored my pulse rate and oxygen.  Within 10, I was wheeled down for a chest X-ray and ultrasound.  And, to say the least, I was feeling quite empowered for the rest of the day.

To be continued . . .

Wednesday, August 24, 2011

My OHSS Story - Part III

Some have expressed their wish that I would write this all in one post.  I apologize for any annoyance about this, but the story is just so long and honestly, I am not together emotionally enough right now to recount the entire story in one sitting.  I write until the tears take over.  Then I stop.  So, while I'm very sorry for the inconvenience, I just can't do it any other way.  Now, the story . . .

. . . Wednesday, I was very surprised to hear from my fertility nurse who had been instructed to call by the on-call physician and have me schedule an ultrasound for Thursday with their chief sonographer.  Whew!  Sigh of relief!  So, that Thursday, I saddled up atop my pillows after waddling slowly out to the car and hung on for yet another agonizing car ride.  Once I got to the office, everyone was surprised to see my state.  The most wonderful sonographer and understudy gently helped me up to the table and proceeded to administer the ultrasound.  In all truth, it wasn't very long because as he moved the wand across my abdomen, he was clearly completely taken aback.  Indeed, even when I lifted my shirt and he saw the swelling that started right under my breasts at my ribs, he said, "This is not good.  You look 6 months pregnant."  Now, I know I  had ballooned, but I still am not sure I looked all of 6 months pregnant.  But, from the mouths of professionals, I guess.  As the wand moved across my entire belly up to my ribs (which had long disappeared beneath the swelling), I could see them--follicles--from all the way down near my uterus to literally all the way up to my ribs.  My husband grabbed my hand and I squeezed, fighting back tears, knowing that this was not good.  As he gently moved the wand across my stomach, he told me over and over again that I should have come in sooner, that the ovaries were now too large for him to even measure.  He was kind, so kind and honest.  The truth was scary--my ovaries had ballooned and were now larger than any he had ever seen.

They rushed me over to do some blood work STAT.  Then they weighed me.  On Monday, the last time I had been weighed at the clinic, I had gained about 5 lbs.  It wasn't good to see, but I assumed that it was "normal in my situation", right?  But when I stepped on the scale and realized that I had gained 10 lbs since Monday, for a total of 15 in less than a week, I lost it, knowing this was incredibly serious.  I had read as much literature as I could on hyperstimulation.  Indeed, this is why I knew something had been wrong the whole week--the whole week that I had been calling the office!  Now, my fears were boldly confirmed.  We were taken into an internal waiting room and sat as the office fluttered around in a tizzy.  I could hear the nurse practitioner sighing as she went over my case.  I was told to chug water and a call was put in for a doctor to come quickly.

Once in the exam room with the nurse practitioner, I was bawling.  "I knew it was bad," I cried.  "But I've been trying to get in and get help since Sunday."  We recounted the events from Sunday to Thursday and she apologized, completely calling out her co-worker for blowing off the ultrasound on Monday.  She explained, with a helpful chart, that hyperstim is common, but dangerous and that I was well above and beyond what they considered severe hyperstim.  I knew, I always knew.  But it was just now being put together.  I was just now being listened to.

The doctor that had then rushed over came in and calmly informed me that I was being directly admitted to the adjoining hospital--to the ICU .  .  .

Tuesday, August 23, 2011

My OHSS Story - Part II

Welcome to all ICLWers!  If you are just stumbling upon my blog, you should know that I am currently pouring out my Ovarian Hyperstimulation Syndrome (OHSS) story in separate posts.  We realized the other day that we had really been dealing with this since the beginning of August.  The first day I started feeling any side effects from the meds was July 31st, when I had to leave a restaurant early because the room was spinning and I was feeling faint and nauseous.  24 days later, we are still dealing with OHSS.  Here is my story, continued...

Within two days of the IUI, five days after the last Gonal-F shot, and four days after the Ovidrel Trigger shot I could barely walk.  The pain in my abdomen was so intense with movement, I simply lay as flat as I could, careful to support my back, which was also throbbing in pain.    Indeed, all the pain was putting so much pressure on my back and entire abdomen that bending at the waist in any degree became out of the question.  We had a wedding to attend that Saturday night and against my better judgement and my husband's worried discouragement, my stubborn streak took over and I became determined to make the event.  Just days earlier, I remembered how I was wondering if I would be able to dance after the IUI at this occasion--today the idea of even trying to move my hips at all was laughable.  So we went.  The wedding was a small affair over an hour away.  Already in so much pain, I took pillows to sit on and support my back in the car.  But still, every bump, no matter how small, sent terrible pain riveting through my body. Later, we would wonder why in the world we had ever attempted to make the trek to this wedding with me in such a fragile state.  As we reflected on this lapse in judgement, hubs, who had fought to keep me home resting would recall, "At one point, I walked be the room and saw you all dressed up sitting in a chair doing your make-up.  I knew you were sitting because you couldn't stand from the pain, but at that point, I just had to give up."  Yes, I was determined.  And most know that they are not going to win when I am determined!

So we went on what is sure to be the most painful journey of my life and proceeded to sit the entire night.  While it felt good to be there supporting my friend, I felt so ridiculous as the mingling cocktail hour of everyone standing, walking, drinking was experienced by me from a chair.  I just could not stand.  To most, I made a lame excuse of throwing out my back, though a select few knew the real story.  At one point, when a large circle was gathered talking, the husband of a good friend I had confided in asked loudly, "So, how long did they say the pain would last?"  I laughed and shook my head for a minute before shrugging my shoulders, saying I wasn't sure.  "Really?"  he continued.  "They didn't give you a time frame?"  Really?  Way to totally blow my cover!  But still, I just laughed.  At one point, as only I could do, I embarrassingly knocked over not one, but two, full glasses of water--absolutely soaking myself and the floor.  And yet, I couldn't bend, I couldn't move.  All I could do was sit there while others ran to clean the mess at my feet.  I felt beyond ridiculous.  We left promptly after dinner. The walk to the car was terrible--crossing over cobblestone bricks is obviously not a sensitive ovaries' idea of fun--and they boldly let me know it, all the way home.

By Sunday morning, I was in such pain I was ready to go to the hospital immediately.  Though I obviously haven't experienced them, I remember saying that I can only imagine that this is what labor contractions feel like--surely no worse.  I was screaming in pain, having to hold on as waves of intense pain shot through my body.  Surprisingly, I even had to breathe through the worst of them.  Urinating had become increasingly agonizing itself.  Though it had actually been uncomfortable for days, now it seemed as though the act rearranged everything in my stomach in such a violent way it was all I could do to hold on.  I called the on-call physician at my clinic who promptly prescribed Vicodin and encouraged me to come into the clinic Monday morning.  Scared that the pill would send me into a vomiting spiral after a similar experience when having my wisdom teeth removed, I actually did not take any, but continued with Extra Strength Tylenol which provided next to no relief.

Monday morning I woke up to use the bathroom and immediately began feeling light headed and began dry heaving.  I was sweating and burning to the touch.  Then, I went to the clinic.  Hubs and I sat across from my fertility nurse hand in hand.  By this time, I could really barely walk.  Instead, I was hunched over moving with the tiniest steps at the speed of a snail.  At some points during our discussion, I had to close my eyes and wince in pain.  She would ask if I was ok and then resume the conversation of how this is all normal.  I told her I couldn't walk-she saw.  I told her urinating was unbearable as my insides rearranged themselves.  I told her I was swollen beyond belief and hard to the touch, starting all the way up at my ribs.  She said it was normal.  She prescribed Tylenol with Codeine for the pain and gatorade to ensure my electrolytes were balanced.  "We could do an ultrasound," she said with a shrug, "but we already know what we'll see.  You are hyperstimulated."  With the way she framed it, as a waste of time, really, we did not insist.  Clearly, we had never been through this and were looking to her for the proper  medical care and protocol in this situation.  They checked my hemoglobin, which tested fine and sent me on my way.

I immediately began popping the Tylenol with Codeine and to my delight, they provided some slight relief.  Yet, by Tuesday night, I noticed that my early afternoon urine had been a bright orange and I hadn't relieved myself since.  Worried of what this might mean in terms of dehydration and organ functions, I again called the on-call physician who encouraged me to wait until tomorrow to see if my symptoms worsened and just monitor it.  I hung up and sighed--resigned myself to the idea that this was really all normal...After all, I had now tried to reach out for help three times and every time I was told, "This is normal."

Not so fast...

Friday, August 19, 2011

My OHSS Story - Part I

Over this past month we toyed a lot with the idea of whether or not to proceed with our infertility treatments or take a break.  Readers may remember this dilemma.  At one point, we thought what is the point of going through all of the injections only to find out that I am hyperstim and all our hard work and financial investment ultimately results in a canceled cycle?  At other points, we thought how can we take a break to make decisions of where to go next without ever experiencing the next step--the injections?  What if I don't even respond to the injections and we don't know that going into the break?  In the end, we decided to go ahead with this cycle.

We jumped in, anxious, nervous, but hopeful that we would successfully get this scary ordeal of our first injectable cycle under our belts.  And so it began.  As I stated earlier, it began in this very bed--the bed where most of the shots were administered by my nerve racked husband.  A nightly ritual that began with tears and screaming itself, I soon learned extreme measure that would slightly ease my fears:

  • #1  Be sure to have taken out contacts and changed to glasses for the night before shot time rolls around.  Why?  simple--when shots time ultimately descended upon us, I could slip my glasses off, rendering me practically blind.  Without the ability to actually see the needle, my nerves subsided a bit.
  • #2  Put pillows over head.  Hug another pillow at chest. 
  • #3  Listen to upbeat music loudly through ipod as injection is administered.
Yes, my nightly ritual was surrounded in fear and nerves only overcome by these ridiculous measures.  How I marvel at all you out there who just do it.  I cannot.  The girl who once thought herself so tough  transformed into a mere toddler.  I felt as though I should get a sucker and a sticker after each ordeal, but I never did.  Instead, I buried myself in my husband's arm, soaking up the love that he let flow so freely.  I felt his kisses on my forehead and felt us just hold each other forever.  Hubs did not enjoy our evening ritual either--often saying he felt so bad for hurting me, apologizing profusely that we were doing this, and getting very near to tears himself several times.  

After receiving five days of Clomid and three Gonal-F shots, we thought we might be done.  But, my ultrasound seemed to reveal the need for more shots.  Another pen was prescribed and ordered.  After two more injections, I had another check-up and then it was decision time.  There was one mature follicle and three or so close.  We could either go with this one or do another injection in hopes more would come forward.  We did another shot, thinking nothing of it.  The next check-up revealed three mature follicles and five follicles that were close to mature, meaning that three follicles would release eggs and the other five may or may not.  My E2 level was through the roof.  "The highest they had ever seen," reported my fertility nurse.  (Actual, mind-blowing number to come after I get records on Monday.)  

Excited by the outcome that we had always been led to believe was a good one, we eagerly administered the Ovidrel trigger shot in order to release the eggs and got down to business in the bedroom.  But business was not good.  Already hyperstimulated after the last shot, or possibly even prior, my belly had already began showing signs of increased activity--my entire abdomen just felt so...busy.  Little did I realize, it was also overcrowded with many more swelling follicles, making our little bout of lovemaking quite short and sweet, not to mention uncomfortable and extremely painful.  But the goods were deposited and supposedly began their swim to the prize that awaited. 

Our first cycle where I had actually responded to any meds whatsoever and ovulated!  Even though we had originally thought of this as a cycle to get one under our belts, we had become so hopeful!  There was no doubt in my mind that this was working!  I could feel it.  Boy, could I feel it!  We knew, as with any fertility treatment, we were still rolling the dice and betting on odds, but the odds were good.  Nothing was overly risky.  We were never led to believe so.  I was hyperstimulated, yes, but I was well monitored and it seemed as though this sort of thing happened at the clinic all the time.  

By Thursday morning, I was increasingly uncomfortable.  We went in bright eyed eyed before the clinic even opened to complete our first IUI.  In the stark and oh so romantic and erotic small exam room, hubs released the boys, which were quickly washed and measured.  The result--impeccable.  Millions of tiny, forward swimming sperm ready for their ultimate pilgrimage to Mecca--yes the Mecca is my eggs!  The actual insemination was quick and painless.  Our fertility nurse gave us her good luck wishes before heading out.  But before she left I explained how uncomfortable I had been over the last 24 hours.  She assured me this was very normal.  I persisted, saying, "It is just so painful inside right now that I have to walk very slowly and every time I step, it hurts."  She again assured me that this is completely normal in my situation and left my husband and I to lay and sit respectively in the room waiting for the magic to happen.  

After 30 minutes in the inclined position, hubs pulled me up.  We kissed, shared a long hug, and stared at each other with hopeful eyes.  We had gotten through it.  We had gotten through it all--the pills and the emotional rollercoaster they launch you on, the shots and the fears and suffering they bring each night.  Even this pain, would undoubtedly subside soon.  We had done it, gotten through it all together, hand in hand.  Now the only thing to do was to sit back, relax, and wait to see if I conceived.  

Not so fast . . .

My OHSS Story - Introduction

I have not been blogging lately.  I took some time away, thinking that the space would do me good, help the subject of infertility not consume my life.  I have been quiet for some time on everything that has transpired this summer--all the emotional talks and decisions we made, the steps that we took.  But, now I am gushing, pouring out words like a waterfall in the aftermath of the last two weeks.  What has come out is unprecedented in my blog thus far and for my sanity and yours, I will have to be delivering the story in segments.  I do not do this for readership or for suspense purposes, I just do it for logistics.  Yesterday, when I began the cathartic ritual of pouring my soul out onto paper I had no idea what would come.  What did come was seven pages of accounts, details, and emotions.  And I am only half way through the story.

What will follow will be my Ovarian Hyperstimulation Syndrome (OHSS) story.  I will not add drama or blow things out of proportion, but be prepared, because this is the most dramatic and traumatic series of events in my life to date.  I hope this story will serve as a call to all women to be vigilant about their care.  For all to listen to their bodies and the signs that it gives when it is in distress.  To demand that others listen and to demand answers.  I hope it will help others know themselves and feel comfortable in their decisions as they pertain to fertility treatments.  As one who understands what it is like to want a baby so bad you will do nearly anything, I do not want it to scare others away from the very things that hold promise in your life.  But, I do want it to be known that this sort of thing can and does happen, though it is extremely rare.

In the end, I sit here on the other side of this ordeal writing from my very own bed, thankful beyond belief that I am more or less fine.  As I sit in this bed, I remember that this is where it all began...
This is where we came to do the injections that started it all, it is where I first awoke to throbbing pain, it is where I screamed out in pain days later, where I made desperate calls hoping someone would listen to my pleas.  And now, it is where I come to recover.  It is where I come to transform back into my old self--physically, emotionally.  The fact that I am intact and will soon be able to reclaim my full health seems incredible after everything we've been through.  And with each thought of where I've been and where I am, more tears flow.

I am already to emotional too begin the real story, but it will come.  So, spanning the last two week period, this is my OHSS story. . .