No News IS Good News

And I have virtually no patience - I want everything now - immediate gratification - if it's not in stock, I have no intention of ordering it. It drives Steve crazy. If I must order it, I will always pay for overnight shipping. Just one little burden I bare in life. So, let me tell you how crazy the communication with India makes me - OMG!!! I knew it going in and I experienced the communication lags during the 'courtship' with the clinic and I read about it and continue to read about it on other blogs and forum boards. Several people have written that 'no news is good news' as it relates to getting updates from the clinic...and I think that is a very powerful statement, mindset and way of 'Indian, surrogate, pregnant life'!

For all of you out there with limited knowledge about IVF or the reproductive process in general, there are a series of hurdles - most critically in the first 12 weeks. The first is the Blood Hcg level tests - the first one is generally done at 14 days following egg retrieval and this tells you whether or not you are pregnant. It is essentially testing for an elevation in one particular female hormone. This hormone concentration in the blood should double every 48-72 hours in the first 12 weeks of pregnancy. I could write an entire page on this topic, but let me just get to the point. So, there are vast ranges of 'normal' depending upon the week of gestation. Everyone insists the value itself (how high or low the number) is not significant, but the doubling of the value every 48-72 hours (or not doubling every 48-72 hours) is the earliest indicator of either a successful pregnancy or a potential miscarriage.

First Blood Hcg (called 'beta') @ 14 days past egg retrieval = 31 (normal range 16-156)
Second 'Beta' @ 17 days past egg retrieval = 61 (essentially doubled in 72 hours, so OK, barely)

INSERT my psychosis here. I went to this awful, crazy place I tend to go when I cannot control an outcome and it was ugly. We were to wait 4 days for the next update. Ugh. I even went so far as to email Rotunda on Sunday to confirm if we should expect the report by email on Monday morning, Tuesday morning or Wednesday morning. Prompt reply by one of the docs on Sunday afternoon - I was told to expect the report via email on Tuesday morning. So, I was thrilled when Tuesday morning finally arrived. This was a pretty critical benchmark.

No email arrived on Tuesday - I emailed them asking if there was a problem. No response.
No email arrived on Wednesday - I emailed them asking if there was a problem. No response.

The emailed report arrived, finally, on Thursday morning (today).
Third 'Beta' @ 21 days past egg retrieval = 392 (doubled almost 3 times in 4 days, very nice improvement, sigh of relief)

This blood was drawn on Monday of this week and the fourth test will be performed tomorrow, Friday. We are looking for the number to hopefully be at least 1500, at which time they will schedule the first ultrasound. This will verify that the embryo is actually attached in the uterine wall (rather than tubal) and that there is a yolk sac and fetal 'pole'. This will tell us if the pregnancy is viable - huge hurdle.

So, back to this communication 'problem'. It 'is what it is' - and I write this to share with anyone heading down this road with Indian Surrogacy. The clinics are busy - beyond busy - and they simply struggle to keep you informed. I honestly believe they are excellent practitioners of reproductive medicine, but could use a business manager! I saw first hand the sheer numbers of people coming thru the doors - I honestly don't know how they even manage to deliver the service levels that exist today. I can only imagine the number of emails that must go unanswered. I often times get emails from Dr Kaushal or Dr Gouri at 2 or 3am (India time)...often times.

So, I am quite certain the docs 'manage by exception' - meaning they deal with the most critical communications - often problems - first and then get to anything else that time allows. That is the only conclusion to draw. My neurosis over a blood test report was not the most pressing issue - keeping in mind one of their clients lost their twins this weekend at 24 weeks - which has saddened the entire Indian Surrogacy community.

'No news really is GOOD news'. I must remember that for the next eight months or else I might just lose it! So, I vow to repeat this to myself - and pray that the phone does NOT ring.

As an aside - I could have 'Skyped' them and spoken to a live person - and that was the plan should I have awoke to no email today - but I am reserving that right for a full flegded panic attack.

(+)

Yes, folks. We are pregnant!!!!! I will share more later, but I just hung up with Dr Kaushal and she said 'Congratulations!' I cannot begin to tell you how this feels - nothing short of unbelievable. Steve and I were both in tears on the phone.

Thank you, thank you to everyone who prayed for us and sent warm wishes and heartfelt thoughts our way. It has really kept us going the past two weeks.

Terry and Steve

'New Delhi Belly' (via Mumbai)

My boss, who recently returned from a business trip to India shared this catchy phrase with me - 'New Delhi Belly' - cute name for a not so cute stomach situation that hit me about two days after returning to the US, from India. Good Lord. I cannot remember a time where I have spent more days and hours either on the toilet or over the toilet. The strange thing was that it came and went - along with a pretty high fever - every several hours - for several days. Just when I would think it was subsiding, along would come a headache (often times late in the day), followed by fever, followed by a poop-tastrophe. Not funny I can assure you.

I had to fly to Chicago last Tuesday and I knew it was going to be a dangerous journey, but off I went. I had a connecting flight and seriously considered deplaning and not continuing on to Chicago - that is how sick I had become mid-flight. Alas, I made it to Chicago and, amazingly, to work on Wed, Thurs and Fri. Only today have I finally had a meal that didn't consist of soup or yogurt or bread. I swear I have lost 10 lbs - in fact, I know I have. I weighed at the gym this morning (first time at the gym in over a week) and I weighed 155 fully clothed. Yikes! Even with my manorexia issues, that was too thin! So, I had breakfast x2 today and will certainly gain back the 10 lbs by tomorrow. Lunch already sounds appealing.

I still have no idea which meal(s) may have brought this on, but I will most likely live on protein bars and bottled water the next trip because this has been a full on nightmare!

So, taking the day off today (still in Chicago) and preparing for a trade show that commences tomorrow and continues through Wednesday. Work will be nuts the next several days - which is good - keeps me focused on things other than babies. Monday is the the day we get the big news - are we pregnant? or not? My emotions the past two weeks have run from one extreme to another. I am just happy that the day is almost here. Steve is confident it will be a positive and I am confident we will be just fine no matter the outcome.

I will post on Monday once I get the news! Love and thanks to all our friends and family for all the prayers and warm thoughts.

Love,
Terry & Steve

3A, 2B

No, not an airline seating chart…the grading of our embryos. I woke up in my NY hotel room this morning to find an email from Dr. Gandhi at Rotunda – I quietly said a prayer before opening the email. We had, what I had previously referred to as a ‘best case scenario’, 5 embryos! I wanted to call Steve, but it is 3 hours earlier in LA – so I waited until 7:30am, NY time, and woke him at 4:30am. We are both thrilled. All 5 were transferred and, as we had known would likely be the case, none to be frozen. Pregnancy test scheduled for Monday, June 15. Yes, I know, I know – 5 is a lot, even with 2 B’s in the mix, but if there is anything that is certain about this process, it is that nothing is certain about this process. My first call was to one of my oldest and closest girl friends, Dana, who lives in Atlanta. Dana went through two IVF cycles a little over 5 years ago – one failed and one successful – her beautiful son Jack will be 5 this November. In her first cycle, they transferred 3 Grade A embies – pregnancy test, negative. In her second cycle, they transferred 2 Grade B-/C embies – pregnancy test, positive. Anything is possible.

One of Our Grade A Embryos

I am sitting on a plane to fly from NY to Washington DC this morning - as I type this. Caroline Kennedy just boarded next to me – love the Kennedy family. I digress.

Fortunately, I am buried in work so there is little time to worry or obsess – though I’ll make some time for these activities I’m sure. I am back in LA tomorrow evening, Friday – home for the weekend. I leave again next week for an unusually lengthy business trip to Chicago and will be gone for another 8 days. Ugh. In fact, I will be in Chicago when we receive the news of our pregnancy test. I only hope I can make a call to Steve that day to celebrate. He is the eternal optimist – me, the realist. Only time will tell.

I did run across something interesting yesterday – our horoscope on www.astrologyzone.com. I was meeting with one of my sales people in NY yesterday and she (a fellow Capricorn) was sharing that our horoscope (mine, hers, Steve’s) spoke to ‘fertility’ for June. She printed a copy for us and here are some excerpts:

‘June could well go down as one of your happiest months of the year.’

‘If you are already married, the topic of having a baby may come up in June. It’s a lovely time to summon the stork, for planets in Taurus are very fertile and loving. If you want a baby, this month would be the time to make that dream a reality.’

‘If you were hoping to have a baby, this would be a month to seriously prepare for that child’s arrival.’

‘You are clearly ready for a life transformation, and doubly so if you were born early in your sign, say, near December 22-25. You seem anxious for the next chapter of your life to begin and happily, there is no more reason to wait. Indeed, everything in your chart is showing that you are biting at the bit, ready to bolt out of the gate.’

‘Capricorn does not make any moves before they have considered all details thoroughly, so chances are, you’re more than prepared for your next big step than you may have guessed.’

It would appear that the ‘stars are in alignment’ - so to speak - but then again, I am reminded , nothing is certain in life. For the next 11 days, however, I will join Steve and err on the side of optimism – the world can make do with one less realist – at least for now.

Terry

Easy Come, Easy Go

Steve and I have a mantra we live by – a simple understanding that life is all about ups and downs – the basic premise that when you find a few dollar bills in your pant pockets while doing laundry in the morning, you shouldn’t be surprised if you incur an unexpected expense later that day to make it a ‘wash’. Today was the epitome of an easy come, easy go kinda day – not in the financial sense – but more so in an emotional sense. Lucky for me, it began and ended on the side of ‘easy come’. There was a whole bunch of ‘easy go’ in the middle and I’m still a little bogged down in it.

The day started with me up before the crack of dawn and getting a good bit of work done. I knew I had some down time today and the driver that Parashar had hired for us was to take me on a tour of sorts – I had a short list of things I wanted to do and see. My first stop was at a nearby Krishna temple. It was beautiful and the energy was unbelievable. I left my shoes with the guy out front in exchange for a red plastic disc with the #99 – my claim check. There were vignettes behind glass that resembled something from a history museum – mannequins set up to tell a story and a narrative on a plaque next to it – in both English and Hindi. There were scenes depicting the lives of the various Lords, which were interesting - but the most interesting of all was the second one – the one that spoke to the heart of this particular faith. There were adults, children, babies and a skeleton. The caption spoke to the fact that life is a circle and that at a human being’s core is the soul and the Hindu believe that the soul moves from one body to the next as one life ends and another begins. There comes with this notion a sense that you should ‘own’ the body you are given and the circumstances with which you are dealt. At the risk of getting too philosophical, I will stop there, but it was moving and stayed with me throughout the day. There were people chanting and dancing and most importantly, smiling – several engaged with me and grabbed my hand to pull me into the circle of activity. It was the happiest bunch I’ve ever encountered in broad daylight with no mind altering substances involved – at least I don’t think there were mind altering substances involved? I stood, watched, pondered and then placed Rs 100 in the offering box and asked Lord Ganesha to remove any obstacles standing in the way of our pregnancy. Away I went to retrieve my shoes and head to my next stop. Now, being a good Catholic boy, I felt obliged to be an equal opportunity thither and headed up to a beautiful, old Catholic church on a hillside (behind the Taj Lands End Hotel) – near the coast line. (Not to digress, but I was amazed at the number of Catholic churches in Mumbai.) I went down to the altar, said my business with the Trinity and, again, placed Rs 100 in the offering box. At this point, I’m feeling pretty darn pleased with my day, my life and myself.

Entrance to the Krishna Temple Near Juhu Beach

Another View

For those of you who aren’t aware, there is a family in Mumbai who are richer than all but about 3 other people in the world. They are in the midst of constructing a high-rise home for themselves in South (Old) Mumbai – literally, tens of stories high. We recently sold them furniture for this little piece of real estate and I wanted to see the place for myself. So, I asked the driver to take me to the home of the owner of ‘xyz’ company – he knew little English, but knew exactly who and what and where – and we headed that direction. Now, I must say the poverty was evident up in Juhu near the hotel – there were slums everywhere, but it wasn’t until we took this drive to South Bombay that it became, for the first time, overwhelming. The drive took over an hour and a half, but could not have been more than 25kms. At moments we sat parked in traffic for 2 or 3 minutes at a time. During these moments, the homeless – who beg aggressively – would approach the car and literally throw themselves against the glass and would not move away – all the while begging in perfect English for some mercy and becoming belligerent when you don’t hand it over – it is painful. You don’t see a ton of westerners – in fact, you see very few outside the large hotels – so these folks flocked to the car when they saw my white ass in the back with an Indian driver in the front – and it was no limo, trust me – but there was a perception that I had some money. The worst part for me was how many of them were disfigured or amputees. I asked Parashar about this and he shared with me that many of them disfigure themselves in order to assist their begging efforts – others remove an appendage to cure an ailment because they have no access to healthcare. Ok. That was too much information. I saw ‘Slumdog’ just like everyone else, but seeing it in person is a horse of a different color.

The trip back featured stops by two beautiful Mosques, a stop at a juice stand that the driver said is ‘famous’ and was so busy I’d be willing to purchase stock if they went public (I treated myself to pomegranate and the driver to apple) - and a lesson on why some Indian men wear turbans (while most do not), why some Indian women have dots both between their eyes and at their hair line (while many do not) and why there are live goats, chickens and cows at all the markets – short answers – family tradition(s), married versus single and to be sold for food – with the exception of the cows which are apparently only for the Muslims – the Hindus want nothing more from a cow than milk – they are too sacred to be eaten.

For those of you traveling to/from the US, all the flights depart back to the states in the evening – which means you pay for an extra night at the hotel or check out and be, essentially, homeless for the afternoon and evening hours. I opted for homeless and grew to regret it. The hotel gave me a late checkout at 3pm, but I still had some 8 hours to kill. We did the best we could to fill the time, but by 5pm I decided I would rather go to the airport and get some work done so I could sleep on the plane. All I can say is that leaving the Mumbai airport is not nearly as easy, or pleasant, as arriving – to say the least!

1. Hunt through mounds of people to find a tiny entrance to the terminal and get turned away because you need to walk 20 ft to another entrance for ‘that airline’.

2. Be turned away by a second security guard because you ‘cannot enter the airport until 3 hours before your flight’. Ok, that would be 8pm and it was now 5:30 and 95 degrees and 95% humidity outside! I must have argued with this man for 15 minutes – who was armed by the way. Who in the world says you cannot enter an air-conditioned space when it is sweltering hot outside – much less a public space? This guy was really getting on my nerves. Suffice it to say I got in the airport - and not in hand cuffs I might add. I even managed a smile out of him – more than I can say for the nurse at Rotunda that I now refer to warmly as Tiny. They actually have a flight manifest for every airline and every flight departing and they check for your name – if you are not on the list, you cannot get into the airport. Thankfully, I was on the list. I suppose you cannot walk in and buy a ticket. This was a first for me. Highly annoyed.

3. Security screening. Hmmm. I am all about consistency and let me tell you there is nothing consistent about this process – thorough you might say, but not consistent. Oh, almost forgot the Rs 600 ‘departure tax’ that Continental levied in exchange for my boarding pass – I am convinced it was a scam but I was too tired to push the issue and I asked a gate agent who was an employee, not a contract worker, who said it was new (and legit) and in the future would be included in fares. I need to make a note to loop back on this. I paid cash and it took 10 minutes for them to get me change. Highly annoyed.

4. Passport Control – check nothing. Immigration – check passport and boarding pass. Security screening – do not ask for passport or boarding pass but insist on seeing my nail clippers and sharing a laugh amongst themselves as they inspected them. No clue here. Shoes stayed on as you walk through metal detector. Gate area – check passport and boarding pass AND go thru another metal detector and baggage x-ray. Shoes came off. Hand-wanding and pat down. This time they took my cell phone apart, fully unwrapped Lord Ganesha and interrogated me about the material from which he was carved and why I bought him. Highly annoyed. Boarding Agent – check passport but do not ask for boarding pass (yes, that is correct). Uniformed agent at top of jet way – check boarding pass but not passport – maybe there is a system after all? Uniformed agent at bottom of jet way along with armed guard – check passport and boarding pass. I hate to complain about security because it is needed – no doubt – but this became ridiculous. There was also one last interrogation by the guy at the bottom of the jet way. I’m exhausted. And annoyed. Highly annoyed.

Now back to how the day ended on ‘easy come’ – just the way it started. I was in Continental’s Business First cabin (upgrade on miles) – to Newark – stopping in NY for business en route home to LA. Maybe not a huge deal, but the seat next to me was empty – and I got extra space and two feather pillows – see, I’m not really all that hard to please.

Note to self: do not lie to get upgraded. We were delayed leaving Mumbai because a woman asked for my empty, neighboring first class seat – she claimed her infant (in arms) was running a fever and she needed the child to be comfortable. Come on lady – I am not one to lie and I could have crafted something better than that on command. Not only did she not get upgraded, the captain tossed her off the plane! When he told her she had to deplane if her child was sick, she said the kid’s fever had just broken – in the last five minutes? Whatever crazy. She sure was standing in the jet way as the boarding door closed. Bummer.

Air carriers: if you have a choice between Delta (non-stop from Atlanta) and Continental (non-stop from Newark) - especially if you are using miles to upgrade – go with Delta. They score better on the seat, service and food – much better.

I will update on the embryo transfer on Thursday once I hear from the docs. I certainly am eager to hear how many and what grade – that is why I created this blog after all – to talk about making babies. I am trying not to obsess but it isn’t working.

Steve, I am almost home honey – two more days. I miss you so much. Thank God for Skype.

Jackie and Lisa B - enjoy Mumbai this week! Sorry we missed each other this trip.

Terry

Ganesha

Well, it has been quite a day. I left the hotel at 9am - arrived at Rotunda at 9:30 and was there until after 1pm. Details to follow...

After leaving the clinic, I had told Parashar that I wanted to make a couple of purchases - I always like to take something special home from each newly visited part of the globe - and, being the first trip to India, I wanted something cool. Steve and I have a growing collection of carved pieces on the shelves above our bed - there are two beautiful Buddhas from previous trips to Thailand and a Boomerang from our time in Australia. Steve and I had talked about getting a 'snake charmer's whistle' (insert joke here for those who know my hometown is proud to be the home to the Miss Snakecharmer Pageant) but I couldn't find one so I shifted gears and began to search for a carving of one of the Hindu Gods. In steps Ganesha...

As I went through the various teak pieces - all hand made and pretty amazing - I looked at everything from the God of Finance to the God of all Gods, Krishna. I kept being drawn to the elephant headed man - familiar image - we've all seen it before - I just never knew the story. Turns out Ganesha is the God for Removal of Obstacles. Hmmm. We want to be pregnant and have gone to pretty extreme lengths to try and get there. I had just wrapped up at the clinic and there is nothing more to do now but wait. So, as I studied the different carvings, Parashar came over and said ' you know, Ganesha brings good fortune and removes obstacles'. Well, no I didn't know that, but sounds like Ganesha is going over the bed, back in LA. It is wrapped up neatly for travel and I don't want to unwrap him so here is an image to show you what I am talking about. Familiar to all I'm sure.

I'll continue the search for a whistle but will be rubbing the elephant's head in the meantime...

Rotunda is about the size of most of my client's terraces. Seriously. I bet the entire space is 1500sf - if that. In that space there is an operating room for the egg retrieval and insemmination procedures, a small recovery space, lavatory, lab room, semen collection room and two small offices - oh, and a lobby that was busier than any doctor's office I've ever seen. I was exhausted just by watching the people in and out of the place. I arrived at 9:30 and was taken back to one of the offices to meet with Dr Gupta. She advised that the egg donor's procedure was for 11am and that I should provide my semen sample at approximately 10:30am. I would meet with Dr Kadam a bit later...she is the Director of the Egg Donor Program. Shortly after they sent me into one of the other small rooms to have blood drawn. Now, the doctors are lovely - really, sincerely nice. This tiny woman, who I guess was a nurse, however, was dreadful. I could not get that woman to smile for the life of me. First of all, she was about the shortest person I've ever seen aside from a midget and had the personality of the syringe she stuck me with. Anyway, whatever. Then I headed with my specimen cup to the 'semen collection room'. Yuck. I must admit, I was pretty worked up about the whole experience, so worked up in fact that I had little interest in the porn I brought along for 'assistance'. I was fairly certain they might knock on the door to see if I was alive before I made something happen. In the end, everything came out alright - at least the doctor's said so after peering at it through a microscope.


So, this now took me back to the lobby by 11am. Where was my egg donor? You could not chase a cat in the place and I did not see her anywhere - I had studied her picture so I knew I would know her instantly. After obsessing for several minutes I decided that, perhaps, she was in this small hallway around the corner - near the operating room. I saw that the lavatory was down that way so I rounded the corner - mind you all of about five feet away from where I was sitting, but around the corner - and there she was. All 5' of her. Now, she is not as short as the lab girl, but short - but also very cute. She had no way of knowing who I was and I believe she had both her mother and her aunt with her - at least that is who I decided they were. They were too old to be patients and not dressed to be staff. The bathroom was occupied which was perfect because it gave me a bit more time to study every detail of her...when she wasn't looking of course - yes, I was discreet. I did share a quick smile with her, but she looked scared to death. I felt really horrible for the poor thing and would have loved to speak with her, but it would have been fully inappropriate and I doubt anyone would have appreciated it. She was in surgery for over an hour and then I heard them wheel her into the small recovery room behind the lobby. She was still there when I left at shortly after 1pm.

So, my meeting with Dr Kadam...well, not the best news, but not anything to freak over. They only harvested 9 eggs from the donor. They generally hope for something in the low teens. The doc was really great and immediately told me that she would do ICSI on all nine eggs to ensure the highest possible fertilization rate. Good case would be 3 or 4 embryos and best case would be 5 or 6 (unlikely, but possible). That means no freezing extras which means no baby if this cycle fails. We would have to pay for another egg donor and another surrogate and, essentially, start over. Or we could end up with a litter which is what happens sometimes when you implant 5 or so embryos. Nothing to do now but wait and give it up to a higher power. I'm totally cool with that and, if we get a 'negative' in 2 weeks then we'll just save our pennies and try, try again.

PS - ICSI (intracytoplasmic sperm injection) - means they inject the egg with one sperm to fertilize it. Generally 70-80% fertilize with this procedure. So, with 9 eggs - 6 embryos is about the best case.

ICSI Treatment - Sperm Injection

Now, last but certainly not least of this three ring circus was the following...Dr Gupta asks me 'would you like to meet the surrogate?' What? I had heard all along that this was tabu. Well, it turns out she was coming in for her final blood work at noon and they would allow us to meet briefly. So, we met - and, the woman was so shy I thought she was going to pass out. She spoke very little English and would not make eye contact with me or the doctor - she just smiled and kept her head down. She is 29 and has two boys of her own. I kept it brief because she was clearly uncomfortable. I thanked her and she smiled. I am glad I had the opportunity to see her - she seems to have a very kind soul. Now let's just hope her uterus likes my ICSI treated, egg donor's eggs!

Thanks for all the warm thoughts and well wishes.

Terry