Thursday, June 25, 2009

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.


jon said...

Oh oh... those numbers indicate either multiples or ONE VERY HEALTHY AND VIGOROUS SINGLETON!


No worries about the lack of communication. We found that the first trimester is the hardest. Second trimester you focus on other things. But third trimester the anxiety comes back with a renewed vengeance. But you are right, NO NEWS IS GOOD NEWS. That's just the way it is in India, if you try to fight it or change the modus operandi you will only drive yourself nuts and get grey very quickly.

I recommend lots of CHAMPAGNE, WINE, BEER, XANAX, ATIVAN, VALIUM, KLONOPIN or any other controlled substance you can get your hands on these next nine months! You'll see that the time will fly very quickly. Take some nice long trips to exotic places that you may not be able to do so in a year's time.

Thanks for sharing your good news. I know you have your doubts but what you have disclosed is very positive for the stage you are in!

Great job guys!


Johnny and Darren said...

We'll be taking this mantra on board too guys...Repeat to oneself: NO NEWS IS GOOD NEWS, NO NEWS IS GOOD NEWS.....

Johnny & Darren

Danielle said...

You are right. No news is GOOD news. You will survive. Pregnancy is just a waiting game. You will survive. XO, Danielle

Rhonda and Gerry W said...

GREAT, GREAT, GREAT news! Will continue to follow you along in your journey and hope for more amazing updates!

Unknown said...

Oh the joys of surrogacy where you virtually have NO control! For those of us who like to have some of is the hardest thing in the world to do!

Keep busy and set yourself small milestones to get through or you will have a few full fledged panic attacks!

Beta numbers look good. Mine started out at a 20.2! I know exactly how you feel!

Hang in there! From where I am sitting, your numbers look really solid!


Mandy said...

you are abosolutely right about the communication, its horrible but again we are dealing with a whole different country.

I'm Mandy (I use to be on the SI forum until we had a negative w/Dr. patel in Feb. and took a step back) but i'm back little by little and your blog is great and refreshing, it encourages me to try again.

All the best to an uneventful pregnancy (and if its a girl the name Amanda wont be

Todd said...

Congratulations on this solid series of results! You are looking in great shape so far and can't wait to hear your next reports!

I can so relate to what you are going through. Yesterday I was a WRECK waiting for our second beta as I was expecting to hear by morning our time... eventually I gave in and sent a panicked Email to our doc, who very promptly replied they had just drawn the blood that day but had nothing back from the lab yet. Whew! And sure enough, I got a call late yesterday evening (next day in India).

It's going to be hard getting used to "no news is good news." Those of us pursuing surrogacy abroad tend to be "hyper informed" and it is so hard being patient. Fortunately, our docs understand this about us!

Axel & J├╝rgen said...

This is Axel from Germany. I just came back from Bombay on Wednesday when I arrived to read the email Dr. Goral Gandhi send us. I just hope so badly that you and us are sitting in the same boat where you guys are only a few seats ahead of us. With now 4A, 1B this is our second try and we are due to get our first beta on the 6th of July. I understand you so well since I was sitting in that waiting room at Rotunda plenty times, waiting for emails or watching the pictures of the embryos. This time they even send us a little movie. I get nervous and frustrated if I don't get the communication in time. But slowly I get to understand India better. During the last months I visited Bombay 3 times and stayed in total about 4 weeks. The pictures i have taken can only show so little

I just like to encourage you to keep on blogging about your thoughts and events. Wishing you guys all the best and success is actually a little selfish on my side. I have met a few couples who have taken home their babies from Rotunda and I want you and us to do the same.

Christy said...

Listen to your inner wisdom and have a glass of wine! You're right. It is what it is. And you are going to worry yourself crazy. Welcome to parenthood:) Every day brings viability! Embrace the joy (and madness) of the present! LOL!


Doug and Bill said...

Thanks for the "skype advice" I am going to take it...and reserve it for the same. We are on our way to India in September and soooo excited to get this whole thing started. Thanks for sharing.

Doug and Bill