Anesthesia – Sharp Curve Ahead

— December 2013 —

If I was to recap my experience during my previous egg retrieval in one sentence… it would be- Never, ever, again. It really wasn’t supposed to be this bad. The story was supposed to go something like being a tad nervous, getting the IV, getting virtually knocked out- suck the eggs out- wake up and ache a tad.

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Yes, that’s a giant needle sticking through me to get the eggs….

However, of course…. it wasn’t. The story was in fact a morning of pure torture. There were two reasons why this was so- the first was that the RN gave me the meds I need so I clot better too quickly which, in turn, made me so nauseous that I dry heaved into a bucket for while getting ready. This could be slightly fixed by slowing down the meds this time, but ultimately, this was an obstacle that one could overcome. On the other hand, the conscious sedation drugs not working at all… now that seemed to be medieval torture. They gave me a heavy mixture of versad and fentanyl… and then more as I started screaming when the needles started through my vagina into my ovaries to suck the eggs out. Yes, never ever again. I still have nightmares.

So the good news is that because we know that it didn’t work, the clinic referred me to the anesthesia clinic at McMaster Hospital. In order to proceed with this surrogacy cycle, I’d need to do another egg retrieval. So this appointment was a must. I was hoping that they would give me a script for some magic formula so that I could sleep through the procedure like the rest of the infertile world.

After chatting with the doc, he gave me the bottom line. My body must not react to one of the two drugs given during normal conscious sedation, so we basically would need to give me full sedation in order to ensure that it works. We know that ‘normal’ sedation works with me as I’ve had a knee surgery and a tonsillectomy successfully.

Well that seems easy enough- right?

Wrong.

The problem with being fully sedated is that there are only certain doctors that are able to perform this. The list is short and basically includes anesthesiologists and emerg room docs in emergency cases. The other obstacle would be that a higher level of equipment would be needed to perform this type of anesthesia.

Okay. Think logically. We can figure this out. As my chest starts to heave in and out quicker and quicker I start to think about what this actually means.

Problem 1: Since Ontario de-listed fertility treatments, I now go to a clinic that is private. It is literally an office that has a couple treatment rooms- not a hospital. That means that they do not have all the hi-tech and fancy equipment needed to do this. Nor do they have an anesthesiologist on staff.

Ok…. Maybe I could have the procedure in the Hospital where they have these docs and equipment.
This leads us to Problem 2: I would then need to ‘rent’ out a surgery room, a recovery room, plus the nursing and physician staffing to go with them. Ummmm…. I’m assuming this cost wouldn’t be minimal.

But… after calling the clinic and brainstorming, that wouldn’t work either.  The clinic staff no longer have privileges at the Hospital.  Plus, McMaster Hospital doesn’t have the right equipment nor trained staff to inseminate the eggs on site.  Therefore, the only option would be  to extract the eggs, then get them quickly to the clinic…. but that won’t work either.  It would take too much time to get them there… they wouldn’t survive.

everythinghappens

Cause if you say ‘Everything happens for a reason’ I may just punch you in the face.

Okay… so the only viable option at this point is to try and get an anesthetist to come to clinic on my retrieval day and put me out.  Again, not simple.  It’s not like it’s a dentist appointment where we can call the doc ahead and tell him to meet us at a place and time.  Nope, the date completely would depend on my cycle- which at the best of times was unpredictable.  This would mean we could give a doc 48 hours notice and we would need them to be at the clinic ready.

… sigh….

The fertility clinic received this report from the anesthesia clinic in the middle of December.  So now that they had it, they could start working on a plan for me.  I would ultimately need to pay the anesthesia  doc whatever they would want to charge for their services (which we have no idea as it would be private so up to them…. $$$$$$).  But ‘it’s only money’, right?.

Stress levels just raised at least 100%.  If they couldn’t get someone into the clinic- what would I do?

At this point, I’m about ready to have a nervous breakdown… and I know the dollar amounts left in our accounts.

Yep.  FML. Again.

Us + Jen + the Shrink

Psych appointments.  Fun.

So in order for the clinic to move forward with the approval of surrogacy, they apparently want to make sure that both we, the intended parents, and Jen, the carrier, are sane.  Fair enough I guess.  But asking your best friend to head into the psychologist to be evaluated is not a normal friend request.

Again, Jen took it in stride.  Dan and I were up first.  This was the same doc that we had seen several times in helping us to deal with everything that was going on.  He was a nice guy that had provided us support and help when we were in need of it previously… and we felt very comfortable with him.  We walked into the appointment hand in hand and sat down.

This appointment felt different.  It felt like we had to say the right things so that we would ‘pass’.  I wasn’t sure what a right thing to say was.  I had already sat in this chair and spilled my heart out.  He knew about my history with depression.  He knew about our struggles.  He knew about my previous break downs after bad news after bad news.

Wait- did that make us not ‘pass-able’?

We sat down.  I suddenly started to get nervous. He smiled and told us to relax.  And the next words out of his mouth were magic to my ears.  He said, “Adele, we have had the opportunity to discuss your upbringing, your struggles, and feelings throughout the other sessions, so I’m really just hoping to talk about Dan today”.  HA!  Score!

Plus, hell, he is the sane one out of both of us!  He is my rock.  The one who always has something funny to say to make me laugh or smile.  The only who always sees the bright side.  Plus, Dan talking about his feelings was a rare opportunity… I felt like I just scored tickets to a good movie.  I say back and my heart rate slowed back to normal.

Dan lost his Father in a tragic car accident when he was 5.  He has very few memories of him… and mostly fills in the blanks with stories and pictures from others.  The doc asked him about how it was growing up without a father and how that played out.  He then brought up his Mom…  Dan’s Mom passed in 2008 of colon cancer.

While it wasn’t easy for him to talk about, he explained in detail about his Mom’s passing and how is affected the family.  He spoke about his closeness to his older sister and the important role she now plays in our lives.

Listening to him talk about his life made me really sit back and think…  Dan has not had an easy go at life this far, yet his outlook remained so bright.  He is truly an incredible guy.  Not once does he play the ‘woe is me’ card, instead, he has ensured that his life experiences assisted to build him into the man he is today.  (a pretty awesome man, I would add!)

The appointment was supposed to be an hour.  After about half an hour, he asked about he felt about my best friend carrying our child.  He laughed and talked about his initial reaction and how we had come together to be genuinely excited about this new, and unique, opportunity.  We were both 100% full steam ahead.

After asking a couple ‘what if’s’ he seemed happy and sent us on our way.  I felt like stopping while walking out of his office and asking- wait, did we pass?  The answer, I knew, was that this was just step 1.wait

Step 2 was Jen’s appointment.  I called her as soon as she got home from her appointment (a week after ours).  She laughed and said he asked the same basic questions surrounding her life, her upbringing, her motivation for volunteering, how she felt this would affect her and her children, and what her fears were.

She said he visit went very well and she was out of there in about 40 minutes.  I took this to mean that this was good news.  If he didn’t think she was sane enough for this, chances are he wouldn’t have sent her packing with a smile and a handshake after 40 minutes.

Well today was a great day.  My best friend was indeed sane, and she wasn’t yet scared away from doing this!

Step 3: The next appointment was going to be the interesting one.  The final ‘pass’ was an appointment scheduled with the three of us to discuss the plan and moving forward.  This was the final session.  The three of us met in the waiting room at the clinic and were chatting and joking around.  No one in the waiting room knew quite what to do.  First off, people we talking- unheard of in a fertility clinic waiting room. Second, we actually sounded happy- again pretty damn odd.  And third, why was there THREE of us?  We got stared at and lots of questioning looks.

The doc called us in and onward we trod into his office.  Three chairs were set up in a nice little semi circle in front of his desk.  I took the middle seat seeing as I was the binding piece to this whole arrangement.  We sat down and all smiled at him.  I think the three of us were weirdly anxious/nervous.  A psych session with my best friend and my husband wasn’t exactly the most normal thing…

We talked about our plans, about our intentions surrounding the legal aspects, and how we hoped this process would move forward.  The doc asked us a lot of hard questions:

– How would it affect our friendship if it didn’t work?

– What would happen if she miscarried?

– Did we think that jealousy was going to be an issue during the pregnancy or afterwards?

-What we do if we disagreed about how to move forward?

Jen and I promptly answered all the questions.  There was no doubt, we were on the same page about everything.  We both answered in unison about what would happen if she miscarried- we both looked at each other and said how terrible we would feel for each other.  My concern was Jen feeling like she failed and holding that weight on her shoulders.  Her first concern was to ensure Dan and I would make it.

Would this effect our friendship?  Well, we couldn’t really get any closer.  And our first priorities were each others feelings.

The doc nodded at all of our answers, then after about half an hour, he chuckled and asked how Dan really felt about this all.  Dan looked at Jen and I and made some joke about getting a word in edgewise… He said he couldn’t be more supportive and happy about moving forward.  We knew we couldn’t be doing this process with anyone else other than Jen- and he said this.

With a nod, and a pen stroke, the doc said he thought we had covered everything and offered his services for us on our journey.  There was about 10 seconds of silence in which I blurted out- so does that mean we pass?  He shook he head and said he wasn’t giving us a pass or fail grade.  He felt like we had had the discussions we needed to have.  We had the right attitude, and we were being realistic with our plans.  So yes, he was giving us his blessing.

Dan got the bill (yes we have to pay for everything….!) and paid him while Jen and I walked out and high fived in the hallway.

This hurdle was cleared…. just a couple more to go!