Hospital Bed Rest

16-11-2011 (24 weeks)

Nov 4th, the day I got admitted (22 weeks)

November 30th- 26 weeks

This wonderful feeling fills me.. Today there was a bedside scan. From morning I was waiting for it, and I had planned to ask doc to show me the monitor during scanning. DrSri came did the scan and I mustered the courage to ask her. She said 'sure', and turned the monitor towards me. First I saw the usual B&W moving unruly waves, then suddenly the tiny body came into focus. My baby was lying on his/her back, very calmly as if sleeping, but moving the tiny hands. the little knees were up, supported on the back and feet. I fell in love instantly. Then the scanner moved ever so lightly inside me and the scene shifted. Now I saw a constantly moving baby, it was difficult to make out the head, body, hands etc. But I saw the baby moving and sort of saw the head. I could almost hear the giggles of a little baby! Then doctor shifted scanner again and I saw what looked like total chaos. Baby C was jumping up and down! A very blurred, constant motion, like a flash, that's it. I was not feeling many kicks, but the baby was certainly kicking. Then the screen was blank as she removed the scanner.

Babies are OK, she said. 'Baby C is very active, that's why you couldn't make out the image. Now you should start counting the number of kicks and mark it on a paper'. So I started kick counting from today. Baby C was jumping and moving like a spear. Me and Ramesh nicknamed him/her 'Chattu'. Baby A was much less active. And surprisingly once I got a real kick from Baby B! Actually that was the only kick, every other movement was just movement, sort of wriggling. I am worried about it. So even if I am doing the kick counting, it is not really making much sense.

01-12-2011 (26 weeks)

Today there was a test to see if I had tendency for gestational diabetics. I was asked to drink two full cups of sweet water. They took my blood samples before and after the test. I got the results soon enough, they said I was low-risk. (It seems my blood sugar level is much less than the standard 140 mg/dL. Besides I do not have a family history of diabetics).

17-12-2011 (28 weeks)

Crossed another milestone. My babies have developed their lungs it seems. I was given an injection for lung maturity of the babies, called Betnesol. I have this habit of going online about every tiny thing- may be because I am jobless, taking bed rest and not allowed to even sit up to write. So all I have is my mobile phone to keep checking internet. I know, it is bad, the radiation is bad. I am praying as much as possible, reading books, but not much, watching TV at times. It is quite boring. Anyway..so while checking net and reading stories of other multiples, I came across this story about a baby born in 27 weeks and survived after a lot of effort from the doctors. Also there are sad stories about babies who could not make it. I feel for the mothers, and the stories are making me get prepared for anything that may come.

Betnesol injection is required only if pre-term labor is suspected to happen within a week. I don't think it will happen, however I did not object when the medicine was prescribed. Its effect will last only for another week. Baby movements considerably reduced after the injection and I was concerned. Nurses said it was only a temporary side effect. They took the fetal heartbeat, and I listened to the beautiful rhythm of fast beating little hearts. My heart leaps with the memory of that music.

20-12-2011

Tomorrow I will complete 29 weeks! Previous night my BP was quite low- 100/60, body became weak and movements became difficult. Now it feels better. Today morning when DrSri came, she was accompanied by a battalion of nurses, and I forgot all the doubts I wanted to ask her. She said that the right due date is March 8th, I have to try and carry at least till February 1st. She asked if I am doing kick counts, if the movements are OK etc. How am I supposed to know if the counts are real baby kicking, or if it is only gas? I wish she spends some time here in peace and talk to me. Then I could ask whatever I wanted to know. At least with DrTC, there was enough time. Then when I was thinking this, DrTC came. When he saw me with the kick count charts he made fun of it saying that 'Goodness! you will need an essay book to mark all kicks from the triplets!' I found that funny, and relieving. He said not to worry about counts being less or more or anything of the sort.

Woke up yesterday morning with a lot of anxiety about upcoming cesarean. There will come a day- emergency or planned- when DrSri will come and say, 'OK, time for C-section! What will it be like! The preparations, the pain afterwards, babies' condition, health, feeding them afterwards, possible infections- a thousand worries hover over me. I do not know what I will have to face after getticg discharged from here.

21-12-2011 (29 weeks)

Successfully completed 29 weeks! Ramesh wrote on his diary:"Today my babies completed 29 weeks on this Earth(his exact words, in Malayalam- ente kunjungal bhoomiyil vannitt inn 29 weeks akunnu). A life in fact forms when it starts pulsating inside the parents, then today is the 29th week completion after I became a dad and she became a mom.."

23-12-2011

I developed a habit of praying early in the morning while lying down. Yesterday for an hour around 5.30 am I prayed while keeping a hand on the belly lying on my left side. All three babies were playing, jumping around! Wonder if they can see/feel each other? Feel me? Afterwards nurses came for the regular check-ups and found that my Hg is low- 9.3. So Iron supplement increased to twice a day. Urine test revealed some bacterial infection, probably due to cervical stitch allergy, and they gave a suppository to use for three days- Clotrimazole, Clindamycin tablet. The infection somewhat scares me, because a friend had a cesarean and she got allergic to the stitch thread, There was too much complication and some major surgery had to be done later to replace the stitch with another thread. I was suddenly running high fever too. And during all this fear and anxiety, a Government order fro Higher Education Department came which made matters worse. Mother tried to make me relaxed- she said we have tried our best, did whatever possible. Now let us wait and see what happens. Anyway, the job is not lost. Whatever financial debts come after this, we can somehow take our time and repay to the Government. Whatever physical problems may come, we will face it and try to overcome. (I was worrying about rejoining the course in July and reapplying for QIP extension in August- the uncertainties of it all). Then gradually I relaxed. Nurses gave Dolo for the fever. And by night I was feeling much better.

My weight is still 75 kg- it was 65 kg in 16 weeks. Doctor suggested eating nuts, cashews etc. and said we will monitor every two weeks.
NEXT... 31 weeks

Pregnancy and Bed rest- from July to October, 2011

May be later I will do a complete week by week or at least month by month progress details, but now I am too tired for that. So I will just attempt a summary of what happened from August 2011 to Feb 2012. 

My morning and day sickness more or less stopped after the first trimester. In the 7th week, 20th July 2011, we had an ultrasound, to determine the babies' heartbeats. It was somewhere between 150 and 170 per minute, for all three. I had read somewhere that baby girl's heartbeat count would be more, though it was unproven. So I just assumed that I had one baby girl and two baby boys. Still I thought about finding three names each for both genders. I easily got three nice girl names. During the initial months of our marriage, me and Ramesh had decided on a baby boy's name. So that was also there, but I just could not come up with two other boy names. So I left it at that. Some time during the 11th week, we had a scan in which we SAW the fetuses. It was three tiny rounds, size of grapes. One was very small. Doc said they were 4.2 cm, 3.9 cm and 3.7 cm long, and that this was normal growth. I remember vividly those images, of beating fetuses and the fast rate at which the hearts were beating.

As days passed, my hormones started taking a toll, and I had bitter mood swings. I would become depressed suddenly, cry a lot, and this made my parents worry. May be it wasn't just my own emotions, but the emotions of the babies as well, merged with that of my own. It is a very complex situation- you have three complete, but unknown and unconscious selves within yourself, apart from your own known, conscious self. And those minds and hearts act through you, something like a multiple personality. And then suddenly one day those selves liberate themselves and come out. You no longer feel emotions that are not really your own..Complex indeed.

Our doctor had suggested hospital stay many times, but I was unwilling. I preferred home, and besides hospital stay would be expensive. Only Ramesh was working at the time, that too in a very erratic work schedule. We had some reserve money, but that was all we had in cash. I did not want to spend it all unnecessarily. But my mood swings and the cramps I sometimes felt, and just general nervousness, together worried my family, and made us think of shifting to the hospital, getting admitted. Still I thought it would be better to move sometime during November. By 15th week, DrTC handed my case over to DrSri, the Gynecology specialist, and said she would be in charge from then on. She is a very sweet person, though much more reserved than DrTC. She gave a small briefing on what to expect, and said it was now too late to think of selective reduction, if we were planning one. We were not. During these visits and later hospital stay, one thing I really disliked was being referred to as 'patient' by all doctors, nurses and hospital staff. I was not a patient, and being and remaining pregnant only emphasized the fact that I was healthy, not a patient. But that was the system in the hospital.

13-10-2011 (20 weeks)

I had a Triple Screening test on 30th September, during my 17th week. This was a blood test supposed to find out if the baby/ies has any neurological disorder like Down Syndrome. The quantity of blood taken for the test was more than the usual blood tests, but by then I was quite used to needle sticking on my body. I coolly let them take the blood, and in the process got some admiring glances from other ladies waiting their turn at the lab, They were scared, and were not used to as many needle sticking. I never got the result of the test in my hand, but later learned from the doc that the test was negative, meaning there was nothing to seriously worry about. She said there was another test called amniocentesis, an invasive procedure, which was done if there was a possibility of risks during Triple test. She said it was not necessary in my case, even a bit dangerous, since it was an invasive procedure, still if wanted to do it, they would do it. I said no, and was relieved. Those days I had this habit of going online for every single thing, every word, every symptom, every medicine, every test. Everything seemed fine, yet I found something new to worry about.

21 weeks

Finally, towards the end of October, one night I had a terrible stomach pain. We rushed to the hospital, waited endless minutes in front of the casualty before someone attended to us. I was writhing in pain eighty percent and fear twenty percent. My mother was with me while Ramesh went to fetch a doctor, and she got very worried. At long last I was taken to the ICU, given medication and finally the pain settled. Much later I was told that the pain came because one of the fetuses shifted position in an unusual way. This made us all get real panicky and finally we decided to move in to the hospital- on November 4th, 2011.

NEXT..24 weeks to 29 weeks

Cervical Stitch

31-8-2011 (13 weeks)

I am worried sick. Doctor told me to undergo a procedure called cervical stitching. It seems this will reduce the possibility of pre-term delivery. A suture will be applied to cervix, under anesthesia. It is a safe procedure, she assured me, yet I am very nervous.

07-09-2011 (14 weeks)

Cervical cerclage is done. It was not painful, nothing serious. I was admitted, taken to labor room. Another table was next to me, a lady in labor lying on it. I was put under general anesthesia. (Frankly, I like the feel of drifting off to unconsciousness when the gases are released in my system). When I came to again, I heard a new born cry somewhere. There were conversations. I am not sure if all this was imagined, or real. Anyway, I was kept under observation for a day, in the room, and then discharged. No pain, no irritation whatsoever.

NEXT..22 weeks

My triplet pregnancy - my diet during pregnancy

Sept 30, 2014
Craving for certain foods during pregnancy is a well known phenomenon. I was also hoping that when I got pregnant I could eat all the food I wanted without the slightest botheration about gaining weight because I would be expected to gain weight anyway. Then during the days of OHSS I developed an aversion for most foods and the bloating of stomach made sure that I could not eat much. Later on, I also developed a liking for raw mangoes and some raw fruits like jambu (champakka/wax apple). During the initial months I had severe morning thickness which lasted till the afternoon, vomiting bitter yellow liquid 3-4 times every morning. It was a horrible time, yet it was very comforting. It assured me that everything was fine, I was still producing beta hcG and all was well inside. On a rare morning when I felt no sickness it scared the hell out of me. But the nausea attacked with a vengeance later in the day. Those days I had the same pre-pregnancy diet.

After the first trimester, things settled a bit. I started my rest period, lying on bed or couch most of the time. I wasn't interested in TV much, but as my parents were watching a few serials which had stories of Gods and Goddesses, I watched too. But mostly I looked through the window, watching the birds outside the house or the cat which had a brand new litter of three kitties. I saw how the mother cat keeps all three kittens safely protected, how she goes out to find food, yet is always at hearing distance so she can run back if something attacks her babies. Not all mother cats have the same luxury or same skill, and many kittens die due to malnutrition, predators, sickness etc. But this mom was skilled and all three babies survived and grew strong. I watched them play outside, learn to climb trees etc. The birds were many, various species, and I even found that we had the nest of a bright yellow oriole on the tree in our yard. I listened to their calls and told the babies in my belly that there is bright and colorful world outside..come, we'll explore it together!

There were various medical tests and procedures, some of which I have mentioned in another post. After a few months I was admitted at the hospital, because everyone-me, my family and the doctors- felt that that would be safer and better. My parents also shifted to a house belonging to a friend (more like a sister) which she very generously let us use during those months. So every morning my husband would leave for work, my dad would come to the room at around 8AM with my breakfast which was idli or dosa with kadala curry (a spicy kerala dish made of Bengal gram) along with a large glass of milk. I was supposed to take full bed rest meaning I was supposed to eat lying down. But that was impossible for me. As such I had no hunger and my stomach became full with a tiny intake, probably because there was not enough space in the stomach after the uterus grew in size with my threesome. So it was difficult to eat anything at all, yet I had to gain weight. So I ate while sitting up, and if by chance the doc dropped in for a quick rounds precisely at that time, I was sure to get a scolding for sitting up instead of lying down. After breakfast there was an assortment of vitamin and calcium tablets. Iron tablets and tonic had to be taken, but if iron is taken with calcium, iron will not be absorbed it seems, so I took iron at night. After the tablets and the regular visit by nurses to check vitals, I used to lie down while dad sat on the balcony and read. At 11.30 AM I had another course consisting of two boiled eggs and two oranges. Now when I think of all that my mouth waters, but those days it was a horror to eat all these food. However I crammed it down. By noon dad would leave and mother would come with the lunch she cooked. Rice, lot of vegetables especially leafy ones, and lime juice. After lunch we would sit(she would sit while I lay on bed) and chat or read something or watch a movie. By 4PM dad would return with a block of cheddar cheese (approximately 30 gms) and a handful of sprouted green grams and sprouted urad. I hated both, but forced them down anyway, followed by another large cup of milk. then the three of would watch TV, the regular Bhakthi serials. We all knew about the damage of TV, mobile phones etc. but it was difficult not to use them. During the evening I would also eat a large spoonful of peanut butter and sometimes a banana. By 7 PM my husband would return from work and my parents would leave. Then both of us would have dinner together, mine consisting of the leftover veggies and rice or chapathis. Then the iron and other vitamin tablets along with orange juice to facilitate iron absorption. We used to sleep by around 11PM.

This was more or less my regular diet. I could not eat lots, so whatever small quantity that I ate had to ensure enough nutrition and weight gain. The idli/dosa, rice/chapathi/banana gave enough carbohydrates. Milk and cheddar cheese ensured Calcium (processed cheese does not have any nutrition. Cheddar or any other type with good Calcium content is a good food during and after pregnancy), and were supplemented with the tablets. The leafy veggies and oranges were for Iron and vitamins supplemented by tablets and tonic, while the sprouts and peanut butter contained lots of protein. This was all I could force myself to eat. Never a chip or chocolate cake or anything. I read online that fish contained Mercury and bacteria which were harmful, so although I liked fish I did not eat it. Once I had a craving for fish, so I chose anchovies (kozhuva), which is among the safer fish varieties, having very less Mercury. Besides I love Kozhuva fry. So that was the only non vegetarian food during pregnancy. Red meat is excellent it seems, to eat during pregnancy (beef etc), but I never liked it. White meat (chicken) was okay with me, but it contained no relevant nutrition. Horse radish leaves is very good. And there are certain foods which should be eaten from the last trimester to ensure good breast milk (which I have noted in another page), a fact which I did not know then. 

I am sure this is not an exhaustive list of options, but this worked well for me. I gained just enough weight (83 kg at 36 weeks, my original weight being in the range of 58-62 kg). The babies, once they started eating solids, showed a peculiar taste for foods- Baby A, who is a very fussy eater, likes peanut butter! Baby B likes fruits, veggies etc, and Baby C loves cheddar cheese! They all like kadala curry! And only Baby A has a liking for sweets. I hope the information will be useful for at least some of you.

NEXT..13 weeks- cervical stitch

My triplet pregnancy - pregnancy spotting, Susten and progesterone

We came to my parents' house a few days back. The news of my triplet pregnancy is not out yet. Relatives and just a few friends know that I am pregnant (nothing about triplets). I am out of Facebook for a while. Morning sickness is there, but not too much. One early morning I had a slight pregnancy spotting, and since then everyday every few hours I check for spotting. That morning we made a frantic phone call to  DrTC and he told me to use Susten (a suppository of natural progesterone, which I had been using before also). Ramesh sprinted out to get to a medical shop, (that was a Sunday, we were in a remote town where shops lazily open at 8.30-9.00 am), and somehow got hold of a Susten (last in the stock I think, but thankfully within expiry date) and rode back full speed and gave it to me. Nothing happened. Spotting was not there anymore. It was really nothing to worry about. But I kept checking. This happened once or twice again, and we bought a box of Susten and are keeping within reach.

Ramesh left for office in the morning, as usual, and I am just spending time reading, watching TV and watching birds through a window. I am also researching good diet during pregnancy, about risks of triplet pregnancy and similar things.

NEXT...My diet during pregnancy

IVF in Kerala - Triplet Pregnancy

We did IVF- ICSI and conceived!. Read here about the IVF

Then started the OHSS symptoms.

It's TRIPLETS!!!

Well, facts are always more complicated than fiction, no doubt. In the last two weeks, especially on one particular moment today morning, my life changed entirely. Whatever I was, whatever I was planning for myself, whatever I was expecting in the future..everything changed so drastically..I am yet unable to believe, and I am exhilarated, I am scared, although what can be the consequences and implications of it all I may not fully grasp until after many years.  

After coming home on 5^th, my parents went to their house to fetch the things for a stay that might be little longer than expected before. When Ramesh left for office, I sat alone. I felt very nervous about my P.G. course. If I do not go to complete the course, then it might become a problem (as described in the post 'Post Graduation'). Besides I did not want to waste the first two semesters of hard work, good fun and good marks. So just to make myself believe that I would be going, I booked train tickets to Chennai, on the 11^th July evening train, for myself and Ramesh. Then I called up my friend and P.G. classmate Sari and transferred the next semester’s tuition fees of around Rs.45,000/-.  

The next couple of days I spent reading something and worrying about everything. On 10^th my parents returned, and my mother took over cooking from the maid. Mily, our pet dog was allowed everywhere inside the house before, but since my parents were worried about pet allergy to pregnant women, she was now allowed only inside the sitting room.

On 11^th  (Monday) morning we went to the hospital, got the blood check done and found that Beta hCG doubling rate has reduced. I was very anxious, and my face showed the anxiety while waiting outside DrTC’s room. He saw me through the half door and we were called inside. He said the Beta hCG rate will get reduced as time passes, and later it will stop entirely. There is a  chance of increased hormone production by body at the end of the gestation period, and a very remote chance of recurrence of OHSS, but it will not be nearly as severe as the one before. He said that the ultrasound scan report says that it was multiple gestation, and he confirmed it by doing a vaginal scan. I told him that I was planning to leave for Chennai that evening, and he said outright that I should not go. There would be another scan on 19^th, and once it was done we could take a decision. If it is indeed multiple gestation, then I would have to take bed rest. I got very agitated by this. We left the hospital, and I cancelled the tickets. The waiting started again. I was too anxious. Anyway, I spent day and night lying down, reading and watching TV. In between we also went to watch ‘Salt n Pepper’ and ‘Harry Potter VII’. ‘Salt n Pepper’ talks about food and the opening scene song sequence features a lot of mouth-watering delicacies. But my stomach was still tight, no trace of hunger, and I missed feeling hungry watching those scenes. HP-7 we watched on 18^th  -a late night show (somewhere deep inside I knew I would not be watching another movie in a movie theater for a very long time to come). Ramesh was tired from office, and he generally disliked HP movies ("books are so much better!”), so he started snoring loudly. People in front rows turned around and laughed. I felt so embarrassed, but there was no way to wake him up.  Gradually he stopped snoring, still slept through the movie.

Today morning I had yet another ultrasound and vaginal scan. My father came along with us as he had a body check-up (after the angioplasty a few months back) at another hospital on the way. We dropped him there and went to our hospital. This ultrasound was done in the main block of the hospital, in the main scan room. The lady doctor with the accented Malayalam did the scan and she gave her findings to the person typing the report. (Online I have read many stories of pregnant women talking about their scans etc. where the doctors show them the monitors and discuss the results. But here it is not like that. We are considered ignorant, delicate weaklings with whom the important medical information about our own body cannot be shared). She was telling something and I noticed her saying ‘triamniotic’. A mild anxiety crept through me. Really, it can’t be triplets... My mind went numb. I could not pray for anything except that all was well. Even if it was triplets..well, whatever God gives, I should happily accept..after all these years..I closed my thoughts and concentrated hard on praying all was well…

I came out, saw Ramesh waiting there and told him that there might be some unexpected news. He frowned, but kept quiet. Then we went to DrTC’s room. The senior nurse was standing outside the room. She called me aside and said ‘Hey, it’s triplets!!’ I smiled, but it was forced. ’ Really?’ I said. ’Yes, Congrats! And now you take good care of yourself’. With that she went inside. I came back and told Ramesh what I was just told. He smiled, but I could not really make out if it was real, or forced. Then we were called inside and DrTC was sitting with a huge smile. He did not know that I was told, so with all the air of breaking a life changing news (which it was), he said, ‘You know, it’s triplets!’ ’Yes, we heard’ I said. The first thing I wanted to know was if I could go back to Chennai. He said, yes, I could, but then if there was some mild problem, or if there was a spotting (bleeding during pregnancy which to some extent resembles a period, but much less in quantity. It is a common occurrence, nothing serious most of the time, yet scary enough), then I might have to visit a hospital there, and as soon as they found out about the multiples, they’d make me stay in the hospital. Unknown hospital, unknown people, unknown city. And if there was any serious problem, then every single person in the family would blame me for going. So, really it was up to me to decide, and yet I had no options. I said I had a comfortable room to stay, good helping friends around. He laughed at this and said I was saying all these because I had no idea how complicated and difficult life could become during pregnancy. Ramesh offered that he could come and stay with me, and again doctor said, the problem was that things were unpredictable. If something happened then all the effort, all the sufferings, all the money, all the prayers and hope everything would be wasted. And so, finally I had to face that tough moment of actually realizing that I was not going anywhere for the next year. I could not believe it.

Then we talked about the babies. Doctor explained that I might have to stay in bed at least in the last trimester, and he would prefer if I stayed in bed during the whole time. Since the first day of my last period was 2^nd June, my due date for delivery, that is 40 weeks completion, was 8^th March. It might not go full term, but it would be very good if I could carry on till 37 weeks or 36 weeks, or at the very least 33 weeks when babies' lungs would be mature enough to breathe. I looked at the calendar and wondered if I could carry on till 14^th February- Valentines day, that is one day before 37 weeks complete. I felt strong and willful, and somehow felt I could carry my babies full term. We discussed many things, like other couples with triplets, the possibility of my continuing the studies later etc. Then DrTC said in a serious tone- ‘It is not going to be easy, carrying three babies, and going full term. You have to rest completely. Then after the babies are born, it will feel like a kindergarten at home. You will need a lot of patience. You have a choice to do selective reduction, that is, there is a procedure in which the weakest foetus is identified and reduced, so only twins will be there. You can opt for it, but then I would advise against it. Because of all the complications, there is a good chance that if we do this procedure, the other babies also might get harmed.’  ‘Oh, We are not planning any reduction’- Ramesh said quickly.  I had read that sometimes when there is a triplet pregnancy, and there is a health issue, then in that case it is better to do selective reduction so that at least the two surviving babies are healthy. So I wasn’t very sure, and remained quiet and listened to the doctor. He said, ’I am not advising selective reduction for two reasons-one, you both hoped and tried so much, and when you got such a blessing, it is not right to do such a thing when you actually can afford to not do it. You are well settled, you can afford three babies. Then you have the support of the whole family. People do selective reduction when they can’t afford to raise multiples due to financial problems, or because they don’t have enough help. Your case is different. I agree that it will slow down your career growth for may be a few years, but well, it will also enrich you in many ways. Second reason is that the process itself needs to be done expertly. And it is not something we have a lot of experience in. Anything can go wrong, it can affect the other fetus also, I am not saying it will, but it can. Also it is not necessary that the fetus that gets reduced was the weakest. It is just an assumption after studying certain characteristics. So, now the decision is up to you. Think about it, and decide wisely. Your decision, whatever it is, is right’

We came out, and I said, ‘In a way it is good now that we know where all the three transferred embryos are, because otherwise I would have wondered where the third embryo went, whether it is in the tube or something..but then the three frozen embryos, what will they do to them?’ Well, we may never find out.

Much later, experience made me wonder about selective reduction, the technique of identifying the embryo to remove if we so decide-in case of multiple pregnancies. If the criteria for selection is weight, then what we find from experience is that the baby born with the least weight is the smartest one. If the criteria is survival instinct, well, how do they identify if an embryo has more survival instinct? Anyway, that is for experts to think and decide. 

As we started back, we discussed selective reduction. Ramesh would not hear of it. I also did not want to do it, now that the doctor assured that if I could carry at least 35 weeks, then the babies would have no major health or developmental issues. So, no selective reduction for us. We picked up my father on the way, told him the news and he got very excited. We reached home, told Amma. She got thrilled too, but also very worried about the health risks for me and for the babies. 

We are planning to go to my parents’ place and stay there for a few days, to get things settled there and my parents can come with us for a longer stay. I am doing a lot of internet research on pregnancy, especially IVF, that is how I read about ectopic pregnancy, where the baby can get stuck in the tube. Also I read about birth defects when it is a multiple pregnancy. The possibility of autism and other developmental problems due to pre-term delivery. I am having all kinds of bad thoughts these days. I am inventing all sorts of reasons to worry.

I was worried about many things at the time and I could not really appreciate the abundant blessing I was provided with. But later we realized the dedication and expertise with which DrTC and the rest of the doctors and nurses approached each case and the care they give to each one.

NEXT...First trimester

OHSS after IVF and pregnancy

I did not have to undergo anymore tapping.  I got my release from SICU on 1^st July, and presently got shifted to room 408. On 30^th June I requested doctor if I could be discharged. He said no way, if he had admitted me the first time- the morning of my OHSS start- the situation would not have become so complex, now there was no way he would discharge me and send me home until he was very sure that everything was stable. Anyway he said I can be shifted to the room, and SisG bid good bye saying that let there never again be another stay at SICU.

Thus began a new routine. My parents would bring breakfast from home (an hour away) every day and when they reached Ramesh would leave for office. Lunch was  arranged to be brought from a nearby hotel, and in the evening when Ramesh came,  my parents would leave. Ramesh would bring tender coconut every day. Every morning before breakfast my blood sample was taken for testing Beta hCG. Initially five bottles of Albumin was given as IV every day (Albumin from Reliance, called Alburel. It actually costs only about Rs.1800/- per bottle, but after all the overheads etc., the hospital gives it at Rs.5000/- per bottle!). Later this became three bottles per day and was stopped gradually, along with saline IV.

Finally, since Beta hCG was doubling properly and OHSS stopped, I got discharged today. Doctor scheduled the next visit for 11^th, and said that I should not leave for Chennai before that. I am worried, but trying to relax since full-fledged classes would not start before 11^th , hopefully.

NEXT...Precious threesome

OHSS after IVF - Bloating stomach and paracentesis

When I was admitted I never thought I’d spend so many days here.. Anyway, I am still here. In the first few days here I could not completely believe it that I was really pregnant. It is only when the sisters who come on a regular basis to check my vitals take a look at my file and comment something like ‘Won’t the baby be hungry? You should eat something, no?’, that I actually believe that I might indeed be pregnant. I befriended most of the nurses, especially the head nurse SisG, who is about 30 and the mother of two school going kids. She had passed IELTS and had a UK work visa but somehow could not go. This made me respect her even more. The other nurses were also quite friendly and helpful except for a few. I spent my days watching the variety of patients coming and going from SICU, and their behavior. They watched me curiously from a distance because I looked so much at home sitting and walking and calling nurses by their names and talking to them and laughing and all. My mind was numb because I did not want to think about all the work I had to do, especially regarding my course, job etc.

A second paracentesis was needed the day after I got admitted itself, that is the very next day after the first tapping, on 26^th. This was done in the afternoon, 3 pm, I think. In the morning when DrTC came, he checked my Beta HCG and said there is a high probability that I have twins. It had become a routine to look forward to the blood test every day morning, and to see beta HCG count mounting. I felt thrilled at the prospect of having twins, but doctor warned me against over hopefulness. When I was taken to OT for tapping in the afternoon, plasma IV was given along with saline. During tapping my body started itching, as if I was being bitten by mosquitoes. I complained many times to the doctor that mosquitoes were biting me in the OT during tapping. Now that I think about it, it is to their credit and the way they cared, that they did not laugh at me, though the doctor just said that OT is free of mosquitoes, even free of bacteria. Then I realized the stupidity of my complaint, and rephrased it to say that I feel allergic to the bed sheet. Then my body started swelling here and there, and DrA, the young and cheerful general physician who was in charge of the IV said that it was an allergic reaction to plasma.(I didn’t feel one bit conscious of the fact that a handful of people, men and women, mostly of my age group itself, were present in the OT during tapping. I had not felt any awkwardness even before, when I was having ovum pick up or embryo transfer. They were all very professional, and I did not feel any more embarrassment than I would have felt if they were looking at my hands. I noticed that DrA turned away when the nurses pulled the sheet from my legs to start tapping, and I assumed that he must have joined recently, and might not come often to see this kind of procedure. On the other hand during my treatment with DrTC, he rushed to the OT one day saying that he wanted to see a particular delivery in progress because he wanted to watch a particular gynecologist at work. These young doctors shared their knowledge, and shared the opportunities they had to learn new information from each other’s case patients). That day also, the painful part was cleaning the pelvic area. Everything else went well, and approximately 3 liters of fluid was drained. At one moment I laughed at some joke someone cracked, and jerked slightly, and felt something sharp against my skin: 'shh don’t move', said DrTC, and I saw him look at me with sudden concern. (I don’t know if my skin was cut, or if something else happened,  but later in the years that followed, whenever there is a brief but sharp pain in the pelvic area, I regret that moment).

After the tapping I was brought back to SICU and DrA gave me an Avil injection for the plasma allergy. Drowsy darkness washed over me, such intense sleep, that my eyes were instantly shut from the effect of Avil. Rght then my parents reached from Alappuzha. Amma came to see me at SICU. My eyes kept closing, my body was still swollen, and I was tired from the tapping. Amma got really frightened seeing me in that condition. I told her what the doctor said in the morning- about the possibility of twins. I expected her to jump with joy, but she remained unhappy and worried about me.  She said that Ramesh had already given the news, and that he was really excited and happy. Then she left and I slipped into a sort of coma. 

The next tapping was done two days later, on 28^th noon time. I was determined to get two days between the tappings, like the doctor said, and I barely got it. He had instructed me to exercise slightly by walking a little, and every day I walked as much as I could inside SICU. At least one hour each every morning,evening and night. Besides this, when there was no one to occupy the bed on my right side, which was at the far end of the nurses station, I used to go behind the curtain there and jog and jump slightly, just to reduce the heavy, full feeling in my stomach. In order to stop the IV saline I started drinking 5-5.5 liters of water daily, including tender coconut and my daily couple of cups of tea. However try as I may I could not get myself to eat the egg whites. Hospital canteen had good rice gruel, and I forced it inside. I hate gruel, however good. All this effort had only one aim- I desperately wanted to get discharged from hospital before 8^th July, Friday, and reach Chennai before 11^th, when classes would start, since I could not afford to break the course. My mind was set upon release. I had no idea how silly I was to even faintly assume this possible. Thus the days in SICU were hard work, sincere, tough effort both physically and mentally, to get over OHSS. SICU was not very strict in my visiting hours unless there was a patient who needed solitary care, and I had four visits every day-Ramesh came every morning and night with breakfast and dinner, and mother and father came every noon and evening with lunch and tea. The food smelled delicious each time, with mouth watering mango pickle, but my taste buds were not functioning. So I just smelled the food heartily, tried to eat mightily by reading Archies and Balarama and all (for which DrTC and DrA regularly teased me saying that this is what they teach at Engineering Colleges), but still everything tasted bad and worse, my stomach could not take anything in. The nurses’ company was good fun, DrTC came twice everyday (including Sunday when he came with his new wife- a pediatrician), still I felt lonely and just wanted to get back home somehow, and move on. May be, if it was not my QIP course period, but my vacation during college, or leave during college/office, I would not have minded the stay, probably would have even enjoyed all the attention, but that was not to be.

Today (30-6-11) when doctor came, he was ready for the fourth tapping. I was taking my regular walking exercises, and I thought he would appreciate that. He did not, and he even looked a little concerned about the way I was exerting. I said I don’t need the tapping and he suddenly looked skeptical. How come you are all right so suddenly, he demanded. Then he checked and understood that it was not that the fluid was not there, but just that my body was adjusting to it, the strain was still there inside the stomach. He checked beta HCG also and was satisfied and left. Later I asked SisG to inform doctor that I felt heavy and would like a tapping. Doctor came, checked and said that we’d wait for a few hours, and if the heaviness lessens we would not tap, let’s not introduce foreign stuff into the body unnecessarily. The heaviness and bloating was not my imagination, it was very real, he said. But because my abdomen muscles were strong the girth of belly was not increasing beyond a limit, and that did not mean that the strain was not there. However it was best to wait for some time. So here I am, waiting to see how it will all go.

NEXT...Back Home

OHSS after IVF pregnancy - paracentesis

We did IVF- ICSI and conceived!. Read here about the IVF
Then started the OHSS symptoms.

26-06-2011    10 pm

Yesterday (25th) late at night, a nurse came to put IV cannula and tried to get a vein in both my hands so they can administer various drugs along with saline IV during tapping (The process of draining excess amniotic fluid in case of severe OHSS is called paracentesis). Ramesh had told me during the day that a fluid called Albumin had to be administered during tapping. It was very expensive and hospital did not have enough bottles in stock, so it had to be bought from outside. Albumin is thick and solidifies very fast in the vein and that’s why they needed both hands’ veins. It proved to be very difficult. My veins just won’t show. Two or three junior nurses tried by sticking needles at various parts of my hands. I cried out in pain, tears flowing down my cheeks. I felt lonely, helpless and miserable. Midnight, all alone, pain shooting through me, I wept. They did not do it deliberately, they were just inexperienced. They called another nurse from a nearby ward and she was slightly more experienced. (I would later see all these girls many times over, learn their names, and befriend them). At long last they managed to find two veins and left after putting the cannula.

At around 7 a.m., I was taken in a stretcher to the operation theater. A group of nurses came along, I closed my eyes and one nurse was saying, ’..I was planning to take a break today- Saturday, and this darn tapping..’ She did not realize that I was listening to her. When I saw the Operation Theater, I was scared suddenly, but then the thought that this immense bloating in the stomach could be relieved made me feel better. One hand cannula had IV saline fluid and the other had Albumin. Doctor came with big gang of nurses. One elderly sister whom I met yesterday night came forward to clean the vaginal area. Although it was shaved for embryo transfer, she had given it a quick shave last night. Now she came with Betadine solution or some such thing and put both my legs up so she could have easy access and view. She then dipped cotton in the antiseptic solution and cleaned inside out. It was like the area was burning. The unexpected pain made me cry out.  Doctor tried to calm me by saying that if it s not done it might cause infection inside. I trusted him but the pain would not stop. Both my hands and legs were firmly held by nurses and there were strainers too. Still I moved horribly. It must have looked like a movie scene where they administer electric shock to mentally unstable people. But the pain was only during the wash. The moment the cotton was removed the pain stopped and I breathed. The whole process might have lasted 2 minutes at most. Then doctor inserted a catheter in the vagina to the uterus. It hurt, but only very slightly. He was looking at an ultrasound scanner while placing it, and then the tapping started.

DrTC explained to me that Paracentesis is the process of removing or draining excess amniotic fluid in the uterus. When the baby starts growing inside, a lot of hormone is produced which causes more amniotic fluid to be generated, especially if there is a history of hormone induced infertility treatments, and/or if there is more than one baby. This excess fluid sometimes comes out from the thin vessels and starts filling up in the stomach and sometimes even in the lungs. This excess fluid needs to be removed, at the same time making sure that there is enough fluid to ensure the baby’s survival. This fluid generation gradually stops in a week or two, but if it stops abruptly before that, it means that something is wrong with the baby inside, most probably it is dead, and one can expect a period in 2-3 days. And because of this one cannot pray that ‘Oh God, Please stop this fluid filling..’  It is a good thing, and a horrible thing, at the same time.

It took around 30-45 minutes to finish the tapping. During the time a few doctors came and left the OT. DrTC was talking to me and to the nurses in general, cracking some jokes and talking about movies and all. Last night he watched ‘Salt and Pepper’ it seems, and ‘Adaminte Makan’ which was made by all youngsters except the hero Salim Kumar, and still turned out to be a great movie, he was saying. Slowly, gradually,the heaviness and uneasiness in my stomach lessened. I felt much better by the end of the process,though not fully recovered. That day 3.5 liters of fluid was removed. I saw the fluid filled in bottles and it looked like blood. Doctor instructed the nurses to test the nature and culture of the fluid, whatever that meant. They attached a urine bag and catheter to my bladder to check my kidney functioning and urine color (Last night at GICU I put a lot of effort to urinate, and red liquid only came out. Doctor had seen it and instructed the nurse to collect, measure and test it. During the whole night I passed 2-3 times , each time 5-10 ml at the most, and blood red in color). The insertion of the catheter and urine bag hurt, but only a bit. It was like an expert job. But the thought that this bag was attached to me was very uncomfortable. I was taken outside and I was dead tired. I longed to go to the GICU and lie down so Ramesh also can be bystander there. Instead I was taken to the Surgical ICU where DrTC came with the urologist DrKM who is a very well known expert doctor and also my friend's husband. Presently he looked at the red urine in the bag, gave some medication through the drip (I could not see what he was doing), and soon the urine became clear. ‘Don’t worry, I think she’s started producing urine’, DrKM told DrTC who looked absolutely relieved at the news and said a heartfelt ‘Thank you’. (Only later when Ramesh said I realized that DrTC was anxious that probably my kidneys failed after dehydration from the vomiting, and was thinking that in that case, I should be shifted to some multi-specialty hospital. By God’s grace, that was not needed.)

I am given the bed facing the door in SICU. There is one bed to my left and two to my right, and again a nurses’ station and a toilet. The room is nice, the nurses are quite friendly. I can see people moving outside when the curtain is not drawn, and I can see all the traffic to and from the room. There is a picture of Lord Ganesha on the wall across me and I can lie down looking at it. Doctor gave some instructions to the nurse there, and told me that I should eat egg whites and drink a lot of water. Albumin and IV fluid is constantly being injected inside. Albumin causes blood to clot in the vein, and so it needs to be constantly shifted. Getting a vein is so difficult and this is causing a lot of pain for me, but never like the one at the first time in GICU, mostly because the nurses here are more experienced. I told Ramesh about details of the tapping, and he is sitting outside and typing away.

NEXT.. Paracentesis

IVF in Kerala - I am pregnant!

I am pregnant!
We did IVF- ICSI and are waiting for the blood test results. Read here about the IVF
Then started the OHSS symptoms.

24-06-2011   11pm

That was not the last night :) I survived it. Early in the morning on 24th I was shifted to Gynecology ICU. Next when I woke up daylight was filtering in. I was in a long and narrow room,with a few other beds and a toilet. Ramesh was sitting next to me, and DrTC had arrived. Seeing my condition he must have regretted not admitting me yesterday morning itself. My body was still not hydrated enough even with all the IV, and they were frightened that there was a chance my kidneys might fail. (They did not tell me that then- only after many days). Then a nurse came with the blood test result, and DrTC said, ‘it’s positive’.

Wham. That simple. A sentence I was longing to hear for so long, for eight years, and it was uttered and heard- just like that. And we could not even properly understand.. Where were all those fireworks supposed to be happening when I heard it, where was the rain inside to cool my heart and soul? Where were the thousand dreams jumping and rushing and coming all together? Where was the joy- absolute, pure, indescribable joy? Nothing. We just stayed there listening. He was saying, ‘It is not yet the day to test blood for beta HCG, but even today the count is much above normal. On 28th only Beta HCG should be reaching count 100, but today it is already 40, and it doubles every 24 hours, so definitely on 28^th it’ll be much more than 100. The high beta HCG count shows that there is a chance that you are having twins- but don’t tell anyone yet. You might have to get an abortion if OHSS become severe and dangerous..’ Even that did not make much sense except that I prayed to God-'oh God, Please let my baby/ies be unharmed…'

Doctor said that as a result of OHSS, there is excess amniotic fluid in me which had to be tapped out. Tapping is scheduled to be done tomorrow morning. I spent today whole day on the bed in a state of semi consciousness. The constant IV drip ensured rehydration of my body little by little. Luckily they allowed a bystander during the day and Ramesh stayed till night until they ordered him out. 

NEXT..Draining the excess fluid

IVF in Kerala - OHSS after IVF

OHSS after IVF - stomach bloating and vomiting

We did IVF- ICSI and are waiting for the blood test results. Read here about the IVF

23-06-2011   1 pm

Today morning started with an unbearably upset stomach and vomiting. My stomach is bloated like a solid mass. Ramesh took leave and we went to the hospital in the morning itself. Doctor did a scan and said it was OHSS like we suspected. He sat with us and told us that this is a good symptom, usually it happens when pregnancy is positive. It will cause some mild uneasiness, but just bear it and it will soon go. If I complain too much, it can even cause a problem with the pregnancy- a good thing that is about to happen may just not happen. If the pregnancy test shows negative, then in 2-3 days the symptoms will go and with the next period everything will be the same again (I could not bear to think of having another period before nine months). Don’t take any medicine, just go home and relax- don’t get yourself admitted in the hospital, he said. I felt relieved, happy and hopeful. I did not want to get admitted. We reached home and my husband left for office. This stomach cramps and bloating is becoming too much. Its OK, it’s OK- I keep telling my body. I am trying to relax.

24-06-2011       3 am

23rd June, early evening, the symptoms started again..vomiting, pains, stomach cramps, nausea, bloating and fullness. And then it became unbearable. I went online again, even those websites advised not to worry, it will go. I messaged  DrTC, and again he replied telling me to relax. Ramesh came back from office, and tried to make me drink water, but whatever I ate or drank just came out as such. I could not hold anything inside. We were both sitting on the bed in our bedroom, Ramesh was bringing many things like fruits, coffee and tender coconut..I could not have anything though I really wanted to. I took a sip of the sweet tender coconut, and suddenly it came out and I ran to the bathroom. I was exhausted. I could not even lie down. Night approached, and the vomit in my mouth tasted like some antibiotic. At around 10pm I had nothing left in me, and I vomited something red. (We suspected it was blood and I got very anxious and scared). Ramesh was massaging my back when I vomited, and he decided enough was enough- ‘Come,we’ll go to hospital. We need not wait any longer’. We drove to the hospital and reached at around 11 pm. (Even in that horrific stage I enjoyed the cold night drive through the city …as always). As soon as we reached I was taken to the labor room and admitted. The large room had around 10 beds with a nurses’ station and two toilets. The lady doctor in charge had a slight Non-Malayalee accent to her Malayalam, and she asked if I was pregnant. I said I wasn’t sure, just had my IVF. She wanted some urine for testing, and gave me a small plastic container to collect it. My body was completely dehydrated and I tried desperately to get 5 ml urine in the bottle. The nurse who took it from me gave an amused grin on seeing the quantity. They started giving me IV fluid drip. I requested the lady doctor to please inform DrTC. She called up and spoke to him, then came and gave some injection. In my half consciousness I felt that this might be my last night on earth. There was a sense of adventure to that thought, a wild thrill. Everything about the hospital became science fiction in my imagination and I thought about my poor husband waiting outside, about the love and bond we share, about the probable presence of a baby inside me, about my parents who would be so scared and yet impressed by my courage to face these things (since they know how weak and scared I am to even think about a hospital or an injection- and here I was getting loads of them, a drip and what not). I vomited again, lying down there. My whole body seems like it has stopped all functioning and I get this feeling that I might die soon, in the early morning hours, as it is long past midnight.

NEXT...OHSS

IVF in Kerala

Hopes and Dreams after IVF
We did IVF- ICSI and are waiting for the blood test results. Read here about the IVF
22-06-2011  2pm

The blood test is scheduled to be on 28-06-11. My classes will start on 02-07-11. I can probably take a week off, if it is needed, and ask my friend to pay my fees for me. I am anxious to get back, finish the course in flying colors. It is quite enjoyable, the experience of getting on the other side of the teaching platform again, to listen to those wonderful classes,and more than anything the friendships..Sari and Eva are filling a large part of my heart, I am enjoying each moment with them..going to canteen, doing the assignments, sharing the tensions, and talking endlessly..and I very much love my single room in the paying guest house, I like the owner of the house and it is too good to have Sari share the same accommodation. All in all the past year was like a dream, a pure joyful one at that..and in my mind I have absolutely no trace of doubt that the next year will be no different. I will return in July, come what may. It is good to be pregnant and studying, and when I finish the course, I don’t have to come back to the same old house shared by just the two of us..we will have a lovely little baby with us, to share everything we have, and to spread immeasurable joy in our lives..we will shift to my workplace so I won't have to travel anymore..may be my parents will come to stay with us for a while, and in the nights, we will all sit in the cool verandah and talk at length about everything..my parents’ lives, my life, our love story, our married life, our baby, and everything…My baby will make us all laugh contentedly with his/her giggles and sweet nothingness..oh God, please let it all happen..please let me be pregnant this time..please let me not see red stains on my undergarments this month too, and get that hopeless despair.Please let me see two lines on the self-check stick for pregnancy..and please let me get gold medal for my P.G..please God please..

On 28^th, the result of blood test should show betahCG above 100. Then I am positive. According to DrTC, there is no reason why it shouldn't be positive. He says this is the most ideal case of the month.there were eight embryos in all, two were discarded,three are frozen, and three were put back into my uterus.all embryos are healthy,I am quite healthy and capable of getting pregnant,in fact a lot like soil ready with all the nutrients and rain and everything, just waiting for a seed to fall on to it so it can blossom and reproduce. I am slightly unhappy that he transferred only three embryos. What is the chance of success? Anyway better three than two. Is there a chance that I’ll get twins? Likely..oohh..then it’ll be too good..one boy and one girl? Wow, that is only a dream,and I am even afraid to dream and hope, lest something might happen..

After the embryo transfer I am very hungry..could be that I am sitting idly at home watching movies,reading fiction,going online etc. and waiting for Ramesh to come from office so we can go out. A maid comes to cook and clean. Mily is here giving me company all day. I miss Karikkatta, our black kitten, who died recently. Mostly I lie down on the sofa and watch HBO or Star movies. Today is 22^nd, and there is ‘Hiss’ in Star plus. I had wanted to watch that movie for sometime..Mallika Sherawat turning into a snake or something. It s at 11pm, now it is only afternoon. I just had stomach full of rice, spicy sambar and very spicy pickle. There is a cramp in the stomach, a burning feeling. Must be the pickle. Stomach feels really full. Sort of like the feeling before ovulation. Ovulation time is medically manipulated, so this cramp doesn’t have anything to do with either ovulation or menstruation. This must be the pickle only..much like the burn from too much spice.

22-06-2011   11.30 pm

I feel like vomiting. I am online, searching the symptoms, and I find that I might be having something called OHSS (ovarian hyperstimulationsyndrome),caused by too much hormone within me.It has three stages-mild,moderate and severe.this must be the mild stage..it ll be ok. I was watching this ‘ Hiss’ movie, and it can make even normal stomachs to throw up with the slithering cobra coming out of the woman and stuff. So I switched off and went to sleep, constantly disturbed by nightmares and uneasiness in stomach. Once I vomited, then went back to sleep. Got up again, and here I am, looking for OHSS symptoms. I guess I should go back to sleep.

NEXT...I am terrified!

IVF and ICSI in Kerala

Once our decision to have a baby was taken strongly, we looked up our various options to do IVF and ICSI in Kerala, and based on our convenience and our friends' advice about the expertise of the infertility specialist there, we zeroed in on Lakshmi Hospital, and started our regular visits to Dr. Tity Chacko. During the first visit he collected a semen sample, and showed us through the microscope how the count and motility are tested. We actually saw the tiny sperms move! I had ultrasound scans which showed poly-cystic ovaries, but DrTC said they do not matter at all. In fact these cysts might be helpful in the treatment, he said. I do not know how that was possible, but it was very encouraging nevertheless. Then he gave us a brief about the treatment procedure. He said he would have suggested three months of attempting conception naturally, but in our case he found it best to start with IUI right away. In the next two months we tried regular IUIs, and in the third month he used a hormone injection. We also had hsG test to see if my fallopian tubes have any blockage. The test was supposed to be very painful, but since it did not involve any needles (at least none that I could see), I found the test to be okay. The results showed very much unblocked tubes. Afterwards he decided it was time to start IVF. 

We said we needed a break, especially because I was dead scared of injections. He said fine, anyway it was better not to do it in February-March due to the heat. Best to do in June-July. So we went back to our life and jobs. Meanwhile I had applied for my post graduation under quality improvement program and got admission at Chennai. So I had to leave in August (2010). We took a long break from the treatment (it hadn't even started properly!) and I immersed myself in studies. Ramesh stayed back at Kochi, with occasional visits to Chennai. My semester break after second semester came in June- one whole month of holidays-June 2011. The first two semesters went exceptionally well, I enjoyed the new place, new college, new-found thirst for knowledge, new friendships, new energy. My colleague and senior during my undergraduate course was also there, and she stayed in the same paying guest accommodation as me. In November 2010 my father had a severe cardiac arrest, and I came back and stayed at the hospital for a few days. We decided that we should continue the treatment- at least that much we should do for our parents, who are really desperate for a grandchild.

So I am home for the June vacation now. The day after I reached, we went and met DrTC, and asked if we could do IVF in the next year, after my course. He said it is always better to do it as early as possible- with each passing day, the success chances diminish. So we reasoned that if we do it now, and if I indeed get pregnant, I can still go back next month and complete the course. My delivery might come sometime in March, and may be I can take a month's leave then. My course might end sometime in May. I can still complete the course, and join back in June, and then again take a loss of pay leave for a few months to raise my baby. So we decided to go for it this June.

I think IVF and ICSI are such a routine procedures now, that I do not need to elaborate on them. Injections started. Everyday one injection for 10 days. Now I am numb to the pain. The needle does not scare me anymore. Quite used to it by now. So  had my last injection of the ten on 12th June 2011, late at night. I don't actually remember why it had to be around midnight. There has to be a day's gap between last injection day and egg collection day. My egg collection day was 14th. I was so scared and nervous. There was a waiting room next to an IVF operation theater where around ten of us ladies sat and waited our turn. My turn was third. I was taken inside, cleaned up like for surgery, and was given general anesthesia. When I woke up I felt no pain. Everything went wonderfully well. I was kept under observation till late afternoon, was allowed to eat only after a few hours (I felt very hungry), but other than that, nothing particular. We got back home late in the evening. Next day Ramesh went and gave collected semen for artificial insemination. They said the procedure would be ICSI.

On 16th we went again, and an IUI like procedure where the embryos were transferred back to my uterus. I asked DrTC how many eggs and how many embryos, and he said there were eight eggs, eight embryos, two were discarded, six were used, three transferred back to me and three are being kept frozen, so they can use it in the next cycle if this cycle is a failure.

Ramesh's cousin- Akka- is a pediatrician at the same hospital, and this was a blessing. She was there to help us and give advice whenever needed. DrTC kept saying during our entire treatment duration that I was extremely fertile, one of the best possible cases he has ever seen. If he was excited about it before IVF, now after embryo transfer he was absolutely happy that everything went so well, and said I have 99% success chance. I will know only on 28th, after the blood test.

NEXT.....Waiting and Hoping

IVF in Kerala

Why we did IVF

There is this very popular dialogue from a very popular Malayalam movie. The hero asks his friend- 'Why Vijaya, why didn't we think of this earlier?', and the friend says, 'Everything happens in its own due course, Dasa..' And the movie goes on to its hilarious sequences. Something similar happened in our married life also. People started asking us 'Why are you both not starting a family? It is high time! Go see a doctor!' 'Why aren't you finding clinics to do IVF in Kerala? It might cost a fortune, but it will be worth it!' 

We replied- 'Let God give, we shouldn't snatch from Him..' 

The real reason we did not go to a doctor was, I am dead scared of needles. And I have heard no treatments for infertility (especially IVF) is complete without poking needles all over. But I could not admit that, could I? If I do, then my own mind would start asking like, 'Is this pain fear greater than the desire for a baby?'. So we said- everything will happen in its due course, besides we should not snatch from God.. 

Okay, so why go and snatch now? 

'Hmm..er..God Himself says in Gita, that one should fulfill one's karma, right?'

Anyway, both of us had various reasons for making it late. For me, it was fear mainly. I had read and heard from many sources that the treatment procedure was painful. I had a terrible needle fear and had not taken any injections for twenty years. Now this treatment demands ten consecutive days of injection..Then there are a thousand stories of the side effects of the treatment..medicines which can cause long lasting health problems. Third reason was our office timings and both of us preferred going out and having fun in the evenings than going to a clinic. Also both of us had a general reluctance to take medicines. And then sheer procrastination. Most often the hormone raging ovulation days ended up in just a lot of tears. Thus precious months passed by us. Finally we visited a gynecologist, and tests there showed that our sperm count was close to zero (we did repeated tests, just to confirm), and we became painfully aware that it would be impossible to conceive naturally. The doctor prescribed some tablets, but even she was not very optimistic. Medicines did not help much except that my husband became even more short-tempered. I was very careful not to hurt his feelings or shake his confidence, which was very vulnerable at the moment. Things were not going very well, so together we decided to leave the treatment there, and moved on with life.

Months flew by. The anxiousness grew, especially because it was obvious that though my parents were not pressurizing us or even asking us about it, they wanted us to take a treatment. They wanted a grandchild. And I was an only daughter, so I was their only hope. Also all our younger cousins who were married became parents. So did our friends. It became impossible to hold a real conversation with a group of friends, because the conversation invariably drifted off to their kids and I was left without much to talk about. So we decided to start the treatment afresh, but this time we thought of doing some alternative medication.Our next visit was to a very good (and expensive) Homeopath. (Find the link to The Clinic). He does not really specialize in anything, but does an overall checkup (with not many equipments, just his senses) and finds out the general health condition of the patients and treats the root causes of the problems. He did a check-up, and prescribed-We should walk an hour a day, both of us together. Drink two glasses of fresh carrot juice(he even suggested a brand for the juicer!), Ramesh should avoid milk and all dairy products completely, and I should drink 3 litres of water everyday. He also prescribed one or two over-the-counter medicines, mostly vitamins and tablets for liver health. All these seemed easy to practice and hearty to do. But of course, the routines were broken many times- we did walk- with our dog- but the walk was done away with when we went for late night movies, or overnight site visits as part of our job. Carrot juice we did drink, and Ramesh completely avoided his favorite dairy items, except a little curd once in a month or so. After six months we did the sperm test again, and we couldn't really believe it- it showed a considerable rise in count and mobility!! Of course, this was not enough, but having a rise from zero 10 lakhs gave us a new ray of hope. (Actual minimal requirement being 30 million! We were not nearly close) We continued the same way for another six months, but too much precious time was being lost. By now it was 2007, I joined Engineering College as a Lecturer, started travelling 4 hours a day, to and fro, sometimes staying back at the work place in the hostel. Treatment lost steam. I crossed the dreaded 30 year old mark.Probably we were not mentally prepared to have a baby. Yes, that is a large factor. We weren't yet so sure that we wanted a baby for us. Were we wishing for the baby just to please our parents and relatives? Just to shut them up and prevent the regular questioning looks? Or was it to avail a rest period- a maternity leave of six months with pay (I always wished for that rest period- not having to rush to workplace everyday, yet get my paycheck)? Or was it to have an excuse every time we were asked to do something unpleasant?-like if I was required to go on a tour I did not wish to go, then if I had a baby I could always say the baby could not travel and I had to stay back to look after her. I was not sure if these were the reasons I wanted a baby, or if the need was genuine, if I was really prepared. When we are mentally prepared, when each atom in the body craves and cries out for a baby, pregnancy might happen, I thought. But, may be by then the body would be too old, and the situations might be against us. For couples who get pregnant naturally, easily, all these do not matter. They get pregnant first, and then prepare themselves. But not so easy for us. Finally, after many years I realized that I genuinely wanted a baby, or even babies. That vacuum in life solidified. Each atom in my body started longing for the baby. And then one day, in a crowded bus, I was sitting in the back seat when a man got in with a toddler. He was trying to get some space to stand and squeeze to the front part of the bus. So he asked me to look after the child and left him on my lap while he pushed ahead through the jam-packed bus. The kid sat on my lap till the stop where the dad got down, and while sitting, he tightly held my hand with his tiny palm. Then it struck me- to love a child I don't really need it to belong to me biologically.

                          

I thought about Mili, our dog. Then about my pet pigeons. If I could love these animals and birds with such passion and devotion, then why not a human child? Why should it matter if it biologically belongs to someone else? So the decision was made. We would try for our own baby, born from us, but if it does not happen, we would adopt a child with not a trace of apprehension. We would love the baby, as our own, why, the baby would be ours only. When I hold the baby close tight to my bosom, that warmth will be more than enough for me to give her all the love and affection in the world. And then there is another virtue-the satisfaction that comes with adopting an orphaned street puppy in contrast to one with a pedigree. To have a baby whom his or her parents abandoned, whom no one else would love completely- to have that baby and love him so completely. And to provide him with all the financial stability and comforts we have. Why would we need all these comforts and facilities and money for just the two of us? If we did not have kids to share it with us? Why this house? Why a job? And there was so much to give- we had to give it.So the decision was taken- to continue the treatment with more rigor and purpose, to forget the fears and pain, to do IVF two or three times. If it did not work out, then we would go ahead and adopt. And when the mind and the body prepared themselves fully, God knew the time was approaching. Through a friend He let us know about Lakshmi Hospital, and the good and kind, efficient doctors there. And we went to the hospital, to start the treatment from scratch.

I should mention here that later I found out that adoption was a much more complex, difficult process in India than doing any infertility treatment. But still I know for sure that if we were not successful with IVF, we would definitely have adopted. And it is something I really want to tell all couples undergoing treatment- do not worry if you do not have a baby biologically. Adopt a baby, and you will be happy. If you are not willing to do that, then maybe you are not yet mentally prepared to have a baby.

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