Re-entry Syndrome - like a car crash

I have been back almost a month now from Ghana, but it has taken this long for things to settle down and for life to get back to a semi-normal state.

Re-acclimating to home after being abroad has been quite tough.  Especially after being abroad in a developing nation and being exposed to things I could not help with or change.  Ghana was a life changing experience that was amazing and wonderful, but at the same time heart wrenchingly sad and depressing.  Returning and re-entering into my own country in just 14 short hours door-to-door was a complete culture shock - bright lights, consumerism galore, excessive waste, loud noises, an array of different smells... even the cleanliness was overwhelming.  Trying to acclimate back into my "normal" life was hard.  I felt sad for all those in Ghana whom I left behind that had so little.  I felt guilty for how much we have in our country and how over-indulgent we are without apology.  I felt isolated because no one I know here can actually understand what I have been through and then there are others who are purely not interested.  I met up with one friend who said she wanted to hear all about my trip, but then talked about her life the entire time.  It felt surreal - like all this was not really happening to me; as if Ghana never happened.  It was a sudden jolt, like a car crash, back into my life that I have known for a year, but yet, it was all different.  I am now different.   

This is what is called re-entry syndrome.  It is a real, psychological response that many people - aid workers, soldiers, prisoners - experience when returning to their former life.  It is quite an adjustment.

To top it all off, I came home to find out that my husband was not leaving in the middle of October like we thought, but rather 3 short days later.  That was a hard pill to swallow.  I ended up crying for 3 days straight.

The day my husband left was my first official day of IVF.  I dropped my husband off at the airport in the morning and then went for my IVF counselling alone.  My RE and her nurse were beyond supportive, giving me big hugs and trying to make me laugh.  It was so sweet that they were there for me when I was at my lowest, feeling so alone and bereft.  

My RE took a look at my ovaries via ultrasound (US) and found that my right one had a dominant follicle.  Even though I was taking OCPs, my body was still trying to ovulate.  This was going to postpone the beginning of my injectables and my egg retrieval.  My RE gave me another prescription to take - Aygestin, a progesin - daily with my OCPs to further suppress my follicular development for another week and 3 days.  I have had 2 more US since then and my follicle has slowly decreased in size with my estrogen levels lowering as well.

Today, I had another US and my follicle, which was 20 mm, is now 16 mm and collapsing in on itself.  My estrogen levels are down as well, and that means we are good to go to start the injectables!!!

I start my Lupron, 10 units subq, tonight and then 10 units in a.m. and p.m. until Saturday.  Then Saturday is D-day where I begin my Gonal-F and Menopur.  All fingers and toes crossed for a successful egg retrieval around 8-10 of November and embryo transfer 3-5 days later!

Wow.  This month has been a whirlwind.  I have struggled with transitioning back to my life from Ghana, then 3 short days later I had to re-transition to living life without my husband, my best friend, and finally now - almost a month later - I am getting back on my feet, I am feeling like things are flowing again, and I am having hope for the first time that I may just get lucky and have a baby in 2012.

Goodbye for September!

I'm off to Ghana for a month to do some midwifery work in Takoradi, near Accra and then swinging through Europe to visit friends before I return back home.  I will return to the blog in October to share all my wonderful stories from Ghana and the experiences I had there.

Au revoir!

Ready, Set, Ghana

I booked my airline tickets about a month ago and today I finalised my balance payment.

It is official!

I am going to Accra, Ghana, Takoradi more specifically, in September. I am so excited I can barely contain myself!

I am going to be working with Work the World - a UK based company that provides medical, dental, nursing, midwifery and physiotherapy electives and placements in Africa, Asia and South America.

In the UK, unlike the US, nursing students and midwifery students do electives abroad during their training and some even do gap year placements. My university had nothing on offer for a study abroad program, so I have decided to create my own experience via Work the World, a company I had heard about from other midwives and nurses when I worked at Guy's and St Thomas' NHS Foundation Trust.

As I have never been to anywhere in Africa, I was not sure where to go, but chose Ghana as it is a placement that allows for direct and highly involved care. There are 3 other locations in Africa - Dar es Salaam, Mwanza and Arusha, Tanzania, but for some reason Takoradi, Ghana spoke to me. The testimonials from other midwives in Ghana are quite inspiring as well and are what helped confirm my choice.

I am quite excited to go... a bit nervous, as always when I travel to a new country and do not know what to expect, but more agog and breathless than anything. I feel assured that Work the World will take good care of me and provide an easy and engaging experience. The process thus far as been worry-free. Work the World provides a 'My Trip' webpage for each candidate and it has easy hyperlinks to click through to learn everything possible about your upcoming trip along with what to do and when. My last 'to-do' is to secure my visa and pick up my malaria tabs.

Easy peasy.

Ghana bound

I have decided to do an elective in Ghana via Work the World in September when I am on my 3 week break between summer and fall terms. There I will be working in a hospital in Takoradi - a 4 hour drive west of Accra along the coast of the Gulf of Guinea. The experiences other midwives and students have had sound phenomenal. I am quite excited to go, albeit a bit nervous as I have never been to Africa and do not know what to expect of the country or the healthcare. I imagine it will be quite shocking at first and not at all what we are use to in our Western industrialised nations.

To enter Ghana I had to have a pre-travel appointment with the travel clinic and found I needed both Typhoid (only good for 5 years and my last was in 1991) and Yellow Fever, which certification of receipt is required to enter Ghana. Upon receiving the news that I was not pregnant (again) I quickly secured my vaccinations since you cannot take either whilst pregnant due to the live viruses they contain.

This now delays my next IUI since I need to wait a month before trying to conceive after taking these vaccinations. I was a bit skeptical about trying another round of IUI in May though, as both Malaria meds are pregnancy C category and if pregnant, I cannot take Doxycycline at all. I also read that mosquitos are more attracted to pregnant women (hence why many pregnant women in Ghana also have malaria), so I am a bit leery about that. I am following up with my physician to ensure it will be okay to be pregnant and go to Ghana. I definitely do not want to work so hard to get pregnant to then put my baby or myself at risk of being infected with a disease.

I have asked for a consultation with my physician, but it seems that all appointments are booked up for consults until May. That is a bit disappointing. I am hoping to get in before we do our next round as I would like to discuss our short term and long term options. Obviously I know we can do another 2 rounds of IUI, but there are further issues to contemplate. I will be gone to Ghana for 3 weeks in September, and sometime around September my husband will also be leaving on business for 4+ months. We hope to inquire about sperm freezing as well as speak about our options with IVF to include how it would work if my husband is gone, financing, risks, etc. I never thought I would consider IVF, but it looks like we are heading that way. I just do not know how it will work with me being out of country most of September and my husband leaving the same month. Possibly we have to do egg retrieval and insemination before he leaves with implantation after I return? These are the questions I would like to learn answers to.

I will be 39 this November. I feel like my time is running out. I want to be pregnant before I turn 40 as success rates after 40 drastically decrease while risks of Down's Syndrome and other age related issues increase.

Gosh. Hoping for a miracle!