Our Journey for Parenthood via IVF.

This is my journal for our IVF process.  I will not publish this until we are ready to, probably after the first trimester if Linh gets pregnant.  But I will date each entry so that I can put my thoughts down and you can follow my emotional roller coaster as it develops.  

3/28/2015 

My wife Linh and I began family planning since the beginning of our relationship in 2006.  Linh was still in school for her BS in Education and we decided it would be best to wait until she finished school and earned her teaching credential.  In 2007, I decided to go back to school, so we delayed conceiving until I graduated with my Master's in Social Work.  In January 2012, we actively were trying to get pregnant.  Due to my spinal cord injury, it was a difficult process.  Without going into too much detail, I am able to have intercourse and ejaculate. After about 6 months, we began to worry.  In July 2013, I had my first semen analysis the results were not favorable: low sperm count and low mobility.  I was devastated, my manhood and my ability to reproduce was facing an uphill battle.

We decided to meet with the Kaiser REI clinic in Fremont in the spring of 2014. The doctor suggested we go straight into IVF (in vitro fertilization - I'll explain more later).  However, she allowed us to try a few cycles of IUI (intrauterine insemination).  IUI is the process of taking my sperm, cleaning it, and injecting them into my wife's uterus to try to conceive.  My wife did one round unmedicated and one round medicated.  During the medicated round, she took oral pills to stimulate more follicles. After two attempts, we gave up.  It was emotionally taxing and we both agreed it was best to wait and do IVF.  With IUI and my low sperm count/mobility, we only had less than a 5% chance of conceiving.  We went in knowing this but wanted to try it.  Fortunately, my insurance covered the IUI and it was only an office copay of $25.  Normally the procedure can cost closer to $1,000 per cycle/attempt.  

Now the road to IVF.  Our Kaiser insurance did not cover IVF, so I changed my medical insurance to one that did have coverage...in fact they covered 90%!  IVF normally costs up to $15,000-20,000 with medication and ICSI (I'll explain further).  With my insurance our copay was just over $1000.  In Vitro Fertilization is an intervention to assist people with conceiving by removing eggs from the female, sperm from the male, place them into a petri dish and hope the sperm can find the egg.  My wife calls this the base model of IVF.  Well with me, my swimmers ain't swimming!  So the next step is actually taking a single sperm and injecting them directly into an egg, this process is called intra-cytoplasmic sperm injection (ICSI).

We originally planned to do our IVF cycle in May, but since I had a job opportunity coming, we moved it up. In March, we began the hormone injections to prepare my wife for the egg retrieval.  The goal of the hormones are to ensure we can retrieve up to 20 eggs.  She responded well and we were able to retrieve 15 eggs last week and 11 were injected with my sperm.  The next day we received the fertilization report from the doctor and only 3 embryos survived and she said they looked "perfect" for 1 day embryos.  This is abnormally low and we became concerned.  Ideally, we should have had 8 fertilized embryos. We would not get another report until Saturday (today).  The two days in between were torture.  Did the embryos survive?  Are they multiplying and dividing like they should?  Are we going to have kids?  The unknown is torture.

This morning we received a call with the updated fertilization report.  ALL THREE EMBRYOS SURVIVED and have divided into 8 cell 3rd day embryos.  They are growing normally and look great.  Our IVF transfer appointment was reschedule from today to Monday so that we can allow the embryos grow into the blastocyst stage (google it).  Basically, this allows us to determine which embryos will be the strongest and has the highest potential for becoming babies.  We hope to transfer 2 and freeze 1 for the future.  Yes, I said TWO EMBRYOS.  Due to the high stress, the cost, and the difficulty to conceive, we figured let's "buy one and get one free."  Our doctor thinks that with Linh's perfect health/labs/etc, transferring 2 embryos will give us an 80% chance of conceiving a singleton, and 60% chance of conceiving twins. YUP TWINS!  We are ok with having twins and are prepared for it if it happens  (how much can you really be prepared for twins?!?!  LOL).  

This is our journey so far.

3/30/2015 9:00AM

Linh received a phone call from our doctor.  She stated that all three embryos are growing and two are graded: 5AA and 2BB.  The last one we do not know the grade.  Basically 5AA the embryo is in the blastocyst stage of development and is very ideal.  The 2BB embryo is still developing into a blastocyst.  We have a 12:45 appointment and we have decided to transfer the two stronger embryos.  The last one will remain in the incubator to allow it to develop further so that it can be viable for cryogenic freezing for future use.

3/30/2015 9:37PM
It's just surreal.  We went into the IVF transfer room and I was full of excitement.  The nurse comes in and preps Linh for the transfer, we sign some paperwork, and she hands us a picture of our embryos.  Yes!  Pictures of our potential baby or babies!  As stated earlier, our doctor expects an 80% chance that we have a singleton and 60% chance for twins since we are using two embryos for the transfer.

Our babies!  Well at this stage 5AA and 2BB embryos.


3/31/2015
My wife informs me that our doctor left a message stating that the last embryo was able to grow into a 5AA and was viable for freezing.  Amazing news!  We have one opportunity for another transfer in the future if we decide to have another baby.

4/2/2015
My wife said I wasn't very supportive over the past two days.  We had a small argument and she was very emotional.  I explained to her yesterday that I didn't have the opportunity to adjust to her emotional mood swings caused by the hormones and the embryos being transferred into her body.  Of course I want to be there to support, love, protect, and be her security blanket.  We have had communication problems through out our relationship but we have always been able to communicate well enough to resolve the issue at hand.  I told her last night that I will give it my all to ensure she feels safe and can be emotional with me.  She is technically carrying my child (children) and I have to support her the best I can.  If you are reading this...I LOVE YOU!

Regarding the embryos, I'm keep researching and reading blogs and articles about IVF and pregnancy.  When will the embryos attach to the uterine lining?  How many cells are each embryo now?  The unknown is very dark for me and it scares the living sh*t out of me.  Not knowing if we are actually pregnant, not knowing how many embryos attached, am I going to be a dad?  All of this is frightening and we just don't know until my wife takes the pregnancy test that is scheduled on April 8, 2015.  I do my best not to think of it, but It's a constant irritant in the back of my head.

4/8/2015 - The Results Are In!
I've been anxious about this day.  Over the past week, Linh has complained about sore and full breasts, one of the many symptoms of pregnancy.  For the past few days I've been looking up anything I can find about parenting from a wheelchair with very little results.  I think this blog will have a large section about parenting from a wheelchair for others to learn from me and my mistakes and accomplishments.

Today Linh went to give a blood sample to test if we are pregnant or not.  Her appointment was at 9:00AM and was told we should have a phone call after 1:00PM with the results.  Our doctor calls Linh with great news, we are pregnant.  Linh calls me right away and tells me the good news, I couldn't believe it and asked her if she was f-ing with me.  Her HCG numbers are pretty high so we might have a chance of having twins.  Linh has an appointment for a 2nd confirming blood test on Friday 4/10/2015 and then a sonogram in two weeks to confirm if we have a singleton or twins.  Either way, I'M GOING TO BE A DAD!!!

4/22/2015 - Our first ultrasound
What an amazing experience!  At this ultrasound we found out if we are having a singleton or twins...well it's TWINS!  We are so excited and can't wait to find out the sexes!  We also were able to hear the heartbeats of each of our baby.  Both heartbeats were strong at 170-180 bps.

5/6/2015 - Last ultrasound @ Reproductive Science Center
Today was our last visit at RSC as we "graduate" from our infertility doctor to an OB/GYN.  During the ultra sound we saw our children dancing...they look like dancing jelly beans!  I watch this video often and shared it with our immediate family and a handful of friends.  It's amazing to see life growing inside my wife.

Fast forward.  Today is June 3, 2015 and last night Linh allowed me to announce our great news on social media and now I'm adding my new post to my blog.  What an amazing journey so far and the twins are not even born yet!  We started to try to conceive in January 2012...3.5 years ago.  After two failed IUI attempts, switching insurances, then rushing to start the IVF because of a job change, we ended up pregnant with twins!  December 15, 2015 is the official due date, however, since we are expecting twins, it will be about 4 weeks earlier.

Here is our announcement photo.  We are huge Oakland A's fans, we are season ticket holders and had our first "non-date" at an A's game in 2006.

Samuel Merritt University: SCI Education for PT Students

For the past few years, I have been invited to help teach a class on spinal cord injuries to second year physical therapy students at Samuel Merritt University in Oakland.  This is my fourth (maybe 5th) year helping this class.  Individuals with SCI are invited to share our stories of our spinal cord injury, sit in an open forum for discussion, and then we become the guinea pigs for the students to do the ASIA (American Spinal Injury Association) exam to test our sensory and functional levels.  We were not allowed to reveal our level of injuries until after the students complete their assessments and report their findings.

It's amazing to see the passion and enthusiasm that these students have in learning from us.  We are able to provide our insight and perspective of our SCI.  Each year I tell the students that it is them, the physical therapist, that builds a foundation of knowledge and skills that we, the wheelchair users, use for the rest of our lives.  I reveal to them the relationship I have with Kelly R., my PT during my rehabilitation.  He is one of the main reasons why I have been so active after my SCI.  He taught me the wheelchair skills, increased my self-esteem, and gave me confidence to conquer all the obstacles I would face in the world built for able-body individuals.   I find it very important to educate these students on how important their job is when working with individuals with SCI and other disabilities. Once again, it was another great class of students and I am confident they will become great physical therapists.

I had a discussion after class with both of the instructors about doing a presentation or lecture to educate the class even further about the psycho-social implications of a SCI for newly injured individuals.  In this lecture I would discuss: 1) why it is important for the students to understand the psychological and sociological changes that these patients are experiencing 2) how to build rapport to foster a safe environment and provide necessary motivation for each patient to be successful in acute rehabilitation.  Of course, this presentation/lecture would be effective as an in-service to all disciplines (PT, OT, SLP, RT, MD, and MSW) who are involved in the acute and outpatient rehabilitation setting.  I hope I have an opportunity to do so and will discuss it further with the instructors and my department when I begin working at Summit.  This is going to be amazing!

Noah's Little League Game

One of my hobbies (whenever I have spare time, which is very little)...photography.  Here are some pictures from my nephew's little league game today.  My brother-in-law, is the team manager.  My 2 y.o. niece Olivia is in the last picture.  I used my Canon 6D with my friend's Canon 70-200/F2.8 USMII lens.  I need to buy this lens one day!

So much going on in 2015

2015 has been a great year for me so far in my personal, athletic, and professional life.  So what's going on?  First, lets talk about work.  My former physical therapist and friend Kelly suggested I email my resume to his manager regarding a Medical Social Worker position that is opening up at Alta Bates Summit Medical Center in Oakland for the Acute Rehabilitation department.  With overwhelming support from people I knew through referrals and recommendations, and of course "blowing them out of the water" in my interview, I was offered the job.  This is as close as it can get for me for a dream job, the only way it can be better if I worked with pediatrics in acute rehab.  When I went back to school to be a medical social worker, I had a goal to work with others with disability and to work for a rehabilitation unit.  Well, at Summit I will be able to work with individuals with spinal cord injuries, traumatic brain injuries, stroke, and other diagnosis in a rehab setting...PERFECT!  I only graduated from San Jose State University in May 2013 and did not expect to land this type of position for at least 5-10 years.  What's even better than working with this population?  The HUGE raise and free medical benefits...AWESOME.  I start this job in mid April.

Athletically I have a new challenged that I wanted to do.  This year I turn 35 and I was considering what I can do to improve my health even more than the usual sports I am doing...triathlons!  I contacted the Oakland Triathlon Club and got a great response from the president of the club.  With his support and the teams support I am training to complete my first para-triathlon this summer.  Most events will have a 1/2 mile swim, about 13 mile bike ride, and a 3.1 mile run.  This is going to be an amazing journey.  This is my version of a mid-life crisis, HAHA!  Being healthy is the main goal but depending on how well I can do, this might be my new sport/lifestyle.

Personally, we have decided to move onward with the IVF process.  Due to my spinal cord injury, I am not able to conceive naturally so we will need assistance.  Details will come in the near future as I agreed with my wife that I would not publish anything until later.

I'm a Survivor Part III: Spinal Cord Injury

As I've mentioned, I've encountered many tragedies.  In my third installment, I will discuss something most people will consider a tragedy.  However, I don't consider it a tragedy, I consider it as my rebirth: Spinal Cord Injury.

Spinal Cord Injury

On August 25, 2002, I was hanging out with my friends for a planned car cruise through Skyline Blvd, Highway 9, and Highway 84 with the now debunked streetracing.org.  These are local windy road that lots of car/motorcycle enthusiasts would drive and enjoy on the S.F. Peninsula.  If I remember correctly we had 100+ cars that day for a beautiful "cruise."  I use parenthesizes for cruise because we exceeded the speed limit much of the time as most car enthusiasts would where driving together. After about 30 minutes we decided to stop for a break and we parked.  Since I was a passenger and not driving, I jumped out of the car and jumped on top of a barrier.  Little did I know, we were actually parked on a bridge and I freaked out and fell about 30-40 to a dry creek bed.  When I landed, I knew already that I was paralyzed because I couldn't feel my legs.  If I remember correctly, I was fully awake, feeling all of the pain.  I remember looking up and seeing my friends faces, faces full of fear, full of pain...something I hope I never see again.

Paramedics were called and I was injected with some WELL NEEDED morphine.  I pass out due to shock.  I wake up for a short instance while I was being carried out into the ambulance, I pass out again.  The next memory was being carried into a helicopter at the local high school football field.  What a great way to have my first helicopter ride, right?  In the air I was told I was going to Stanford Medical Center but I was diverted to Santa Clara Valley Medical Center (SCVMC) in San Jose.  I arrive at SCVMC and into the emergency room where they stabilized me and eventually transferred me to the ICU.  Fortunately for me, SCVMC has one of the best trauma units and one of the best Spinal Cord Injury units in Northern California.  While all of this was happening, my friends contacted my sister, my girlfriend at the time, and other friends and family.  I don't remember how many people were in the waiting room but from the pictures, it was well over 30 people.  This support from my family and friends has carried me through my "rebirth."

In the ICU, I was in this contraption, this "bed."  I don't know the name of the hospital bed, but it rotated in a 360 degree horizontal head-to-feet axis.  If you watched the movie Dragon: The Bruce Lee Story, you know what I'm talking about.  In the movie Bruce Lee was also in a bed similar to the one I was in after he broke his back in a fight.  I was strapped into it and it would rotate every few minutes throughout the day and night.  If I fell asleep looking at the ceiling, at times I would wake up facing the wall, other times facing the ground...very annoying.  The purpose of this bed was to prevent pressure sores as I waited for my surgery which was one week after my injury.

In my first discussion with my doctor, he shared the dreaded news that I already knew.  I had a compression fracture in my thoracic region of my back and some broken ribs.  The fracture in my spine was at T7/T8 which partially severed my spinal cord causing a complete ASIA A spinal cord injury (SCI).  The American Spinal Injury Association (ASIA) impairment scale grades the level of  impairment of a SCI from ASIA A, complete impairment below the level of injury to ASIA E, which is normal or no impairment.  To clarify, T7/T8 is approximately where my sternum is.  From that level down, I have no sensation or motor function.  I do have a small band below T8 that has awkward or prickly sensation, which is more bothersome than good.  What does this really mean in layman's terms?  Below my injury level, I have NO FUNCTION that I can control.  I can't use my legs to walk, urinate normally, or have normal bowel movements.  Now you're wondering, can he have sex?  Yes, I can have an erection thanks to pharmaceuticals such as Viagra and Levitra.

Here's an infographic that I've found on internet so you have an idea of what I'm talking about.

So after one week, I had surgery to fuse my T7 and T8 and have Harrington rods installed to support my back from T1-T12.  Harrington Rods are metal rods made of titanium and are screwed and wired into my back.  I cannot twist or bend throughout my thoracic region of my back, I can only twist or bend above at my neck and below at my waist. After a day or two from recovering from my surgery, I was cleared to have some light rehabilitation with physical therapists and occupational therapists.  This is why I call it a rebirth, I have to learn how to do EVERYTHING over again.  How to push in a wheelchair, how to change my clothes, how to open a door, how to cook and clean, how to use the bathroom...it has all changed.  This was a very hard process and it caused a lot of anger and frustration, but it had to be done.

One more week passed and now I'm transferring to my in-network hospital in Berkeley at Alta Bates Herrick hospital.  I met my favorite physical therapist, Kelly R., and he pushed me to my limits in physical therapy.  He gave me a great foundation in which I can conquer all obstacles that I face.  He gave me the encouragement and support through my frustrating days.  To this day, Kelly and I speak often and I even help him teach in a PT class at Samuel Merritt College about SCI and the student have an opportunity to practice the ASIA exam on me and ask me personal questions to gain knowledge of my perception of life as a person that uses a wheelchair.  After about three weeks at Herrick and I'm discharged.

Crap...where do I live now?  My apartment isn't wheelchair accessible because it's on the second floor.  My parent's house that my sister and I owned is not wheelchair accessible.  My sister and I decided to live together and rent an apartment in Jack London Square in Oakland but was not ready until the first of December.  Now I needed to find a place for two weeks.  My god-mother Joanne was nice enough to have some ramps built in her house and allowed me to stay there until we were ready to move into our apartment.  She had a guest room with a bathroom that was somewhat accessible.  It worked until we moved into our apartment.

At this point, it was been about 3 months from injury to moving into our apartment.  My sister was my largest supporter.  She stayed with me at the hospital almost every night.  She would go to college, then work, then would sleep on the little pull out bed next to me in my room.  She would study for a few ours then do it all over again the next day.  She gave me a shoulder to cry on, she gave me encouragement through my frustrations.  Lynda was there every minute that she could and I appreciate all of it.  I owe her so much and I will never be able to repay her for it.  This process made us very close and I'm happy to have such a wonderful loving and nurturing sister.  The apple doesn't fall far from the tree, she and my mom are so much alike.  I love you Lynda.

So, that's what I went through when I became a paraplegic.  It's crazy to think back and remember all of this.  It has been twelve and a half years since my injury and I'm still living and enjoying life.  These first three blog entries are to give you an idea of what I've been through.  I have a B.A. in Sociology and a Master's of Social Work degree, I find it important that you know and understand my past to understand who I am as a person.  This blog will continue to share my vulnerabilities, and accomplishments as I face life as an individual with a SCI.

I'm a Survivor Part II: Murder/Suicide

As I mentioned in my first post, I will have to share some intimate personal information so that you can understand me.  I am not here for a pity party but I am here to educate you, the reader, on who I am and why I am.  I've encountered many tragedies and this one is very hard for me to share...but it's important.  I'll provide an overview of it but will not go into full detail

Murder/Suicide

Family life was always difficult for us.  My father was a militant/authoritarian type disciplinary yet loving father.  My mother was a very loving, nurturing and very supportive on everything I've done.  My father tended to drink a lot would use his loud Khmer dialect to yell and scold us.  At times he would use his hands and many other objects around the house to discipline me and my family.  There are many times when the police would be called to help us and protect us, but no charges would ever be made.  When I was 12 years old, I was finally old enough and strong enough to stand up to him and fight back.  After that, our relationship deteriorated even further.

Unfortunately this is quite typical in a lot of Cambodian and Southeast Asian families, but domestic violence will always be wrong.  My father had a few strokes within the last few years of his life.  My father was always depressed and angry.  The Khmer Rouge left a lifetime of pain for him.  Today with my education as a Medical Social Worker, I'm certain that he would be diagnosed with depression and PTSD (post traumatic stress disorder) caused by the war in Cambodia.

Fast forward to December 2000.  One night, I can home from hanging out with my friends.  With his breath smelling like Hennessy, my dad wanted to talk to me.  At this point of our relationship we didn't talk so I knew something was wrong.  He asked me if I can take care of the family if he and my mother weren't around.  We began to argue and it escalated fast.  I look for my mom and find her in bed, not resting, but dead.  I was enraged and started to yell "why?"  Tears filled my eyes and I fight with my father, after knocking him down on the ground, he pulled out his newly purchased gun, put it his mouth and pulled the trigger.

To this day, December 9th of each year I have a breakdown.  As time passes, it gets easier.  Most people say time heals wounds, but not this...not for me.  I will never forget what I saw that night.  No one in this world deserves to see what I have seen and it's imprinted in my head.  I've suffered from PTSD and depression, but I never let anyone see it.  I've suffered from grief and guilt that I haven't been able to shake.  I had to see counselling when I was attending San Jose State University because I was taking a domestic violence class that brought back so many bad memories.  I had a mental break in August 2013, when I became depressed because I graduated with my MSW and couldn't find a job and had a pressure sore that kept me limited in what I could do.  During counselling I learned that I have not had closure because of the murder/suicide.  I always told my mom that I would protect her from him...I didn't.  I did my best, but I wasn't there that night.  My counselor reminded me that I would not always be able to be by her side to protect her and this is not my fault.

This by no means is a way for me to seek pity from you.  This is a way for you to see how my upbringing was and why I am who I am today.  I stay busy so that I don't think about my past.  I use my family time as a way to rebuild the family we have.  I have a beautiful wife that supports me in everything I do.  I have a beautiful sister that has given me the pleasure of having two nephews and a niece.

As a kid, I played tennis, baseball, football, basketball, roller hockey, ice hockey, swam competitively, raced BMX bikes, snowboarded.  Today, even after my spinal cord injury, I play and have participated in wheelchair basketball, wheelchair tennis, monoski (skiing for person's with disabilities), sled hockey, handcycling, water skiied, kayak, and now I started swimming and training for a para-triathlon.  I stay as busy as I can because it's so painful to just sit and think about my past.

Sports and recreation is a way for me to escape my own mind, the shadow that chases after me.  I still have my nightmares and endless nights of unrest, but I am coping and surviving.  I've gained strength and perseverance through this tragedy and it has helped me through my next chapter in life that happened on August 25, 2002: Spinal Cord Injury

I am a Survivor Part I: Khmer Rouge

This will be my first ever post as a blogger.  The goal of this blog is to share my knowledge and experiences as I live my life with a spinal cord injury and as a person who uses a wheelchair.  So hopefully the read will not be too dry.  When it comes down to it, why should you read my blog?  Who is Steve Lau?  It just depends on who you ask.  I have a very unique perspective in life because of my life experiences.  I am usually not too open about my past because it is so painful, but this blog will expose many of my past life experiences that can be personal, painful and intimate.  This way you can understand where I'm coming from and why I am who I am.

So who is Steve Lau?  I really hate using labels, but to describe myself and explain who I am to you, I will use one label.  I am a Survivor: Khmer Rouge, murder/suicide, and a spinal cord injury.

Tragedy #1: I survived the Khmer Rouge regime.

I am a Cambodian Refugee who was born in a refugee camp in Thailand in September of 1980.  The Khmer Rouge regime was a communist party that wanted to bring the Cambodian society to "year zero" by killing all of the citizens who where educated, business owners, and who can stand up against them.  My father was targeted because he was educated and a successful business owner, from the stories my father and other family members told me, he was quite wealthy in Cambodia.  My father, mother (about 6 months pregnant with me in her womb) escaped Cambodia in 1980 and left their home in Phnom Penh to the Thailand border by foot with many days of monsoons, the lack of food and sleep, the fear of the Khmer Rouge military catching up to them, gunfire in the distance, and military shells falling from the skies.  After I was born in the refugee camp, we were sponsored by a family in Lansing, New York and we escaped, survived, and had new hope for a prosperous life in the United States.  We only stayed in Lansing, New York for 3 years.  My sister Lynda was born in Ithaca, NY in 1982 and my dad decided to move us across the country to join some family and friends that settled in the San Francisco Bay Area.  Oakland, CA is where we settled down and I love this city.  I currently live in San Leandro, CA, but my wife and I plan on moving back when we can afford to buy a house in a safe neighborhood.

There is a lot more to say about this life experience, but I just don't have time to discuss this further.  Maybe one day in a book.  I've had numerous people tell me I need to write one, I'll start with this blog.  The next installment of "I am a Survivor" will be a hard one to write, give me a few days to put my thoughts down on paper.