Executive functioning and IVF

November 22, 2019 3:55 PM

My executive functioning has not been the best since I had a concussion this past spring, and I'm about to start my first IVF cycle, which has me worried about coordinating everything that needs to happen for it. I need help!

Specifically, I have been having difficulty making and carrying out plans. So, for example, a while ago I knew I needed to go to the grocery store and then was surprised when there were no groceries. The middle bits (making a list, actually going to do the thing) just completely disappeared. I am concerned that when it comes to the IVF cycle (calling the insurance company, calling the pharmacy, going to the pharmacy to pick up the drugs, giving myself the injections, coordinating with the sperm bank and doctor's office to ensure the donor sperm arrives in time, going to all of the appointments, etc.) I am going to miss something important.

I do best with small, discrete tasks when they are written down in front of me.

Is there some sort of, I dunno, IVF planner or app? My nurse gave me a calendar of medications but it's missing a lot (e.g., how to get the dang meds in the first place).

More general recommendations are also welcome. I used to be the person who just held everything in her head at all times, so I'm really struggling with finding alternate strategies for daily living!

posted by coppermoss to Health & Fitness (6 answers total)

Not to freak you out too much, but when you do get pregnant you'll need all these coping mechanisms too. My brain on pregnancy hormones sounds exactly what you are describing for post concussion brain (not sure if the change is permanent yet). I used to be able to remember the tiniest of details from meetings months ago, now I remember nothing.

I have found making a calendar that I check multiple times a day and schedule out everything on. Walks, pills, meetings, tasks... For tasks I assign a time when it will be done. Much more effective than just a to-do list. I also keep to a daily routine for all daily maintenance items (vitamins after dinner in a certain order), etc. Helps me remember what I have done so far and what's next.

Good luck with everything! Sending all the good thoughts your way :)
posted by KMoney at 4:13 PM on November 22, 2019

I have terrible executive function. I always have. My key coping strategies are writing everything down (sometimes I’ll tell myself oh I’ll be able to remember this but IT’S A LIE I WON’T don’t lie to yourself like I do) and liberal use of reminders/alerts/alarms on my phone. For things like appointments, I’ll set up reminders a day before, an hour before, and 15 minutes before (or however long it would take me to get there if I didn’t leave until the reminder went off). I used to space on appointments ALL THE TIME before doing that. Also, get in the habit of scanning your calendar every morning.

Specific advice for the things you mentioned:

Meds: My (IUI for me, but they’re also used for IVF) meds were delivered. After my RE called in the prescription, the pharmacy contacted me and said hey, what delivery window would you like? Then they just live in the fridge. Set up alerts on your phone for doing the shots if you want more reminders than the schedule from the nurse.

Sperm: Does your clinic charge for storage? If not, just go ahead and get it shipped now. Ask your clinic what they need from you for the delivery. They’ll tell you how to address the order, if there’s anything to else to let the sperm bank know, etc. They will probably also send you a form to fill out. My clinic wants the sperm on hand by the time my cycle starts, so if you aren’t ready to ship now, aim to do it at least a week before that. If that’s a ways away, set up an alert now so that you don’t forget by the time it rolls around.

Appointments: Along with all my alerts, my clinic texts me reminders the night before appointments. If you’re able to schedule appointments for roughly the same time each time, that will also help you keep track. If you do before-work appointments, make sure to adjust your morning alarm accordingly.

If you have some sort of cycle coordinator, don’t be shy about asking them all the questions. I email mine...a lot.

Good luck! You got this.
posted by tan_coul at 5:36 PM on November 22, 2019

I did IVF the last time in 2009 so there was no app per se, but this is seriously smack dab in the wheelhouse of your IVF nurse/coordinator. They are the gate keepers of information and can help you figure everything out. There is no reason you should have to try to figure out where to get your meds, the schedule that you should take them on, etc. It is in their best interest to spoon feed you this information as much as possible, because one small hiccup will kill the cycle (not saying this to scare you but to impress that IVF clinics are MASTERS at planning and should be sharing ALL of the information with you).
posted by tafetta, darling! at 7:01 PM on November 22, 2019 [2 favorites]

IVF is complicated to a sickening degree. You will have to be a patient, accountant, coordinator, and medical ombudsperson all in one -- often with no pants on. You are wise to know your limits and prepare yourself.

Things that worked for me:

• Keep your own notes each appointment and look over them with your nurse at your next visit.
• When they give you the date and time for your next appointment, put it in your phone and show it to them, asking "is this right?" Neither clinic I went to gave out appointment cards. For the life of me, I don't know why.
• If you have a local option for medication delivery, seize it. Alto changed my life.
• Nthing phone alarms. Notes on pillows work well, too.
• Pill organizers are nice. I put notes in mine as well as pills.
• If no one introduces themself as your specific case coordinator, ask who is. If the clinic doesn't assign you one specifically, pick the nurse you like best. One point of contact is a beautiful thing.
• Leading up to the procedure, I had BIG trouble remembering not to drink water. A couple of times, on autopilot, I took a big swig from the bathroom cup before catching myself and spitting it out. The day before the procedure, consider moving or hiding your usual water cups, if you have any.

If it helps to know -- and it absolutely may not -- clinics and patients make mistakes. All. The. Time. Even very good practices and very sharp coordinators and very alert patients who are trying their best to get everything right. My clinic(s) have forgotten to schedule procedures, gotten my history wrong, called in wrong prescriptions, and forgotten to have me sign needed paperwork. I've missed messages about dosages, given myself a shot on the wrong day (cycle went ahead anyway), and forgotten a shot altogether (cycle got scrapped). If your clinic makes a mistake, you have the right to ask how they intend to fix it. If you make a mistake, you have the right to forgive yourself.

It's hard. I'm sorry it's so hard. Be gentle with yourself.

Good luck.
posted by AteYourLembas at 7:52 PM on November 22, 2019

I do not have an issue with executive functions but things I did to keep myself organised:

- Multiple calendar reminders for appointments. Basically you put in the appointment but you also put in another appointment reminding you of the appointment (ie “scan tomorrow”, “scan today”)
- Use your reminder app with the recurring function to alert you about your injections. Put in multiple reminders like the calendar appointments to remind you of an upcoming injection time. When the alarm for injection goes off drop whatever you are doing and do the injection. Full stop. Do not finish your meal, or reading that email or whatever. Stop and go.
- Put ALL your supplies into one bag. Some injections need to be refrigerated so one of those lunch cool bags is fine and you can store in your fridge. Put all the solutions, syringes, sterilisation wipes, band aids whatever you need, in there so it’s all in one place and ready to go.
- Decide where you want to do the shots and always do them there. Bedroom, bathroom, on the couch, doesn’t matter. Somewhere comfortable with good lighting. Couch under a lamp was my spot. This is now your designated Injection spot. Always do it here. This will help develop a habit so you will need to think less about it.

On preview, my tips make it sound very strict but it’s just tips to help you be vigilant. There is definitely a bit more wiggle room than you think so always get in touch with the clinic if you miss a shot or are late and they will talk you through it. So don’t overly stress about it! Just do your best and let the clinic help you as much as they can. They want you to succeed too!

Good luck!
posted by like_neon at 12:49 PM on November 23, 2019

Re: getting your meds. Ask your coordinator! Just order from where they say. Sure you could maybe save some money by searching around but I don’t think that would be worth it for you maybe. I often just bought my meds from the pharmacy downstairs from the hospital for a premium, just to be sure I had them in hand that day.
posted by like_neon at 12:57 PM on November 23, 2019