Tuesday, August 30, 2011

close call

Ugh, yesterday was stressful. I actually woke up in a good mood, even though it was much earlier than usual, but I had a terrible blood draw experience. Then at 9:50 I had my ultrasound at my OBGYN and they found a 17mm cyst.
Of course the RE’s office didn’t call me until about 4PM, so all day I worried and stressed and catastrophized about what this meant. Really the worst case scenario was that my cycle would be pushed back a few weeks, right? But my level of anxiety was really not proportional to that outcome.
I just really hate the feeling of waiting for a phone call. I feel like it ruins my whole day and I’m just waiting for a bomb to get dropped on me. It’s one of the most difficult parts of infertility for me.
Anyway, they did call at the end of the day to tell me that my estradiol was only 17, and as long as it’s under 50 they let you stim. I have no idea what that means, but I was relieved.
I had no idea how attached I was to this cycle until I thought it was going to be yanked out from under me!

Monday, August 29, 2011

visits to the vampires


Someday this infertility crap will be over. One way or another, I will move on, and knowing this keeps me going at the hardest times. Someday I can look back and say “Whew, that sucked, glad that’s over.”

I’m afraid that once I’ve moved on I will forget the pain. Naturally, the gut-punch, sick-to-your-stomach pain of pregnancy announcements will fade, but hopefully I won’t forget it entirely. What I think I might truly gloss over, though, is the pain in the ass logistics of IVF.

So today, I will document for posterity the process I undertake every morning that I need bloodwork done.

  1. Wake up an hour earlier than usual. Grumpy, right off the bat.
  1. Drive 25 minutes to the hospital in town. Not as bad as driving three hours to my RE, sure, but still.
  1. Use the valet parking. Feel guilty because I am able-bodied and healthy and could feasibly park in the parking garage which is a 10-minute walk away from the lab.
Stop feeling guilty because, seriously, your parking sucks so when I’m in a hurry you force me to use the free valet.

  1. Check in at the front desk. This is staffed by a grouchy, hard-of-hearing volunteer, who can’t hear or spell my name even though my first and last names combined have nine letters and are spelled phonetically.
He fills out a form that explains what I’m wearing (“gray shirt, pants” or “purple dress”). I cringe every time because they use a full sheet of paper for this.

  1. Wait in the waiting room until a registration desk opens. Even though I arrived 5 minutes before the lab actually opened, I am the fifth person to sit down in the waiting room.
  1. Check in at registration. The registration clerk walks over to the front desk to pick up the full sheet of paper that says my name and “gray shirt, pants” on it.
She calls me back to her desk where I tell her my social security number, address, phone number, birth date, what doctor called in the order, and provide her with my insurance card so she can scan it. I am not allowed to skip any of these parts, even if I was there three days ago. It is not enough to say “address and insurance are the same”.

She puts a wristband on me with a bar code and all my vital information.

  1. Wait in the waiting room until a lab technician opens up. You know how good I am at waiting.
  1. Check in with the lab technician. Verify my birthdate, name, and what I’m here for. Usually have to argue with them as they cannot seem to receive orders from my doctor correctly. She scans the barcode on my bracelet.
  1. Get blood drawn. Usually takes one prick through the skin and 3-4 to get into my vein. Try not to pass out.
  1. Receive my cotton ball and band-aid. The lab technician snips the bracelet with all my information on it and throws it in the trash.
I’m glad we go to such lengths to be secure just so someone can take my bracelet out of the garbage and steal my identity.

  1. Drive 20 minutes to work, usually late at this point, and spend the rest of the morning massaging my inner elbow.
Then of course, there’s the ultrasound at my OBGYN which is a separate trip and goes MUCH more smoothly (thank god).

OH THE DRAMA OF THE BLOOD DRAW.

Tuesday, August 23, 2011

Friends


When 2011 began, I had two very close friends here in town. One of them is pregnant and due in three weeks, and we haven’t spoken in months.

I have spent so much time going over in my head what went wrong with that friendship. I have analyzed every email, text, phone conversation, and facial expression, trying to place fault, to find the moment where the friendship died. I have documented much of this here.

It’s sad to lose a friend. My heart was broken and I felt a lot of anger, but I have healed and now I can see the benefits of the situation.

I have learned how to be direct about my infertility-related needs, and what I realized is that all I really want is compassion. I want acknowledgement of my trials and celebration of the good things that happen to me. I don’t want advice or empty words (there is a plan, everything happens for a reason, blech), I just want people to check in with me from time to time, say “that sucks” when things suck and “I’m happy for you” when things don’t suck. It doesn’t seem like much to ask.

More importantly, I have learned to voice my sincere appreciation to those who do support me through infertility. I tell them now that I know this is an awkward and difficult thing to talk about, but that their support means the world to me.

In the past few months I have grown close with a new woman, and I was terrified to open up to her during my IVF cycle – I thought surely she would run the other way. She has become one of my greatest sources of support.

People can handle this, they just have to want to. They have to prioritize the friendship over their own discomfort with the subject.

My new approach to friendship has worked wonders. I have a vast array of friends that I didn’t have 8 months ago. I have crawled out of my comfort zone and I like it. My social circle and support system is widening.

I have forgiven myself for my friendship that failed this year. I am not a hard friend to have. I do not need you to bail me out of jail. I don’t have an abusive boyfriend I keep running back to. Infertility is my one thing – it is the reason I need support.

If someone else can’t handle that, this is not a reflection on me. It is an indication of a lack of compassion on their part, and it’s time to move on.

Friday, August 19, 2011

Happy Friday!

Here is a great video I read about in the Washington Post. It's a humorous but truthful infertility awareness campaign. While it doesn't address ART patients, I really appreciate the effort. It's created by the makers of the drug Gonal-F.

Here it is on the facebook page.

Here it is on YouTube.

It's like the TTC version of the swagger wagon video.

Thursday, August 18, 2011

IVF #2 Protocol


8/12 start BCP
8/23 start Lupron
8/29 suppression check and bloodwork, take last BCP
9/2 start Bravelle and Menopur
9/7 follicle check and bloodwork
retrieval week of 9/12
transfer week of 9/19

If you’re cycling with me, let me know!

Also, I’ll be traveling with both the Lupron and the FSH this time, so if you have any tips about flying with needles let me know. I’m getting a doctor’s note but I already tend to look suspicious to security people, and it’s a few days before 9/11, so I’m a bit nervous.

Wednesday, August 17, 2011

Blogging Besties


I use Google Reader to keep track of all my favorite blogs. I have “Trying” “Preggers” “Parents” and “Etc” categories (Etc encompasses blogs about interests of mine other than TTC, which believe it or not I do have).

Lately I have felt a bit disconnected from the blog world. This is odd because I have more followers and am getting more comments than ever before. Then I realized why.

I started getting heavy into the blogging in January when we were starting our first IUI. At that time, I mainly made friends with bloggers who were doing IVF. There are an infinite amount of TTC blogs, as you know, and I spent hours (*cough* at work) combing through them all and finding women who had voices like mine (or way better, in most cases), whom I could identify with, and who elicited empathy and didn’t annoy me. I am easily annoyed so that last one was more important than you might think.

Now, all of these carefully selected blogging friends are pregnant. Hooray! Oh how I rejoiced when they got their BFPs.

And now there is a new wave of blogging friends. My cycle sisters are women I haven’t known as long. Don’t get me wrong, I love getting to know new bloggers. The more virtual friends, the better. But all my “best bloggy buddies” are in my preggers column now…and I hope someday to catch up with them.

So if you are interested in reading some ART success stories, here are my tried and true (and pregnant) blog friends. Let me know if I got your info wrong, ladies.

-          Drevas at The Fertile Hurdle, pregnant (twins) after FET
-          Roccie at Roccie Road, pregnant after FET w/DE
-          Marissa at Eggs in a Basketcase, pregnant (twins) after IVF
-          Mare at Just Beginning, pregnant after IUI
-          Jay at The Two Week Wait, pregnant after IVF
-          Still a Guest Room, pregnant (twins) after IVF
-          Alex at Alex’s Adventures, pregnant after FET
-          The Infertile Gynecologist, pregnant after IVF

And here are just a few of the blogs I’ve been getting to know recently

-          Unfertilized
-          MoJo Working
-          Better Full than Empty
-          Tortoise Baby
-          Still Dreaming
-          The World Needs More Nerds
-          The Annoyed Army Wife
-          Our Fertility Adventure

Disclaimer: This is just a sample of the blogs I follow. There are a lot more and I love them all equally. So sorry if I left you off my list. I’ll do this again soon : )




Friday, August 12, 2011

And we're off!


I had my head all wrapped around a break. I will be in California in three weeks and I thought that by taking a cycle off of synthetic hormones, maybe my hair and skin would look nice in my photos. I had convinced myself that a break was a good thing, and I was actually looking forward to it.

But when I spoke to my Dr. for our follow-up last night, it went a little like this:

Dr.: (in his best compassionate doctor voice) “So, there’s no rush, no hurry, think about what you want to do and when you’ve decided, give me a call.”
Lulu: “Oh, we want to do it again. We want to do it again right away. We assume we need to take a cycle off since it’s CD4 already.”
Dr.: “If you’re ready, I’m ready.”
Lulu: “What?”
Dr.: “Are you on birth control?”
Lulu: “No. Wait, what?”
Dr.: “I can call in BCP for you and get you a protocol tomorrow.”
Lulu: “What? [pause as she considers getting through airport security with needles and Qcaps, decides that diabetics do it every day and that she can live without close-up shots of her in San Francisco, after all that’s what photo re-touching programs are for right?] Okay, let’s do it.”

Dr. Friendly thinks he can address my shitty fertilization report by increasing my stims (2 Bravelle, 3 Menopur the whole time) and ICSI-ing all of my eggs. I asked him if he was concerned about my egg quality and he said absolutely not. About two minutes later I asked again “So you don’t want to do any further bloodwork? You think my eggs are fine?” He said he’s not concerned about my eggs at all.

I heard him say that twice, ladies and gentlemen (listen to me, like there’s a single gentleman out there reading this blog). There was no discussion of Premature Ovarian Failure, an egg donor, an AMH test like I had geared myself up for. Just poor stim timing, which is correctable.

I feel like IVF#1 was child’s play compared to this upcoming cycle. I didn’t gain a single pound (!) and had very minimal bloating and pain. I know with this more aggressive protocol I won’t be so lucky this time, and I told him that.

Lulu: “Pump me up, I don’t care how uncomfortable I am, I want something to freeze this time.”
Dr.: [chuckling, probably asking himself how he deals with these hormonal women every day of his life] “Well, I will hold you to that.”

Fasten your seatbelts, here we go!

Thursday, August 11, 2011

Cost of IVF #1

As you know, I am touchy about the fact that my insurance covers IVF. Please know that my coverage is not due to any diligence or merit on my part. It is sheer luck that I was born in this state, chose to settle here, and this state has a mandate.

Whenever those closest to me discuss my treatments with me, I explain how I am currently feeling: good, bad, and ugly. But I always, always mention how fortunate we are to have insurance coverage. IVF would not be an option if we did not. I mention this every single time because no one here knows how much things vary from state to state and it feels like a tiny bit of advocacy.

Regardless, I feel that mentioning my insurance coverage is like pouring salt into the wounds of those who do not have it. I believe that I would feel that way if I were in your shoes. If that is the case, feel free to skip this post.

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While it’s always possible that the miscellaneous EOB might still roll in, it has been a week since beta so I think I’ve gotten the bulk of them. I thought I would post this image (which should enlarge if you click on it) of my spreadsheet of costs for this cycle.

A few notes:
-          I think it’s legitimate to include my Wellbutrin (WB) as an IVF cost. I have struggled with depression my whole life but only when my last IUI failed did I turn to medication. I do not believe infertility causes my depression; I do believe it exacerbates it to the point of needing medication.
-          This is only the cost for IVF. This does not include my two IUIs in 2011, or the laparoscopy I had.
-          I have officially reached my Out of Pocket Max for the year. All IVF procedures I have before 12/31/11 will be covered 100%. Our next cycle we will have to pay the drug co-pays and the $640 for cryopreservation (we’ll feel fortunate to get to pay this if we end up needing it).
-          Please don’t decode my abbreviations and use them to stalk me. Thank you.
-          I am really only sharing this because I think it’s interesting. I like spreadsheets. I’m a nerd. If you are not a nerd, don’t like spreadsheets, and don’t find it interesting, I apologize.

Tuesday, August 9, 2011

IVF #1 in review


A summary of IVF #1:

What I feared: Crazy hormone side effects, bruises from injections, severe bloating, weight gain, that I would forget or mess up my medicine, the retrieval, the two week wait

What I got: Crazy hormone side effects from birth control only, everything else was fine. Injections went well. I didn’t bloat hardly at all, although I still complained about the bloating that did happen. I haven’t weighed myself but I don’t feel like I gained any significant weight. I did mess up my medicine but I ended working it all out. The retrieval was fine. The two week wait was rough.

What I learned:
-          Take nothing for granted. I really should have learned this by now, but I am foolish enough to continue to assume things. I remember those days when A and I were so na├»ve (like in June) when we sat around having lengthy discussions about what to do with the millions of embryos we’d have leftover in cryopreservation. Should we donate them to science? Adopt them out? Risk having a bigger family than we had planned? Well, the joke’s on us because my eggs suck and we have nothing in cryo and it’s likely to stay that way.
-          It’s different for everyone. I had none of the scary Lupron side effects I had been warned about, but my BCP was awful. I had very manageable pain post-retrieval, when I expected the worst.
-          It’s out of my hands. Duh.

The worst part: The fertilization report. I don’t think I have ever been so heartbroken in my life. It was far, far harder than finding out I wasn’t pregnant, being diagnosed with PCOS, or any pregnancy announcement I’ve ever seen or heard.

The best part: Getting the phone call that our one embryo continued dividing and would make it to transfer. How quickly one went from being not nearly enough to meaning the world to us.

What I’ll remember most:
-          On our way into the hospital for our initial consultation, I told A that someday we’d tell our kids how they got here, and this moment would be part of that story. It had been raining and there was an earthworm on the sidewalk. A picked up the earthworm and returned him safely to the grass and said “I hope you’ll remember to tell them that their dad is the kind of man who saved an earthworm from getting squished.”
-          Leaving a party at a winery to go get my Lupron out of the lunchbox in my car and inject myself. It was a surreal moment for me and I thought “is this really my life?”
-          On the way to the retrieval, we stopped to get fast food and got a cup of ice water for our two dogs. We have a big dog and a small dog. I said “He needs to drink first because he has a little tongue. She can get all the way down to the bottom of the cup when he’s done.” He looked at me and said. “That’s a good point. You’re going to be a great mom.”  

What I will keep in mind for next time:
-          IVF is not your life. Keep doing things. Don’t let your life revolve around your next injection.
-          Make sure your phone is charged because Angry Birds really takes the edge off of waiting room anxiety.
-          Make sure you always have more medicine than you need for at least the next four days.
-          Post-IVF periods are awful.
-          It might not work.
-          That doesn’t mean it will never work.

Monday, August 8, 2011

FMLA advocacy


Friends-
I have decided to fight hard against my company’s decision that intermittent FMLA cannot be used to pursue fertility treatments. I think I have a great case. If you read from the bottom up, you can see our conversation in May. The top is the draft I’m going to send this week.

Please let me know if you have anything to add, and feel free to borrow my words to use in your own advocacy if necessary. If you feel so inclined to link to this post so I can receive more input, I’d very much appreciate it.

Edit: I have deleted the rest of the email chain for privacy reasons.
-------
(Draft)
HR,

I feel strongly that this matter deserves another look. Infertility is a disease of the reproductive system, and in Illinois there is a mandate for group insurance plans to cover infertility just like any other medical condition.

As FMLA can be used to attend to your own serious health condition (link to company’s intranet and leave definitions), I fail to see why infertility treatments do not qualify.

I recently completed an in-vitro fertilization attempt that required six days out of the office. In addition, I’ve had laparascopic surgery to treat endometriosis this year, which required two days off, and I took additional time to pursue other, less invasive treatment options before finally turning to IVF. All of this time was used attending to a medical condition that is standing in the way of building my family.

My IVF attempt was unsuccessful; therefore, I am looking at taking an additional 6 days before the end of 2011, and perhaps twice that if the second attempt is also unsuccessful.

I admire (Company)’s commitment to helping employees find a work-life balance, and the company’s goal to promote diversity. I feel that excluding infertile employees from utilizing FMLA in this matter directly contradicts both of these aims.

I have formed a local RESOLVE Peer-Led Infertility Support group, and through that experience I know that other large corporations here in town do allow employees to take intermittent FMLA in this instance.

Since it seems to be a subjective decision, I would greatly appreciate a chance to meet with the person who makes the decision to present my case. In a legal gray area, I feel decisions should be made in favor of employees who are already under enormous emotional and financial strain.

Lulu

Friday, August 5, 2011

Beta day

I went in for beta today and had this test this morning. I am sick to my stomach with nerves.

Update: negative. Hcg was 2.5. I'm so glad it's all over.


Wednesday, August 3, 2011

BFN

That's right. This cycle failed.

I knew yesterday because the positive HPT was way too faint. Today, 10dp3dt, it was just plain negative. No booster, no fetus, no pregnancy.

Yesterday was honestly a day full of soul-crushing disappointment. I could barely keep it together and I'm afraid I was a bitch to everyone at work. It was not a happy anniversary. I was blinded by this recent loss and couldn't see anything but three years of failure.

But really, look at what we have done in three years:

  • A finished his master's
  • we moved
  • we bought our house
  • we got a second dog
  • we bought a car
  • I quit my old job and got this current job
  • A got his current job
  • I've been promoted twice
  • I've been to the ER
  • I've been to California,
  • A has been to Oklahoma
  • We went on a honeymoon in Mexico
  • We took a Caribbean vacation
  • I got diagnosed with PCOS
  • I've have a wisdom tooth extraction, HSG, laparascopy, and egg retrieval
  • We've had two failed clomid cycles,
  • Two failed IUIs,
  • and a failed IVF
So that's quite a lot even though I'm still so heartbroken that we aren't parents yet.

Today I'm just angry and bitter and I know from experience that this will linger. Get ready. I plan to be drunk a lot.

Beta is Friday and I wish I could just save my time and money and skip it. We are definitely going to try again, as soon as we are able to.

For now, I have fun plans with friends this weekend while A is away, and I have a trip to California coming up in less than a month. 

I will get through this.

PS--we are making plans to skip Christmas this year.

Monday, August 1, 2011

8dp3dt


Apparently my threshold is 7dp3dt. That is as far as I can get without going crazy.

Yesterday I lost control. I woke up feeling like it didn’t work. I sunk further and further into depression so that by the time we got in the car to go to my mom’s house, I was crying and my heart was just so, so heavy.

I haven’t cried in a while, not since we found out Little E was going to make it to transfer, and those were tears of relief.

On Friday, I went to see my co-worker/friend’s two-day old baby and I didn’t even cry then.

Yesterday I started the mourning process for this first IVF cycle.

But then. Then! This morning I continued my pee stick routine. And there is no doubt about it (well, a little doubt, but not much). Yesterday and today (7dp3dt, 1 day post booster 3 and 8dp3dt, 2 days post booster 3) are a little darker than 1 day post booster 2 and 2 days post booster 2. Can you even read that sentence? I told you I’ve lost my mind. I even started posting photos of things I’ve peed on to twitter.

This could mean anything. HPTs are not reliable, let alone after a bunch of hcg boosters. The lines will either continue to get darker tomorrow, Wednesday, and Thursday until beta on Friday, or they will fade. I can deal with either result, I know I can.

I don’t think it would be so hard if our anniversary weren’t tomorrow. On my wedding day, I never, ever, EVER would have thought I would reach my third anniversary without a child in my arms. The fact that we have been married for three years without so much as one pregnancy is gutwrenching to me.

Furthermore, I’m so disgusted by how much of our marriage has been consumed with this bullshit. From the “longing to TTC but waiting for health insurance” stage, to “waiting for ovulation”, to “waiting for Metformin to work”, to “clomid”, to “do you have sperm or not?” (yes, thank God), to “is my uterus messed up?” (no, thank God) to “surgery time”, to “IUIs”, to where I am today…that’s our entire three years. It hurts.

Anyway. We shall learn a lot in the next 48 hours, ladies.