You Can’t Change It (IVF Update)

I am a realist. It’s just who I am to my core. It doesn’t mean that I am negative, but that I like to know every possible way something could go, and what the odds are for each scenario. I also like to have a plan. And a plan B…and C…I do not like to be caught off guard.

There is a huge difference, at least in my head, of knowing what could happen, and actually experiencing it play out in your own life. There was a time, when we first started trying, that I knew there was a possibility there could be an issue, but even as I started to see my OB and my RE I didn’t actually think there would be a problem. Those first few months with the RE, having surgery, getting diagnosed with endometriosis, and experiencing 3 back-to-back failed IUI’s I felt pretty blindsided most of the time. Still with each obstacle or failure I went into the next thing believing that it could be successful. Even though the odds of getting pregnant from and IUI are small it does work for a lot of people, and I fully believed I could be one of them. When it didn’t work out I was disappointed, but not surprised.

When we started fertility treatments I thought we would do 6 IUI’s before moving onto IVF. After the first three failed we made the decision to try one more with injectables. Because the cost was so much higher for an IUI cycle with injectables it didn’t really make sense to try it more than once. I thought, at the time, if that cycle weren’t successful and our next step was IVF, that I would completely breakdown. It had been a long year, changing jobs, my grandpa passing away, and my dad getting sick. When we finally did the IUI, and it failed, I don’t even remember crying. I just felt kind of numb, and went on with life. As much as I wanted it, I couldn’t change the outcome, and the odds were not in our favor.

More than being upset about the cycle failing, I was concerned that I only produced ONE follicle using the more powerful drugs (Gonal F), which was the exact same response I had to taking Femara. During our consult for IVF a few weeks later the doctor assured me that this would not be a concern because I was on such a low dose. For someone my age they expected to get at least 15 eggs.

This is the part where I continue to remind myself that I cannot change the decisions I made, or the way things have played out. If only I had known, right?

We decided to take a year off from treatment. I wasn’t mentally ready to do IVF, and I wanted to be able to pay cash rather than finance the cost. We spent the year (especially me) focusing on improving our health. I lost weight. I purged our home of chemical products. I replaced many plastic products in the kitchen that could be leaching BPA. I changed every single product I put on my body. I started using oils instead of pills when possible. I started acupuncture. I cut a huge amount of sugar out of my diet, learned new REAL food recipes, and as IVF got closer cut out caffeine and alcohol completely. While all of these things are very positive changes and regardless of what happens I will continue to do them for probably the rest of my life, as far as my fertility is concerned, they did not make an impact.

A year later when I walked into the fertility clinic to start IVF, this time excited and ready, I was, again, blindsided by the AMH results and a much lower antral follicle count from the year prior. But I was told by basically everyone that I just needed to be positive. Everything would be fine. I asked the doctor about the result (because she never brought it up to me so I had to ask her about it) and she just told me that it was “kind of low” and she had adjusted my protocol to account for it. The only person that acknowledged that there could be an issue was my nurse, and I honestly really appreciated it. Everyone else, including my husband, just told me to “be positive”.

So I tried to push it out of my head, or at least to the back. I didn’t bring it up anymore because everyone make me feel like I was upset about nothing. I was tired of being told to be positive when I felt that I had a legitimate concern. I knew I couldn’t change what was going to happen, and of course I hope(d) for the best, but I just didn’t understand why no one wanted to admit that, given the information we now had, there could be an issue with the number and quality of the eggs they would be able to retrieve.

The first few days of stims were significantly more difficult for me than the last. I felt pretty crappy and exhausted and I started to feel really full/bloated. And then on Tuesday it all went away. At first I gave my acupuncture credit for feeling so good. My E2 level taken on Tuesday (CD7) was 950 which from what the nurse told me, and what I researched online seemed to be a good number for where I was in stims. Wednesday I started to feel worried because the full feeling I had previously had completely gone away. I actually felt totally normal. I just pushed it out of my mind because I knew if I said something I would be told again, to just “be positive”, and with all of the extra hormones pumping thru my body I might lose my shit.

Thursday I went in for monitoring. I felt a little anxious. I had a hard time sleeping the night before but I was still in a light happy mood. I was sincerely praying for 10 follicles. I thought that seven or eight might be more realistic given my antral follicle count was 10. As soon as she started the ultrasound and went to the right side I started to feel panic. Three follicles. There was another that was about ¼ the size of the three, and one that was so smalls he couldn’t measure it. And then the left side. Two follicles. And another that was too small to measure. So five follicles. The doc also confirmed that they were all mature and that I would trigger that night which was a complete surprise to everyone.

I was honestly shocked. I got dressed and they moved me to another room to wait for the nurse. It took her a while to get everything in order because my retrieval wasn’t expected until next week. I sat there, letting the information sink in. Five. Just Five. I text my husband, and my good friend D who has also done IVF. The nurse and I went over instructions and final medications that needed to be taken, but she had to wait to schedule the exact time until later in the morning. She gave me a hug and told me she would call me later. I called my husband to give him more information about what had transpired, to let him know he would need to find time to clean out the pipes as soon as possible (awkward because it was on a business trip in meetings all day), and to plan what we would do with my stepson on Friday night/Saturday morning since he could not come with us. Our conversation was brief.

I headed into the office and in the 30 minute car ride I could feel the tears welling up. I wasn’t crying because I lost hope or because I thought this was the end. It most definitely is not the end. But after being told so many times to ignore all of the not-so-great things that have happened the past few months in the name of positivity, I needed to acknowledge that this was not good news.

I promise you I totally understand that it only takes one. I am praying that we have one. I know that is 100% possible and I have not given up on that. Two feels like a dream come true.

Tomorrow morning we will go in and see what happens. I know I can’t change it. I can’t control it. I have prayed for it and I have done everything I could do.

For now…To be continued……

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Pill Poppin

I am admittedly not a great “pill taker”.  By that I don’t mean that I have trouble swallowing them but I have trouble remembering to take them at the same time of the day every day.  You would think that I would be awesome at it, because I have had to take a pill for my thyroid my entire life, but truthfully I have always struggled with it. 

I have tried several things that have been somewhat successful, like keeping my thyroid pill bottle in my car, so as soon as I get in the car to go to work I see it and take my pill.  That works great, until the weekend when I don’t necessarily get in the car in the morning.  I have also tried keeping it in the bathroom, but will all the other stuff cluttering my counter; the bottle would get buried or stuffed in a drawer….and out of sight out of mind unfortunately.  For the past few years I have been pretty good about taking it at the same time consistently which has been a major win for me. 

Well…..now with all the added supplements and extra medicine that I have to take on certain days, at certain times….I am screwed.  Especially since a lot of what I am taking shouldn’t be mixed with other things.  Oh, and in addition to all the extra pills (especially on cycle day 3-12), my primary doctor just changed my thyroid dosage.   I have to take one dosage Monday-Friday and a different one on the weekends.  This makes things even more difficult to keep track!   For the record I have been awesome about taking all of my prescribed pills every day as required.  Not one miss.  What does seem to get missed is my supplements, because they have to be taken at odd times so they aren’t mixed with the actual medication.   So I finally broke down and got 4x a day pill box.  I feel like an old lady using this thing, but it has already helped so much.  You can actually pop out the boxes and take them with you, which is pretty awesome, and they are super deep so they can actually fit my big calcium chews.  It is also awesome when I travel that I won’t have a huge bag of pill bottles.  I can just take the boxes I need which will take up a lot less space!

Image

In other news…..

The end of last week really sucked.  After my not-so-wonderful experience with my clinic on Thursday my drive home (which is about 130 miles), took four and a half hours.  There was one complete hour that I only moved 9 miles.  By the end of the drive, even though I was finally able to go 70 mph, I was in tears.  Sobbing.  And completely freaking out about the “what if this doesn’t work and I never get pregnant”  I have never let myself get there.  To that place where I really let myself thing/believe that it is impossible for me to have a child.  Yes I completely realize that two years and two IUI’s is nothing in the scope of infertility.  Unfortunately it was the perfect storm on Thursday and after hours in traffic I was mentally and physically exhausted.  A perfect time for my emotions to take over.  When I finally got home I was a zombie.  I felt horrible because obviously I hadn’t seen my husband since Monday, and he was leaving the next day for the weekend.  But I just couldn’t.  I took a bath, and we watched a few of our taped shows but I just couldn’t talk.  At all.  And after all of that I started Friday with a migraine.  Thankfully I was able to kick it fully by noon, but I was not myself all Friday. 

I started my Letrozole on Friday night.  My RE actually upped the dosage from 5 to 7.5.  No explanation was offered to me to explain why he decided to do that, which is annoying.  I spent all of Saturday with my Step son and babysitting my friend’s little girl who is two.  Sunday was a day for me.  My husband was gone in SoCal, and I spent the day reorganizing my closet.  It was amazing.  I still have a few things left to organize, but it’s a million times better than before.  It had really gotten out of control.  It just makes me feel better to see it in order.  Being able to walk in and actually see everything is amazing.  Today I am wearing a shirt I forgot I even had!  It was a great way to start the week, and today I am much more relaxed.   Of course since I spent pretty much all day doing the reorg, I did not go grocery shopping, so that is on the list for after work today. 

CD1 and Pissed! Updated

Ok, to be clear I am not pissed that it is cycle day one. I am happy about that actually. I could totally tell it was going to happen today when I was getting ready this morning so I actually prepared. My lady parts are wreaking some serious havoc and I sort of feel like crawling under the table in the fetal position, but such is my life with endometriosis. I will power through (I hope).

So why am I so pissed? Well….I called my clinic to let them know that it was CD1 and I need my meds like any good fertility drug addict would do and when they called me back this is kind of how it went…

Nurse: Hi, I got your message that it is cycle day one for you, but we don’t have a treatment plan for your right now.
Me: UM WHAT!?!?! How is that possible!?!?!

I will pause for a moment to reflect on this first bit of news. First, I talked to a nurse on Tuesday, two days ago, when she called me to let me know that my second IUI was not successful and before I hung up the phone I specifically asked her if my next step was to call back on CD1 for my next go. Her answer was YES. After my first failed IUI, the clinic wouldn’t even call me with the beta results until my doctor had reviewed my results and written up a new treatment plan. Apparently that was the “protocol”, and it appears in the last 30 days said protocol has changed. When the nurse called with my IUI #2 results she was certainly not offering up what I was to do next, I had to pull it out of her. So I ask you, what if I hadn’t asked the nurse on Tuesday what to do, and had not called today on CD1. Would they have just forgotten about me/gave up on me after two IUI’s because no doctor ever gave me a new treatment plan? Clearly all of this is Cycle Day sensitive, and my period has shown up the second morning after stopping progesterone so there really isn’t a lot of time to just dilly-dally around waiting for a doctor at the clinic to realize that I am in fact, not pregnant and suggest what to do next.

Ok…back to the conversation between me and the nurse today….

Nurse: Well, Dr M and Dr A are here, but Doctor SA is YOUR doctor and I am not sure if he is available to give you a new treatment plan but I will see what I can do…(and keeps talking and talking and talking….)
Me: Ok stop for one second please. Why is Dr. SA now my doctor when Dr M has been my doctor for the past six months? I have only met Dr SA twice, because he happened to be the procedure doctor on the day of my IUI. We have never even had a conversation!
Nurse: Well its our protocol that the doctor that treats you does your next treatment plan.
Me: Well I would really feel more comfortable if Dr M would do it because I have actually met with him multiple times and like I said, I have never even had a real conversation with Dr. SA.
Nurse: Ok well I will ask Dr M if he will do it since he is here. We will call you when your treatment plan is done.
Me: Thanks.

I totally understand that RE clinics have to be open 365 days a year due to the time sensitive nature of all of this. And I know that the Doctors do other things besides just see patience in the office, like surgery. I accept the fact that I will not always get to see my doctor every time I go in for an ultrasound or IUI and I am ok with that. I am not ok with having someone who I have never talked to make a treatment plan for me. Maybe I am overreacting, but there is a huge difference between someone performing a procedure on you that they have done a million times (like an ultrasound), and someone who actually is going to give a recommendation on the next step. What if they come back with something different than what I have been doing the last two months? Will the doctor explain to me why he is making a change, and how it will affect me differently? They don’t ever say “well if this doesn’t work then we will move on to this….”

This whole process is upsetting, personal, and really emotional. I feel like the only pseudo security is feeling like the doctors you are entrusting with your body (and money), know what they are doing, and know YOU and your personal issues/situation. I don’t even like to go to my primary care doctor and find out I have to see someone different, and this is just on a whole other level. I went from feeling happy to get this cycle moving to sort of feeling insecure and betrayed in all of 30 minutes. I feel like the clinic should give you a little 10 minute tutorial on what to actually expect so at least I won’t be surprised about the way they do things.

😦

UPDATE:

The nurse did call me back and let me know that my Dr, Dr M, gave me a new treatment plan. By new, she actually means exactly the same as the past two. This is update worthy because she also told me that I needed to take a home pregnancy test before she would call it in. So basically, on Tuesday they called me to tell me my beta was less than one, but today, Thursday, I need to take a home pregnancy test to relive the disappointment? Its been 20 days since my IUI, and I am full flow right red crimson tide…..and have had a confirmed negative blood test….but you want me to pee on a freaking stick? You have got to be kidding me. When I questioned her on why this was necessary she seemed surprised (btw it was necessary before my first IUI cycle, which was understandable, but not before my second….because you know, I had just had a negative blood test!). She left me on hold for like 5 minutes and then came back to tell me that the blood test would suffice as my negative pregnancy test. Well I really hope so because if you can’t trust a blood test to tell you that you aren’t pregnant, what can you trust really?
So everything is back on track, and I have my plan for the cycle which is good. I am just not sure why it had to be so difficult to get there…..

Hand Selfie and other updates

I must explain my hand selfie.  I have NEVER in my life had long beautiful fingernails.  EVER.  I usually chomp those babies down at the first sign of stress or excitement.  I have been biting my nails since I was little.  My mom tried everything to make me stop when I was young, and I have tried many things as well as an adult and nothing has ever worked.  I don’t want to bite my nails.  Actually when I think about it, it’s really gross and dirty.  For whatever reason it has been a compulsion my entire life.  Completely subconscious.  Usually I have no idea I am doing it until it’s too late.  The exciting part, however, is that for whatever reason for the past few months I stopped biting them.  They are long and amazing for the first time in my life.  I am so excited.  The prenatal vitamins have really helped with making them grow out quickly, and as soon as they were all long enough I rewarded myself by getting a Gel manicure.  I have kept them manicured for about the last 5 or 6 weeks, and as long as they are looking good with the gel polish I have had no urge to bite them at all!  At the first sign of peeling I have to get the gel redone, or else I will literally peel it all off, and start biting them again.  I have about a 24 hour window from the first one chipping.  Yesterday on the car ride home from our trip I started to enter the danger zone.  If you have ever had gel, you know when your nails start to grow out it will peel up near the cuticle.  My gel lasts just over 2 weeks thanks to the rapid growing of my nails right now.  We got home pretty early in the day and a friend asked me to join her for a manicure.  Now for the tie in to my blog….I went with Green polish, which turned out to be a little more out there than I thought it would be….BUT green is not only my favorite color, but its a lucky color.  I figured I could use a little extra luck this month!  IUI #1 will likely happen by next Wednesday!

A side note…taking a flattering hand selfie was more challenging that you might think!

hand selfie

 

In other news, our weekend in Napa/Sonoma was perfection (minus that small incident on Thursday night).  I am so grateful for the amazing friends that we have, and everything really fell into place perfectly.  I have been planning (and saving) for the trip for almost a year, so it was so nice that everything worked out as perfectly as it did.

Tomorrow is cycle day 7, and my last day of taking Femara.  Thus far I haven’t really had any side effects which I am also grateful.  Wednesday I start taking estrace, which from reading the literature sounds like it has the potential to have more side effects that Femara so we will see.  I also leave for the bay area on Wednesday morning to spend one night in San Jose and one night in San Francisco.  I am hopeful I can get out of the city early enough to beat any bad traffic but who knows.  While I am not excited to travel this week, it should make the week go fast.  Saturday I will start OPKs, and I will be going in by next Monday at the latest (day 13).  One week from today…..which is crazy.  Based on all of this, and my travel schedule (trip to LA for work the week after Thanksgiving), the first day I will be back and could do a blood test is Dec 5th.  That also happens to be my husbands actual 40th bday.  While I know a negative has the potential to put a damper on the day, I am going to just look at it as a good sign.

It has sort of amazed me out the timing on everything has worked out.  I mean with the trip we were already taking last weekend, the holiday with family coming into town, and my work travel schedule, it could have been a real nightmare (not to say things won’t just pop up work wise).   I barely even had cramps this month which is very rare for me with my endometriosis.  Even that could have ruined part of my trip and I was somehow okay.  I have been really careful not to get my hopes up too high but I really do have a positive feeling about everything, and with how the timing has worked out I can’t help but know God is really looking over me on this one.

ICD-9 Code: ‘6253’ Diagnosis: A lesson in Health Insurance

This is a very long-winded post.  You have been warned J

 

I am really counting my lucky stars today that in my adult life (which for purposes of this discussion started when I graduated from college and got a job…and my own insurance), I have had very few health issues. Health insurance has always seemed like this completely confusing thing that is really overwhelming, and that I will NEVER understand. I will never forget being 23 years old at the first day of my first big girl job and being sent home with a huge stack of books. From these I was to pick out which health insurance plan I wanted. Well I picked WRONG because a few months later I found myself in the parking lot of some random lab crying my eyes out to my mom because I could not find a lab that would take my insurance. I have had hypothyroidism since I was born, which means on a yearly basis (if not more frequently) I have to get a blood test to confirm that my medication dosage is correct. Well this is a problem when your prescription is out of refills, and the only way to get the doctor to refill it is to get a blood test. How did this turn out you may be wondering? Well my mom called in a favor to our family doctor who wrote me a new prescription for 6 months without getting the blood test…..and I never found a lab to take that insurance. A few months later during the open enrollment I switched to a new plan. Since that traumatic incident I have really been insurance drama free…..until now.

What the aforementioned experience should have taught me, was to learn about health insurance coverage. BUT I was 23 and naive to real life. I did learn in the past few years that the particular insurance I had is not necessary bad, IF you live a reasonable distance away from one of their health care centers. At the time I would have had to drive several hours to get to one of their centers. These days I actually live a few minutes away from one of their hospitals, but I still would never elect to have that insurance just based on past experience (if I had another choice of course).

Lesson two on insurance I recently learned: you need to have a good understanding of what your plan covers, and how much out-of-pocket you could end up spending before the coverage kicks in (ie your deductible), and how much you will need to kick in after you have met your deductible.

My first fail was last March. My husband got a new job and we decided that I would go onto his insurance plan rather than getting my own insurance through my employer. This decision was purely made based on money, and by money I mean the amount that we would be paying for our coverage out of our paycheck. Stupid. Stupid. Stupid. He is required to have insurance through his employer (and cannot be on my plan) because he has a child he is required to insure as well. I did absolutely no research into what my plan covered vs what his plan covered. SOOO STUPID. As it turns out my employers insurance covers the diagnosis and treatment of infertility. His insurance doesn’t cover shit (as it relates to infertility). The difference in me paying for my own plan and being on his plan is roughly $60 pretax dollars per month. So from April to now, that would be $360 pretax more that we would have paid. Instead we have spent roughly 5k post tax on doctors’ appointments, tests, labs, surgery ect. All because we didn’t understand health insurance.

So fast forward to today…..my surgery is actually partially covered by my insurance, however it’s not without its complications. There are four claims currently in the queue for the surgery.

1. Pathologist: Claim paid, I owed roughly $20.

2. Surgery Center: Claim paid: I owed roughly $400

3. Anesthesiologist:  Claim on hold due to verification of pre-existing conditions

4.  Doctor:  Claim on hold for unknown reasons (Already had to prepay $700).

So I received a letter last Friday from my insurance company regarding claim #3, that was VERY confusing.  Question one, why would the first two claims be paid, but not this one.  I mean they are all for the SAME procedure right?!?!  The letter asked me to prove that I had received treatment for my supposed pre-existing condition ICD-9 Code: 6253.  I had no idea I had a “condition” until July.  It may have existed, but I certainly wasn’t being treated for it (whatever IT is).  Thank goodness for Google.  ICD-9 Code: ‘6253’ is the diagnosis for Dysmenorrhea.  Again, thank you Google…. Dysmenorrhea menstruation cramping that affects daily activities.   I love that the letter used a code to describe my diagnosis rather than actual words.  If not for Google I would have no idea what the code meant so how could I possibly provide the backup they were requesting?  Also, nowhere on the form is there a place for you to tell them that this condition was not previously diagnosed or treated.  So I called the number on my card and after a million voice prompts finally talked to a person.   He told me to simply find a blank spot on the form and write that my condition was not previously treated/diagnosed, and that apparently I can get a letter from my previous insurance company saying I have had coverage for 12 months prior which will void out the supposed waiting period for pre-existing condition coverage. And another lesson learned…apparently insurance companies can refuse to cover pre-existing conditions for up to a year if you didn’t have coverage before.  WHAT!?  I mean this isn’t an issue for me because I have had health insurance my entire life, but that seems so messed up!  Thankfully I was able to get this letter from my old insurance company really easily, but seriously why is this so complicated in general?

For my forth claim I have absolutely no idea what information they need.  The person from my insurance company wasn’t helpful either.  The claim notes also said that they had “requested the information from the provider over 90 days ago”.  Well my surgery was less than 30 days ago, and 90 days ago I didn’t even know I was having surgery…..WTH!?!  When this eventually gets sorted out I should actually get money back from what I prepaid.  Since I have more than met my deductible my plan now goes to 80/20 coverage, and $700 is less than 20% of the total bill.  So now I am just sitting here….exhausted from trying to figure all of this out, and really wishing I had never switched plans. 😦

 

Recovery and Results (part 1)

In my surgery day post I did not mention the results of the surgery.  There are two reasons.  One I wanted to focus on just the experience of the day.  The other is that the only information I really have is second hand.  Dr. M. spoke to my husband immediately after my surgery but I was still lights out, so what I know came from my husband.  I absolutely love and adore him, but he is not great with details.  Apparently Dr. M. also showed him pictures, which probably was a little disturbing and distracting for him I can imagine.  Does anyone else ever wonder if you and your husband are going to need to see a sex therapist after all of this just to have a normal sex life?

Anyway, so here is what I know.

My right ovary is still there.  Big win.

While they were fishing around down there, they found I have stage III endometriosis.  HUGE BUMMER.

The cyst they removed was not a dermoid cyst.  It was a chocolate cyst, which is a type of endometrial cyst.  Hope you are ok with graphic info…. If not you might want to skip to the next paragraph (you have been warned).  The chocolate cyst gets his name because it’s basically covered in caked on layers of dried blood that resemble chocolate syrup.  Gross.  I can only imagine my poor husbands face as Dr. M showed him pictures of this thing.   No really, I fear our sex life may never be the same.

Our follow up appointment is in a week.  I have a feeling it’s going to be a very long week.

As far as my recovery goes….the first two days were pretty brutal.  I actually am ok with pain, but I hate being nauseous.  The first day was just pain, but as long as I just laid in bed I could manage it.  Day two was pain and just feeling so nauseous all day.  I pretty much slept all day.  Around dinner time a friend brought me some soup and other goodies (by goodies I mean ginger ale and other sickie food) and we chatted which was nice.  Friday I actually felt a lot better and boredom totally set it.  I don’t ever spend this much time by myself.  Further I am not really into TV or movies and there wasn’t a book out that I was dying to read.  The one movie I was excited about watching I thought was available on Amazon Prime, actually wasn’t and I really didn’t want to pay $15 on iTunes to get it.

Friday night I finally had an appetite and my husband picked up an In and Out Burger. I basically inhaled it.  So delish!  Unfortunately since then I have gone back to having very little appetite.  From the time I found out about this surgery in July until actually having it I gained weight.  Mostly from stress eating foods I normally don’t have in my diet.  Since having the surgery I have lost 6 pounds in 7 days.  Not bad considering I still feel bloated from the gas they pump in you during the surgery.

I will say a lot of people told me they got super sore in their back and shoulders after laparoscopic surgery.  That actually didn’t happen to me at all.  I definitely was/am bloated but I guess it just stayed in my lower abdomen area.

I mentioned in a previous post that there was mention by the surgery scheduler of what part of my cycle I needed to be in to have the surgery.  The doctor later told me it didn’t matter when we did it, and it ended up falling at the very end of my cycle.  Why does this matter?  Well because my new cycle started during my recovery, three days after my surgery.  What a bitch.  I stopped bleeding from the procedure after a day, one day off, and then aunt flo came for her visit.  I hate wearing pads.  Absolutely hate them.  In addition after feeling so much better on Friday, it went back downhill.  More cramps, headache, exhaustion, and I am an absolute emotional wreck.  Literally crying over nothing, spontaneously.  While the physical symptoms are annoying they are manageable, but it’s hard to explain to your boss why you are crying when he asked you to sign an invoice.  He told me to go home early today.  I also cried about that.  Seriously I need to pull it together.

I am also having issues sleeping, likely due to stress/anxiety.  First I thought maybe I couldn’t sleep because I slept so much the few days after surgery, but clearly my body is tired and needs sleep to heal.  I really feel exhausted.  I tried taking an Excedrin PM the last two nights.  I couldn’t figure out why they weren’t helping because I haven’t taken a sleeping pill in over a year and usually they put me out in 15 minutes or less.  Well tonight I actually looked at the bottle before taking one, and they expired at the beginning of 2012.  As I mentioned, it’s been a long time since I have taken one.  They are on my target list for tomorrow because I have got to get some real sleep.

My anxiety mostly is over the unknown.  Over the weekend I started doing research on Endometriosis.  Before last week I had no idea what it even was, but after my husband told me what Dr. M. told him I just looked it up.  I told some of my close friends about the diagnosis and none of them knew what it was, so I need to be able to give a brief description.  For a few days that was good enough for me, but then as I started to feel better I started to dig into it more.

It comes down to this: I am scared shitless that Dr. M. is going to tell us our only chance is IVF.

First of all, I am not sure I am ready to do that to my body.  I have read a lot of blogs the last few days.   A lot of REAL stories from real women with amazing details that really make you feel for them.  Some of them have beautiful babies right now, and some of them don’t.  Aside from the emotional connection I felt though reading their stories the information was very more specific and useful than anything else on the internet.  Reading about what these hormones do to your body during IVF is paralyzing.  I know they think it’s worth it.  I think it’s worth it.  I’m just scared I’m not strong enough to do it.

Then there is the financial part.  Our insurance covers nothing when it comes to fertility treatments.  NOTHING.  We have already spent thousands of dollars over the summer just getting to where we are now.  We both have great jobs, but we do not have money for even one round of IVF right now.  As I understand it endometriosis comes back, rather quickly too, so we are on a time table on top of all of it.  How far behind do we want to get?  How do you make a decision on how much debt you are willing to go into to have a child?  How are you even supposed to make that decision?

Perhaps I am getting ahead of myself since we haven’t even gone to the follow up yet, but it’s hard to ignore it.

Like I said, this is going to be a very long week.

P.S. It’s my birthday this week, and I have never been so not-excited for my birthday.  I really believed I would be pregnant before I turned 31.  Really at the beginning of the summer when all of this started I thought everything would be fine.  The only thing making me feel better right now is writing it all down.  Typing out every thought I have about all of it.  It’s the only thing keeping me relatively calm and sane.

Surgery Day

I have never had surgery before, except getting my wisdom teeth out, which was a whole ordeal in itself. Given the whole pre-op “you could lose your ovary” information I stayed really calm. To really put that in perspective you should know I have to take valium to get a cavity filled.

The weekend before we had a BBQ on Saturday where I definitely drank more than I should have, likely just due to nerves.  We spent the rest of the weekend laying low.  I got a pedicure and didn’t eat much because I was instructed to “clean out” my system.  Monday I started my soup diet (a great friend was sweet enough to bring me a pot of homemade chicken noodle) and Tuesday was go time.

My surgery was at noon, which is so annoying with the whole “no food or water” thing.  I tried to sleep as late as I could which wasn’t that late.  We left earlier than we need too, to be there an hour early as instructed.  I was calm, but also not in the mood to just sit around and wait at home.  I wanted to just get it over and done already!

We stayed in the car in the parking lot and listened to some of my favorite Christian music for a few minutes since we were so early.   It always makes me feel more at ease.  Once we went in it all went pretty fast.  I signed in at the front desk and forked over some cash to pay the surgery center.  Thankfully this was actually partially covered by my insurance (a lot of the previous tests/visits are not covered), and I had hit my deductible so insurance kicked in at 80/20.  Even paying just 20 percent out of pocket was several hundred dollars.  L

My husband and I sat in the waiting room for a few minutes and they came to get me.  I am still not really clear why they didn’t invite him into the pre-op area.  Every other person there had a significant other or family member with them.  They did the usual, weight, blood pressure, temp ect.   Then asked me a million questions, and again I got to get all fancied up in a hospital gown.  All of the nurses were so very sweet.  They really made me feel comfortable.  At one point the surgical nurse asked me if I had come alone.  When I told her my husband was in the waiting room I think the pre-op nurse realized she made a mistake and she went to find him.  I am not sure where he had gone off to but she came back and told me he wasn’t in the waiting room (later I found out he went to get food).  The time went really fast and Dr. M came in to exchange pleasantries and ask where my husband was (because it was so awkward he wasn’t next to me!).  Apparently Dr. M. went to the waiting area and by that time he had returned because Dr. M came back to verify that was him by what he was wearing.  Minutes later I was being wheeled into the operating room.  I moved from my pre-op bed on to the table and that was it. My butt hit the table and LIGHTS. OUT.

Next thing I knew I was in recovery finally with my husband by my side.  And I hurt. BAD.  Obviously this part is a little fuzzy as I was coming out of my anesthesia but I do recall being given some crackers and water so I could take a pain pill.  Unfortunately those didn’t stick around in my stomach very long, so the kind nurse gave me some nausea meds in my IV and I drifted off again for who knows how long.

The next time I woke up things were slightly better.  I didn’t feel sick.  I did feel pain.  The very sweet nurse kindly told me that “this would not be a pain free day”.  I sipped a little more water and over the next hour actually started to feel a lot better (relative to where I started of course).  The nurse gave us some home care instructions and said we could go home!  This was great news because it was still before rush hour, and I get motion sick on my best day so sitting in traffic after surgery would probably be a disaster.  My husband went to pull the car up and I hopped in to my sweet ride (ie Wheelchair).  The nurse told me to I should use the bag they had kept my clothes in as a “just in case”.  Good call on her part.  We made it no more than 20 feet before the crazy nausea set in once again.  What a rough ride to the car.  Thankfully since I could lay down in the car on the way home, that part actually was ok and I didn’t feel sick at all.  I finally made it to bed, took a real pain pill, and passed out.  What a day.

Chicken Pox

As I mentioned previously i was given quite the list of labs to complete. Since they were sent to me by mail, no one ever explained to me what they were for either. Oh, did I also mention there were three lab sheets, for two different labs. Really? I can’t just go to one lab?? I made an appointment at the first lab which was quite the experience. I am used to going to the lab attached to my local hospital/medical center. It’s in a huge, new medical building. The same building actually where my OB/GYN office is located. They don’t take appointments, and no matter what time you get there you wait at least an hour. It’s always packed to the brim in the waiting room. Sometimes there aren’t even seats. If you don’t happen to be lucky enough to have a seat you have to stand awkwardly in the middle because they will not go outside to look for you when it’s your turn.

Well, this was NOT the experience I had at my first lab draw. First, the lab they sent me to had appointments, so I made one. I put the address of the nearest lab where I made my appointment in my GPS and I was on my way first thing in the morning (I had to fast, of course). Well it was not located where my GPS sent me. I eventually found it but it was basically in this little “shack”. I walk in, and there were three chairs against the wall, a desk, and this screen looking thing with another chair (the kind you sit in to give labs) behind the screen, and one person working both the desk and taking the labs. There was also a door, behind which I presume was a restroom for pee samples. Well thankfully I had made an appointment because there were a few other people there, and she took me first. It was crowded to say the least. The room was barely bigger than my master bathroom in my home. She took nine vials of blood. That is by far the most I have ever had taken at once. Some of them were like twice the size of the normal ones I get taken for my thyroid checks. I was light headed afterwards to say the least.

My second lab appointment was also at a rather small lab. I was also able to make an appointment. This lab had two employees. One at the desk and another drawing blood. The area where they took the labs was also separate from the waiting room. And by separate I mean there was a wall in between them, not a screen. This draw was only 4 vials of blood and a pee sample. Much easier.

So at this point I still don’t know what they tested with all that blood, except I was instructed to start taking Vitamin D3 supplements, and get a chicken pox vaccine. Again, nothing can be as simple as it should be….

So the nurse at the clinic tells me that chicken pox is lethal to you when you are pregnant and apparently even though I had chicken pox when I was a child, I am not immune to them. Given that my step-son is in kindergarten and hasn’t had them yet it’s probably pretty important for me to get vaccinated now. The nurse told me that these vaccines are widely available at most pharmacies so it should be super simple for me to get. WRONG.

So I started by doing a search online of every local pharmacy (CVS, Rite Aid, Walgreens). You can “make an appointment” online if they have the vaccination available. Well after over an hour of searching I finally found one Walgreens that had it available. I did not make an appointment because it was located in a really inconvenient location and I wasn’t sure when I could actually go.  About two weeks before my scheduled surgery I was able to sneak away from work and I drove to the Walgreens.

I should take this moment to also mention that the chicken pox vaccine (Varivax) is a two dose vaccine, which must be taken 28 days apart.  It’s also a live virus, so you cannot get pregnant for basically 60 days from the first shot.  So getting this first shot before my surgery was pretty important to “start the 60 day clock” as soon as possible.

I was able to sneak away from work to go to the Walgreens a few days later and when I arrived I discovered that they, in fact, did not have the vaccine in stock.  Shit.  The pharmacist did offer to order it for me, took all of my information, and said they would call me in three days or so when it came in.  GREAT.  While the pharmacy was not in a convenient location from my home, or local office, it was sort of on my way home during my Thursday commute home on travel weeks, so I could stop on Tuesday or Thursday of the next week.  Score.

Well fast forward to the next Thursday (and a few days before my surgery) still no call from the pharmacy.  I decided to just stop in on my way home completing assuming that it was there for me, and they just forgot to call.  WRONG AGAIN.

Of course the people working were not the same from the first time I had been in, and there was no record that I was ever there, and no one ever ordered my vaccine.  ARE. YOU. KIDDING. ME!?!?!?!  Not losing my shit on these people was a serious challenge but I kept it together.  I mean I didn’t want to be the crazy woman flipping out about her “emergency” chicken pox vaccine.  Thankfully the pharmacist working that day was actually a very nice man who literally called every Walgreens in the area in search of my vaccine.  When it seemed all hope was lost, and I would have to wait another 2 weeks plus (until after surgery/recovery), he found it….AT THE WALGREENS DOWN THE STREET FROM MY HOUSE.  What a wonderful man he was, and he was probably really perplexed as to why I was so incredibly grateful to get a chicken pox vaccine.  If there wasn’t a counter between us I would have hugged him.

The next morning on my way to work I got my first vaccine and all was right with the world.  And at the end of September I get dose #2.

Pre-Op Day

My pre-op appointment, which was scheduled with absolutely no input from me, was supposed to be on a Wednesday. Wednesdays and Thursdays are the most inconvenient days for me work wise. I travel every week for work, Tuesday-Thursday. Tuesdays I have some flexibility on what time I leave, but Wednesday and Thursdays are not flexible. Actually not traveling those days involves me trying to find someone to cover part of my job because someone needs to be present to cover it. Thankfully I at least had some advance notice so figure things out, and literally to train someone to cover my spot (also for the time I would be gone for surgery). What a hassle.

At the last minute they changed my appointment from Wednesday to Thursday. At that point it didn’t really matter I guess, because I already planned on not traveling that week. I am more just annoyed that there seems to be very little respect for the fact that people do have jobs and lives to schedule around. I totally understand that my health is way more important, but not having things change at the last minute would be great.

Anyway enough complaining. I went to my pre-op appointment on Thursday, and it wasn’t what I expected (whatever that was). Basically I went back to Dr. M’s office and he explained to me every single thing that could go wrong. I should also mention that my husband was not there with me. His boss was in town so he couldn’t come to the appointment. So there I sat, by myself, while he told me how my cyst might be attached to my bladder or my bowels causing damage, and that the cyst may rupture while they were trying to get it out. Not to worry though. Apparently they just wash everything out. He also said “it’s much easier to remove a cyst on the ovary if you remove the ovary and tube too”. UM WHAT!?! I’m not really interested in what might be “easier”. I would like to keep my ovary if at all possible thanks. I think it was just a poor choice of wording on his part. He did follow his statement by saying “of course the goal here is to have children so we are going to try our best to keep your ovary intact”. So at this point I was officially freaked the F out. I know they have to tell you the worst that can happen, but geez. I then had to sign my life away, acknowledging that he told me the information, and of course that I wouldn’t sue him if one of those terrible things happened to me.

After our fun little chat, it was time to get dressed up in one of those oh-so-stylish hospital gowns and hop back in the stirrups for another ultra sound. If only i could have my lady parts up on the “big screen” every day. And by “big screen” I mean the wall mounted TV in the exam room. Dr. M. confirmed my left ovary was in great shape and I had an egg about to release (it was day 14 of my cycle so it was right on), and my poor little right ovary was still being overtaken by the cyst. He also said from the ultra sound picture he was pretty sure it was a dermoid cyst. Before I left he handed me copies of all of the forms I had signed, three prescriptions to fill, and an ultra sound photo of my cyst. Of course I went home and immediately hung it on the fridge. OR NOT. Do people ask for these things? What is the purpose of having an ultra sound photo of this thing? Again, awkward.