Back in the Stirrups

Normally I don’t talk to myself, but if you saw me this morning you would be convinced I was a lunatic. The talking to myself was necessary….because I was trying to talk myself down from the impending panic attack I was feeling knocking at the door to my sanity.

So my morning went like this….

I left my house and headed straight for the pharmacy. My original thought was, Great my appointment isn’t until 9:15 at the clinic which leaves me ample time to get my prescription for Letrozole and Estrace first (so I could get my butt to work as fast as possible after the appointment). Well as it turns out, my pharmacy opens at 9. SHIT. This isn’t the biggest deal, but I just knew they wouldn’t have it ready by the time I got there and so I would have to wait….which just adds stress on to the whole “missing work” thing.

I took a few deep breaths, and drove to the Starbucks next door. Might as well have a nice latte while I still can right? I got my coffee and proceeded to call Freedom Pharmacy to set up my Ovidrel and Gonal-F delivery. The good news….they actually had the prescription this time. The bad news….because of the holiday weekend they cannot deliver on Tuesday (the day I need to start the Gonal-F). My choices are tomorrow or Saturday, but my husband and I will both be gone starting tomorrow. And my office closes at 1 on Fridays in August so I can’t even have it delivered there! And in rolls the anxiety. I told her I would figure something out and call her back and I started to drive to the clinic literally out loud trying to get myself to calm down. When I arrived in the parking lot I was able to get a hold of a friend who lives a few minutes a way that is actually going to be in town for the weekend. I am having everything delivered to her and hopefully she gets it all in the fridge.

I entered the clinic feeling slightly better but still on edge just wondering what else might not go as planned. As I mentioned I met with the financial coordinator last week. At that time she told me the cost of my cycle, and that it would be due when I arrived for my baseline ultrasound (today), and that I could pay by credit card, check, cashiers check, or debit card. Pretty much anything except cash. Well then today the receptionist gave me a hard time about paying by check because of some random technicality in the system. I forgot to check how much my debit card allows in transactions per day before I left, and I was literally beginning to lose it when she finally figured out that I could pay by check. Such unnecessary stress!

Thankfully the actual appointment went well. It was with my preferred doctor at the clinic, Dr. M, and I was clear of cysts. Even the whole ultrasound while on my period thing wasn’t as bad as I thought it would be. I had a quick meeting with the nurse coordinator and then off I went back to the pharmacy.

As expected they did not have my meds ready. And I needed to pick up my thyroid meds as well which I knew I would have to ask them to do for me since they can’t seem to figure out how to keep them on auto refill since I take two different dosages. There were seriously like 8 people working behind the pharmacy counter and it was complete chaos. After finally talking to the pharmacist he tells me that one of my thyroid meds only has enough left on the prescription for ½ of what I need for a month. What?!?! How is that even possible? I was able to convince him to give me those pills so I could get through the weekend, while he got the refill from my doctor. It still took 30 minutes to get out of there.

By the time I got back to work I was a wreck stress-wise. I was thankful that my boss was not in the office when I got back. I got right to work and accomplished everything on my priority list quickly. Of course not long after I got back I got a message from my doctor that they will only refill my thyroid meds for 1 month because I need a blood test! I literally just saw her when she made me come in in May for a “Med check” appointment and she didn’t say anything about needing one soon. Actually I asked her to give me a lab sheet for Lab Corp in case I wanted to get one voluntarily. It was stupid enough that I had to go in for an appointment with her so she could “see how I was doing taking my thyroid medication that I have taken my entire life”…..and how this! I mean what a waste of time and money!

Keeping my eye on the prize, I am super grateful that all of this worked out and I know I need to seriously work on keeping a little calmer when I get curve balls. Honestly if my boss hadn’t made me feel so uncomfortable about missing work for doctor visits, I think I would have handled all of this better. I am so thankful I had no cysts and can go forward with this cycle, and that thank goodness my next ultrasound appointment is on a Saturday. My beta day will be Sept 23 or 24th which could be the perfect belated birthday present.

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The Next Level- Prep for IUI #4

Today was my appointment with the financial coordinator and nurse coordinator at my RE’s office.  It was a lot of information to soak up in an hour, but I left feeling more like a legit infertility patient.  I mean it’s not necessarily that I didn’t feel legit before, but my first three IUI cycles felt different.  For one, it felt reactionary and shocking.  I had no idea what to expect.  It was kind of like being in the kindergarten of infertility treatments.  You are qualified to be there, but they just easy you in with the “easy” stuff.  Apparently when you start injectables  you have graduated to another level, and shit gets real.  

First, I never had to see a financial coordinator for my Letrozole only cycles.  I just paid for each appointment when I came in that day, and no one ever really told me the overall cost for appointments or medication.  This time things are different.  Even when she came to the waiting room to get me she took me to a completely different part of the office I didn’t know existed.  For a mixed cycle (or straight injectable cycle), you pay for everything at your baseline ultrasound.  That includes all ultrasounds, two back-to-back IUIs, a Beta at their lab (they always sent me to an outside lab before), estridol testing, and possibly other things I am now forgetting.  She also gave me an estimate on my medication cost.  All in all, this cycle will likely cost about $600 more than my Letrozole cycles, which is honestly a big relief.  She also gave me an estimate on the straight up injectable cycle, which was about double the cost of a mixed cycle (5k-ish). Honestly I do not see us ever doing that, but rather going to IVF.  The other interesting thing was that she went over the positive beta scenario with me, as it relates to billing.  Up to this point, no one at the clinic had ever mentioned to me what would happen if I actually got pregnant.  I learned that they basically do monitoring for you until 8 weeks, and she went over what would be billed to my insurance in that case.  I also had to fill out a form that stated I understood all my treatment was out-of-pocket (until positive beta), which I had never had to do before.  

Next I headed into the nurse coordinator’s office.  She went over what seemed like a mountain of paper work with me.  She first informed me that apparently I need a PAP.  Mine expired like 30 days ago…..and my OBGYN takes like 3-4 months to get into for a PAP.  I sort of started to freak out, but apparently they do them in the RE office, so I am scheduled for next Wednesday.  Also if the schedule doesn’t work out for the IUI for my next cycle, I will need blood work, because I have a few tests that expire this month.  She then went over the cycle schedule and what medication I would be taking on what day.  She is also calling in my Ovidrel and Gonal-F now.  She then went over some handouts she went sending me home with about fertility stress management, counseling, resources, ect.  I sort of laughed at this only because I was a little surprised they wouldn’t have given it to me A YEAR AGO WHEN I BECAME A PATIENT.  Again, apparently when you start shooting yourself up that’s when they start taking you seriously.  The next set of handouts had to do with do’s and don’ts that will start the first day I take fertility meds through when I get a positive beta (again, this was not discussed for oral cycles).  Finally she started to grill me on my prenatals and supplements.  She even sent me home with a big bunch of prescription prenatals to try (because most over the counter ones make me nauseous).  

Then we got to the hard part……the demo on giving yourself shots.  I mean it seemed easy enough to inject into a red cube, but when I am shooting a needle into my stomach I think I will feel differently.  Maybe it won’t be a big deal by the time I get to trigger, but right now Ovidrel scares me the most.  For my oral cycles the clinic has always done that one for me, and its possible they will again at my CD 11 appointment but she said i may have to do it myself.  I really wish I had a best friend in the nursing field.  

I also talked to the nurse coordinator about trying to work scheduled appointments in the early morning or later afternoon, since I work so far away.  Basically she said they would do what they could but I should really hope that some of the appointments fall on a weekend.  The only way that will really happen is if my cycle is 27/28 days or 32/33/34 days.  At this point I am really pulling for the 32-34 range…….not that I have any control :-).  

Despite the overload of info I am really trying to keep the most positive attitude possible, and not focus on the “this is it or its IVF” thing.  We will see how that goes when I start filling my body with hormones.  I am super relieved that this cycle is *only* going to cost around 2k.   I really expected it to be a lot more.  it’s funny how 2k feels like nothing when you have already spent thousands more than that on something.  If it brings me a baby, obviously money well spent.  If not…….well lets not think about that.  It’s honestly kind of weird to be back to blogging about all of this again after so many months of just waiting.  I already remember how doing treatment plans literally takes over your whole life.  I do feel more prepared this time mentally and emotionally.  I am just really praying that everything goes smoothly with no unforeseen stress, and of course for that positive beta…..finally.