One Small Step

Got the pre-op appointment out of the way today.

Quick recap:

Dr. Spa proved true to type, didn't include ANY measurements of the polyps on the saline sono-thing report that they forwarded to my real RE. Of course.

Dr. Real gave me a pre-op physical hisveryownself. Took a while, but he located one tiny tiny polyp on the ultrasound and maybe two even smaller ones, but they were so small that he couldn't be sure. The one he definitely saw was so small that no one would have seen it if they weren't really searching just for that.

All the paperwork is done. I call with CD1 and they start looking for an available OR slot. He is confident we can get this done in December. One step closer to the next step.

Mumble, Mumble, Moan

Fair warning - this is mostly moaning.

The family has vacated the premises, so it's safe to log back in. We had a lovely (if short) visit with the parents. We ate way too much and drank too much wine, and there is enough food (and wine) left over to feed another table of six. I didn't even bother to log my calories on myfit.nesspal. BFF(B) very kindly stashed my meds in her fridge so the parents wouldn't accidentally stumble on them and NOBODY mentioned grandkids or babies at all. Nice.

Started working on the Christmas lists (for giving and receiving). Actually ventured into the retail wilds on Saturday and scored a few gifties for Prof so I can start crossing things off! That was traumatic enough, I think I'll stick to the internet for the remainder. Funny, I used to love shopping, but now it's absolute torture.

Pre-op consultation with the RE is this Tuesday. No idea yet when the surgery will be, but this will get us on the waiting list so if someone else cancels in December we might get in sooner rather than later. Otherwise, looks like it might be January. More waiting.

I've been wracking my brain trying to figure out how we'll pay for the IVF if we end up on that road. My maxed out FSA will cover most of it, but they don't cut me a check until a procedure has been performed and a claim sent in. The IVF has to be paid in full two weeks before retrieval. Which leaves a gap that my credit card can't handle. So there's that.

I have our last major work event of the year coming up this Thursday. I had to leave this event early last year with the onset of what I have since decided was an early miscarriage. After three days of sore boobs and brief flashes of nausea (the likes of which I had never experienced before and have not seen since), I got what was one of the worst periods of my life right in the middle of this event.  My period is due over the weekend (can't pinpoint since I didn't track ovulation this cycle), so if my luteal phase is shortened, I may get to have my period for the event this year as well! Good times, can't wait.

We should get our new appliances this week (if all goes according to plan - ha! ha!) and I need new tires on my car before we get actual snowfall (or godforbid ICE). I'm more thankful than I can express that we have the cash to do these things right now and don't need the credit card for Christmas gifts this year. Not all bad. 

Every inch of my body hurts and if I breathe deeply, I get an unpleasant hot feeling in my lungs. With everything I need to accomplish this week, I DO NOT need the flu. I just want this week to be over already.

Just to Hear Myself Talk

Still trying to manage direct contact with my original RE (really need a name for him) to discuss next steps in regards to the saline sono-thing and the polyps. I left a message, but have not received a call-back. I'll try again Monday. Not critical yet as the whole records transfer thing is still in process, but I just want to feel like I have a plan of action. I'm really in limbo at the moment. Not quite Hell, but it sucks all the same.

Tick-tock, people. Tick. Tock.

Professor is home safe and sound, no further airplane malfunctions. He did opt-out of the nudie scanners and got thoroughly groped for it. He also caught a bug and has been a little under the weather, but all in all, just glad to have him back.

We ordered a new fridge and stove on Saturday. The ones we have now came with the house when we bought it and have seen better days. Neither were much to speak of when they were new, and that was clearly a long time ago. We had hoped to have the new ones in place for Thanksgiving, but alas, that was not to be. I am inordinately excited by the prospect of new appliances. I keep catching myself giggling at the prospect of loading up my fancy new fridge shelves. And an ice-maker! At last! With these appliances installed, our kitchen will be done! We have been working on it little by little since we bought the house over four years ago. I think the master bedroom may be next...

This will be a busy week. I have a haircut and we are double-dating with BFF(B) and her DH on Tuesday - to see HP7! We also have rather a lot of housekeeping to get done as we are hosting my Dad and both of Prof's parents for Thanksgiving this year (thus the hope for the early appliance delivery).

May not be posting again before the holiday, so just in case:

Happy Thanksgiving! Try not throttle anyone!

Second Opinion (Think Again)

I went today for the saline hysterosonograph at the second opinion clinic. First thing I asked was if they had my blood work back from last week. They did (so why didn't they call me with the results?) and the verdict is:

FSH = 10.7
AMH = .33

The FSH is up from 9.1 in September. I have yet to consult Dr. Google about these results, but only because the doctor was pretty clear in her analysis. Basically it could be much worse, but this isn't very good news. They will have to push me a little harder to get a good response for IVF. Not a big surprise at any rate.

That conversation out of the way, we moved on to the saline thingy. My overall impression of the whole procedure was "wet". The doctor kept asking me how much pain I was in, but honestly, I never felt a thing other than wet. I kept waiting for her to get started, and it wasn't until I saw what was happening on screen that I realized what she was doing. The upshot is there are a few very small polyps at the top of my uterus. She didn't think they would necessarily prevent me getting pregnant, but they might. She did say it would not be a great thing to get pregnant with them in there because they could get larger and bleed and cause problems, and it would be better to have them out before going any further.

The only thing that makes me think this really does need to be done is that this office can't do it. They suggested I have my regular OB perform the hysteroscopy. I had them send the records to both my midwife and my original RE. I'll discuss it with them both before moving forward on anything, but it looks like this puts us out of the running for a December IUI. Which also puts IVF further in the future.

I wonder how fast my FSH is rising...

Saturday Night Fever

In true Slackie fashion, I am spending Saturday night curled up on the couch with the cats. Professor is on his way to Paris for the week on business, so I'm feeling a bit sorry for myself. Sure I've been to Paris before and yeah it's only a week and he'll be in meetings for ten hours a day, but I'm spoiled. I would have preferred either to go with him or for him not to go at all.

So here I sit, fretting about the airplane he is on (which had a malfunction necessitating de-planing for a while) and focusing perhaps to an unhealthy degree on the likely next steps in our IF journey. God it's awesome being thirty-eight!

I'm doing a lot of thinking about IVF even though we still have one last IUI to do.  I've done a little more digging to see if there is anywhere in reasonable driving distance that we should consider for a proper second opinion, and all signs continue to point to our original clinic being the top IF group in our area. I can't help wishing that we had gotten a real second opinion. I feel like last week's appointment was mostly just a look at what not to do. I've revisited the IVF success rates for our Chosen Clinic versus our "Second Opinion" and the Chosen Clinic has much better numbers. In reviewing their standard protocols, it looks as though for patients my age (38) with my diagnosis (unexplained), they recommend both assisted hatching and ICSI.

I'm still waiting on the blood work results from the second opinion appointment. The AMH takes about ten days to get results because it has to be sent away for the test, so I'll be waiting a while yet. This Tuesday I have a saline sonohysterograph as I've never had one. I'm slightly nervous, but don't really expect to find anything problematic there. After that I will just wait for CD1,which will be around December 5th. Then it will be full steam ahead on injectible IUI#3! I bet I have my baseline the same day as the IVF info session at our clinic. Any takers? The timing will actually be pretty good, with stimming, monitoring and IUI all wrapped up just days before the family descend on us for Christmas. I'll know the outcome by New Year's.

I'm trying not to think about what the new year might hold.

Second Opinion (Second Thoughts)

I have to preface this by saying that when we started fertility treatments, we did our research and asked around before we settled on our original choice of RE. We didn't take cost into consideration at all. The clinic we just visited for our second opinion was presented to us a few times as being a really excellent and less expensive option (and my acupuncturist went so far as to say it was better than our original choice), so we were confident that we chose the best for the first go around, but had this highly recommended back-up for our second opinion.

The best word to describe the second opinion is BIZARRE. If nothing else, the experience highlighted the fact that for the last twelve months, we have been in treatment at the premiere fertility clinic in our area.

Y'all. The place is a spa. That's the only way to describe it. It looks from the outside like a boutique hotel with beautifully landscaped grounds. When we walked in the door, we were standing in front of a hostess desk boasting ads for specials on Ave.da make-up and could see a huge glossy display of OPI nail polish in the room down the hall.

All I could think was "WTF?"

Things just got weirder from there. The receptionist offered us coffee from the new coffee shop they had just opened downstairs and seated us in what looked like a living room with a roaring fireplace and a huge display of self-help books and even oracle cards for sale.

My records still hadn't been entered in the system, even though they'd had them for over a week. The doctor wasn't on the premises yet and it was already nine o'clock. When they finally got my info in the system and the doctor came in for the consult, things seemed to start looking up a bit. Until it became clear that he hadn't really looked at my records. The first thing he said after a quick glance over our treatment history was "You've really been through the ringer!" He asked the right questions and gave good answers to the questions we asked, but still. He briefly reviewed our treatment history and jumped straight to the IVF talk. He was enthusiastic about getting me the AMH test and a couple of other basics that haven't been done. He also was quite clear that for someone my age, he would transfer 3-4 embryos in IVF. Y'all, I'm not comfortable with that!

All of the decor was a posh mixture of Mediterranean/Asian/ShabbyChic (even in the ultrasound rooms). It was like going for a facial and getting wanded instead. They left Professor and I alone a few times throughout the appointment, and we both just kept looking at each other with wide eyes. It was really kinda hard to believe it was for real. And TWICE before we left, the nurse mentioned all of the workshops, yoga classes, massage and acupuncture services, etc. that they also offer onsite. I'm sure that for some people, this would be a very warm, relaxing, comforting environment, and I hope those people can find this place and can make all their dreams come true. I, however, am definitely not one of those people.

BIZARRE.

At the very least, we will get the tests this new guy suggested and since today just happened to be CD1, they were even able to do a blood draw for those. We'll then be comfortable going back to our original RE and placing ourselves and our finances unreservedly in his care. I think I'm ready now for a final IUI in December.

*Bonus update: We have achieved yet another unmedicated 14 day luteal phase! Yippee!

All Eyes On the Scoreboard

I'm staring down yet another CD1 and contemplating my third benched cycle in a row. We go in for our second opinion tomorrow morning and may or may not be getting some new ideas. With only two covered injectible cycles left on my insurance, it seems wise to hold them in reserve pending new information and a potential change of plan.

In ten days, on November 18, we will hit our one year anniversary in fertility treatments. Like the rest of you, I never expected it to take this long or require this much effort. It's been a busy year to say the least. As we approach the twelve month mark, our IF scoreboard reads as follows:

CD1s: 12
IUIs: 6
Clomid Cycles: 5
Injectible Cycles: 2
Benched Cycles: 5
Pregnancies: 1
Miscarriages: 1

Those last two are a real kicker, huh? Looking at those numbers, I know we've done a lot this year treatment-wise. I think if we had done any more, we would literally be done at this point, yet I've been feeling guilty for not jumping immediately back into treatment as soon as the last cyst resolved. I even felt guilty the one cycle I took off this summer to preserve my sanity from the Clomid Crazies. The first CD1 after the most recent cyst fell at an incredibly inconvenient time, but if I had been more motivated, I probably could have found a way to squeeze in a baseline appointment. And this month, it is only the voice of fiscal responsibility cautioning me to conserve my insurance coverage that is keeping me from pursuing treatment. Both months perfectly good reasons to skip a cycle, and yet I feel this guilt.

Help Where It Is Needed (Updated*)

Since being told we were looking at IVF in the next year, and then being told that our insurance won't cover any of it, I've been keeping my eyes and my mind open to ways that we can scrape together the funds for it. We have no real savings. What little money we do have put aside is earmarked for the tax bill (self-employment has its down sides and the tax bill is a big one). All spare cash that comes in is going straight to paying off debts like student loans, credit cards and back taxes (see previous comment on self-employment down sides). We have some equity in the house, but adding more debt really doesn't seem like a sound plan of action.

So what can we do, short of begging our parents for help (which would only be a last resort)?

First and foremost, I will max out my FSA contribution this coming year. Providing I have leftover meds from the next and final IUI, then the FSA will cover most of the remaining cost of one round of IVF. One. Round. And my paychecks will be reduced by a terrifying amount for the entire year. I am so scared of the possibility of the Professor having a month or two when the contract work isn't paying out and having to figure out how to pay our regular bills on my greatly reduced income. My income alone isn't enough to cover our expenses as it stands, but with that level of decrease... well, it's just frightening. It's still not a brilliant plan, but it's a start.

*Updated: I just realized that by January, our back taxes and my student loans will be all paid off! Those payments total about half of the monthly salary reduction I'll see from maxing out the FSA. Things just got a little less scary!

In an effort to find some other solution, I started looking around and found the following non-profits that offer grants for IVF or adoption assistance. They are all for US citizens only as far I can tell, but other parts of the world must have similar resources where the health care systems don't fill the need. I'm going to create a Resource page and add these there, but if you know of others, let me know so I can add them as well!

INCIID IVF Scholarships
Tinina Q. Cade Foundation
Fertile Dreams
Parenthood for Me
NYS Infertility Demo Program (varies by clinic)
*B.U.M.P.S. Inc.

More options and suggestions from Resolve.

Happy Holidays (harumph)

I love the Holiday Season, as long as it stays a few months in the future! There's something magical about the promise the holidays hold as long as they aren't right upon us. Of course, once we hit November 1, all bets are off and the stress just builds until the grand yet soporific anti-climax of New Year's Day.

This time of year always brings back memories of idyllic childhood Christmases, and those memories get all rolled up with the stories in the multitude of holiday children's picture books I've collected over the years. My Mom is a regular June Cleaver and really did an amazing job of building these memories for me to carry forward. She would be in the kitchen baking holiday treats while my Dad fought with the Christmas lights in the living room, and I would bounce between the two "helping". Somehow these ghosts of Christmas past are so seductive in their air of fantasy, that there can be no chance of present-day reality living up to their standard. I know I'm not alone in this, that this is part of being a grown-up. But I can't help but think that, in the usual way of things, grown-ups get to move through this transition into recreating those fantasies for their children, sharing the stories with new little ears, seeing the lights with new eyes. And we all know how that's panning out in this house.

So all of that leads to a host of conflicting emotions. I feel like I should be jolly and hopeful, but I can't help reminding myself of Reality. I want to be generous and giving, but some days have trouble just dragging myself along.

• I hate traveling.
• I hate family drama.
• I hate feeling like I have to go broke to make things "Merry".
• I hate wondering if this will be my last Christmas with my grandma.
• I hate the fear of the inevitable questions about the absence of offspring in our marriage.

That's a lot of hate. Hmmmm... what about things I love about this time of year?

• I love evergreen scented candles.
• I love Christmas trees and decorations.
• I love making cookies and other tasty treats to share.
• I love the early season snowfalls, as long as I'm not driving.
• I love sitting down for a big family meal and seeing my loved ones faces around the table.

Sorry if this post was a bit of a bummer for you guys, but it's where I'm at today. I know this is no great revelation. This is just Life. It is what it is and it's down to me to make the most of it.