Oh My Hell, or Wednesday in NYC

Sorry for the delay in posting, but this week truly kicked me. Hang tight: this might take a while, but I promise it all ends up OK.

For anyone who is not yet aware, there just happens to be a national (I'm in the US) shortage of Lupron. There are still a few pharmacies here and there with stock, but it's getting incredibly hard to find. No one has been able to offer me any kind of explanation for the shortage.

I was scheduled to start Lupron injections for IVF#1 next Saturday.

WEDNESDAY
 
All seemed to be going quite well until mid-day Wednesday. I had a business trip to NYC that was supposed to be less than 12 hours on the ground. This was the culmination of all the work stress I've been under for the last few weeks. Big Day. I would even have ONE hour to spare after our business concluded, and I planned to meet up with @the2weekwait and @thisispersonal for coffee before heading to the airport for my flight home.

I started the day in the airport with a phone call from my RE telling me they had found a pharmacy with Lupron in stock and I should expect a call to arrange delivery AND even better, my insurance company confirmed my meds would be covered. Awesome! I boarded my plane, shut off my phone and was off to the Big Apple. When I turned my phone back on in the taxi, there was a voicemail from the pharmacy.

Long story short, they do have Lupron in stock, but are refusing to fill prescriptions for new customers unless it is part of a complete cycle order. So I'd need to order a cycle's worth of GonalF as well. In spite of the fact that I already have all I need. I escalated up the chain of command, but this company just doesn't care. Since I've never ordered from them before, they won't fill my prescription.

I called my RE and left a message explaining the Lupron situation and they called me right back. They were changing my protocol from Lupron to Ganirelix and sent in a new prescription to my usual pharmacy. I called my pharmacy thirty minutes later to get the ball rolling, only to be informed that they were out of Ganirelix. Because of the national Lupron shortage. Everyone is being switched over, just like me. Smack in the middle of this phone call, a coworker walks up to me, cell phone to his ear. He mouths, "Our flight home just got cancelled". Due to weather. And not just ours, lots of flights.

Cue full blown panic.

My IVF teaching appointment is scheduled for 9:30 the next morning. After thirty minutes of frantic googling and phone calls (God bless my iPhone), I had a new flight out. But I'm in Manhattan and need to be at the airport in an hour. It's 5:30 PM. Rush Hour. Fifteen minutes of arm waving and one burst of hysterical tears later, a rather shell-shocked cabbie is taking me to LaGuardia against his better judgement. He kept handing me kleenex and granola bars and offering to charge my iPhone. I got through security with about 10 minutes to spare. As he drove, I texted Jay and Jen to let them know I couldn't do coffee. Poor Jen had had an even worse Wednesday than I did. What a bummer. At least I got home before midnight.

THURSDAY

The first thing I did when the nurse called us back for our teaching appointment was tell her the names of everyone at the clinic that I felt the need to apologize to after the previous day. She seemed amused by that, particularly awkward since her name was on the list.

Then I told her about the out-of-stock Ganirelix (I never got a chance to relay that information the day before). To my amazement, they already knew. She had a brown bag full of Ganrelix samples that she handed me. All I will need for my cycle. The Internetz seem to put this at about a $600 value. And they just gave them to me. I *may* have cried just a little.

She then ran us through our protocol and calendar, and demonstrated each of the new meds for us (we already have experience with GonalF, Ganirelix and Ovidrel). For the record:

BCP through 5.31
Baseline 6.1 (Pay-Up Day)
GonalF (375iu) starting 6.4
Menopur starting 6.9
Ganirelix starting 6.9
Ovidrel trigger TBA
Retrieval week of 6.13
PIO (50mg) starting day of retrieval
Antibiotic & steroid starting day of retrieval

Assuming we get eggs, they will perform ICSI on all of them. Assuming embryos develop, they will perform assisted hatching the day of transfer (Day 5 if possible). The antibiotic and steroid are in aid of the assisted hatching, which can make the embryo more vulnerable to potential infection during transfer and to prevent my immune system from rejecting the embryo as "foreign matter".

TODAY

I had a phone call first thing this morning from my pharmacy. They were calling for my approval of the co-pay amount for the Menopur, antibiotic and steroid: $146. It will ship Monday. I am so lucky.

We are still waiting to get the final dollar amount to be paid at my baseline, but it's looking like right at $7K. I keep telling myself how lucky we are the price is that low and my meds/monitoring will be covered just this once.