Monday, May 30, 2011

I'm A-Scared

I admit it. I'm scared to do this IVF. I keep having this irrational urge to cancel the whole thing.

What if it works? Shit y'all, I'm nearly 39 years old. Will I be able handle such a major life change with my sanity intact? And what if it doesn't work? Will I be able to let that go? Will I feel compelled to accumulate more debt just to keep trying? Will I resent making that monthly payment on the debt we've already acquired to make this one shot possible?

And then there are the longer-term repercussions. My mother had estrogen sensitive breast cancer. I have been pumping my body full of excess estrogen for a couple of years now and IVF will raise that bar exponentially. Does that make me even more vulnerable to the same disease? My right boob was killing me the other night (it has stopped now), and all I could think was, "What if we go through all of this, and I end up with cancer like my Mom? Would it be better or worse to at least have a baby to show for it?"

I don't have an answer.

Saturday, May 28, 2011

IVF Update

I took another BCP this morning. Three more to go.

Dramatic stuff here.

All of the meds are in the house. Estimated retail value: $7,683.

Wednesday, May 25, 2011

What's For Dinner?

I made a crazy-tasty dinner tonight, so I though I'd share. It wasn't from a recipe and doesn't have a name, but it was basically a Tex-Mex quinoa salad. I served it with fresh sliced avacado and a cheese quesadilla.

Recipe for the quinoa salad:

3 C quinoa, cooked
1 can black beans, rinsed well
1 medium tomato, chopped
1 fresh jalapeno, seeded & chopped
1/2 red onion, chopped
2 cloves garlic, minced
juice of two limes

Spices to taste:
salt & pepper
red chili powder (1/4 t)
ground, toasted coriander seeds* (1/2 t)
ground, toasted cumin seeds* (1/2 t)
chopped fresh cilantro (1/4 C)

Mix well and chill before serving. Makes about six cups.

You could use another grain or rice, but quinoa has been getting a lot of press lately as a superfood, and it's also a favorite of the gluten-free crowd. I was suprised how much I actually liked it!

*About ground, toasted coriander and cumin seeds... we always keep these whole seeds handy and toast as needed in a miniature skillet, for 2-3 minutes. Grind toasted seeds with a mortar/pestle. It really doesn't take much extra time, but the flavors are amazing. Toasted coriander particularly adds a nutty, citrus-y note without the acidity of lemon or lime.

Saturday, May 21, 2011

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.

Thursday, May 19, 2011

I Need A Moment

I old my Tweeps I'd post an update on the IVF prescription situation tonight, but this migraine is taking precedence. All is well & I'll fill you in as soon as I can get rid of this headache.

Sunday, May 15, 2011

Can We Just Skip This One?

Nothing new to report, no cycle progress, no funny stories to tell.

Work hell continues, but will let up considerably after this week. I try not to talk much about my work online, because that's not really what this space is about, but it's kinda all consuming at the moment. I've even been dreaming about work stuff and I really resent it.  I have to take a day trip on Wednesday which will be exhausting and mind-numbing all at once, but at least I'll be home and sleeping in my own bed at the end of the day (technically very early the next morning, but that would be splitting hairs). I'm not a great traveler. I like being other places, but I don't enjoy the process of getting there/back. Airplanes make me anxious and nauseated. And I have to admit, as much as I appreciate my immediate coworkers, I have trouble relating to them on a personal level and this makes me feel very isolated and lonely, very "other". Throw travel into the mix, and it's not a fabulous day.

Aaaannnnddd... I have some serious thinking to do about my job. It was originally supposed to be a foot in the door, to get me in with this great employer. Now it's been two years, and I'm pretty comfortable in my position. Maybe too comfortable. I've learned a lot and built some new skills and confidence. I'm really quite lucky in the people I work with on a daily basis, but there are certainly aspects of my work that make me want to bash my head against the wall. For all that, the thought of leaving my department is scary, but it's the only way I'll be able to move up at all (if I even decide that I want to move up). But with the whole IF thing still in mid-air, do I really want to try making a big change? I just don't know, so I'll sit on it for a while and revisit the question in a few months perhaps. I have made a preliminary investigation, and didn't really find any appealing open positions elsewhere in the company, so it's not as if I feel like I'm missing out on anything in particular at the moment.

When I get up (later) Thursday morning, we'll head to our teaching appointment and get our official Plan. I'd like to just skip to that, please.

Friday, May 13, 2011

Meanwhile...

I never have had any hint of acknowledgment of my NIAW letter to Human Resources requesting the addition of IVF coverage to our health plans. Crickets. Disappointing, but not surprising.

All of our pre-IVF testing came back clear. Prof deposited his back-up swim team at the clinic. Our medication teaching appointment is set for next Thursday and the IVF Team (we have a whole team!) has presumably created our plan, but no one has called yet to share it with me. I'm guessing we'll get it at the appointment next week.

I did speak with a nurse a couple of days ago, and she gave me a tentative meds list:

BCP (already taking them)
Lupron
GonalF
Menopur
Ovidrel trigger
PIO

I've already got all my GonalF (13 pens... ugh) and my Ovidrel thanks to leftovers from my covered IUIs. It only just occurred to me that the BCPs were covered by my insurance when I went to pick them up. Nice.

I also spoke to the IVF financial coordinator at my clinic in preparation for making payment arrangements, and she called my insurance for me and found they will cover my IVF monitoring appointments since I still have one unused covered IUI left on my plan. HUGE help there! She is submitting paperwork for me to find out if they will also cover the rest of my meds.

Sneaking up on IVF, one step at a time.

Thursday, May 5, 2011

Anyone?

Am I the only infertile in the history of ART to walk eyes-wide-open into an out-of-pocket IVF*, fully expecting it fail? And I'm doing it anyways, because if I don't... how would I be able to live the rest of my life at peace? How would I ever be able to look my darling husband in the eyes if I didn't at least try?

*That was a lot of hyphens.

Tuesday, May 3, 2011

A to Z of TTC

This has been making the rounds and it's kinda fun, so here you go: TMI Central!

A. Age when you started TTC: 36

B. Baby Dancing or Sex: Groovin'

C. Children wanted: Two

D. Dogs/Cats/Fill in Children: Two cats

E. Essential Oils/Vitamins/Snake Oils: Prenatals & the occasional shot of wheatgrass

F. Fertility Meds I’ve taken: Clomid, GonalF, Ganirelix, Ovidrel, Crinone, First Progesterone

G. Gain: 20 pounds since ditching the BCP (have now lost 13, looking to drop another 12)

H. HSG (Hystosalpingogram): Whooo-buddy, check it out.

I. Infertile Pet Peeves: People who complain about how long it's taking to get pregnant, after trying for all of three months. SUCK IT!

J. Job title: Director of LaundryFolding (yeah, what-of-it?)

K. Kid’s names you’re afraid will be taken by the time you can use them: Seriously? If I tell you, you'll just steal them, because they're THAT cool. Nice try though.

L. Length of time TTC: Two years, four months

M. Miscarriages:  One, blighted ovum. Full story here.

N. Number of times you’ve switched OB/GYNS, REs, FSs: Assuming since TTC (not lifetime), none. Did get a second RE opinion, but went back to the first RE afterward.

O. Ovarian quality: No known problems

P. POAS or wait for AF: Varies by cycle, depends on how hopeful I am. Hope = POAS. No Hope = Why waste the money?

Q. Quote from an obnoxious fertile: Honestly, I'm very fortunate that there aren't any of these in my life. I've wracked my brain and come up with zero anecdotes. Please God let it stay that way!

R. RE, OB/Gyn or other? RE

S. Sperm: Above average in every factor

T. Time you tried naturally:  10 months to start, occasional un-medicated cycles since starting treatment

U. Uterus quality: No know problems. Once described by my RE as "beautiful".

V. Vagina: Yep. I got one of those.

W. What baby stuff do you already have? One sling.

X. X-tra X-tra Hear all about it! How many people know the ins and outs of our crazy TTC journey? Aside from us & our medical team? Maybe three or four. Oh, and thousands of people on the internet.

Y. Yearly Exam (do you still go in even though someone sees your lady parts most months?): Indeed, very compliant over here.

Z. Zits: Only with my period, and then it's worse than when I was a teenager. Which actually is still not that bad.

So now you’ve read mine. What are your IF A to Zs?

Sunday, May 1, 2011

Show Me the Money (Updated)

Money is such a sticky subject, and one that is constantly at the forefront of most discussions of fertility treatments. We do OK. We don't sleep on a pile of Benjamins, but we know we are better off than so many others. If you remember, we paid off our car last Fall. Turns out it was a good thing too.

Our IVF cycle is coming up soon (OH-SO-SOON) and we'll need to pay between $7,000 and $9,000 up front. I maxed out my FSA this year, so it will reimburse about $6,000 of that, but only after the fact. We have to pay UP FRONT. We have a little money saved up and a little room on our credit card, but even those two options combined are insufficient to the task. After countless calls to our bank, we determined that our only reasonable option for raising enough cash to prepay our IVF cycle was to take a personal loan using that paid-off car as collateral.

(sigh)

Fortunately, the application process was quick and easy to complete over the phone. All the bank needed was a copy of our title showing all liens paid off. Oh snap! We never ordered that when we got the release after the payoff. So a quick trip to the DMV to order the new title and then wait for it to come in the mail. After about a week, it occurred to me that we had no idea how long to expect the new title to take.

Off to the internet I went and lo and behold the DMV website states that when requesting the removal of a lien, the new title can be expected in 60-90 days. OMG OMG OMG. This was our only viable option!

(Cue panic)

After 5-6 hours fraught with the fear that our lien release would not get processed in time to get the loan pushed through before our IVF start date, I checked the mail to discover the title had been delivered that afternoon. Five days. Whatever, I'll take it.

The loan was approved, the funds are sitting in my checking account. So that's that. Now we just have to wait for CD1. Today is CD1. Blood work tomorrow and BCP start Tuesday. Here we go!

UPDATED: What I neglected to mention above is that my leftovers of refills from my last (insured) IUI are almost all I need for meds. I will need to buy the BCP, Lup.ron and PIO. So, not too bad really for prescription expenses.