We had our first ultrasound late last week. One little inhabitant with a heartbeat, measuring exactly on target. This is a first in our four year journey. There were more than two people with tears in their eyes at the clinic that morning. I swear the nurses came out of the woodwork to congratulate us. It was so very sweet.
I have to admit, it was just a little bittersweet to see that there was only one. We will not be doing another cycle for any reason. We are done, and there are no freezer babies. If this little one makes it, he/she will be an only child. It's hard to explain... we are both only children and I think we are feeling the pressure as our parents begin to age. I suppose a sibling is no guarantee of shared burden or support, but it just seems like it would be nice to have one.
I had blood work done as well and they are beginning to wean me off some of my meds already. I will have one more blood draw in two weeks to determine the next dosage reduction and will be off all meds entirely sometime between Christmas and New Year's. SO SOON!
As my midwife requested, I sent her an email after the scan to let her know the details. She was also very excited and told me to go ahead and call for an appointment. Sadly, I will not be having another scan, probably until the NT scan with my midwife in January (I think).
Showing posts with label meds. Show all posts
Showing posts with label meds. Show all posts
Sunday, December 9, 2012
Tuesday, November 13, 2012
Making PIO My Bitch
I am happy to report that the PIO shots continue to go smoothly and (very nearly) painlessly. They hurt about as much as the old GonalF injections, which is to say, not much to speak of. I can honestly say I'd take the PIO shot instead of a flu shot any day! I also tend to bruise if you look at me too hard, but my backside remains unmarked.
Since this is notably unusual, I thought I would share our technique as best I can. Keep in mind, neither of us is a medical professional and your doctor may have different instructions for you. Below are the instructions our doctor gave us.
1. Warm the PIO to body temperature by tucking the vial into my bra for about 30 minutes pre-shot.
2. Swab the top of the vial and then the injection site with alcohol.
3. Using the larger needle, pull out the syringe plunger to 1cc (my dose) and insert into the vial.
4. Push plunger in completely and then draw the dose into the syringe, taking care to eliminate any bubbles.
5. Switch to the smaller (injecting) needle and push the plunger carefully until a bead of oil appears at the end of the needle.
6. I bend over the back of a chair, resting my ribcage on the chair back and my elbows on the table, putting all my weight on my left leg for a right-side injection (or my right leg for a left-side injection).
7. Prof uses one hand to pinch up the flesh in the target area and the other hand to work the syringe.
8. Needle goes in all the way, and quickly.
9. Prof maintains the "pinch" with one hand and shifts his grip on the syringe to be more stable/steady.
10. Pull back on the plunger. If blood appears in the syringe, pull the needle out and reinsert in a different spot. If the plunger resists and there is no blood, proceed with the injection (maintaining the "pinch" at all times).
11. When the full dose has been injected, remove the needle and apply pressure with a sterile gauze pad.
12. Massage gently, stroking outward from the injection site to disperse the oil.
13. Apply a band-aid (just in case). The band-aid also helps me remember which side was done last.
PSA - Never reuse needles and always dispose of them in an approved sharps container.
In discussing this with Prof, we've decided that confidence on the part of the person wielding the needle goes a long way to minimizing pain.* Don't hesitate! Get the needle all the way in quickly, in one stroke, then keep the syringe steady (no wiggling). While injecting, push the plunger in slowly and evenly. Prof takes nearly 10 seconds the push through the 1cc dose.
*If the person doing the injecting needs some practice to build their confidence, an orange makes a good target (just use water in the syringe). This will provide an opportunity to work on quick insertion and maintaining a steady hand while managing the syringe one-handed.
Since this is notably unusual, I thought I would share our technique as best I can. Keep in mind, neither of us is a medical professional and your doctor may have different instructions for you. Below are the instructions our doctor gave us.
1. Warm the PIO to body temperature by tucking the vial into my bra for about 30 minutes pre-shot.
2. Swab the top of the vial and then the injection site with alcohol.
3. Using the larger needle, pull out the syringe plunger to 1cc (my dose) and insert into the vial.
4. Push plunger in completely and then draw the dose into the syringe, taking care to eliminate any bubbles.
5. Switch to the smaller (injecting) needle and push the plunger carefully until a bead of oil appears at the end of the needle.
6. I bend over the back of a chair, resting my ribcage on the chair back and my elbows on the table, putting all my weight on my left leg for a right-side injection (or my right leg for a left-side injection).
7. Prof uses one hand to pinch up the flesh in the target area and the other hand to work the syringe.
8. Needle goes in all the way, and quickly.
9. Prof maintains the "pinch" with one hand and shifts his grip on the syringe to be more stable/steady.
10. Pull back on the plunger. If blood appears in the syringe, pull the needle out and reinsert in a different spot. If the plunger resists and there is no blood, proceed with the injection (maintaining the "pinch" at all times).
11. When the full dose has been injected, remove the needle and apply pressure with a sterile gauze pad.
12. Massage gently, stroking outward from the injection site to disperse the oil.
13. Apply a band-aid (just in case). The band-aid also helps me remember which side was done last.
PSA - Never reuse needles and always dispose of them in an approved sharps container.
In discussing this with Prof, we've decided that confidence on the part of the person wielding the needle goes a long way to minimizing pain.* Don't hesitate! Get the needle all the way in quickly, in one stroke, then keep the syringe steady (no wiggling). While injecting, push the plunger in slowly and evenly. Prof takes nearly 10 seconds the push through the 1cc dose.
*If the person doing the injecting needs some practice to build their confidence, an orange makes a good target (just use water in the syringe). This will provide an opportunity to work on quick insertion and maintaining a steady hand while managing the syringe one-handed.
Wednesday, November 7, 2012
Transfer (and Correction)
Transfer went smoothly - two eight-cell embryos! You gotta love those high-res ultrasound machines - and seeing the little white bubble left behind when they pulled back the catheter. I was instructed to take two days of couch-rest (no cooking/cleaning or other exertion) and we got a little picture to take home.
It turns out, since we had fewer than 10 viable eggs they used ICSI on all of them. All eight that fertilized were still growing at the time of transfer, though the embryologist did say some of them were growing slowly and wouldn't be expected to make it to freeze (he didn't say how many). He will call us later this week to let us know the final stats.
We have also started the PIO shots and I am happy to report that so far, it does not hurt one bit. Prof has lots of IM injection experience from the days when he helped care for his Dad, so I'm guessing that helps. Dare I hope this will continue to be the case?
So now, we wait. Of course my RE is one of those who like a little extra time before beta, so it will be nearly Thanksgiving before we have any real results. We are still debating the wisdom of POAS (I am pro and Prof is con). I am remarkably calm for now and very much aware that if this going to work, it will work and there's not much else I can do.
It turns out, since we had fewer than 10 viable eggs they used ICSI on all of them. All eight that fertilized were still growing at the time of transfer, though the embryologist did say some of them were growing slowly and wouldn't be expected to make it to freeze (he didn't say how many). He will call us later this week to let us know the final stats.
We have also started the PIO shots and I am happy to report that so far, it does not hurt one bit. Prof has lots of IM injection experience from the days when he helped care for his Dad, so I'm guessing that helps. Dare I hope this will continue to be the case?
So now, we wait. Of course my RE is one of those who like a little extra time before beta, so it will be nearly Thanksgiving before we have any real results. We are still debating the wisdom of POAS (I am pro and Prof is con). I am remarkably calm for now and very much aware that if this going to work, it will work and there's not much else I can do.
Monday, October 29, 2012
One Step Closer
We had our lining check and YAY for another 10mm triple stripe! My ovaries may be slackers, but my uterus is a very diligent worker. We are expecting an update on the donor's progress any day, at which point we will have a better idea what the rest of the calendar looks like. Of course, like any IVF cycle, things will remain flexible and tentative until the last minute. Naturally, this has served as a wake-up call to the hamsters in my brain and my anxiety has suddenly exploded. Until quite recently, I was calm and unconcerned. Today, I need more information like a junkie needs a fix. I am ready to crawl out of my skin for lack of information. I also feel like I have a massive reserve of energy that needs to be targeted to some sort of "productive" project. Like a crochet blanket, or perhaps building a second bathroom on our house. With my bare hands.
Breathe in.
Breathe out.
We also had our IM injection instruction "refresher". We did have the verbal instruction a year and half ago, but as we never made it to retrieval in an IVF cycle, we have never had an opportunity to put it into practice. THUS. Prof had to perform a practice injection in the presence of the nurse when my lining check was complete. Neither of us was expecting that. I mean, we knew we would have to do a PIO injection at some point, just not right that moment.
The nurse did a dry run so we could see the process and drew the targets on my hips. I was surprised how high up and how small the viable area was. Not much room for site rotation in those little circles... I was having a really hard time refraining from vomiting and/or running from the room in a panic with my pants around my knees. The nurse then turned it over to Prof and he did the actual injection (with saline only as it's still too early in the cycle for actual PIO). He totally nailed it! I barely felt it. That great huge needle, all those nerves... and it was much less painful than a flu shot.
I've seen so much talk about the trauma of PIO injections. The huge needle, the excruciating pain... I know that once we're dealing with oil instead of saline the after-effects will be more troublesome, but at least I've conquered the fear of the giant needle itself.
Breathe in.
Breathe out.
We also had our IM injection instruction "refresher". We did have the verbal instruction a year and half ago, but as we never made it to retrieval in an IVF cycle, we have never had an opportunity to put it into practice. THUS. Prof had to perform a practice injection in the presence of the nurse when my lining check was complete. Neither of us was expecting that. I mean, we knew we would have to do a PIO injection at some point, just not right that moment.
The nurse did a dry run so we could see the process and drew the targets on my hips. I was surprised how high up and how small the viable area was. Not much room for site rotation in those little circles... I was having a really hard time refraining from vomiting and/or running from the room in a panic with my pants around my knees. The nurse then turned it over to Prof and he did the actual injection (with saline only as it's still too early in the cycle for actual PIO). He totally nailed it! I barely felt it. That great huge needle, all those nerves... and it was much less painful than a flu shot.
I've seen so much talk about the trauma of PIO injections. The huge needle, the excruciating pain... I know that once we're dealing with oil instead of saline the after-effects will be more troublesome, but at least I've conquered the fear of the giant needle itself.
Thursday, October 25, 2012
Hindsight
I had to go back and review my notes from the mock cycle to check if the side effects I'm seeing now are a repeat of those I had previously. Good news? They are. I'm so glad I took notes!
The crazy thoughts and fears, the bloating... all down to lup.ron. And lo and behold, now that my estrogen is rising, the crazy is fading fast (though not the bloat... sad trombone). Knowing the crazy for what it was made it SO much easier to ride it out this time. I've really been surprisingly calm so far, though a little more diligent about my meds schedule than I was during the mock cycle. I am also loving the smaller estrogen patches y'all. I am now sporting four of these little transparent beauties and I barely know they are there! I love them even more for having been covered by insurance...
We have not yet received an update on our donor, but she is stimming now. We are hoping to get an update in the next few days. Trigger should be sometime next week and at that time, Prof will get his appointment to drop off our swim team on retrieval day.
The crazy thoughts and fears, the bloating... all down to lup.ron. And lo and behold, now that my estrogen is rising, the crazy is fading fast (though not the bloat... sad trombone). Knowing the crazy for what it was made it SO much easier to ride it out this time. I've really been surprisingly calm so far, though a little more diligent about my meds schedule than I was during the mock cycle. I am also loving the smaller estrogen patches y'all. I am now sporting four of these little transparent beauties and I barely know they are there! I love them even more for having been covered by insurance...
We have not yet received an update on our donor, but she is stimming now. We are hoping to get an update in the next few days. Trigger should be sometime next week and at that time, Prof will get his appointment to drop off our swim team on retrieval day.
Sunday, October 14, 2012
Feelings and Numbness
Feelings
Hope of finally seeing a BFP and a heartbeat.
Absolute certainty that this cycle will not work.
Terror at the notion of telling our parents, either way.
Stress and anxiety stemming from our busy season at work.
Relief that our busy season at work wrapped up on Saturday.
Happy that BFF(H) is pregnant and NOT suffering secondary IF (there was some concern).
Disbelief at the pregnancy announcement from the couple whose wedding we attended in August. Who am I kidding... disbelief isn't really the word.
Numbness
What if DEIVF works for us and we actually get a take-home baby?
What if DEIVF doesn't work for us?
I keep remembering BFF(B) asking me how I felt about all this. I still don't know... I somehow just don't. Either way, I just want to get on with my life. I really need to start remembering my mouth guard at night. My lips are numb from clenching my jaw.
Cycle Update
My lup.ron shots are under way. The crazy kicked in pretty fast this time, but I've been riding it out better knowing it for what it is. I will start estrogen later this week and if it goes like last time, that will make me feel much better in no time. I'm not sure what's going on with our donor, but I'm assuming all is well or they would call us. I know they will call when they schedule her retrieval, but that is quite a ways off still.
Hope of finally seeing a BFP and a heartbeat.
Absolute certainty that this cycle will not work.
Terror at the notion of telling our parents, either way.
Stress and anxiety stemming from our busy season at work.
Relief that our busy season at work wrapped up on Saturday.
Happy that BFF(H) is pregnant and NOT suffering secondary IF (there was some concern).
Disbelief at the pregnancy announcement from the couple whose wedding we attended in August. Who am I kidding... disbelief isn't really the word.
Numbness
What if DEIVF works for us and we actually get a take-home baby?
What if DEIVF doesn't work for us?
I keep remembering BFF(B) asking me how I felt about all this. I still don't know... I somehow just don't. Either way, I just want to get on with my life. I really need to start remembering my mouth guard at night. My lips are numb from clenching my jaw.
Cycle Update
My lup.ron shots are under way. The crazy kicked in pretty fast this time, but I've been riding it out better knowing it for what it is. I will start estrogen later this week and if it goes like last time, that will make me feel much better in no time. I'm not sure what's going on with our donor, but I'm assuming all is well or they would call us. I know they will call when they schedule her retrieval, but that is quite a ways off still.
Friday, July 13, 2012
And Now, For Something Completely Different
For my next trick ladies and gentlemen, I will fail - completely and utterly - to bleed. Or I should say rather, I HAVE failed. For the first time ever (excepting the nine weeks I spent harboring the blighted ovum). When the lovely nurse declared my mock cycle a triple-striped success and gave me the go-ahead to peel off the patches and stop with the shots, she told me I should expect to bleed within a week, two at most, and if I didn't bleed after two weeks to call in for further instruction.
Instruction, in this case, meant "Go to the lab and get lots of blood drawn. Immediately." Two hours later, I had my blood drawn while fully hydrated for the first time in my memory (read: after 8:00 am). Turns out that was a mistake, and my choice of a black sweater that morning was not. Yes, I had been hoping for a bleed. But not from a vein.
Another two hours (HOW did they get those results so fast, I ask you?!) and the nurse called to tell me that I am not pregnant and will not be bleeding without further assistance. Here's hoping seven days of Prov.era will get things going.
This is uncharted territory for me. Somehow, I feel more helpless now than I remember feeling in the whole of the last three and a half years. I can't even bleed right anymore. I can't feel like this is a good sign.
Instruction, in this case, meant "Go to the lab and get lots of blood drawn. Immediately." Two hours later, I had my blood drawn while fully hydrated for the first time in my memory (read: after 8:00 am). Turns out that was a mistake, and my choice of a black sweater that morning was not. Yes, I had been hoping for a bleed. But not from a vein.
Another two hours (HOW did they get those results so fast, I ask you?!) and the nurse called to tell me that I am not pregnant and will not be bleeding without further assistance. Here's hoping seven days of Prov.era will get things going.
This is uncharted territory for me. Somehow, I feel more helpless now than I remember feeling in the whole of the last three and a half years. I can't even bleed right anymore. I can't feel like this is a good sign.
Friday, June 29, 2012
Ticked Off and Triple Stripe
One more to-do ticked off the list. The mock cycle is complete, right on schedule.
If you follow me on Twitter, you may have seen me mention that my E2 blood work earlier this week came back way too low. The ginormous estrogen patches weren't having enough impact, so they added little blue estrogen tablets to my protocol (not to be taken orally) which had the unusual side effect of blue cervical mucus. Good times here in SlackieLand!
The emotional roller coaster evened out quite a bit with the decrease in the lu.pron dose and the addition of the estrogen, though the headaches continued undiminished. I was doing OK until Thursday when I had to increase the number of patches to four and ran out of unused belly real estate. These things are ridiculous! They are perfectly round and about three inches in diameter. As a result, I had to place them higher on my abdomen than I liked and BOY was that a miserable sensation! Every move I made caused the patches to pull and pucker and it was driving me batshit. There was an awful lot of pouting on the couch last night.
This morning was the Big Reveal - my appointment at the RE to check my lining and see how I responded to the mock protocol. When the nurse walked in and asked how things were going, I kind of exploded about the patches. Oops. I felt like she was humoring me a bit, but when I pulled up my shirt and showed her just how big these patches are... she agreed that they were ridiculous and suggested I request a smaller brand when I refill (which, you bet your boots I sure will).
The good news was that I managed to grow a lovely triple stripe lining just under 10mm, even with my earlier sub-par E2 levels. So the mock cycle was declared a success and the nurse let me pull off all my icky patches right then and there. YAY!!! In other way-to-start-the-weekend news, Prof's emergency swim team got an even better report than the crew he dropped off last year when we tried IVF for the first time with my eggs. Smiles all around!
So - the Plan is that I call the nurse coordinator when I start bleeding next week (uh.. didn't I just do that LAST week?) and she will present us with one or two donor profiles to review. I'll go back on BCP and stay on them until our donor starts stims. When the time comes for our real DEIVF cycle, I will start the estrogen patches and the little blue tablets at the same time. Otherwise, they are happy with my plan.
NOTE ABOUT PATCH ADHESIVE: There has been much commentary between here and Twitter regarding the removal of the patch adhesive. The ones I have are less sticky I guess, since after two days most of them started to release on their own even though they were meant to stay on four days. The silver lining is that my Purp.ose facial cleanser got all the sticky bits off with no scrubbing or struggle at all.
If you follow me on Twitter, you may have seen me mention that my E2 blood work earlier this week came back way too low. The ginormous estrogen patches weren't having enough impact, so they added little blue estrogen tablets to my protocol (not to be taken orally) which had the unusual side effect of blue cervical mucus. Good times here in SlackieLand!
The emotional roller coaster evened out quite a bit with the decrease in the lu.pron dose and the addition of the estrogen, though the headaches continued undiminished. I was doing OK until Thursday when I had to increase the number of patches to four and ran out of unused belly real estate. These things are ridiculous! They are perfectly round and about three inches in diameter. As a result, I had to place them higher on my abdomen than I liked and BOY was that a miserable sensation! Every move I made caused the patches to pull and pucker and it was driving me batshit. There was an awful lot of pouting on the couch last night.
This morning was the Big Reveal - my appointment at the RE to check my lining and see how I responded to the mock protocol. When the nurse walked in and asked how things were going, I kind of exploded about the patches. Oops. I felt like she was humoring me a bit, but when I pulled up my shirt and showed her just how big these patches are... she agreed that they were ridiculous and suggested I request a smaller brand when I refill (which, you bet your boots I sure will).
The good news was that I managed to grow a lovely triple stripe lining just under 10mm, even with my earlier sub-par E2 levels. So the mock cycle was declared a success and the nurse let me pull off all my icky patches right then and there. YAY!!! In other way-to-start-the-weekend news, Prof's emergency swim team got an even better report than the crew he dropped off last year when we tried IVF for the first time with my eggs. Smiles all around!
So - the Plan is that I call the nurse coordinator when I start bleeding next week (uh.. didn't I just do that LAST week?) and she will present us with one or two donor profiles to review. I'll go back on BCP and stay on them until our donor starts stims. When the time comes for our real DEIVF cycle, I will start the estrogen patches and the little blue tablets at the same time. Otherwise, they are happy with my plan.
NOTE ABOUT PATCH ADHESIVE: There has been much commentary between here and Twitter regarding the removal of the patch adhesive. The ones I have are less sticky I guess, since after two days most of them started to release on their own even though they were meant to stay on four days. The silver lining is that my Purp.ose facial cleanser got all the sticky bits off with no scrubbing or struggle at all.
Friday, March 30, 2012
I'm a Donor Too
I donated all of my leftover Meno.pur to a couple who had no prescription coverage. I was so excited to know that I was helping someone else towards a shot at their dream and so relieved that the meds wouldn't just be going to waste in my closet. Still... it was surprisingly hard to drop off the boxes, smile and walk away casually.
I've been holding those meds for months now, knowing I would never use them. I told Prof later, that it felt a little like giving away my "blankie".
God please, I hope their cycle works.
I've been holding those meds for months now, knowing I would never use them. I told Prof later, that it felt a little like giving away my "blankie".
God please, I hope their cycle works.
Saturday, July 9, 2011
Without A Doubt
I've been taking my DHEA for over a week now. The warnings on the bottle are a little alarming. There is even one that warns against use by women of childbearing age... which was, as I'm sure you can imagine, a little confusing. I had a persistent headache for the first five days or so, but that has abated now, thank goodness. I have also had VERY vivid dreams, just before waking, every day since I started taking the DHEA. Not nightmares or sexy dreams, just weird nonsense dreams that I remember clearly after waking (which is unusual for me).
I did a little online research and read some promising things about this treatment. Things that actually gave me hope. I almost wish I hadn't. Because as much as DHEA appears to increase the odds of a successful pregnancy in circumstances like mine, we all know there are NEVER any guarantees are there? There will always be someone for whom things just don't work out. If that's going to be me, it would be so much easier to go into it without much hope. I'd rather not have to deal with the crash. I wish there was some way to know in advance if I will be one of the lucky women for whom DHEA is the answer.
Our local S*bux has a Magic Eight-Ball on the pick-up counter. We stopped in on our way home this evening, and of course I just had to go there. The answer:
Without a doubt.
I did a little online research and read some promising things about this treatment. Things that actually gave me hope. I almost wish I hadn't. Because as much as DHEA appears to increase the odds of a successful pregnancy in circumstances like mine, we all know there are NEVER any guarantees are there? There will always be someone for whom things just don't work out. If that's going to be me, it would be so much easier to go into it without much hope. I'd rather not have to deal with the crash. I wish there was some way to know in advance if I will be one of the lucky women for whom DHEA is the answer.
Our local S*bux has a Magic Eight-Ball on the pick-up counter. We stopped in on our way home this evening, and of course I just had to go there. The answer:
Without a doubt.
Tuesday, June 21, 2011
Taking a Bullet
So yeah, I took the statistical bullet last week. I'm pretty sure we all do at some point, but I figure someone else can have the honor next time, okay? That actually sounds kinda shitty. I don't wish this on any of you. I sincerely hope all of you who got your BFPs and excellent fertilization reports appreciate my sacrifice! (And in case it was unclear, that was intended to be humor. I'm a wee bit dry.) Unfortunately, this leaves me disinclined to blog for the moment. In keeping my Bullet Theme, you're getting a list today:
- All of my meds have been refilled (at no cost to me, since I met my co-insurance in May) and are boxed up and waiting in the back of my closet for the do-over IVF. It wasn't until I started IF treatments that I even knew what co-insurance meant. If you've never been introduced, it means that I've paid my yearly limit of co-pays and for the rest of the year any covered medical expenses (excluding prescriptions) will be paid 100% by my insurance. I've spent THAT much in co-pays already this year.
- The box of meds is in my closet because my mom and my MIL are coming for their annual summer co-visit. This is good. I love them both and they have a great time together.
- The box of meds includes a just-in-case refill of my Crinone because next week, my employer sponsored health insurance is switching prescription coverage and Crinone will be bumped into the highest tier. I'm guessing my employer is gonna be saving some serious cash because my prescription costs are about to go up. Bastards.
- These are the same Bastards that have neglected to respond to the letter I sent in honor of NIAW. I console myself with the virtue of having sent it at all.
- I've fallen of the Fitness Wagon. I haven't exercised in... months. I am consistently exceeding my calorie limit for the day. Granted, my daily calorie limit is ridiculous at a mere 1,200. I AM at least maintaining. My weight has not gone back up, but the loss has plateaued. If only I could convince myself to get off my ass and back on the elliptical. It would probably also help if I could refrain from restocking the ice cream supply in my freezer.
- If I have to see one more 5-6 month pregnant woman pushing a one year old in her grocery cart, I refuse to be held responsible for my own behavior. The produce section is a perfectly acceptable location to lay down and beat the floor with my fists while screaming.
- Fortunately, I can avoid the produce section for the most part in the near future since our CSA box started back up last week. Dude, I LOVE garlic scapes. And having an excuse to see my BFF more often.
- BFF thinks I'm depressed. She's probably not far off.
This shit sucks.
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.
Dramatic stuff here.
All of the meds are in the house. Estimated retail value: $7,683.
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.
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.
Monday, March 28, 2011
Public Service Announcement (UPDATED)
I was cleaning out my fridge this weekend and organizing my crisper full of Gon.alF by expiration date and I made a discovery.
The expiration date on the pharmacy's prescription sticker was NOT the same as the expiration date on the actual box the pen came in.
Big revelation, huh? I hadn't even realized there was a date on the actual box. I only saw the one printed on the pharmacy sticker. My pharmacy is part of my health insurance company. Those sneaky bastards put an expiration date FIVE FULL MONTHS earlier than the one printed on the box. And the most recent batch of meds I received... the pharmacy sticker has a date that is THIRTEEN months earlier than the date on the box.
Anyway, the moral of the story is check your prescriptions carefully to be sure of the expiration date. Don't let the insurance bastards put one over on you.
UPDATED: (re: Rx expiration vs Meds expiration) Excellent question C, and one I asked myself at first as well. But no. I know this because when I called the pharmacy in January to order a refill, they told me the Rx had expired and I would need my RE to call in a new one. The last box of medicine I had left over from the previous Rx had an expiration date of 3/01/2011 on the pharmacy sticker. More than two months after when the pharmacy told me the Rx had expired and yet five months earlier than the date printed on the box.
Sunday, February 27, 2011
Crinone
If you've been reading my story for any amount of time, you know I tend towards luteal phase defect and my RE always gives me extra progesterone supplementation after ovulation. For my final IUI, he changed things up and prescribed Crinone instead of my usual suppositories. This is a progesterone gel that is delivered vaginally via pre-filled applicator like yeast infection creams.
I've seen quite a few other bloggers and tweeps who used it, but they usually just refer obliquely to ickiness, build-up and discharge. I hadn't really seen any practical suggestions for minimizing the ick. So for the benefit of anyone who hasn't taken this form of progesterone, but wants to know, here are the tips I got from my IF Twitter girls. If you have experience with Crinone, feel free to leave your own tips & tricks in the comments! For anyone else, this may be TMI in a big way. Consider yourself forewarned!
I've seen quite a few other bloggers and tweeps who used it, but they usually just refer obliquely to ickiness, build-up and discharge. I hadn't really seen any practical suggestions for minimizing the ick. So for the benefit of anyone who hasn't taken this form of progesterone, but wants to know, here are the tips I got from my IF Twitter girls. If you have experience with Crinone, feel free to leave your own tips & tricks in the comments! For anyone else, this may be TMI in a big way. Consider yourself forewarned!
- Wear all cotton underwear, and not your nicer selections.
- Wear a liner if you don't mind them.
- There will be build-up. Be pro-active about removing it.
- You will need to go in and remove the build-up yourself. Do this in the shower.
- Your insides will feel very strange indeed.
- No douche allowed.
- Side effects include: sore boobs, constipation, bloating, headaches and more.
- You may have to wait a few days for CD1 if you get negative beta and stop taking the medicine.
Monday, November 8, 2010
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.
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.
Thursday, August 5, 2010
Much Ado About Nothing
Y'all that totally did not hurt.
We've started the GonalF shots. I say "we" because the Professor is currently performing the injections for me. I say "currently" because now that I know exactly how little they hurt, I am determined to do this myself (under his expert supervision) before we are finished. I think I'll still let him do most of them for a number of reasons. I know I have an hourglass figure, but I somehow never realized until this evening how tricky it is to look directly at my belly because my boobs stick out so far. It's a curse. More than that though, I want the Professor to be as heavily involved in this process as possible. And I like when he does stuff to take care of me. Sticking me with a tiny needle and injecting me with hormones totally counts as taking care of me, especially since I was so scared to begin with.
I was so anxious about this first shot that I couldn't even think about food when I got home from work, in spite of my hunger. I basically sat on the couch and waited for eight o'clock to roll around. I re-read the instructions that came with the injector pen. I made the Professor re-read the instructions as well. I had him recite the procedure in full detail from memory as we set up shop in the bathroom.
I pinched. He poked. We counted to five and it was over. I barely felt it.
Professor admitted after the fact that in spite of his experience at this particular task, it had been hard to do that to me, because it was ME. I assured him it really was painless and we had a good giggle about how anxious I'd made both of us.
God I'm starving! Time to order a pizza to celebrate!
We've started the GonalF shots. I say "we" because the Professor is currently performing the injections for me. I say "currently" because now that I know exactly how little they hurt, I am determined to do this myself (under his expert supervision) before we are finished. I think I'll still let him do most of them for a number of reasons. I know I have an hourglass figure, but I somehow never realized until this evening how tricky it is to look directly at my belly because my boobs stick out so far. It's a curse. More than that though, I want the Professor to be as heavily involved in this process as possible. And I like when he does stuff to take care of me. Sticking me with a tiny needle and injecting me with hormones totally counts as taking care of me, especially since I was so scared to begin with.
I was so anxious about this first shot that I couldn't even think about food when I got home from work, in spite of my hunger. I basically sat on the couch and waited for eight o'clock to roll around. I re-read the instructions that came with the injector pen. I made the Professor re-read the instructions as well. I had him recite the procedure in full detail from memory as we set up shop in the bathroom.
I pinched. He poked. We counted to five and it was over. I barely felt it.
Professor admitted after the fact that in spite of his experience at this particular task, it had been hard to do that to me, because it was ME. I assured him it really was painless and we had a good giggle about how anxious I'd made both of us.
God I'm starving! Time to order a pizza to celebrate!
Monday, July 26, 2010
For My Next Trick
I'm back! I had a great visit with my BFF, and I'm home. I REALLY don't want to go back to work.
*sigh*
Anyhow... we had our follow-up consult with the RE last week. We're changing things up! Once this "resting" cycle is over, we'll be starting injectibles.
Whoa. For realz y'all.
The RE was still confident that Clom.id would eventually do the trick, but also agreed that we would be smart to step up the game. So we're switching to Go.nal-F plus Ovid.rel. He mentioned the increased chances at pregnancy (10% increased to 20%) and the increased chances of multiples (again 10% increased to 20%). It also means a lot more monitoring, so more time out of the office.
And shots. I'm such a wuss. *shudder*
We sat with a nurse and got the run-down on the injections, plus a little practice kit so we could familiarize ourselves with the injector. We played around with the demo pen for while. Seems pretty simple. She also gave us samples of a new alcohol swab from Walgr.eens that has a mild anesthetic in it. Apparently, other patients have been reporting good things about these new swabs. I'm game!
The nurse will sort out the pre-authorizations and order the meds for me. I just have to call the pharmacy this week to arrange for the delivery (and find out how much it will cost).
Anyone else who has used this same protocol out there... what side effects (if any) did you notice?
*sigh*
Anyhow... we had our follow-up consult with the RE last week. We're changing things up! Once this "resting" cycle is over, we'll be starting injectibles.
Whoa. For realz y'all.
The RE was still confident that Clom.id would eventually do the trick, but also agreed that we would be smart to step up the game. So we're switching to Go.nal-F plus Ovid.rel. He mentioned the increased chances at pregnancy (10% increased to 20%) and the increased chances of multiples (again 10% increased to 20%). It also means a lot more monitoring, so more time out of the office.
And shots. I'm such a wuss. *shudder*
We sat with a nurse and got the run-down on the injections, plus a little practice kit so we could familiarize ourselves with the injector. We played around with the demo pen for while. Seems pretty simple. She also gave us samples of a new alcohol swab from Walgr.eens that has a mild anesthetic in it. Apparently, other patients have been reporting good things about these new swabs. I'm game!
The nurse will sort out the pre-authorizations and order the meds for me. I just have to call the pharmacy this week to arrange for the delivery (and find out how much it will cost).
Anyone else who has used this same protocol out there... what side effects (if any) did you notice?
Sunday, July 18, 2010
Trying... Not Trying (My Wandering Mind)
I'm sure I won't be the first (or the last) to fail to truly rest during a TTC break. You're with me on this, right?
I told myself early in the last cycle that my heart and mind needed some time away from the hormonal roller coaster that Clomid brings with it. To say nothing of the concern that I've done five rounds of it now, and recently read that more than six is not recommended.*
I also had a fair bit of travel scheduled for this cycle and didn't want to be stressing about timing a trigger and IUI (and potentially being on the road at the critical moment, thus having to cancel), and then traveling with those lovely progesterone suppositories.
And then with the onset of CD1, everything fell into place such that the Professor and I would be in town together at just the right time. Of course, I still wanted a break from the prescriptions and certainly didn't want to travel with them. So it became an official break.
Except... I went out and restocked the OPKs because... oh, please. We ALL know why. And of course, I bought the combo pack that comes with a digital HPT. Because, OF COURSE!
Because I will be in town from CD8-CD14. And I always ovulate between CD9-CD14 and the Professor and I will be following our instincts as per usual. And we've all heard the stories of people who took a break and suddenly their bodies just did what they were supposed to, even without the prescriptions.
So here we are trying, when we aren't really trying. And my mind is all over the map, even without the fertility drugs. And as scattered as I feel, I also feel frighteningly blank. I've been reading my Twitter feed and keeping up with my blog reader, but most days I just can't think of a thing to say. I'm sorry I haven't been commenting much on your posts. I have been riding the waves with you, I just haven't known what to say lately.
I feel like I'm not really here.
*Remind me to ask my RE about that. Did I mention that we have a consult scheduled with our RE on Monday? I'm so worried that there is something more wrong with me that they missed because the luteal phase defect was so obvious. I don't even know what blood tests were done at the beginning. Maybe our one BFP was actually a total fluke? I'm hoping he brings his crystal ball to the appointment.
I told myself early in the last cycle that my heart and mind needed some time away from the hormonal roller coaster that Clomid brings with it. To say nothing of the concern that I've done five rounds of it now, and recently read that more than six is not recommended.*
I also had a fair bit of travel scheduled for this cycle and didn't want to be stressing about timing a trigger and IUI (and potentially being on the road at the critical moment, thus having to cancel), and then traveling with those lovely progesterone suppositories.
And then with the onset of CD1, everything fell into place such that the Professor and I would be in town together at just the right time. Of course, I still wanted a break from the prescriptions and certainly didn't want to travel with them. So it became an official break.
Except... I went out and restocked the OPKs because... oh, please. We ALL know why. And of course, I bought the combo pack that comes with a digital HPT. Because, OF COURSE!
Because I will be in town from CD8-CD14. And I always ovulate between CD9-CD14 and the Professor and I will be following our instincts as per usual. And we've all heard the stories of people who took a break and suddenly their bodies just did what they were supposed to, even without the prescriptions.
So here we are trying, when we aren't really trying. And my mind is all over the map, even without the fertility drugs. And as scattered as I feel, I also feel frighteningly blank. I've been reading my Twitter feed and keeping up with my blog reader, but most days I just can't think of a thing to say. I'm sorry I haven't been commenting much on your posts. I have been riding the waves with you, I just haven't known what to say lately.
I feel like I'm not really here.
*Remind me to ask my RE about that. Did I mention that we have a consult scheduled with our RE on Monday? I'm so worried that there is something more wrong with me that they missed because the luteal phase defect was so obvious. I don't even know what blood tests were done at the beginning. Maybe our one BFP was actually a total fluke? I'm hoping he brings his crystal ball to the appointment.
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