Good to go!

Thursday, what a day. I think I spent about 5 hours in the car, 2 hours in waiting rooms, and 3 hours involved in actual medical stuff. First, it was up to the RE's office for the second piece of the clomid challenge, the CD10 bloodwork. 70 minutes up, then 35 minutes back to my office to get some work done. The phone rang at 10:15... RE's office letting me know that last week's mammogram results had been received, but included a request for "additional views." The RE won't sign an authorization for insurance coverage of donor sperm until I have the all-clear on the mammogram. So, panicked phone call to the diagnostic imaging center and I wrangled an 11:45 appointment. Bear in mind that I also had a 3:00 HSG scheduled, in the big city hospital 70 miles away from the mammographer.

So, I ditch work ("Sorry, boss-woman, but due to a medical miscommunication, I need to leave at 10:45 instead of 1:30 today."). Another 50 minutes in the car and I arrive at the imaging center. Much very painful smushing ensued, followed by a lengthy wait while the on-site doctor reviewed the images. All-clear, good-to-go, letter in hand, I hit the road again at 1:20 and met C at a rest area so he could drive me in for the HSG. I was a nervous wreck already and didn't want to deal with traffic and parking on top of the stress of the procedure. I was convinced we'd be late, but the traffic gods smiled (momentarily) and we arrived right on time.

The HSG deserves its own post, so I'll discuss those details later. Not because I want to recount them, but because the information might be useful to someone else. For now, suffice it to say that the HSG wasn't the horror I expected but I hope never to repeat it. I did get to see the dye going in and through everything, which was pretty cool. The doctor and radiologist reviewed the image with me afterwards and said my tubes and uterus are exactly as they should be, all clear. I retrieved C from the waiting room and we headed out to face rush hour.

It took us, no exaggeration, 45 minutes to get out of the parking garage. Another 20 minutes to get to the highway, about 4 miles away. When we reached the HOV lane, though, it was smooth sailing all the way home. We agreed that we deserved a reward after a pretty rough day- stopped at BK for that angry onion concoction that's been advertised the last few weeks. Mmm, mmm... hot! Very tasty, but now that I've had one, I think my fast food urge is sated for the next few months, at least.

So, aside from the mileage and stress, yesterday was extremely productive and all the remaining pieces of the puzzle have been completed. I faxed the mammo results to my RE this morning, then they called with yesterday's blood work results. Everything checks out, and the authorizations should go out later this morning so I can place my order this afternoon (2PM cut-off for same-day shipping!) and plan on a double-dose of IUIs in the middle of next week. It's all covered by my insurance! I can't believe how lucky I am in that respect. And lucky too with respect to my health- everything is a-ok. The only explanation for not being pregnant via donor-IUI is my age and the usual odds.

That's comforting in a way. I think it bodes well for how a pregnancy will progress once we do conceive. My body is functioning well in every way that they've tested. Next step, POAS, look for the smiley face (I don't like the uncertainty of comparing lines, so I've gone digital), and make a date with lucky #18. Hello, TWW... I'm coming back!

on the eve

Another snowy day in the great Northeast. Another day that C wasn't called out to plow. I guess the rain/snow line fell right where he's assigned, so there was very little accumulation before it changed over completely. It's become an icy rain here at my office, which is about 30 miles north of C's plowing route. Remarkably, I'm not overly concerned with our finances at the moment. We're doing OK between my paycheck and C's unemployment benefits. We've cut back on everything- groceries, our social budget, random car trips. We're being very very good. And it's helping. I was clueless about our IF issues last winter, but felt more stressed about finances then than I do about IF and finances combined this year. It's a good feeling, this lower-stress.

That said, I'm not completely without worries. Take tomorrow- HSG day. I have never met any of the people who will be involved with the procedure tomorrow. I've heard that some doctors use a very fine, flexible canula to inject the dye, while other use a larger, metal tube. My squishy sensitive insides don't want to meet cold, inflexible metal. Why would anyone use a metal tube??? I specifically requested a female doctor- what gender will anyone else in the room be? How many people will be there? I hate being on display, not that I'm overly prudish or self-conscious, but this is very personal and intimate. These are not the circumstances under which I like to meet new people. I'm afraid it's going to hurt.

Then I worry what the results will be. And if we'll have all the results in time. And if the doctor will send the authorization to my insurance and the sperm bank in time for me to place an order. And if the order will be delivered before I ovulate.

But it's slightly less than my financial worries of last year, which woke me up at 2 am every other day. We're off to a good start this year. C applied for a job last week and they suggested he might be better suited to a soon-to-open supervisor position instead, with a bigger salary. That interview should be in a few weeks. I got a promotion last week- no raise involved, but I went from being an insanely overpaid admin to a slightly underpaid analyst. The salary potential is a lot better as an analyst, as are the growth opportunities. I'm pursuing an accounting certificate, on my company's dime, and enjoying my online classes.

I still claim 2009 as "our" year.

moving the goalposts

I like my RE, although I've only consulted with her in her office. I've never experienced her doing anything "medical." I like her patient coordinator, who has been a veritable font of knowledge and guidance as I deciphered the insurance options available and compared out of pocket with covered costs.

But maybe I should find a new RE. Every other day, someone tells me some other thing I need to do before we can have an IUI this cycle. It's already CD3. I ovulate between CD14 and CD17. I have to place the order by CD12, which means that my RE needs to send a signed authorization to the bank no later than CD12 or it won't be covered by my wonderful new insurance. That means I have NINE DAYS to get everything done and the results submitted to the RE's office. NINE DAYS!

And today, out of the blue, I get a call on my cell (I've told several people in the RE's office that I can be reached at my work number during normal business hours- cell reception at my office is horrible, but they keep calling my cell and my house.) from a nurse in the RE's office. I am now told that I not only need to schedule the mammogram before we can proceed with an IUI, I need to actually have the damn thing done and results sent to the RE before the authorization will go to the bank. Two days ago, a different nurse said it just needed to be scheduled. I am frantic here- I am trying to get everything done that they told me needed to be done, but they keep changing the rules on me!!

I hung up on the nurse. I know that was rude, but I didn't want to start yelling at her or crying out of frustration. Before I hung up, I asked her if she knew any place that would schedule a mammogram within the next 10 days. She said one just a town over from my home might. She didn't know the name or their phone number, but suggested I Google it. That's when I hung up. I did successfully Google the place, and managed to get an appointment for tomorrow. I called the nurses' line at the RE's office and left a terse message that I had rescheduled my mammogram for tomorrow, and if they need to reach me during business hours to call my work number. Then I had to find the phone number I just called yesterday to schedule the original mammo, for 2/17, and cancel it. Everything was on scraps of paper all over my desk- not very organized, but that was long-ago yesterday when I though this was still relatively simple.

So, today I am frustrated and tense and woried that I won't even know all that needs to be done to have an IUI this cycle until it's too late. It really seems like the rules have changed every other day since my first insured RE visit just two weeks ago.

Oh and another great kicker... for a donor insem, my husband needs to drop off the sperm or else I can't have the IUI done. "Luckily" C is still out of work (I never thought that could be a good thing), so he can drive 45 miles to the RE's office in rush-hour traffic two mornings in a row to drop off the sample, but if this were the peak of construction season, he'd be jeopardizing his job. And apparently, they don't make exceptions.

C keeps telling me that he likes this doctor's office. They seem very professional there and appear to really know what they're doing. I feel like a number- they have all these rules, many of which make no sense, and they don't make exceptions for anyone. [And they don't like to tell you all the rules ahead of time... like it's more fun to spring them on you little by little to keep you on your toes.] I've talked to a different nurse each time, and each of them has contradicted her predecessor. But I will do what they say because I want an IUI this cycle. I am NOT wasting the clomid-spiked eggs. I am not going through this cycle just to be tested when I have the chance to do another IUI.

Still frustrated. I need to focus on work now and try not to think about TTC for a few hours.

I must be having "fun"

Time has sped up. It dragged in December, when we weren't doing anything related to IF. Now that we're back on track and newly under the guidance of an RE, time has accelerated dramatically. I have a long list of hoops to jump through if we're not to waste the clomid-spiked eggs this cycle, and it's possible there may be more that I haven't been told about yet. I really don't like it when I am required to do something, but no one tells me ahead of time.

The RE insisted I (or maybe it was "We;" I'm not sure so I dragged C along) speak with a social worker. Done.

The RE required that C have several blood tests done, including such things as HIV, type, and HepC. Done- results for most of the tests should be ready for C to pick up tomorrow morning. I'm still not entirely sure why these were necessary. The sperm bank thoroughly documents donor testing, and if C were to infect me with something, wouldn't it have happened already?

The RE requires that I/we (which is it? I'm not sure, so I'm taking C with me) meet with her staff nurses and bring along our donor information. Our apointment is tomorrow, and I printed all the info we have on "lucky" #18. I hope they don't think they have any right to reject our selection. Do you know how many Rh-, CMV-, blue-eyed caucasian donors there are? Very few. And then if you narrow further by looking for an Open donor with confirmed pregnancies and a healthy family history... well, there's only one "lucky" #18. Why would I need their approval on *MY* donor selection anyhow?

The RE wants my "records" from the MW office. I called ans asked for those weeks ago, but they told me I really had no record. There's just a list of dates when I showed up for IUIs. But, my word (and my receips/cancelled checks) are not evidence enough that we've gone through 4 IUI cycles already, so tomorrow I must remember to call the MW office and insist that their meagre record of my existence is needed. They're closed today for MLK Jr. day.

The RE requires I undergo an HSG before progressing on to any procedures at all. I'll schedule that this week- as soon as AF shows up. I'm worried I may not have the results in time to place the order for donor sperm and have it here before I ovulate.

The RE requires I do the clomid challenge before we move on to any procedures. I filled the prescription already and am just waiting for CD1 so I can have some blood drawn and get started. So, in addition to tomorrow's trip to meet with the nurses, I'll be back in the RE's office on Thursday or Friday for a blood draw. The second draw will be on CD10... again, I am concerned that we may not have the results in time for me to place the order so the donor sperm is here before I ovulate. On Clomid, I ovulated on CD16, but I'd want the sperm here two days early, just in case I ovulate early, so I'd need to place the order by CD12, at the latest.

It's really the time crunch between blood draw #2 and ovulation that has me worried. And even though that's close to two weeks away, I feel a sense of urgency about getting all the other stuff done. I'm concerned there may be more requirements that no one has mentioned yet. And I am not willing to skip this cycle because-
1. I'll be taking Clomid. Why deal with the side effects and then let the resulting eggs go to waste?
2. Health insurance that covers all this IF stuff is costing me nearly $500/month. Yes, it's far less expensive than paying out-of-pocket, but C is still laid off and our finances aren't in the greatest shape after going it alone, IF-wise, last fall. And we still have to pay the deductible. If we can do anything that might result in a pregnancy this month, I want to do it. Once I'm safely pregnant, I can drop the second insurance (I still have my original insurance to fall back on.).
3. I'll be 41 in just two more months. The ticking of my biological clock is nearly deafening. I just don't have the patience to do "nothing" for a whole cycle when it's not necessary.

Wow- long post today. There's a lot on my mind. I'm also looking for a fertility buddha, a pocket-sized elephant, and some moonstone and rose quartz beads. It can't hurt to surround myself with items that promote fertility, right?

one more thing about the social worker

I mentioned to the social worker that, in addition to reading a few books, consulting with the RE and the MWs from my IUIs, I have been reading blogs posted by women also dealing with IF. Her response, "Be careful!"

I'm not sure what I'm supposed to be careful of, and I really don't care. I ignored her comment. I said nothing in response and let her move on to some other subject. I let her act like the one in-the-know, with pearls of wisdom to impart. And as soon as I had the chance, back to blog-land I went.

I would be lost without the wit and wisdom of the blogging IF community. I'd have run out of hope and optimism a while back if not for the successes I've "met." I would be ill-prepared for the joy and pain of this journey. I don't care what some social worker says. I'm happy in this community, and I intend to stay. And I am NOT being careful.

sanity? check! relevance? ummm, no.

Well, we had our little visit with the social worker. I told her I really wasn't sure why we were there, and she nodded in agreement and said, "I don't see why anyone should have to prove they want to become parents." Is that why we were there? I could have understood, perhaps, a consultation with someone versed in the issues surrounding IVF and the use of donor sperm. I could accept that unforeseen, unplanned obstacles or crises might threaten a marriage or the relationship with the resulting child. But "proving" that we wanted to be parents???! What the?!!

Now, don't get me wrong, it wasn't the social worker's fault. She knew I'd been referred by my RE, but she didn't know exactly why. She is not an expert on IVF- or donor sperm-related social issues. She's just a social worker who, 11 years ago, happened to undergo a successful IVF cycle with the same office where my RE practices.

Anyhow, C and I chatted with her about our families for about 35 minutes. We told her how we had learned our current male-factor diagnosis and what a horrid year 2008 had been. We told her that we were completely open with our friends (true) and family (not entirely true) about our efforts to conceive, and plan to be open and honest with our children about their origins. She again stated that "you should not be required to prove that you want to be parents," advised us to exercise regularly in anticipation of needing to keep up with a child in our advancing years, and declared us finished with the social worker requirement.

All in all, a somewhat bizarre appointment. But if that's one of the hoops we need to jump through on the way to getting pregnant, OK. So many hoops done, who knows how many left.

the RE... mixed feelings

Had my appointment with the RE this morning. It was similar to my first appointment with her, back in July, except that I am a lot less clueless now. Oddly, she didn't ask anything about my cycle, when the current one began or what day today happens to be. I was very surprised to learn that they require blood work from my spouse, even though we're using donor sperm, AND that C's blood work will not be covered under my insurance. We could be looking at $1600 or more unless his PCP is sympathetic and codes everything in a way to mask our fertility focus. There's a chance that some of the tests have already been done, and recently, because C just had surgery a month ago.

The other surprising requirement is a visit with a social worker. I'm not sure what that's supposed to accomplish, although I do recognize that there may be a few women or couples who go into donor insemination without really thinking about it. I think I should be allowed to submit a 10-page essay explaining my responses to questions of ethics and transparency. I believe I'd get more out of writing my thoughts down than from having a directed conversation with some stranger. I just hope we can fit in the blood work and meeting with a social worker before ovulation happens in my next cycle. Good thing today wasn't CD5!

The RE also requires, as I expected, that I do the clomid challenge and undergo an HSG. Since we wouldn't be able to start an IVF cycle until getting the results, we'll do one more IUI next cycle and see what happens. Why waste a clomid-enhanced cycle if insurance will spring for the donor sperm and inseminations? I'm planning to barrel through my deductible pretty quickly anyhow, and then everything is CIF (covered in full)- I just love those words! And who knows- maybe the HSG will clean out my insides so the next IUI will be all we need. I could live with that, even though I'd be kicking myself for not starting with an HSG as the RE recommended back in July.

watch your step

I don't pay much attention to weather forecasts, especially during the winter when you simply know it'll be cold outside. And since I'm not planning a lot of outdoor activities at this time of year, all I need is the 3-day forecast every couple of days so I have an idea when a storm is brewing (C and I own a truck with a plow, and C is laid off now, so I'm always hoping for a sweet little 5-inch, 12-hour storm to help us out).

We had a little ice incident on Sunday night that didn't make it into any forecast I caught. I peeked out the windows on Monday morning to see if I'd have to scrape the windshield, but everything looked perfectly clear. So, when I stepped outside to head off to work I didn't pay any attention to my footing. I didn't notice that the car looked clear because it was perfectly glazed in 1/4" of ice. I didn't notice that the front steps and path resembled a freshly-Zamboni'd skating surface until I was lying flat on my back. The sound of my head meeting the top step was loud enough to wake my husband and scare the cat into hiding. Youch! My first concussion in years. It isn't bad enough to warrant a trip to the ER- I never lost consciousness or experienced any symptoms of a "serious" head injury, but man did it hurt.

So, I am going to plug an item that my brother gave me for Christmas 7 years ago. A safety item that saved not only my skull and tailbone, but countless cups of coffee as I walked across slick parking lots and driveways. Please, if you live where winter can mean icy walkways, buy yourself a pair of YakTrax. They're inexpensive, easy to use, and they don't snag carpets or scratch the heck out of wood floors. Most of all, the darn things work, and that's all that really matters. Mine eventually got dry rot and broke apart, but someone told me once that if you spray them with arm0r all they last longer. I ordered some for myself and for C today. I can't imagine what that fall would have been like if I were pregnant, or worse- carrying an infant in my arms. So, please watch your step this winter. Stay safe!

ignorant insensitivity

I'm going to vent for a moment...
A few weeks ago, I stayed home from work one day because I had some serious sinus congestion. The kind that makes your head feel like it's going to explode when you lean over to tie your shoes. I was dizzy, nauseous, and horribly headache-y. I didn't trust myself to drive all the way to work, so I drove instead to the nearest drug store. Generic sin-u-tab is great! About 20 minutes after taking it, I was feeling 1000% better. Three hours forty-five minutes later, I had to take another dose (they're supposed to last 4 hours... I guess they came close enough that I should not complain). At the mercy of my wonderful new favorite drug, I stayed home all day rather than head in to work a half day.
I work with my mother. If I'm out, she knows. And my supervisor is the kind of person who announces to the whole office (all six of us) what someone is out with if anyone calls in sick. So, of course, my mother learned about my symptoms. She called to ask how I was... and asked if I might be pregnant.
I informed this woman, my mother, (with whom I have never been and cannot see myself ever being close to) of the nature of our IF issues months ago. I told her less than a month ago that we were taking a month or two off from the expense of donor sperm so that I could invest in health insurance that covers IF. Aside from the fact that it would be completely IMPOSSIBLE for me to have gotten pregnant since the last failed IUI, and knowing the intenventions so-far involved in trying to become pregnant, did she actually think I could be pregnant and NOT know it? I'd bet she doesn't even remember why I haven't gotten pregnant. I don't believe she really pays any attention when I speak, especially if she can't one-up me in some immediate way. I know that our (C's and mine) IF is not "her" issue, but it hurt just a little to learn that she doesn't remember what I am dealing with. Of all the people in the world, my own mother doesn't remember? That just reinforces my belief that blood doesn't necessarily make family.

So, that's insensitivity #1. Number two struck a few days ago and then again today. The fairly new receptionist (not in my building, ergo not privvy to my supervisor's excessive disclosures) is very gabby... loves to talk and interrupts when you answer a question she just asked. She asked how my New Year was, and I mentioned that my brother proposed to his girlfriend and she was showing off the ring at a family dinner yesterday. The receptionist's comment- "And soon there will be babies!" A few days ago, she was talking about how she was thinking of having another one just because she's 40 and she might not be able to have another (she has two daughters) if she waits until she really wants to have a third kid.
That just seems wrong... I know I'm a little hypersensitive about the whole baby thing, but especially the comment about my brother and his fiancee... she doesn't know them. Who is she to assume that babies will just start appearing as soon as the bouquet is tossed?

I'm more irked by #1. Some members of my family are wonderful and I love them and feel very close to them. Others, like my mother (who will never know this blog exists) rarely fail to disappoint.

But now, it is 2009. My RE appointment is on Thursday. My new insurance card arrived in today's mail. I start an accounting class on Monday, and work is paying for it. This is MY, OUR, THE year!