Medical Issues

Why isn't it getting any easier?

TMI Warning...

Last cycle, the first with no medical intervention (read between the lines, ladies: no needles! no meds! no rushing for bloodwork! no early morning "good mornings" from an ultrasound wand!) I started to spot/have bloody mucous around day 7 of my cycle. It through ovulation, stopped for a while, and started up again five days before AF arrived. It was pretty much non-stop, and, while not varying a lot in intensity, it and the slight cramping that accompanied it was a nuisance.

Now this cycle. It's day 11, and I've been having the same thing for the past three days (since day 9). I've just gotten off the phone with the RE's office, and have an appointment for Monday. I'm hoping it's just hormonal, and that my body is trying to get back into some normal pattern. Keep your fingers crossed for me that that's what it is.

Going It on My Own

Okay, for anyone who read my last post about us being done... well, let's just say that we're done going to the RE for now. We have tried as much medical assistance as is going to happen in my life (only going as far as IUIs), but I'm still going to try on my own and...

TMI WARNING!!!!: since DH doesn't seem to be in any rush to replenish his supply of birth control (i.e. no Trojan Mans in the bedside table) nor does he seem to be wanting to follow the celibacy route...

I'll just see where this takes us. I did buy more OPK sticks for my ClearBlue Fertility Monitor, and I'm about midcycle and starting to surge. I guess we'll see if Nature would like to lend a hand all on her own (or if enough hormones are still surging through my body). Not counting on anything, but won't close the door on the possibility.

4 for 4

That’s it. I haven’t had the heart to blog about this past IUI. Three weeks ago on Wednesday, we had the fourth IUI done. Great follicles, great lining, great sperm count, everything went great. Just like the other three times. And, of course, just like the other three times, the cramping started last week, three days before the scheduled bloodwork. Light staining on Columbus Day, and then, last Wednesday, the morning of the bloodwork to confirm a success, AF arrived full force.

We are done. DH knows I’m not happy about this. I must admit, I do have some sense of relief of getting off the monthly IUI hamster wheel. I do not miss the nightly needles. I do not miss the almost daily early-morning drives to the center to be poked and prodded. I have been able to go out to dinner with friends and have a glass of wine like a normal person. The focus of my daily life is no longer what cycle day it is and when is the Center going to call with my next instructions. At the same time, not ending this entire experience with a babe in my arms is frustrating and sad to say the least.

Last week, I was talking with two other moms at our 10 yo boys’ soccer practice. They both have been there through all of this. In fact, one of them was the mom, I’ll call her E, who, at our first Spring soccer game after we lost Jimmy, greeted me with “hey, where’s the baby?”, as the other moms flinched and one of them tried to get to her before she asked anything else and before I had to tell her how we had lost him. They also know about the miscarriage last year, and everything we’ve gone through. The only thing that they, and most of our friends, do not know is how much medical intervention we’ve had in this struggle. E asked how it was going, and I told her we were on our last legs as far as trying with medical intervention was concerned. I added that DH was really against going any further, and she said, “yeah, but what about you?”

My response was that I was going to just put the baby stuff up in the eaves for the time being, get through turning 40, and then deal with getting rid of the stuff in the spring. Her comment back struck a chord: “who says you can’t keep trying on your own? Don’t give up on something that you obviously don’t want to give up on. What harm is there in trying on your own for a few more months?”

Hell of a point, E. I knew I liked her. Just one question: how do I continue trying without DH realizing my plan????? One thing is somewhat decided in my mind - at this point, I'm going to take a journey down the acupunture avenue. Can't really hurt now, can it?

So this isn't over, folks. Just the IUI road is closed. Another intersection I never expected to be at in my life. We'll see where I end up next.

Baby Shower Fallout

So when did infertility and conception issues get to be grounds for one-upsmanship between women, like it’s a freakin’ contest. The baby shower at work I mentioned: I responded to the hostess last week when I saw her at a work function that I wouldn’t be coming because 1) it’s Halloween and I’m leaving early for trick-or-treating, and 2) I’m just not comfortable with baby showers. Her response? “You know, I lost three before I had my son. That’s one more than you lost.”

What the fuck?!? What do I say to that? “Oh, yeah, well, did you ever lose a child seven months into your pregnancy, have to be induced and labor for 36 hours, deliver, hold, and then have to bury your perfectly healthy baby?!?” I don’t understand it. Then she asks if I’m pregnant yet. This is not a close personal, come-over-on-a-Friday-night-for-drinks-and-talk girlfriend; she is a work friend, the kind that you eat lunch with but don’t socialize out of work with. What she does now is that we're still trying and that we're seeing an RE. I respond “we don’t know yet”. Her answer? “Well, have you thought about adoption? You should really adopt.” And then she turned her attention to another person who had just walked up to the table.

I’m chalking her up as a clueless chatterbox. But the fact that someone who’s been through the struggles of infertility can be that abrupt and condescending is tough to get my head around, especially now.

Baby Showers

A baby shower. I got an emailed invite to a baby shower at work from a girl I’m on a committee with, for a baby shower she’s throwing for another girl on the same committee. On Halloween. At work.

I used to attend these events. Hell, I even hosted one or two myself. That was before Jimmy. I was pregnant with Jimmy at the same time as three cousins were also pregnant. Most with their first child. My mom’s niece was expecting twins, my dad’s middle sister (Aunt A)’s son’s wife was expecting their first, and my dad’s older sister (Aunt V)’s daughter was expecting her second after miscarrying her first.

My dad’s niece, my cousin M, miscarried her second child. This is a girl who we never thought would be married, let alone have kids. She had really severe endometriosis and had been told there was little hope she’d ever get pregnant (I actually think one doctor told her she’d NEVER get pregnant). She married a great guy who had three kids from his previous marriage. And then she got pregnant… twice. And lost both. It was determined after the second loss that she had severe gestational diabetes. But that was it. She didn’t see any specialists, didn’t go to an RE, she just said that was all she could handle.

My mom’s niece’s shower was the day that I delivered Jimmy. Mom and I were going to drive down to it. That didn’t happen. Her twins were delivered about two weeks before Jimmy’s due date. She had been hospitalized with contractions for about a month. The delivery of her son went just fine, and then things went really sour really fast. Her daughter was a crash C-section delivery, and had aspirated meconium. She was having major breathing issues, so they Med-flighted her to a hospital 45 minutes away from the hospital my cousin was in, where she stayed for about two weeks. Everything was fine in the end -- they’re both healthy and happy little kids. But the day this all happened, my mother called me at work, and I went to the ladies’ room and sobbed. I couldn’t handle the thought that another child in my family wouldn’t make it.

And then my cousin’s wife’s shower. Two months after Jimmy, I was supposed to attend her shower with my cousin M and our mothers at the mom-to-be’s friend’s house. For a baby that was due one week after Jimmy.

On a good day, I wouldn’t choose to spend time with the group who was hosting the shower. Think young Stepford Wives, who think a broken fingernail is a tragedy. And the mom-to-be’s sister is a witch. She was the wet towel at the wedding, ordering everyone around (my husband nicknamed her “the General”). But I responded to the mom-to-be’s sister that I would do my best to be there. I did add that I’d have to “play it by ear”, and see how I was doing the day of the shower. Why? Because this cousin and his wife came to Jimmy’s service. Even after we told them that we would understand if they didn’t, with her being at the same place in her pregnancy as me. They came anyway.

The deal with this shower was that if I was going, my cousin M would go. Well, the morning of the shower, I just couldn’t do it. I couldn’t go and listen to a bunch of women smile and gloat all over someone who was still pregnant while I was picking out a gravestone for my son. I couldn’t watch my cousin M’s face. I couldn’t watch everyone congratulating Aunt A on the grandchild-to-be while my mom and Aunt V sat there. So, through the tears that wouldn’t stop that day, I called my mother to tell her I wasn’t going.

Boy, did I get an earful. How dare I tell them all that I would go and now I wasn’t! I must be very depressed, and truly need medication! I wasn’t being very considerate of her, my aunts, or my cousins! I called my Aunt A, who was VERY understanding (as I sobbed on the phone), and my Aunt V (to have her call my cousin M, who wasn’t handling the day well either and who wasn’t answering her phone) to tell them I wasn’t going. Then I went over to my parents’ house to drop the gifts off for my mother to take. I got greeted with more crap. The problem: she didn’t want to go anymore than I did, because it was going to be a painful day. But instead of dealing with that, I got the brunt of her anger. Even my father told her to lay off. I finally screamed back, as I was going out the door, that after having had a husband have a heart attack three months before and then burying my perfectly healthy son in the course of three months, the fact that I wasn’t in a corner somewhere drinking/popping pills/smoking something, but instead was still standing and functioning was a miracle in itself, and to lay the hell off.

So… I haven’t been to a baby shower since. In many ways, I’ve been lucky, being older, because most of my friends and family are beyond the baby years. That was the last baby shower I was supposed to attend. Until this invitation came along. My favorite SIL is right: they shouldn't have these things until the baby has arrived and is safe in his/her mother's arms. Now that I know what can go wrong. I don't know how to get around that particular elephant in the room.

Last Dance at the Center

IUI #3 was a bust too. AF arrived right on schedule. So we’re now on CD #8 of IUI #4, or what will be my last medically-assisted attempt at achieving a pregnancy. My left ovary, for some reason, has, for the past two cycles as well as this one, become the overachiever in the pair, producing follicles like there’s no tomorrow (but, luckily, within the range of acceptability, so there’s no talk of hyperstim’ing or canceling of a cycle). I have just gotten the call that I trigger tonight, and the procedure is scheduled for 11:00 a.m. Wednesday.

I am trying to stay positive. I am trying so hard to grasp the edges of my reality. I may never be pregnant again. I may be ending my childbearing years not out of choice. It’s funny, because when we started this journey, I had drawn my lines in the sand of what was and wasn’t acceptable in terms of medical assistance. Now, as the time grows shorter and my chances fewer, I’m willing to grasp at straws that before weren’t feasible. The rational side of myself keeps yelling out, “Give yourself a break. Be done with this part of your life, accept the results, and move on”. The emotional side of me says, “Bullshit! We’re not going down without a fight!” The question to answer is how much of a fight am I willing to give Mother Nature.

The other person in this intricately timed dance has made his feelings very clear. DH has had it. Thalia recently blogged about how often we forget how sad our men get. I have known from the start of this entire process that he was just along for the ride because his alternative was divorce. I mean that. No anger, no hostility. Just a very factual statement. When we lost Jimmy, we were still in the throes of dealing with the after-effects of DH’s heart attack (at age 38). It was like we were living in a snow globe that some idiot picked up and shook, and I was trying desperately to get us back to some sort of normalcy, some level ground. I wanted to make sure, most of all, that our two boys were not traumatized unduly by this twist in their lives. You know, I just didn’t want to them on the six o’clock news, shotguns in hand, screaming that it was all because their father had had a heart attack when they were 8 and 4. So we dealt with it.

For the record, I come from a family of people who have had the Fates deal them really shitty hands (DF’s parents died within four months of one another when he was 11; DM’s DF (my DGF) was a nasty drunk who beat up my grandmother and couldn’t keep his zipper up around town (much before my time; he was a great GF to me). I have suffered my own trials (molested by a friend of my parents’ when I was 4, and again by a teenaged male babysitter when I was 8). I’m a survivor. And I’m not particularly fond of those who use the circumstances of their lives as an excuse for their poor behavior. Sorry, but everyone has a drunken/molesting/divorcing/abusive family member somewhere in the branches of the family tree. Get over it and get on with it.

So, when the Fates saw that I had managed to keep my family on course, upright, and afloat, they decided that I must experience losing a perfectly healthy child seven months into my pregnancy. I must bury him. I must live with that loss every day. Then, just to piss me off, they decided that the next pregnancy would begin badly and end quickly. Oh, and for good measure, they would have the biggest BOOB of a doctor NOT do a D&C, but instead let the whole episode drag on for TWO fucking months before my OB/GYN (same practice, different doctor) finally got a clue as to what was going on and did a hysteroscopy/D&C.

Then, as you can read on this blog, I’ve had issues with my lining and the insurance folks at the Center. And through it all, I have struggled on. Trust me, there are mornings when I sob as I drive down the highway towards my impending date with a needle and an ultrasound wand, wishing for myself and all of us that it were not this way. But it is.

I think a lot of my demands regarding our stroll down Infertility Lane came from the reaction of my family members, particularly DH and DM, when I got pregnant with Jimmy. The questions about how I would juggle three boys, a DH who doesn’t do much to help out, and working full-time. The negative vibes over the pregnancy. Then losing him, and trying again. More negative vibes. The impressions that no one could understand why I couldn’t just stop pursuing this, another pregnancy. And me “getting my Irish up” as they say, and deciding that I would decide when it was enough for me. I told DH that this was the only thing that I had ever asked of him. I had stood by him when I found out he was in debt (oh, yeah, and bailed his ass out), when he was audited by the IRS (because he has no clue what “record-keeping” means), when his parents and brothers came before me, when he changed jobs a NUMBER of times, when he needed a push to finish his degree, and so on and so on. I have always been the steady one, the grounded one. So when he said “I’m done. We have two healthy kids. We lost Jimmy. We lost another one. I can’t do this anymore,” and then put back on thirty pounds post-heart attack, I drew my first line. Told him nicely that he could hit the road in that case, so that I could pursue a relationship, and a pregnancy, with someone else. That sounds so heartless, but, for me to be able to not hate myself for quitting, I needed to forge ahead. And, in my mind, if my best friend and partner could not understand that, and (more to the point) couldn't do that for me, then he truly was not the person I thought he was, and not the person I needed to be with. You don't want to think that, when push comes to shove, the person you've chosen to be with turns out to not really know you at all.

I truly, deeply love my DH. He is my best friend. There are no words to express the terror that I swallowed in that ER three years ago on October 20 as the doctor walked me into a private waiting room (NOT a good sign, for the record) and told me that DH had had a heart attack, and, if the clotbusting meds didn't work within the hour, they were MedFlighting him to Boston. I didn't know that terror could be surpassed hearing another doctor say, three months later, "I'm so sorry. I don't see a heartbeat.". Quite honestly, though (and I'm not saying this in a bragging, toot-my-own-horn manner), the one who held it together was me. And those moments when I couldn't, it was my mom and dad. Because they (the medical staff and my parents) were afraid of what the stress of the induction and delivery of Jimmy would do to DH (he was gray around the gills, and I found out later they had a crash cart waiting outside my L&D room for him, with a cardiologist on call), my mom stayed with me through the whole thing. My dad stayed with DH. Through all of this, I have learned that you don't get a choice in getting off the ride halfway through; you have to stay on until the end, like it or not. And I have learned that I need to put me first sometimes, particularly regarding this issue, because no one else will.

The man who loves me deeply resolved himself to this path I have forced him down. I don't know if he has any grasp of my need to do this, to be able to say “I did everything I could, short of IVF, to be pregnant again”. But he is here with me, willing to do this because his alternative was living without me, without our marriage. We don't talk about it. I mean, at all. I just let him know when his appointment is, and he shows up. He cannot find the words, but I know his thoughts are not joyful and happy ones when his monthly presence is required. The first month (June), I tried to talk to him, which quickly dissolved into me screaming and crying while he stood there looking at me with a half-smirk, half-"oh, give me a break, I went and gave them a sample, didn't I" look. I ranted, finally identifying what was making me so emotional (besides the hormones): I was the only woman in the Center waiting room without a male companion. Everyone else was having their hand held by their guy while they gave blood, had the wand stuck up their hoohaa, and were possibly impregnated with their child. Me? I drove myself in, sat by myself, waited through the procedure by myself, and drove myself home. I pointed out, rather harshly, that it would be nice if he could at least be in the room if that were the moment our child was being conceived. The next day, he waited with me, with the look of a kid who'd been shamed in public on his face. But he was there. Since then, he's been there for most of them. I don't mind if he just goes to the Center, leaves his sample, and has to go right back to work. That I understand. But it is nice when he at least waits in the parking lot for me, and gives me a squeeze and a kiss.

So, here we are, on the last round of IUI. I turn 40 in three months. I had said I’d clean out the baby stuff, the clothes, the crib, the strollers, in October of this year. I will put it in the attic for now, and get to the other side of the holidays and my birthday. I need to get to that side before I can face the sadness that I will have to deal with when I clean it all out and send the signal that I am truly done with my childbearing years.

Wish me luck. I'm gonna need it. And, for the record, my left ovary is KILLING me right now!

Insurance Hassles (AGAIN!)

Well, it’s been almost a month since I last wrote to my blog. Needless to say, by now I know my body way too friggin’ well, and AF promptly arrived in her full glory that Sunday morning, kindly enough so I could let the ladies in the monitoring room know that the bloodwork that I had driven down through the pouring rain for was no longer necessary.

As a side note: decided to give acupunture a shot, which I did the day after my last blog. I had an appointment with a group affiliated with my Fertility Center, and I was spurred on by the literature they provided in the waiting room, particularly with regards to the rates of improvement for IUI patients. Had a great session (it did relieve the PMS cramping), had no problem with the needles (who would after sticking themselves as much as IF patients?), and then decided that I wouldn’t pursue any further treatments. Why?, you ask. Because the gentleman that saw me told me that they like to “get their patients ready” by doing a combo of acupuncture, herbs, and other stuff while having the patient take a three-month breather from IF treatments. Thanks, but my clock is ticking and the DH is becoming inpatient with this whole thing, so we’ll have to forge on without Eastern medical assistance.

So, IUI #2 is a bust. They call me later that day to tell me, yes, once again the Insurance Monster has put a note on my file, and I can’t come in the next day for IUI #3’s CD2 u/s and bloodwork. Now I’m pissed. Last month, we went through the same crap. So I leave a voicemail at the center in the general mailbox, telling them I want this solved by noon on Monday and a phone call telling me I’m good to go. Surprise, surprise… no call. 1:30 p.m., I start calling. Because the girl in Insurance that I was referred to is on vacation, I’m going to have to deal with L, which by now stands for “LOSER” in my book. She’s at lunch. Then I get the office manager, S, on the phone. As she tries to put me off, I tell her that last month L dropped the ball, and I shouldn’t be doing her job. Then I call Tufts.

Now we have the “chicken versus egg” dilemma. New regs at Tufts demand FSH levels on CD3 and CD10. Tufts won’t approve the IUI cycle until they have those. The Center won’t let you do a cycle unless you have prior approval or you shell out $2600 upfront (NOT an option in my household right now). The head of the ART office at Tufts is on the phone, somewhat patronizingly telling me where the prior approval form is located on their website, and that, if the Center sends it through as a priority, they may be able to okay it. Much pissing and bitching on my part, and she snaps to attention when I mention that I have not received notice of these changes in my coverage as promised last month, and will be contacting the head of Tufts about their lack of customer service.

Ladies, this is when the Internet proves to be a great, wonderful place full of interesting information. As I look at Tufts’ website, I find the document that I still haven’t received in the mail. On page 21 is the name of the M.D. who is the VP of Medical Affairs, and apparently the jackass that didn’t see that his new regs might be causing some issues. I call Tufts membership line, and some very sweet young rep gives me this guy’s DIRECT LINE! And he answers it himself!!! After totally confusing and scaring this poor man with my tale of woe and talk of being on the 6:00 news, he tells me he will look into this situation and get back to me. Fifteen minutes later, one of his people calls me back, a lovely woman who sympathizes with me and asks for everyone’s names who I’ve spoken with both at Tufts and the Center. She then calls me back twenty minutes later, telling me we’re all set, and “oh, by the way, I know you said you were only doing one more IUI cycle, but I’ve given you approval for two so that if you change your mind, you won’t need to go through this issue with us again”. Hallelujah! We’re on again!

Turns out, after all that, that Tufts had contacted the Center and told them that they would be willing to work out any issues that came up with the new regs (and, yes, I believe Tufts). The best part: the test results that Tufts needed I had had done at the Center in October, and those satisfied their requirements.

The Center calls, and I’m in the next morning for u/s and bloodwork. Then S calls, and patronizingly says “are you doing better today?” Smarmy bitch. So I unload. She states that she’s going into a meeting with L and will bring all my issues up. I tell her great, and I’ll be sure to bring up both L and her attitudes when I speak with my RE, who happens to own the place, as well as speaking with the other partners. I tell her that, while everyone in the medical part of the Center is pulling for every patient, she and L appear oblivious to what a three- or four-day wait can do to an IF treatment cycle, and seem to do their best to be unsupportive and difficult. And oh, I’m sure to let the partners will be interested to hear that I have had to take care of my own insurance clearances for two IUIs in a row. The minute I mention this, she becomes somewhat apologetic. I could care less. I also mention that the VP’s person who gave me the two months worth of approvals told me that she personally spoke with someone at the Center the week before regarding the issues that Tufts patients would be facing, and how Tufts was more than willing to work on these issues with the Center. I thank her again, telling her that I appreciate her addressing these issues with L, and that I’ll be sure to mention that when I speak with my RE.

Now for the real challenge. DH’s agreement with me was that he would do three IUIs. That was IUI #2, so obviously IUI #3 will be in the beginning of September. Now we have permission to do 4 IUIs, and somehow, in the back of my mind, I’m considering the extra cycle a gift. To do any more IUIs would be a total hassle with the Center getting insurance clearance, and honestly, I don’t know if I can emotionally take any more of this. Something for me to think about…

Finally Triggered

Trying not to sit here and think about the cramping that’s starting. Thinking instead about what a lousy blogger I am. I have no time to do much of anything beside work these days. Working in a community college means that from now until about September 15th, my life is ruled by a bunch of people who don’t understand that you cannot wait until the day before classes start to register for the term and expect to get seats in the sections you want.

We did finally manage to get the IUI in. I, of course, heard NOTHING from the Center Friday. Knowing that they close at 5:00 p.m., I waited until 5:30 before turning into a P.O.P. (Pissed-Off-Patient) and calling the service. Told the woman on the other end that I had had bloodwork that morning and was still waiting for a call with directions. Fifteen minutes later, one of the nurses called. Surprise! I was to trigger Friday between 6:00 p.m. and 8:00 p.m. (guess I got the call just in time!) and report for 9:00 a.m. IUI Sunday morning, with DH set for 8:00 a.m. specimen supply. When I asked what time on Monday for the second IUI, I was told that “the latest research shows only one IUI per cycle is needed”.

My, my, how things change in two months. So, I triggered, and then had my way with DH. Saturday, we managed to go out by ourselves for dinner, and I had my way with him again. Sunday morning, we went in for the procedure. Monday, I blew off work, and had my way with him one more time, in the afternoon.

HPT bloodwork is scheduled for Sunday morning. I even bought a box of HPT yesterday, but now wonder why I would do that to myself. I hate this ebb-and-flow of emotions that come with every two week wait, and then the drop-off of hope when friggin’ AF shows up.

Waiting for a Trigger

CD #14 and still waiting for the magical call to tell me to give myself the HcG trigger shot and come in the next two afternoons. Sunday (CD#9, in case anyone’s keeping track), went in for u/s and bloodwork. Was told to continue the 150 units Sunday and Monday, come in Tuesday (CD#11) for u/s and bloodwork. Then another call: continue 150 units for Tuesday and Wednesday, and come in Thursday (CD#13) for u/s and bloodwork. Notice the friggin’ trend?!? Yesterday, my lining measured 16, with 2 follicles on the right side of 10mm each plus 2 more under 10mm, and 4 follicles on the left side measuring 16mm, 10mm, 12mm, and 12mm each plus 3 more under 10mm. I apparently am overachieving at follicle production this cycle.

I mentioned to DH last night that my fear now is that they won’t do the IUI because I’ll have hyperstim’d, and told him that part of me would love to just convert this to an IVF cycle. He will have no part of it. None. That’s not happening in my world with this husband. So I patiently (yeh, right!!!) await the call telling me to trigger tonight. That brings the whole “what do we do with the kids this weekend” question into play, unless we do the parking lot handoff game (DH drives down, gives his specimen, I leave 30 minutes later, meet in a parking lot somewhere near the center and exchange cars and/or children (whichever’s easier), and then I go in to sit in the stirrups for 20 minutes).

All I can say is that they’d better hurry up, as today’s bloodwork will show them that I’m going to “O” on my own during the next few days. I peed on the OPK stick and put it in the monitor this morning, and my LH is on the rise. I'm also concerned that if we don't do this during the next day or two, I'll be told that it's too late in my cycle to do the IUI as (if I were lucky enough to have an egg fertilize) there wouldn't be enough time in my cycle left to allow for good implantation. My cycle is usually 28 days (according to my calendar on www.cyclespage.com), but the last two have been 25 days each (thanks to the meds in June, I'm sure), so the clock's ticking.

Any thoughts or have any of you been through a similar cycle? Would love to hear of your experiences...

DH's Comments

We're on again! Welcome to IUI#2, or IUI Redoux. Made it to the Center with minutes to spare yesterday, due to traffic. U/S was good, showing a few under 10 mm follicles on each side (3 on the right, 2 on the left), and the lining was 2.7mm, so I got the green light to start the Follistim last night. Five days of 150 units, then back to the Center early Sunday morning for more bloodwork and another u/s. At least traffic won't be bad...

Have to mention something here that REALLY ticked me off over vacation. DH and I were lying in bed Thursday night, talking about next year’s vacation. The place we go has a number of trailers (2 bedrooms, about 37’ feet) that we all rent down on the beach. If you like your unit, you have the option of reserving it for the same week next year. You have to pay a $75 non-refundable deposit by Thursday night, and the place is yours (you then pay half in January and the rest on arrival). Of course, all nine families reserved for next year. I mention that I’ve been concerned that I was going to get AF while we were in Maine, and sort of review the month’s plan with DH. He then says “well, I’m not coming up here next year with a baby”. Just like that. My response? “Well, then I guess I would be coming up alone with three kids, huh?!?” I point out (in a very sharp tone):

• that’s a great way to guarantee that our boys really would resent a new sibling (“hey, kids, we’re not going on vacation with all your friends because of the baby”), and
• maybe we should wait to get pregnant first, so that we could then worry about staying pregnant, then try to have a live delivery before we decide whether we would be coming up next year.
  

I love him, but he can be SUCH a jackass sometimes! In the golden days (remember those, before IF was a reality in your world, before you knew anything about REs and IUIs and IVF and how to mix your trigger shot and deciding the best place in the frig to keep your meds and where your sharps container should sit?), it seemed like you could worry about things like how having a baby might impact your vacation plans. Now the worry is planning your cycle and treatment plans around your vacation. I can only hope that we have to make that type of decision this time next year…

Insurance Issues

Whew. Been a while since my last post. With trying to tie things up at work and get packed for our vacation, there was no time to post. And so much for the Wi-Fi connection at the campground we went to last week… it didn’t, connect I mean. One of the girls I was with is a E-Bay store owner, and was the first to let us know that it didn’t work. I didn’t catch on until Thursday that she actually left the campground every day to visit the little town library and log on. Had I only known!

We didn’t try on our own. Not at all. I think we have had sex once all of last month, and it was nowhere near when I was O’ing. And I spent most of last week on the little beach at the lake on the campground with stomach issues (we think that many of us had some kind of 24-hour virus). I couldn’t even really enjoy drinking cosmos until Wednesday (made up for it Thursday and Friday though).

About midweek, I got a little nervous because I finally looked a calendar, and realized that, thanks to the meds from last month, there was a chance AF would start while we were in the middle of nowhere. Then the fun would begin. Would I let another cycle pass without trying, or would I come home early, leaving DH and the boys alone to finish our vacation? Well, Mother Nature loves me this month, because AF didn’t arrive until Saturday morning, the day we were headed home. Checked out, drove through a monsoon (remnants of Tropical Storm Beryl), and got home safe and sound. Once we had unpacked the van and the trailer (we borrowed my dad’s utility trailer so that we only had to take one car), I called the Center to let them know it was CD1, and I planned on driving down Sunday morning for CD2 u/s and bloodwork for IUI #2.

SURPRISE!!! The nurse tells me that there’s an insurance hold on my file, and that I’ll have to clear it with my provider Monday. I have to clear it Monday, so that I can come in for CD4 u/s and bloodwork, otherwise the cycle is off. Oh, and the hold was placed on Thursday the 20th.

WHAT?!?! Not one letter in our mail. Not one phone message saying “hey, by the way, we’ve got a small problem with your insurance.” Nothing. Now I’m pissed. If one frigging mistake costs me a cycle, I’m going to have someone’s job. I don’t care anymore.

I take a hard look at the insurance company’s website (BTW, it’s Tufts for anyone wondering) to see if there’s anything I’m missing. And lo and behold, there it is. As of August 1st, Tufts is “implementing a prior authorization requirement for gonadotropin therapy and intrauterine insemination (IUI) when used in conjunction with gonadotropin therapy for all female Members.” Problem: it’s not AUGUST 1st!

Can you guess who was on the phone with Tufts at 8:00 a.m. Monday? Yep, me. Then I left a message for the Insurance department at the Center. Pretty direct, stating very directly that between the Center and Tufts they needed to clear this hold by 3:00 p.m. or supervisors on both ends would be brought in, because I was not going to cancel a cycle due to an insurance paperwork glitch. No way. Hyperstim? Sure. Bad lining? No problem. But someone not checking a box on some obscure goddamn form? No!

Was assured by the first Tufts rep the hold had nothing to do with the Aug. 1 policy. Just have them fax an approval form over and ask for it to be expedited. L. the Insurance Czar (very snippy at times) returned my call, telling me that she had sent the paperwork in on Thursday, and hadn’t heard back from Tufts. She’ll “follow up”. Yeh, well, so won’t I, honey, because you really don’t seem like you care if another month passes me by. That or you’ve heard the saga one too many times to have any compassion left in your voice.

I call Tufts back, and finally get a competent ART rep. Guess what? It is the policy. It was enforced prior to its deadline, so she speaks with her supervisor and actually calls me back to tell me that she’s cleared everything up. Give that girl a great big hand, folks! I thank her profusely, and get her direct number (score!). She adds that my insurance office will be calling me shortly.

Hah! Two hours later, L. calls. She’s none too pleased when I correct one of the bits of information she’s giving me and tell her that L. the Tufts rep already called me. The rest of the story: speak with L. at Tufts again regarding meds, speak with the nurse regarding tomorrow’s appointments for u/s and bloodwork, and then speak with the pharmacy three times so that I can drive up and pick everything up, which, of course, isn’t ready when I finally get there at 7:00 p.m. Finally got home at 8:00 p.m., and then had to call one of my friends to ask if I could drop the boys off at her house at say, 7:00 a.m., and she could drop the boys off at their day camp at 9:00 a.m. Thank God I have friends like her, because I couldn't do this. She, without hesitation, said okay. She, who is diabetic and used to needles, who volunteered to give me my shots if I couldn't do it myself. I hope that all of the other IF bloggers out there are lucky enough to have someone like C. in their lives.

Happy 4th of July!

I feel at loose ends. I'm alone in the office, just a girl and her Internet connection. No, seriously, I think there's four people in the building today, and I'm the only one on the second floor. I brought in a bunch of my CDs, and am typing while listening to Amanda Marshall (VERY underated singer, by the way).

I'm off of everything this month. While we're on vacation, DH and I figure we'll ttc the old-fashioned way. Can't hurt, even though our chances seem slim at this point. What's the worst that can happen, that I don't get pregnant?!? Well, news flash, I'm getting really used to that recurring theme.

On a totally unrelated-to-the-infertility-dance note: Happy Independence Day to everyone who celebrates it! We get to celebrate more than Independence Day in our house. Tomorrow is my mom’s birthday, and her mom’s. That’s right. My mother was born in 1944 on her mom’s 26th birthday. After my Grampie died, we found the Red Cross telegram and the letters from both sets of their parents letting him know that, while he was off in the middle of WWII, he had become a father. Pretty cool family history.

Now for the embarrassing part. Until I was about 7 years old, my Grammie and Mom had me convinced that the reason that everyone had the day off and we had fireworks and cookouts and a day at the beach was because it was both their birthdays. And worse, I believed them. Of course, I also believed that my mother was the little girl in “The Wizard of Oz” (she and Mom have the same name). Grammie told me that one too, trying to calm my fears that the Wicked Witch would finally get Dorothy, telling me that Dorothy grew up and had kids of her own (meaning me and my brother). This all SO explained why, when I was a teenager and couldn’t stand my mom, I would cheer the witch on, just hoping she’d catch a break this one time.

So, HAPPY BIRTHDAY to my Mom. I make her a cake every year, since I am the baker in the family. The usual: lemon cake (no, I’m not that great a baker; it’s a Duncan Hines mix, but then again, that’s what the instructor at my Wilton cake decorating course said she uses all the time) with buttercream frosting (another Wilton trick: it’s butter-flavored Crisco and sifted confectioner’s sugar, with some vanilla extract for flavoring. Best part: it doesn’t need to be refrigerated). I’ll also have fresh sliced strawberries to put on top, Mom’s favorite. We will sit and have cake tonight, and watch the fireworks at the beach from their porch.

And, since I know she’s looking down on me, HAPPY BIRTHDAY to my Grammie. I wish you’d been able to stick around longer than 59 years.

IUI #1 = Apparent Failure

DAMN IT!!!!! DAMN IT!!!!! DAMN IT!!!!!

Tomorrow morning I'm supposed to go for bloodwork to see if IUI #1 worked. Early in the morning. By early, I mean between 6:30 a.m. and 8:00 a.m., to a town fifteen miles away. Which means me (NOT a morning person) needs to be up and moving at like 5:30 a.m. to get everyone else where they need to be. And, thanks to the surprise awaiting me in the ladies' room just now, it’s a futile trip. AF has arrived. My boobs weren’t tender because of pregnancy, they were sore because that’s what happens just before AF arrives. And the cramps are starting. So now I’m pissed that I have to get up and go in anyway. I may just call them and see if they can just run the bloodwork today.

Okay, that’s a big “NO”. Just got off the phone with one of the Center’s nurses, and I still have to go in tomorrow AND keep up the progesterone suppositories until they say I can stop. I had actually raised the question about taking July off and then cycling in August with one of the nurses when we first started the Follistim last month. Her response was “well, slow down, let’s hope this one takes and then you won’t need to worry about taking a month off”. She obviously hadn’t seen the black cloud hanging over my head when I walked into the Center for all those ultrasounds and bloodwork.

I’m pissed that it didn’t work. I’m pissed that I’m not pregnant. I’m scared that it did work, and I’m bleeding anyway, just like the very troubled pregnancy last year with our Little One started out. I’m scared that I am pregnant and that something is very wrong. I’m scared that I’m not pregnant and I won’t ever be again. I'm scared that I'll have the same problems with my lining being too thick and having to put off our next IUI; I mean, we had to wait three frigging cycles to get this IUI in. And if I’m not, somewhere there is a sense of slight relief that next month, while we’re camping two hundred miles away with a bunch of friends, I won’t be constantly wondering if the pregnancy is going well, if everything’s okay, or if my bad luck is holding, and it will be another lost child in our lives. This sucks!

We’re taking next month off, much to DH's dismay. Well, it's not that he's upset that we're taking a month off, it's that he was a little taken aback when I explained that I wanted to take July off, and then try two more times (if possible) in August and September. He thought it would just be two months in a row and then we were done with this whole chapter. And it might have been, if my frigging lining had cooperated!

As I said before, I’m not doing all this while I’m trying to enjoy one of the few weeks I get off to spend with my family. I just can’t do it, mentally or physically. Shooting up with hormones every night and the scheduling of everything just won’t work. On the bright side, I can now have a few margaritas or cosmos sitting on the beach, instead of trying to explain why I’m not drinking without giving away too much info; so far, this past month I’ve just said that we’re trying and I can’t drink with the medication I’m on, and that’s been said to only a few of the girls. And I won’t have to listen to the vast array of responses, ranging from “good for you, sweetie, we’re pulling for you” (thank you, thank you, thank you to those friends) to “what are you, nuts, you want a baby now at your age?!?” (for the record, I’ll be 40 in December, and yes, I want another child at my age. P.S. for those people: until you’ve walked in my shoes, shut the hell up! If I didn’t want another baby, I sure as hell wouldn’t be trying so hard, huh?!?).

So now, I wait until August to start the process for IUI #2...

I'm Not Infertile, I'm Birth-Challenged

This has been bugging me for a while. As I read everyone else's blogs (wishing I had half the writing skills of most of you, and the sense of humor too!), I realize, that for many of us, we're not infertile. We are fertile. We get pregnant. We just can't seem to stay pregnant, for whatever reason, known or unknown.

I’ve been pregnant four times, for crying out loud. I’m more fertile than most of my family or friends. I think there needs to be a different word for women and couples like me and DH. Well, not DH, because apparently he’s just fine in that department, according to the embryologist who handled two days of his samples (Thanks, me and my old eggs really needed to know that it’s me, not him. Maybe a little more stress will help, huh?!?)

On that note, I realize that I’m not suffering secondary infertility. I’ve had four pregnancies, so that means I’m experiencing quinary infertility. Don’t laugh. I actually Googled it (I Google everything). On www.askoxford.com, it poses the question “What comes after primary, secondary, tertiary?” The answer is: “The sequence continues with quaternary, quinary, senary, septenary, octonary, nonary, denary. Words also exist for `twelfth order' (duodenary) and `twentieth order' (vigenary).”

So my situation would be better described by saying that I am a quinary birth-challenged woman. Hey, if we can go from “garbage man” and “housewife” to “sanitation engineer” and “domestic engineer”, then I can be a quinary birth-challenged woman.

Moon Face

I've got moon face already. Ugh! Both Monday and Tuesday, I left work at midday to drive to the Center, confirm that yes, that is my husband’s name and date of birth on the side of the syringe you’re inserting into my hooha, and then sit with my legs up reading a really good book (Sara Paretsky’s “Fire Sale” – I LOVE V.I. Warshawski books!) for 10 minutes. Last night (Tuesday) started the progesterone suppositories, 1 in the AM, 1 in the PM. I know the reasoning behind prescribing them, and I will stick to the directions, but can I just say: THEY ARE SO MESSY!!!!

DH stayed yesterday for the procedure, after a very long pointed conversation Monday night. Doing the infertility dance was part of it, but other issues came up as well. Trust me, the hormones don't help! But he was in the parking lot yesterday, waiting for me, and told me he would come in if I wanted him there. I have a better sense of humor (my family can find humor in anything), and told him I thought it might be nice if he were in the room when I'm impregnated with his child. Of course I want him there! So in he came, acting like "a cat in a roomful of rocking chairs".

I really want to try to combat the weight gain these things bring on, but can’t do Curves until tomorrow. The end of the school year is next Wednesday, and between meetings, projects, and appointments, I’m going to have a hard time fitting even Curves in. Really going to have to watch the food intake too. When I went on the progesterone before (last year, as a last ditch effort for the Little One that we knew wasn’t going to make it), I socked on about 7 pounds and had such a puffed face!

Have the bloodwork to see if the IUIs worked on June 27th. Two weeks of waiting and mess and pads. If it doesn’t work, I’m taking July off. We’re going camping with a bunch of friends, and I cannot do this in the wilds of Maine. The week also falls midcycle, and I cannot be driving two hours each way to do this whole thing. So, if we’re not pregnant this time, we’ll wait until August to try again.

On the Road

Okay, we’ve had four days of 75 units of Follistim, followed by bloodwork. Then, a call from the Center: increase from 75 to 100 units for two nights, then come in for bloodwork and an ultrasound. Did that this morning. Ultrasound tech Wednesday and today was the same woman, and she’s awesome! Answers questions, turns the screen to show you everything.

Wednesday and today, they had students on externships drawing blood. Wednesday, they asked if I would be okay with a student drawing. I said “no problem, okay with me”. A female student from one of the local colleges drew on me, and was pretty good, but then again, I’ve always been told I’m an easy stick. This morning, no asking for permission, they just assigned a guy to me who looked like the last place he wanted to do his externship was in a fertility center. He did okay, but I had to remind him to take the rubber tourniquet-thingy off after he withdrew the needle and applied the gauze/tape combo.

Now I’m waiting for another follow-up call to tell me what to do next. I am very proud of myself as DH won’t go near the needles, so I’ve been handling the injections. Did the first one in the thigh, which was okay but not great. The rest I’ve done in my stomach, being a big brave girl each time I have to watch that needle go in. Did mention to DH that, if he can't take the needles, he'd better drop some weight (as his MD had mentioned) before his blood sugar rises anymore and he becomes a full-fledged insulin-dependent diabetic...

I just want to send out big hugs to Zarqa and Thalia; I thought of both of you this a.m. There was a couple there this morning who were coming out of an exam room as I was going in for the u/s. They had been in the waiting room when I got there. She was clutching a crumpled ball of tissue, and he was walking behind her with his head hung down. My heart goes out to them, and to Thalia, and to Zarqa, and all of us who’ve lost someone before we could even say “hello”.

Waiting to Start

We’ve finally getting to delve into the world of infertility treatments, because for the last three months, we’ve been on standby. Actually, we’ve been on hold since November. First off, as you folks on the same road as me know, you can do nothing after your consult until the great hand of the insurance company deems that you can. Then you need to have the initial tests, and then more insurance approvals. Then you must, at least at our RE, attend an IUI informational session, along with all the other couples in the same boat. And I’m sorry, but going to a session two days before Christmas wasn’t going to happen in my house without serious psychological harm being done to my mind (in that everything-must-be-perfect-for-the-holidays-now-trim-that-tree-and-wrap-those-presents-and-who-cares-as-long-as-the-cards-are-postmarked-by-Christmas mode).

So we finally get to a session in January. Then DH travels in February. Then in March and April, I’ve got too thick of a lining at the start of my cycle, and they want nothing to do with me. Actually, my RE wants to do a hysteroscopy and endometrial biopsy in April, so we schedule it for a Monday I happen to have off (but so do the kids and DH). The Monday happens to be the day after Easter Sunday, and on Easter Sunday, the Center calls my house and leaves a message, changing my 2:00 p.m. procedure to 11:30 a.m. We, of course, are at Easter dinner at my folks with my brother and his family, and we don’t get the message until that night. Now comes the fun part: how can you physically get a 10-year-old to his orthodontist appointment twenty miles away from where you need to be dropped off thirty minutes later for your procedure? The answer: you can’t, unless you call your aunt, who was going to watch your kids that afternoon while DH took you to the original appointment, and she graciously offers to drop you off. So I get dropped off at my reassigned time, and get all the way through the gates of scrutiny. Just before they come to give me the La-La-Land I.V., the nurse hands me a prescription for an antibiotic, which I quickly realize is harmful to fetuses. I mention this to her, and her eyes glaze over. She asks why I would be concerned, and I tell her that I am ovulating (according to those sticks I keep peeing on every month), and since we had five minutes to ourselves while we were hiding the Easter eggs, DH and I had “unprotected relations”. She goes in search of my RE, who kindly explains that, while he truly doubts that I would be getting pregnant on my own with the lining issue, my procedure is now OFF; he doesn’t want to risk flushing an embryo into my tube. So another month is down the drain.

I should explain one thing here. My mother’s mother’s mother died of endometrial cancer, which was finally diagnosed one Easter when she and my great-grandfather were visiting my grandparents. She starts to hemorrhage, and her son-in-law, my grandfather, who was an OB/GYN, took her to the hospital and ending up consulting on her diagnosis. So my concern isn’t so much that I can’t get pregnant because my lining is continuously too thick, but that there’s something more ominous going on down there. At this point, I mentally decide that if, in the great scheme of things, my losing Jimmy and the Little One were so that I would be followed this closely and that something bad would be caught and treated early so that I would live to see my grandchildren, then I would be somehow find resolution in all of this.

We plan to do the procedure early in May, and it’s done by one of the other REs on a Friday. He mentions inflammation, and I’m put on that antibiotic that stopped everything in its tracks last time. Then I’m told to wait for the results, that I’ll get a call in 7 to 10 days.

You know what happens already. No call. I wait two weeks, and then I call. The first nurse says that the results aren’t even in my file (electronic or paper). Then she calls back, says everything is fine, and we can go ahead with our scheduled April/May IUI. Please note from above, it’s now mid-May. I call the Center in a very agitated state, requesting that my RE call me regarding this budding FUBAR chain of events. He calls me back within thirty minutes (very impressive!), and tells me that all the test results read “normal”, that the other RE shouldn’t have said “inflammation” and that I’m to call CD#1 of my next cycle so we can start the IUI process. He adds that, if I have any other concerns or problems, call him directly (wow, a doctor that will speak directly with his patients!). So, now, after four Follistim shots, I wait for the call regarding this morning’s bloodwork, and for my head to stop hurting where I've been banging it against the wall of bad customer service...

Jumping In

No way to start this blogging thing like jumping in feet first. Welcome to my blog about life, love, and the emotional trials of pregnancy loss and secondary infertility. I have started this blog because I have no time or money to get to a therapist, so I thought maybe my venting could be put to use elsewhere. It may do no one else any good, but I hope someone can find consolation, wisdom, or a good old-fashioned belly laugh from something I write...

Today is Cycle Day #4 of what I hope will finally be our first IUI cycle. Two shots with the Follistim pen down, two more to go... oh, then the trigger shot, then the suppositories, daily early morning drives (all before work!) to the Center for bloodwork, and more bloodwork, and more bloodwork, and an occasional ultrasound (internal, of course; nothing like that to wake you up, huh, ladies?!?). Did I mention NO drinking of alcohol, caffeine, soda, no dying of hair, no eating of soft cheeses, cold cuts, peanuts or tree nuts, or most seafood? All in search of a rising HcG and a healthy pregnancy and an OB/GYN practice that can actually handle dealing with the care and concerns of an “older gravida” (because I’ll be 40 in December) who’s had multiple losses for the forty weeks of nail-biting 24/7 worry. It is worth it? In my opinion, in a word: YES!

All this while dealing with DH, who’s looking like I just stole his soul or something; he’d have been perfectly happy stopping after we lost Jimmy, and when the topic comes up, often acts much like a bull being led into the ring by the nose. I also have to continue the day-to-day mom thing with the lights of my life, the 10-year-old and 6-year-old sons that we do have living safely under our roof, both of whom were conceived, carried, and delivered the old-fashioned way, who allowed the shield of innocence regarding fertility to remain over my eyes for all that time. God, do I miss those days!