Mommies Here!

Yesterday morning I took the first of three consecutive gan.ir.elix shots.

When we woke up,  Nadia looked at me and said, “I don’t think I remember how to do it. It’s been so long.” And I said to her, “Well, shooting injectibles is just like riding a bike.”  And it was, sort of. 

As my friend, Sarah at Dreams and False Alarms, reminded me, the gan.ir.elix needles are a bit dull. Nadia’s first attempt to penetrate my stomach was unsuccessful, as the needled bounced off of my abdomen. But Nadia and I were not phased. After a few giggles, we soldiered on and got the job done.

One down, two to go!

So far, I don’t really feel any side effects. But I am sensing a glimmer of that old familiar fuzzy feeling. It’s the feeling that I comes over me after a few days of fertility medication. Let’s see, it’s one part ‘i can’t concentrate on any one thing for too long, ’ two parts ‘let’s just get this over with’ and three parts ‘eight million people is just too many people for one city!’

Yesterday, I had my endometrial co-culture biopsy. It wasn’t too bad. The procedure itself was midly painful but it was over in a flash. Tomorrow I start the estrogen patches. I’m starting to get the jitters.

What if this doesn’t work?

When I went to the clinic earlier this week to have some blood drawn, I saw all of these women preparing for battle. Some were new recruits, some were veterans like myself, some just had blank looks on their faces as they stared off into the distance. I saw my reflection in each one of their faces and I got a little panicked.

How much more of this can I take?

Let’s face it, I’ve had 10 failed IUIs, 1 failed IVF and now I’m on the verge of another (hopefully, successful) IVF. This clinic requires daily monitoring, so once I start there will be no sleeping in, ladies. I feel tired just thinking about it. And Nadia is extremely tired of all of it. Many of you have been through  more than me and some of you have been through less, but everyone’s ttc journey is unique.

I really hope this works. I got a lot riding on this one.

For the last couple of days, I have been testing and waiting for the big O, but my test turned positive last night. So, I should ovulate within the next 24-36 hours?

TMI?

Yes,I know, but here’s the plan…

Sometime in the next week, I will go into the clinic to have an endometrial co-culture procedure, most likely that will be on Thursday. My clinic recommends endometrial co-culture samples for ‘poor responders’ like me.

Ten days after the postive test for ovulation, I will start my estrogen patch and the day after that I start ganirelix.

About 5 days later, I’ll start my cycle and begin IVF #2.

And it all starts with the big O!

Eight months after my first failed IVF-cycle, I very close to beginning my next one. I am scared out of my mind, but also a bit excited.

Here we go!

Ladies and women, I am not pregnant. I actually found out on Wednesday, when my monthly friend came early. Ugh!
 
Okay, so now, it’s on to IVF #2. Hopefully, the number 2 will wind up as my lucky number this year. I don’t think I can take much more of this egg drop drama and Nadia is definitely tired of the whole rat race.
 
Monday, I will call the evil insurance company to confirm my IVF authorization. And I’m letting you know  that reserve the right to ask some of you to travel with me–out of state–to my insurance headquarters to pummel them if they say ‘no’  to my insurance request for some preposterous reason.
 
If all goes well, I will start  IVF#2 in mid-march. March is my favorite month of the year, and I  hope that IVF madness does not ruin it.

After arguing with my insurance company all day yesterday, I feel like my wings have been clipped. It’s a long drawn out story, but to make it short, it looks like I may have to do one more IUI before they will approve the IVF coverage.

I believe that what happened was that my old RE had negotiated with them so that I would only have to do two more IUIs before being approved. I even have that in writing, but somehow now that’s come down to the wire, they are singing a different tune.  I think it’s because one of the IUI’s that he was able to have counted was actually a fcanceled IUI cycle. Now that I am at a new facility, dealing with new people, they have gone back on their word.

Sure if I had the money or if my bio-clock was ticking, I could and would fight them in court, I definately think that I have a case, particularly because they have different medical standards for single women and women in same-sex relationships but, ultimately, I think I need to stay focused. Don’t get my wrong, I am going to speak with a lawyer and see what is possible, but no matter what happens, it doesn’t look like I am going to start my estrogen priming cycle next week. And that is my goal–to get started on IVF #2!

It’s all very frustrating and draining. Nadia keeps reminding me that they are doing this because they don’t want to pay. They are fighting this authorization tooth and nail because once I am approved, I think they are on the line for six IVF cycles, but I know I don’t have the stomach for that.

Anyway, I will keep you posted.

So I am still waiting to hear from my health insurance company about my IVF authorization. I can’t believe that they’ve had my complete information for weeks and yet they still haven’t made a determination. I think that they should be sued on criminal negligence.

Monday is a holiday, so they will probably be closed. Next Tuesday I am supposed to go have a biopsy for my endometrial co-culture and then I am supposed to start my estrogen patch on Tuesday. When are they going to get back to me?

What infuriates me is that Nadia and I are paying a hefty price for me to  be on her insurance and I can’t believe that I still haven’t heard anything.

I think the reason I haven’t heard from them yet is because they haven’t found a reason to reject me. I’m imagining them furiously pouring over 2 years worth of case files, checking every ‘t’ and ‘i’ to see if they were crossed and dotted correctly, hoping beyond hope to will find something out of place. God, I would love to meet one of them, so I could tell him to ‘get a life!’

I pray that tomorrow I get something from them in writing authorizing the procedure. I am extremely pissed off and I haven’t even started my medication yet!

So I’ve settled into my boring work routine and am just wanted to checklist off everything on my ivf prep checklist. Even though, I’ve only been back for a short week, I’ve done pretty well so far:

1.  Saline Sonogram–check
2.  SIS or sounding–to measure the transfer  etc.–check
3. Insurance Authorization–stil waiting on pins and needles
4.  Surge monitoring–check, started on Saturday
5.  Endo-metrial co-culture (scheduled after my ovulation/positive surge on test)
6.  Estrogren priming–will begin after my surge
7.  Ganirlix-a day after I start estrogen.
And then the wait for my period followed by a day 2 blast off to the IVF drug haze. 

 
The two procedures, I had last week were painless and I was out of the office in half an  hour. The last time I did a saline sonogram, I waited two hours suffered through what seemed like an endless procedure and then went straight to bed with excruciating cramps. In previous posts I named the saline sonogram the no-pain-no-gain exam because I hated it so much and thought it was going to kill me. My former RE, the doctor formerly known as Dr. Feelgood scared the beejesus out of me by stating “my uterus was stil distorted after the surgery”. And when I asked him what that meant, he said, “I don’t know,” which put me in a panic. But yesterday my new RE, Dr. Yoda, said that everything looked good. There was no mention of scaring or weird uterine formations.
 
So I’m waiting for insurance authorization and feeling an odd sense of calm.

We’re back from our South American Vacation and Nadia and I had a wonderful time. There was a lot of fun, family, beach, sand, sun, surf, beef, beef, beef and lots of love.  Nadia and I  were able to totally relax and enjoy one another. We connected in ways we hadn’t since we started the ttc, so the trip really did wonders for us.

We spent time with family for Christmas, then visited  some of the most beautiful beach towns I have ever seen and then we spent more time with family for New Years just before coming home.

Nadia is very close with her aunt, Chiquita who is 75. We spent as much time with her as we could because her health is deteriorating. She is a darling! She accepts me as Nadia’s wife and is really routing for us to have a baby. In fact for Christmas, she got me a flowered shirt “so that I can bloom”. It made me very emotional because we don’t have  a lot of support from Nadia’s family. Both of her parents died within the last three years.

 We also spent a lot of time with Nadia’s cousin, Mariella.  I love her to pieces! She is 39, recently married and on her own ttc journey. Needless to say, we’ve bonded around that. I will write more about her when I am less jet lagged; there is a three hour time difference, you know!

As you can see, the beach towns are gorgeous! It was summer down there but it wasn’t oppressively hot the way it gets in New York.

 It was a magical ttw and I actually convinced myself that I was pregnant, but I’m not. I celebrated New Year’s Day with Auntie Flo. Let’s face it, it would have been a great story, but it’s not my story.

IVF here I  come–again!

I went back to school this past week and I gotta admit that it was a lot of fun.  While Nadia was safely tucked at home recovering, I went to a mandatory IVF class at the new RE’s office. Of course, I still have one more natural IUI cycle to contend with before my insurance will pay for IVF and, hopefully, that natural IUI cycle will do the trick, but in case it doesn’t, I wanted to get the class out of the way.

One thing I never mentioned was that my new RE is in the same facility as Nadia’s oncologist. In fact, they are practically on the same floor. Something about their proximity makes me feel oddly comforted. So when I went to my class last week, I passed her doctor’s office en route to my clasroom.

 There were about seven women there, some with their husbands and some of them were flying solo like me. The nurses went over a 65 slide presentation, which reviewed such basics as:

a) What is IVF? b) What is considered day 1 of a women’s cycle? c) What are the side effects of fertility drugs?

And then they proceeded to go over specific procedures for day 3 IVF protocols, retrievals, and transfers. At the end of the class, they reviewed how to mix fertility drugs like menopur, how to prime pens like Gonal-F, and how to administer subcutaneous and intramuscular injections. After we watched a 15-minute video, they had each on of us “admininster” a progesterone shot on the rear end of a life-sized dummy.

Of course, the injection primer was just a review for me, but I have to admit that I really enjoyed the two hour class. It gave me confidence and hope. The nurses seemed like they really knew what they were doing. They were open to answering questions and even seemed as if they would be open to answering the same question twice–which is always a good sign. At the end of the class, I didn’t feel as if  I were too old for this, which is ususally how I felt when I left my old RE’s office.

After the class, I met with my IVF nurse, to review my IVF protocol. Let’s hope that  my upcoming natural IUI works and I  won’t have go on this protocol, but in case I do, I will give you a sneak peak. If it comes to this, I will probably begin in January after my holiday vacation in sunny South America.

Dr. Yoda’s IVF Protocol:

Ten days after I ovulate, I will start the estrogen patch. After starting  the estrogen, I begin three days of Ganirelix injections. On day 2 of my period, I will begin with 450 Gonal-F and 2 vials of Menopur. That’s when the daily monitoring begins. When my follicles are ready to pop, they will schedule the retrieval. More than likely, I will have a 3-day transfer.

I’m feeling hopeful. Nadia will have her post-op appointment on Wednesday, when we will learn if the cancer has spread. I have a good feelings about her appointment and our baby making journey.

Okay, so Nadia and I have a had seen at least three doctors together in the two weeks. I think that we both missed our callings and that at least one of us should have been in a medical professional.  We’ve gotten so good at seeing doctors because of the whole TTC thing, and now with Nadia’s cancer diagnosis it’s gotten to the point where we are telling the nurses and doctors what do to. Oh, well.

 Last week we went to see the second of two surgeons who specialize in the treatment of thyroid cancer. This guy, Dr. Yes We Can, even told us that she may not have to have radiation after the surgery, depending on the pathology.  This was definitely more than we hoped for. I mean, who wants to become radioactive if they don’t have to?

We scheduled her surgery for Thanksgiving week. She will only have to stay in the hospital overnight. Whew! He also reiterated what the first doctor said–she should make a complete recovery because the cancer was found at such an early stage.  We are thrilled. He said that she could return to work whenever she felt ready, but I am hoping that she takes at least two weeks off.  If nothing else, this will give us something more to fight about during our downtime… there is never a dull moment at our house.

As for the TTC, Nadia and I met a new RE this week. Originally, after my failed IVF, I was planning to interview several doctors, to get a sense of my options, but after I learned of Nadia’s diagnosis, I canceled some of those appointments, and just kept the one with the guy who was the most highly recommended. So this week we met Him, the doctor that I have been hearing about since I started my TTC journey.

So did he live up to the hype? Does anyone ever live up to the hype?

Well, before I answer that question, let me tell you about the medical facility. It is the most beautiful, pristine medical facility I have ever seen, and I’m sorry to say that I have seen quite a few in my lifetime. When I entered the building my eyes were drawn to a waterfall and I immediately felt soothed.

When I reached the reproductive endocrinology floor, I thought I heard harps playing in the background. It was very surreal. Everyone was so nice and everything was so organized. While waiting to see the doctor, I totally understood why everyone raved about the place. And I need to add that we only waited about 20 minutes, which included filling out the requisite paper work. At my former RE’s shop, we would wait at least an hour to see him– not including the paper work–even when we had an appointment.

Anyway, when we finally sat down to meet him, Dr. Yoda, he was very pleasant and quiet. I didn’t hear any bells or whistels going off during the consult, but I also didn’t hear him say, my old RE’s refrain, “Well, you are 38 and your eggs are old so…well, what can I say?” This guy was more optimistic and suggested some new approaches including estrogen priming and autologous endometrial co-culture (say that 10x fast!). Estrogen priming involves wearing an estrogen patch the cycle before you start to help with the upcoming protocol. I think it is sometimes used to help (ahem) older women with their egg production. The endometrial co-culture thingy involves growing a patient’s embryos on a layer of her own uterine line, which helps unexplained IVF failures and poor embryo quality in a previous IVF cycle, so this seems like something that would definitely help me–the one only produced one 5-cell embryo her last cycle, but I digress!

Anway, he definitely gave me hope and even Nadia was hopeful and kinda into it. I told him about my insurance nightmare (well, not the whole long boring story but the abbreviated kind, the kind you tell during a 15-minute consultation) and the fact that I needed to do two more natural cycle IUIs so that those bastards at my insurance company would finally pay for the IVF. In response, he suggested that I start right away and do an IUI this weekend.

Huh?

When he said that, I looked at Nadia and told him that she had thyroid cancer, which meant that we were putting all of our energy into her healing process, that the TTC was off for now, and before I could say any thing more, Nadia looked at me like I was crazy and said, “you should totally do it this weekend.”

Huh?

So I cleared my throat and told that doctor that we had to discuss it. But since we left his office, Nadia has been pushing me to do the IUI this weekend. Finally last night, I said, “why do you want me to do this now given everything we are dealing with?” And she said, “well, the sooner you do the IUI’s the sooner you can do IVF.”

Huh?

I have to admit that I don’t understand her. Sometimes I swear she just contradicts herself just to keep me on my toes. I thought she wanted me to table the TTC so we coud focus on her cancer, upcoming surgery, and healing, but I guess I was wrong–again. She said to me, “just because I want to be a priority (when was she not a priority?) doesn’t mean everything has to stop.

Huh?

I love her to pieces, contradictions and all. She is my infuriating angel, sent from heaven just to drive me batty.  I do love her and the fact that she wants me to do an IUI this weekend. I have to admit that am a bit weary of jumping on the ttc hampster wheel so soon after my failed IVF, but the truth of the matter is that this IUI should be pretty low stres–it’s a natural cycle afterall, this is the equivalent of a straight woman going bear back with her husband, except there are about 10 more people involved, including nurses, embryologists and doctors, and lots of cold sterilized instruments, but you know what I mean.  This IUI will give me an opportunity to learn more about this new doctor and new facility.

So it looks like I will be doing an IUI this weekend. And it all starts tomorrow morning with a 7 AM appointment for an ultrasound.