Valium and Videos Tomorrow

Tomorrow (CD9) I am doing something called a hysteroscopy which involves some kind of camera up my uterus.  I got the valium this time ($1.15 out of pocket).  I did not get the valium for the HSG.  I don't know who I was trying to impress with that display of bravery, but NO ONE WAS IMPRESSED.  And here's a tip.  If you already know you have one tube after your ectopic, get the damn valium for your HSG.  Those other infertiles with all their working tubes have no idea what they are saying, and no one will be impressed.

This is the last procedure before the stimming starts.  Well, scans I guess.  Don't even notice those anymore.  I've been on birth control since CD2, and we have all the blood tests, sperm tests, so many tests.  So tomorrow we also have to watch a bunch of videos, sign a bunch of paperwork, get a calendar, figure out meds, figure out the medical portals, figure out money, all kinds of stuff.  Going to be a fun morning.  Shit is about to get real.  Thanks for those who are following with me, it helps not to feel so alone.  Cross your fingers for me, I'm feeling nervous all of a sudden.

My Diagnosis

At my first appointment with my new RE, he printed out a piece of paper with my diagnosis that he made me sign.

Secondary infertility, tubal cause

Secondary???  OUCH!  Yes, secondary.  Because I got pregnant on the second try (oh the blissful arrogance then!) I can get pregnant and the genetics/sperm/a bunch of other stuff are considered OK.  And you don't have to have a "live birth" to qualify for secondary.  Awesome.  So I am in a secondary infertility boat with no baby.  Great.  Like peeing every 15 minutes on progesterone when I'm not even pregnant.  Just swell.

Tubal is no surprise.  The new RE said that it's very rare for just one tube to be compromised with an ectopic like mine, but he said he agreed with the treatment plan to do IUIs/natural for a bit first to make sure.  He said what I felt in my gut.  It's time to just bypass the tubes and go to IVF.

He said my numbers looked fantastic, sperm numbers looked great, responses to various medicine looked perfect, especially the Gonal F.  He said I was "ideal" but that IVF is always guesswork and chance.  Boy do I know all that by now.  He said he put my odds at 60% fresh, 40% frozen, which is what I expected.  He said he thought that based on my age and ovarian reserve he hoped to stock the freezer.  Yay!  Let's get this shit on ice!  Did I mention how much I like my new doctor?

Announcing and Not Announcing IVF

Since it's been a really long slog to get here, I figured I had to announce it at least to people who knew about the original surgery and have noticed that 2 years later there is still no kid.

I told my mom, my mother in law, my sister, a couple of friends, and my friend who did this herself six years ago.   I have a decent amount of support.  I have support to drive and call and that's in place now, so that's good.  I also am so lucky that I don't have anyone in my family or extended familiy who has some bullshit opinion about IVF that I don't care about.  My MIL was raised Catholic and I had to explain to her why the Catholic Church doesn't support IVF, so obviously they are terrible Catholics.

But I have a friend who doesn't "believe in" IVF.  Let's call her Leah.  Leah actually told me she was opposed to IVF when I told her I was on Clomid, like a million years ago.  Dude, I'm just on Clomid, I said.  It won't get that far.  And she said that if it ever did she didn't want to hear about it.  And it's her BFF who referred me to the first RE!  Leah's BFF had twins at 42 with IVF.  Of course, Leah had three kids in her early 20s easily.

I'm actually seeing Leah this weekend.  Part of me wants to talk about it anyway.  So maybe she doesn't believe in abortion or divorce or adultery or punching people in the face, but if your friend is going through that tough shit that you don't believe in, shouldn't you be there for them anyway?  I've actually never had an ethical debate about IVF with anyone, and I'm not sure how it would go.  Probably crying.  Probably can't end well.  So I'm suddenly glad she flagged me with this knowledge so I can lie for our mutual comfort, so I'll probably just tell her I'm still on Clomid.  Or I could tell her the truth, I am now on BIRTH CONTROL!!!  Nothing to see here.

IVF Here We Come

Here we are Cycle Day 2.  Blood has been drawn, 12 vials for all kinds of shit.  Another "sample" for insurance or something.  I started birth control pills (oh cruel universe! I remember when I had an alarm set for these for the opposite reason!)

Hysteroscopy scheduled for next week.  We have to watch a bunch of videos.  Tons of papers.  I am now on IVF.  Wow.  I am now doing IVF.

It happened so fast, but at the same time I have been waiting for years.  Day 2 of the Rest of My Life.

A Big Day

Choices have been made and I feel so nervous and sick, but also settled, like we are finally moving forward instead of wasting more time with IUIs.  IVF time.  Let's go.

The new doctor was as TOTALLY different experience.  It was possibly the nicest office/medical environment I've ever seen (even nicer than the freaking spa at the mammogram center.)  The billing people were ON POINT.  The receptionist knew all my shit.  The doctor was prepared.  I waited less than five minutes.  Everything went right.  It also helped make my decision that I had to call the old doctor for a code for the portal to see the records and spent 30 minutes on hold.

I'm not in love with this doctor's manner or some of his opinions (he gives a lot of interviews), but his numbers are some of the best in the whole country.  He explained everything, and he took his time.  He seemed very calm.  Maybe that's because I was trying to decide how to narrow down the million thoughts in my head.

He said I looked like an absolutely perfect candidate, and there should be no reason it doesn't work.  He estimated my success at 60% fresh, 40% frozen.  Best numbers I've heard in a while.

So I got a new doctor.  I also got approved by the insurance for IVF, and they cover EVERYTHING!  OMG.  It's even better than I thought.  The financial lady said it's possible they might only cover transfering one embryo?  I guess we'll cross that bridge when we get there.  Now I have a calendar and a whole plan.  And maybe I can get pregnant by Christmas after all.

Feeling Nauseated at This Decision

I have an appointment with the other doctor on Monday, and my current doctor on Tuesday.  Monday.  Choices will be made.

I feel sick to my stomach.  Of course, it doesn't help that progesterone makes me unable to sleep and have to pee every five minutes and then there's the wicked nightmares.  Ugh.  I am so very nervous.

This is something we have planned and looked forward to and realized was a possibility over a year ago, and yet here we are and I think I'm going to puke.  My husband and sister are going with me.  I know this will completely take over my life until Christmas, take every financial, emotional, and time resource we have, and I have all but decided to do it.

The more I think about the doctor situation the more I realize I just don't feel comfortable with my current RE's office.  It's not the doctor, it's the staff.  What good does an awesome doctor do if no one calls you back?  Or if no one reads my chart?  And the lab.  The dismal success rates for women under 35 have to at least part the lab, right?

Mostly I'm scared.  All these blogs seem full of pain and failure that drags on for months and years.  It has already been so long, and I am so afraid of the next step.

A Big Appointment and Second Opinions?

My big appointment with the doctor is a week from today.  A week from today we will be making decisions about IVF.

I feel like I have no idea what I am doing, there are too many choices, and I am just overwhelmed.  I did some research and my clinic is among the lowest in the state for IVF live births for women under 35, at about 35%.  The competing clinic is at about 60%.  That's a big difference.  There's another, much bigger clinic that is in the high 50%s.

The competing clinic is way closer to my house and I bet they answer the fucking phone and pay for your parking.  I am seriously thinking about booking a second opinion.  Like tomorrow.

A Royal Timestamp

In case you live under a rock, William and Kate are having another baby.  Oh boy.  According to the stalwart news source that writes in first person apparently, the Daily Mail, "The couple confided only recently to friends that they had wanted to try for another baby this summer. ‘It was the plan, but they are surprised and of course delighted it has happened so quickly,’ my source added."

Yes, so magical and great.

My Perfect Breakdown had an interesting piece feeling sorry for the Duchess and her chose fishbowl with no privacy.  And yea, that sucks for her I guess, and I can't even imagine what it would be like to have that level of fame and so many people interested in her uterus, and I write a blog for strangers about my uterus.  Even at its worst moments, I can't say I would trade my life for Kate's.  I think all of us in the infertility community have a more cynical view of pregnancy and all the shit that can go wrong.  So being forced to announce so early would be pretty much my personal hell.

But mostly I'm so pissed off about having to endure another news cycle about Kate's maternity dresses/nannies/baby names/cloth diapers/food cravings/natural childbirth.  Just like last time.  Last time, she got pregnant right around when I did.  Right after I woke up in an operating recovery room with no baby and no tube, the blessed magical royal baby was announced.  Oh joy.

I said on My Perfect Breakdown that to me the Royal Baby is a timestamp on my grief.  My lost baby would have been so close to George's age, and now she has two maybe.  TWO.  In the time we've just been trying for one.  It's just a reminder of how long all this shit has taken, and how heartbreaking it is to fail at something that is apparently so easy for everyone else.  Everyone but me.

Failure and Fear IVF

I have one friend I met at the clinic.  That waiting room is brutal, and you feel like either you or the person next to you will break into tears if you make eye contact.   But somehow, in my five million visits, I made a friend who's about my age, lives around the corner from me and obviously has a lot in common with me.  The first time we met up, we finished up a bottle of vinho verde and we got each other.

After I didn't hear from her after I knew she had a retrieval, she texted that her IVF had failed.  My heart just sank.

She's 31!!!  How can her IVF fail?  FAIL?  Like just fail?   Honestly, this hadn't occurred to me as an outcome.  I thought you'd at least bank some in the freezer and one of those would take eventually.  She's younger than me but has ovulation issues and touch of male factor.  I think she might have some PCOS stuff that I know nothing about.  But she's younger than me, at the same office (though different doctor) and it FAILED.  She said it was too conservative.  I have no idea what that means.

She's now got some serious crazy talk going on involving traveling to Denver to CCRM and changing clinics, and hating the lab, and so on.  My heart is just breaking for her.  But it's also filling me with fear.  It was enough to make me do some research on CCRM as well.  And I'll be in Denver anyway in a few weeks....

This is crazy, but I actually looked into this.
 For starters, they don't take my insurance, and I have like 15K to blow first, so I plan to do that locally, but I have to say that I am now thinking about it.  Oh god, am I already thinking about the next cycle when the cycle I haven't even started yet fails???  WTF?

This place I'm going to now doesn't have the best stats in town for women under 35, they're about average.  We do have better stats in town, but it's impossible to know what means anything.  Now I'm not sure how I picked this doctor at all.  I know more about my fucking dishwasher.  I'm so frustrated.  I know this clinic takes on a lot of tough cases, and I know I am not one of those cases (I hope) as I just have wonky tubes.  I'm the dream patient, right?  I don't need CCRM right?

Thoughts on Mammograms Before IVF

I posted yesterday about my mammogram I got before IVF because my doctor made me.  I'm 32 with a mom who had breast cancer at 37.  So obviously I'm higher risk than most, and maybe my doctor wouldn't have made everyone go.  I'm not sure.  I do know that I would have put this off until after IVF if the doctor hadn't made me go.

Turns out Giuliana Rancic, who I find totally annoying, but one of the only celebrities really out there about her struggle with IVF, found her early stage breast cancer at 36 because the doctor
also ordered a mammogram before her IVF #3.  Wow.  That means IVF might have literally saved her life.

Now, I hope that this isn't my story and that I did waste my time getting a mammogram.  I hope I don't have a story like Giuliana's about how IVF was the only reason I caught my breast cancer.  But I REALLY hope I don't have a story where I am pregnant and THEN diagnosed with cancer, God forbid.  I hope no one has to face that.

And then there's this.  Some doctor on NBC saying that mammograms aren't necessary for 36 year olds and they aren't necessary for IVF.  Seriously?  Screw you, doctor on TV telling people not to get mammograms before pumping themselves full of hormones that are known to accelerate some kinds of breast cancer, and hopefully will result in pregnancy, a non-ideal state to treat cancer.

What exactly is the downside here???  It took 30 minutes, it was completely free on my insurance, but costs $55 + $50 radiology so $105 out of pocket if you pay upfront in cash (I asked, infertility has made me very attuned to weirdness in cash payments in the medical field).  So maybe I wasted a little cash and time because I probably don't have cancer.  IVF takes every waking moment and multiple hands in your vagina.  Having your boob placed on a shelf is nothing compared to a dildo cam three times a week.  IVF is literally tens of thousands of dollars, what difference is a piddly little $105 mammogram?    Shit, I have spent more just on parking at my RE.  You should waste 30 minutes and $105 too.  Just throw it in the air as taking as long as another scan and rip up those dollar bills costing 1/3 of a Follistim shot.  Why wouldn't you want to do this before IVF?

The Spa, er, Hospital

It's been fun and filled with radiation and cervical scraping as I finished my list of stuff to prepare for IVF: dentist, pap smear, and mammogram.  Great three days.

But I want to talk about my first ever mammogram.

You probably don't need a mammogram to start IVF, but my mom had breast cancer when I was a teenager, so it is seared into my brain that I will get breast cancer very young and that breast cancer is damn scary.  (Don't worry my mom is OK.)  As I was filling out the forms, I am now 32.  32!!!!  THIRTY TWO.  Yes, I have been failing this long, and I put off this mammogram this long and probably wouldn't have gone before IVF if the doctor didn't make me.  My mom was 37 when she got breast cancer.

But what struck me was how much the mammogram center, in a major medical facility, was like the RE office.  That was exactly what it reminded me of.  It was so huge and new and clean.  It had little consult areas, free coffee, comfy custom sofas, beautiful art.  It was all pink with pink ribbons, but the gist was the same.  Money.

In the locker room to change, it was like a spa.  Bubbling rock features, free drinks, teak benches, beautiful settees, soothing music.  Hell, I expected to see a sauna in the locker room.  We waited in lovely plush robes and then the tech was so very nice.  Better than my RE's at least, but how can anything be nice in the stirrups?  After constant scans with a dildo cam, a mammogram was nothing.  And you can do it too.  It's nice, and unlike the RE's office, your insurance will probably pay for this level of luxury.  I didn't even have a copay.

A Pap, Back to the OB

Before starting IVF, the doctor gave me a list of stuff to do that I can't do during IVF or pregnancy.  I need a first time "baseline" mammogram because of my family health issues.  I need to get dental x-rays.  And I need a pap smear...  This should be a fun couple days!

I haven't been to my OB since following up after surgery.  Has it been over a year???  So, I had to go back there and get a pap smear.  Oh boy.

The second I was back there, with a million teenage pregnant moms and ill-behaved toddlers screaming all over the lobby in eight languages, I started to panic.  It all came back to me.  Waiting in that very room, for over an hour just like this time with the same teen moms and toddlers, I had written a journal entry saying goodbye to my baby.  I had cried there before.

The actual pap was no big deal.  Stirrups are no big deal at this point, it was like nothing.  I can't believe I used to consider a pap yucky or uncomfortable or something.

The doctor, though, was very interested.  I've gone to him for a million years, he's the only doctor I actually have a relationship with.  He even gave me his cell phone to text him when I was pregnant, which I used only once, after it was over.  He wanted to know everything about my RE, he wanted to know why he hadn't seen me.  I couldn't even get the words out, I was so upset and crying.  I could feel my blood pressure going up.

He had a lot of opinions about IUI and IVF, doesn't everyone.  What I gathered is that he was baffled why it got this far and why nothing has worked.  He seemed optimistic about IVF.  He wanted to see me more.  I don't know.  It was a very confusing appointment.  He was impressed at the 20 lbs I've lost since the pregnancy, and I was too, considering how many drugs I've been on so long.  So I'll take that silver lining.

Call Me Maybe, Doc

After calling on Tuesday at 10AM, I never heard back from my doctor's office nurse line, which is just an answering machine.  I needed to schedule a scan, and I needed them to do the new paperwork for this cycle, you know, so I could actually get my meds.  Nobody called back, but Femara is covered anyway, so no big deal.  I can get my Ovidrel later.

I called back twice on Thursday at 1 and 3, and the line was failing or busy or something weird.  So, I'll give them the benefit of the doubt that they had phone issues.  Yes, maybe the phones are a disaster.

I called again on Friday morning.  I said in my message that no one had called me back since Tuesday and that I could email or something if that were easier because I just needed a freaking day 13 can.  I got a call back an hour later.  No explanation about the phone.  Everything is completely normal, I guess.  Apparently, I am supposed to have a baseline scan at day 3, which is fun and wasn't on my paperwork from the actual doctor.  Oh, and it's now day 4 and 3PM, and you never called back, so fuck you.

I get that actual emergencies happen, and I get that phone issues happen, and I get that a Day 13 scan is not the most urgent thing.  But the complete lack of communication is freaking me the fuck out.  I'm actually thinking about getting a consult at least from the handholding IVF clinic across town.  Honestly, it has better stats in my age group anyway.