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Wednesday, May 25, 2011

new calendar

If this transfer works and the baby makes it to due date, DH has declared that March will be a Carnivale-type celebration of the birth of our family members. A month long celebration of us! :)

Here's the new calendar (note: we are only transferring one embie this FET. It says 3 because we have 3 available for transfer but we are only transferring one):

All the meds are the same (just taking a few more BCPs). The FET will now be 7/13. Which I think is a pretty darn good sign as that's my SIL's birthday. :)

Ladies & Gentlmen, AF has entered the building!!!!!

whoo-hoo!!!! AF is here! So now I can get my calendar and have a tangible plan. And get back on BCP's which will hopefully help with the weight gain and the acne (my body does SOOOOOOOOOOOOO much better when I'm on BCPs than when I'm off them).

I'm hoping my calendar is unchanged. I was excited for a Feb due date if this FET works. If we have to postpone it's not the end of the world. March is a great month. In fact, DH and I both were born in March. I was just hoping that the baby's birthday wouldn't be right on top of DH's so that both can have their own special day each year. But at this point, we'll take any due date we can get!

So, inspired by a dear CCRM friend, I'm going to set some resolutions for the next month to prep for FET:

1. exercise at least 3x per week that doesn't aggravate my healing ovaries. I'm thinking yoga, bike to/from work, and walking my dog around the lakes. I need to set a schedule for this as I'm much better at doing it if scheduled. So this week I'm going to walk the dog tonight, bike to work tomorrow, and yoga one day this weekend (I'll be at my in-laws so I'll have to find time to get away to do some sun salutations in our bedroom).
2. no more alcohol :(
3. continue to eat organically
4. get 8 hours of sleep per night
5. one caffeinated beverage (black tea) per day.
6. eat/drink more antioxidants (e.g., herbal tea, POM)
7. start meditation and foot salts 1 week prior to FET at the latest

Monday, May 23, 2011

Waiting for Aunt Flo: A Tragicomedy in Two Acts

I was in such pain this weekend I was starting to freak out that I had cysts rupturing or something. I was finally all set to swallow my midwestern pride and email CCRM to find out what might be causing my pain. Then this AM I woke up sore, but not in pain. Which was enough to clear my head apparently because it dawned on me -- I did some heavy-duty digging on Saturday morning around one of our oak trees. The ground there is very hard and each time I stuck the shovel in the ground I either hit a root or rock hard dirt. I am sure that must have put too much pressure on my little ovaries, causing the pain. And I've done some gardening throughout the past 2 weeks which woudl explain why I've been sore the past 2 weeks. Mystery solved. Whew! No more shoveling for me.

In other good news -- spotting today! Which I hope means AF is right around the corner.

Lately I've been feeling like I'm living a modern day, feminist remake of Beckett's existential play "Waiting for Godot" --  "Waiting for Aunt Flo: A Tragicomedy in Two Acts". In this case, Act 1 is waiting for AF and hoping she never comes as that means BFP (the first half of TTC and early stages of IF treatment). Act 2 is waiting for AF as AF signals the beginning of each new phase of IVF (which will hopefully result in BFP). Each act involves waiting waiting waiting all in the hopes of a BFP that never comes.

And in my head all day has been my remake of the Rawhide song:

Waitin’, waitin’, waitin’
Waitin’, waitin’, waitin’
Waitin’, waitin’, waitin’
Waitin’, waitin’, waitin’
Aunt Flo!

Sunday, May 22, 2011

CD31 and still no AF (but maybe some wicked PMS)

I feel terrible. Sharp ovarian pains. And nausea. I'm hoping this is all some sort of wicked PMS. Last month when AF came I actually vomited. My nurse and I chalked it up to wicked PMS as a result of elevated hormones from the ER. I'm hoping that's what this nausea is. The ovarian pains are more of a mystery. I've been having them on  and off for ~ 2 weeks now. Today they've been especially bad. And they are on both sides, suggesting they probably aren't from late ovulation (although maybe I'm ovulating from both ovaries really late this month? but for 2 weeks...?).

As you can imagine, I'm uber frustrated. I'm so tired of not feeling well. It'd be one thing if I was not feeling well because I was pregnant. Or if I knew that all this feeling crappy would result in a baby. But alas none of those is the case. So I'm just annoyed. I'm annoyed with feeling bad. I'm sick of hearing myself bitch about how I don't feel well -- I can only imagine my friends and DH must be sick of hearing it too.  I miss my body. I miss feeling like myself. So seriously, AF is very welcome today. I'm hoping that when AF comes that plunge in hormones will be the final step in ridding my body of the hormones from ER so I can maybe start to feel like myself again.

Saturday, May 21, 2011

Cycle Day 30 and no AF

Which is odd for me because my cycles are usually short (short luteal phase -- which is what alerted us that we needed IF treatment in the first place). I'm sure it's because I still have too many hormones coursing through me from the ER which is why I'm still so bloated. I've heard from other ladies going through IF that AF can be delayed after ER. So I'm not worried. Just waiting. And hoping AF comes soon so my FET isn't delayed or delayed too much. My nurse said that as long as AF comes in the next few days that they can just adjust the # of BCPs I take so I can still have FET on 6/28. So come on AF -- I'm ready for you. Let's get this show on the road.

Friday, May 20, 2011

OHSS continues

Lest we forgot about good ol' OHSS, I'm still suffering away with it. It seems like forever that I've had this. For the past week, though, it's calmed down enough that I've just been feeling "fat and ugly" (still 5 lbs more pre-ER and my chin remains covered in zits). But last night, ol' OHSS reared her ugly head with a vengance.

I'm still waiting for AF. Two days ago I had wicked cramps and backache and thought AF was coming for sure. Nada. Yesterday I had some GI distress and bloat. But not enough to knock me out. DH and I had theatre tickets so we went to see the show -- a fun date night. However, toward the end of the show, I started getting that hot, goose-bumping feeling I get when I'm about to be sick. I tried to fight it so we could see the end of the show and not send some sort of message by walking out of the show before it was over (esp because it was a great show! Very well done. Super funny. We were really enjoying it).

But I finally couldn't take it any more. Last month when AF came, I literally was getting sick out of both ends simultaneously (sorry for the TMI but hey, this is what I've been dealing with here). And I was not going to let that happen in a public bathroom. Additionally, during the course of the show, my little bit of bloat had exploded so that I had developed what my brother calls a "booby-do" (bc my belly sticks out more than my boobies do). And I'm about a C and a half so we're talking some serious bloat. Oh it was so uncomfortable.

So we left Luckily getting outside and some fresh air was just what I needed. By the time we got home, I no longer felt like I was about to explode. I took some preventative meds just in case and went to bed.

Today I feel much better. Still bloated but no booby-do. And still no AF. I'm now on CD 29! I don't know how that happened. I missed a week somewhere and thought AF should have come this week. Turns out it was last week when I was in so much ovarian pain. Time is flying by with my IF brain melt.

In good news, our local RE was reimbursed for some procedures we paid him out of pocket for, so we should be getting a check for over $1,000! Always nice to get even a fraction back of the thousands we've spent so far on IF treatment.

Thursday, May 19, 2011

insurance companies are the devil

Wow it's a good thing I have a job with flexible hours. I just spent over an hour with my prescription insurance company (Express Scripts) and several hours today dealing with this mysterious $400 charge for my endometrin. The official reason I was denied coverage for the endometrin is my failure to respond to ovarian deduction combined by my meeting my maximal allowable benefits for this diagnosis (infertility). As discussed earlier, there is no such thing as ovarian deduction (this was verified by my CCRM nurse). Also according to the express scripts rep, my lifetime max for fertility treatment is $5 million and I've thus far spent $28,000 (of Express Script's money. This doesn't include the $$ DH and I have paid out of pocket for meds that were denied coverage). So none of this adds up.

This is now making me wonder whether other times we've been denied for various parts of our coverage whether I should have called to follow up on that as well. The thought of doing that for sometimes weekly treatments over the past year makes me want to barf.  Because we're talking thousands of dollars that DH and I have paid out of pocket for meds for IF treatment over the past 1-1.5 years.

So my options are:
1. appeal which I plan to do
2. get CCRM to write a new Rx with a different diagnosis.

Luckily I have a few weeks before I have to start taking the endometrin to try to sort this out.

I'm also going to activate my on-line Express Scripts account and try to review my prior claims. After taking some anti-nausea meds.

Ovarian deduction what?!

I called the insurance company to find out why they won't pay for my endrometrin (the progesterone suppositories). I was informed that it was denied because "the patient has had previous infertility treatment and has not responded to ovarian deduction". Yes. Deduction. That is correct. I had her say it like 17 times. The conversation went something like
"I'm sorry, ovarian what?"
"deduction."
"ovarian what?"
"deduction."
"I'm sorry, ovarian what?"
"deduction"
"ovarian what?" and on and on.

Then I made the poor woman spell it. Then spell it again.

I thought perhaps I was going crazy. Have I lost all sense of vocabulary in the brain melt that is years of struggling with IF? But no, Mr. Webster (as my granny would say) agrees with me:

a : an act of taking away <deduction of legitimate business expenses> b : something that is or may be subtracted <deductions from his taxable income>
2
a : the deriving of a conclusion by reasoning; specifically : inference in which the conclusion about particulars follows necessarily from general or universal premises — compare induction b : a conclusion reached by logical deduction 

So what the deuce is meant by "ovarian deduction"? 
That this patient hasn't responded to someone taking away my ovaries? To my knowledge, taking away of my ovaries has not been a part of my treatment. In fact, my ovaries are producing, not deducing, as evidenced by my awesome 29 eggies. 
Alternatively, do they mean that this patient hasn't responding to a logical conclusion about my ovaries? And what would that logical conclusion be? That my ovaries are producing eggies? And if that is the logical deduction, that has nothing to do with my need for progesterone.

Seriously.

So I'm obviously going to fight this. Because unless there's some medical definition of deduction of which I'm unaware, this makes no sense. I have a call into my CCRM nurse to get to the bottom of this.

At the very least, I can thank my insurance company for giving me a couple of laughs. Ovarian deduction. That's just funny.

*********
update: 
I just called DH to tell him the news. I told him that I was denied because of my failure to respond to ovarian deduction. He's response was "Ovarian what?". Exactly.

Things not going as planned...again...

Two annoying things happened yesterday. AF did not come. So our calendar is now unknown. Could be July now depending on when AF comes. So more waiting.

The second thing was that when our meds came (see previous post on meds), they didn't send the progesterone because they needed to get prior authorization from our insurance company. They have a policy that you have to be there when meds are delivered to sign for them -- otherwise they are not responsible for the quality of the meds. So I assumed they would call me when they heard from my insurance company to schedule delivery. They told me that my copay would $0. My insurance is awesome.

However, yesterday our credit card got charged $400 for the progesterone. And they shipped it without telling me so I wasn't home to sign for the delivery and it went back to FedEx.

So I called Freedom Fertility (the pharmacy my insurance wants me to use for fertility meds) to find out WTF. The woman I talked to agreed it was all very weird. Someone is supposed to call me back but so far nada.

I hate to complain about having to pay $400 for my meds as I know most of you doing through IVF are paying much much more. But it was just another freaking thing going wrong, that we haven't been planning on, etc.

Ugh - I just want to fast forward to July and know whether all this (time, money, emotional rollercoaster) will be worth it.

Monday, May 16, 2011

It must be getting real again -- the meds have arrived

Here are most of the meds I'll be taking the next 1-2 months:

Not as bad as prepping for ER although sadly there will be some shots involved. And messy vaginal suppositories. Fun times.

Here's my tentative calendar (all dependant on when AF comes):
If AF comes 5/18:
5/20 I'll start BCPs (to shut my natural hormone action down)
5/27 I'll start Lupron shots (10 units daily)
5/31 last BCP
6/3ish AF arrives and I'll start estrogen replacement therapy (estrogen patches) on CD 3 of this cycle. I'll have a new patch every other day, starting with 1 patch and working my way up to 4 patches by 6/17. I'll also start aspirin every day and reduce lupron to 5 units per day.
6/11 blood test to check estradiol
6/21 u/s and bw to test estradiol

Calendar will then be revised based on results of u/s and bw but will look something like:
~ 6/23 continue estrogen patches and add endrometrin (progesterone suppositories 3x per day). Add tetracycline at bedtime then 4x per day and Medrol (16mg) once each evening for 4 nights. Stop lupron shots.
~ 6/28 Frozen Embryo Transfer (FET)

after FET:
continue estrogen patches and progesterone suppositories until pregnancy test. If BFP, I'll stay on hormone treatments until my doctor says stop. If BFN, I'll stop hormone therapy.

Thank you makers of Zicam. Thank you very much.

I took a ton of Zicam yesterday and I think I may have nipped that cold in the bud. We'll see how I feel as the day goes on but so far feeling so much better than yesterday.

Which is great because the countdown to AF has begun. If I go by a typical calendar, AF should come around Wed. But my body is rarely ever typical -- usually AF comes sooner than that when I'm not on BCPs. But I've heard from some ladies that AF can be delayed the first few months after ER. So it's more waiting, waiting, waiting. My meds to prep for FET are scheduled to arrive today. I'll be sure to tell you all about those when they get here. I'm working from home today to be here when they arrive. I've found it's easier to be here if I can on days the meds come because I don't feel comfortable having them shipped to my work. And if you waive the signature then if anything's wrong with them when you get them your SOL. I could ship to DH's work since his co-workers know what's going on but this just seems easier. His work has already been so understanding about letting him miss work for ER, etc.

Sunday, May 15, 2011

Wrench in the plan -- getting a cold

I'm freaking out today. I think I'm getting a cold. My chest hurts and my head is fuzzy. AF should come any day this week. I'm worried that if I get a cold this week that I should postpone my FET to next cycle month (i.e., end of July). I hate to postpone it because I'm getting so tired of my life being consumed by IF treatment and waiting. But I don't like the idea of having a cold the same month of FET. If anyone has heard any of research on this at least heard of treatment recommendations about having a cold the same month as FET I'd really appreciate it (I couldn't find anytning on pubmed this AM. But then again, my head is pretty fuzzy).

Wednesday, May 11, 2011

Back to the Gym

So when I'm being a really really good girl (and not recovering from OHSS) I go to the gym 4x per week (this rarely happens mind you. But it's what I shoot for) -- 2 spin classes and 2 body pump classes. Trying to get my body in shape so I can be strong and healthy for pregnancy.

I haven't gone to the gym since I left for Denver beginning of April. Until today. I went to body pump. It felt awesome. Hard and I was totally weak and I'm sure I'll be sore tomorrow. But I did it. My right ovary was a bit sore on the drive home, but I'm starting to think the ovarian pains/soreness I've been having this week are from my poor little ovaries being overstretched and still healing from that. I'm very proud of myself for going today -- it's always really hard for me to get back to the gym after a hiatus. So the plan now is to slowly ease back to the gym so I can get back to being strong and healthy for pregnancy. 

Tuesday, May 10, 2011

checking in

Sorry I haven't been posting lately. Not much new to report. Just waiting for AF so we can get the calendar set and I can start prepping for FET.

I did have a weird experience on Sunday. Wicked strong ovarian pain on my right side. It seems a little late for ovulation pain. But a little early for AF cramping. Whatever it was it knocked out back on the couch for the rest of the evening (luckily it came toward the end of my errands on Sunday so I could just relax and take it easy). I was hoping it was AF cramping so I could start my FET calendar (even though it was only CD 17 -- but my luteal phases tend to be short which is what got me to the RE in the first place. But a 17 cycle would be super short even for me). But so far, no AF. Felt fine Monday and today. 

Tuesday, May 3, 2011

CCS results and FET calendar

I spoke with my nurse today to put together my FET calendar. It's all based around AF coming on 5/18 but AF is not very reliable and tends to come earlier than that so we'll see if this calendar holds up. But if it does, I'm scheduled to start BCPs on 5/20, lupron on 5/27 (yes more shots! fun times), estrogen replacement therapy on 6/3, vivelle patches on 6/5, and endometrin on 6/24. I will need blood draws on 6/11, 6/21 (ultrasound that day as well), 6/25, and the day of FET (6/28). I will need to fly to Denver on 6/27 and can fly home 6/30. 

It's exciting to have a plan but tough to get too excited about it given all these dates are subject to change which makes it tough to plan anything yet. But good to know I’m on track for an end of June FET!

I informed my nurse that we’re still planning on transferring one this time.  

I also asked her for more details regarding the CCS results:
One had an extra c-some 15
The rest were missing chromosomes:
One was missing chromosomes 7 & 14
One was missing an x or y chromosome (which we knew from our phone call from Dr. S)
One was missing chromosome 16
One was missing chromosome 7

So no clear pattern emerged. Which seems to me to be a good thing in that it suggests there’s not an underlying genetic problem that’s contributing to the chromosomal issues. On the other hand, it suggests that I may be considered AMA, at least when it comes to my body’s ability to successfully engage in cell division.