Decisions

Today was our consultation with Dr. Henry to decide on a new plan for us. In the end, there was really no definite plan. It just left us with decisions that I frankly don't want to make.

1) Different fertility drugs and IUI again. At about $3500 a cycle and only a 20% chance of pregnancy we quickly made that decision. No.

2) Exploratory surgery. I'm not sure of the cost, but I'm sure it is more than I am willing to pay. And I don't know that my SHITTY insurance would cover it. The doctor suggested that this be a last resort since it would be very invasive and in the end, he may find that I have no issues other than the unexplained infertility. So, that's a no.

3) In-Vitro. You don't even want to know the cost. It's thousands. And again, my SHITTY insurance doesn't cover it. But...Matt's does. We left the appointment today with the decision to see if I could get on Matt's insurance. The reason we have not looked into this before is because 1) I didn't think it would get this far and 2) cost. The monthly rate to add me to his insurance is more than a weeks pay for me. But, it is definitely much, much less than the cost of the in-vitro.

Decisions, decisions. I HATE them. It's difficult enough for me to choose a restaurant to have dinner. But, I alone did make a decision today. We're done with the fertility treatments. This is stressing me out more than you will ever know. I am sad. I am angry. I am disappointed. I am heartbroken.

A while ago I had a 20 year old girl in my office. She saw a picture of my niece Aubrey and asked (like almost everyone else does) if she was my daughter. I said no. Then she said something like this: Well, you look old. Don't you want children? I already have 2 kids. I politely said yes while in reality I wanted to punch her in the face. It's not fair.

Strike 3

Needless to say, I started today. I am not surprised. I have felt it coming for days now.

The next step: Consultation with Dr. Henry next Tuesday in Terre Haute to discuss a new plan of action. I haven't the slightest idea what it will entail. Injectables maybe? Which just screams expensive. But, per the okay from Matt (the breadwinner in the family) we will keep on keeping on until I have a small Fry (haha) growing inside me.

Speaking of Matt...he was very upset about the news. Much more upset than I ever imagined he would be. I, on the other hand am okay. Which is weird. Just last week I cried so hard from hearing that someone was pregnant that I vomited. I'm sure I'll cry all the way home from work. I do that from time to time. And I'll cry while I'm in the privacy of my own home, before Matt gets home from work. And I'll cry when he walks in the door. And when I shower in the morning. By then I will feel better, but still heartbroken.

Strike 3, but we are not out of the game yet.

Intrauterine Insemination

I wanted more than anything for us to be able to conceive on our own, the traditional way, but that has not worked out for us. So, we made the decision to go ahead with intrauterine insemination. Today was the day. And I have mixed feelings about it.

On one hand, I would do anything to be able to get pregnant. We tried for more than a year before seeing a Reproductive Endocrinologist. After two medicated months with no results, IUI seemed to be the right choice. On the other hand, the thought of not getting pregnant naturally is a little upsetting. Test Tube Timmy…or in our case Turkey Baster Tommy was not in my master life plan. But, a lot of things that have happened to me were never part my plan. I think my certainty in having the procedure was based on this…if I end up pregnant, we will never really know if it was naturally or with a little help. Either way, I will love that child like I have never loved before. In the end I know that it is undeniable that we made the best decision.

Our appointment was at 8:30 am (Indiana time). Since my last early morning appointment, both Matt and I grew a little more intelligent and got a hotel room this time. I love staying in hotels and I thought this for sure would relax me. I was nervous. We were nervous.

Our hotel was a whole 3 minutes from the doctor’s office, so not only did we get to sleep in, but we also got to miss all the early morning traffic that Indianapolis brings. We arrived just in time. I am not sure if it was the anticipation of what was to come or the hotel powdered eggs I ate for breakfast, but nausea overwhelmed me. We waited, and waited, and waited. Finally, just over an hour later (there is a process that is done beforehand that takes some time, but I won’t mention it as I do not want to embarrass my husband) it was my turn.

I won’t go into too much detail, but the process is much like a pap smear; lie on table, feet in stirrups, cold speculum. But for this procedure, a small catheter was inserted into my uterus and the “wash” was injected. It took less than 5 minutes and was not as painful as I had convinced myself it would be. It did indeed feel much like a pap smear, uncomfortable for sure, but not excruciatingly painful. The nurse set a timer and I was instructed to lie there and relax. And that I did. Ten minutes later Matt and I were on our way home with smiles on our faces this time.

And that brings me to now. As I sit here and write this I am still a little crampy and a bit nauseous. The sick feeling is nerves, I know. I am by nature an anxious, inpatient creature. October 7^th (when I test) cannot come soon enough. Please say a prayer for us; not only that we get pregnant, but that if I do not, I will be strong enough to get through the heartache and try again.

Follicle Ultrasound #3

Not that I really needed to mention it, but Round 2 was unsuccessful. After testing everyday since September 2^nd, I started on September 7^th (35 day cycle this time).

On with Round 3. Third time’s a charm…right?!

On cycle day 4 (September 10), I started my 3^rd (and highest) dosage of Clomid at 150mg. Again, I was told a larger dose would increase the number of mature follicles. My first cycle I had 1 mature at 22mm and the second cycle they were all less than 14mm.

Again, with the maximum dose there is a chance of increased side effects. This time though there were no crying spells. My eyes stayed dry. This time I was just plain mean. And hot flashes…oh my! Poor, poor Matt; I apologize, honey.

Today I had my 3^rd follicle ultrasound. Luckily, it fell on a day that I was able to have it done in Terre Haute instead of making the trek to Indianapolis. As overly ready as I was last month, I decided not to be so prepared this time. There is no feeling worse than getting excited about my future as a mother and then being disappointed when things just don’t work out. But, to my surprise, all hope was not lost today. I have six (3 on each side) almost, not quite mature follicles with the largest being 16mm! This is good news. But, I still needed to hear from Dr. Henry’s office before I got my hopes up.

My first cycle (if I remember correctly) the doctor’s office called within the hour with the results and plan of action. This time it was more than 3 hours before I heard from them. Waiting….waiting…waiting; I seem to be doing a lot of that lately. Could it have been that they were waiting for me to call and make payment ($95 for doctor to read the ultrasound and $300 for a possible IUI)? Because I called right at 9am and paid. Or was it just that they were busy and got to me as soon as they could? I like to think the latter of the two. Either way, I did finally hear from them.

The plan: Since my follicles were not quite ready today I am to give myself the Ovidrel injection at 9:30 (Indiana time) on Wednesday (September 21^st) followed by Intrauterine Insemination on Friday (September 23^rd). Wish us luck. Cross your fingers…cross your toes…your eyes…your heart and pray, pray, pray.

There is nothing more in this world that I want than to be a mother. And Matt…he will be an amazing father. I just know it.

Follicle Ultrasound #2

On cycle day 3 (Aug 3), I started my 2nd round of Clomid. A larger dose (I was told) would increase the number of mature follicles (larger than 14mm). If you remember last cycle I had one mature follicle at 22mm.

And of course, with a dosage increase the side effects were worse. Or should I say side effect...singular. The only thing I experienced was a couple of horrible crying spells. Matt was horrified. And he should have been. Looking back now, it was kinda ridiculous.

So, last Friday (Aug 12) we got up at 4am (there is a 1 hour time difference and it takes approximately an hour and a half to get there) to be in Indianapolis by 8am for my follicle scan. I was prepared. I was Prepared to shell out $220 (my insurance is now covering nothing since the "infertility" diagnosis. I was prepared for the ultrasound to be uncomfortable. I was prepared to give myself the Ovidrel injection. What I wasn't prepared for was...NO MATURE FOLLICLES! What? I'm confused. I doubled the medicine this time. None? Really?

The nurse very kindly discussed the results with us. I'm not sure that I heard anything she said. "No mature follicles" just kept running through my mind. It was all I could do not to burst out in tears. I assumed she would have told use to wait a day or so to let them grow a little more and then take the shot. But, no...she suggested to hold off. The Ovidrel is expensive and in her opinion it would be best to save it for my next cycle. She advised us that there was a possibility that I could ovulate on my own and still get pregnant. She explain that we should have intercourse every other day (OMG...every other day?!?!) for the next two weeks. I cried. I quietly paid my $220 and proceeded to cry all the way home.

In the end, I think that decision was best. We do not have a money tree and at $100 a shot, the Ovidrel injection is not something that we need to waste. Plus, Matt was going to be out of town for a couple days and we would have missed out 2 day window for August anyway.

So what do we do now? I'm not sure. The nurse said it was all up to us. Another round of Clomid (150mg this time)? IUI? We haven't decided yet.

The good news is that I did ovulate (the 17th and 18th) so maybe there is still a chance for us this month. Fingers crossed!

Round 2

I started today. That's all I have to say about that.

Round 2 starts on Wednesday. Wish us luck.

Follicle Ultrasound

I had my follicle ultrasound today. Fortunately (or unfortunately) I have had a transvaginal ultrasound before. So, I was prepared for what was going to happen. For those of you that have never had one, just remember this..it's not painful. I promise.

The results: I had one mature follicle (22mm) from my right ovary. The rest were less than 10mm. That means that this evening (in about 10 minutes actually) I will give myself the HCG injection. And I am nervous.

I just keep telling myself that if my sister can give herself an insulin injection into her pregnant belly (she had gestational diabetes with my niece Aubrey), than I can surely do this.

To be continued...

Clomid

Today I started my first (hopefully only) round of Clomid. I was warned of the side effects; upset stomach and hotflashes. So far, so good. But, I only took it an hour ago.

These things I am used to. I have been taking Glucophage (since I am diabetic) for a year now and I have had an upset stomach pretty much every day since. I also have hotflashes every now and then. Once, I got so hot and sweaty in the morning while getting ready for work that in a fit of womenly craziness, I went and got my hair chopped off.

It is what I read last night on WebMD that is freaking me out a bit...Ovarian Hyperstimulation Syndrome (OHSS). This causes fluid to suddenly build up in the stomach, chest, and heart area. It's supposedly very rare for this to happen. But with my luck...

I would take that risk every day though just to have a little Maryn (my favorite girl name) or Nolan (my favorite boy name) sleeping in my arms someday.

Our journey continues...

Here We Go

The bad news: I started today. 36 days in between cycles this time. Ahh!

The good news: I start my first round of Clomid on Saturday. My ultrasound is scheduled for Monday the 18th. Hopefully (please cross your fingers) there will be mature follicles so we can get this started.

I am anxious. Can you tell?

Here we go...

Bills, Bills, Bills

Don't get me wrong. I did expect them. I just want to complain like everyone else. I can do that.

I have worked in medical/billing/insurance industry for some time now. Previously, with a large clinic that did everything they could to squeeze every exuberant, at times highly overpriced or even irrelevant charge into a visit that most people would have assumed (that's the problem...makes an ass out of you and me) would be at least be less than their weekly salary. On the bright side, the insurance they provided to their employees was phenomenal. I left because the commute was killing me and my marriage.

Now, I work for a much smaller (think 300 doctors smaller) clinic that does everything it can to squeeze every exuberant, at times highly overpriced or even irrelevant charge into a visit that 99% of people cannot afford to pay...even after insurance. Speaking of insurance...theirs is horrific. I was spoiled before.

In short...when I worked for the "large clinic" I ended up owing only 10%...of ANY SERVICE after I met my $250 deductible. I paid less than $20 a month for this insurance. With the "small clinic" have a $1550 deductible and will owe 20% on services after that (if I go to an in-network provider). This is insurance that I am already paying almost $100 a month for...that doesn't cover anything after the diagnosis of infertility. The coverage is so horrific I want to vomit.

Currently, I have been billed a disheartening $1,946.10. Not all of this is has processed with my insurance yet, but regardless I know I will owe more than $900 to satisfy my deductible. I did the math. And this is just the "inexpensive" stuff now. Ugh.

The initial consultation with Dr. Henry was $200. This I expected. The 6 labs ordered by Dr. Henry totaled $559.85. Holy crap! I'm not shocked though. Labs are outrageous anywhere. And then the HSG...$1186.25. I could be wrong, but I believe this the radiology fee only. Dr. Henry may bill separately to perform and read it. The $1,946.10 total does not include the office visit we had after the HSG or the medications I have purchased ($114 so far). Ugh.

Done. I am done grumbling. I could go on and on about the medical industry and how it is ruining the lives of Americans. But I won't. That is another story for another blog.

Money doesn't grow on the trees in our front yard. And Matt and I are by no means wealthy. But, we will pay these bills with and continue our journey. There is a baby girl...or boy...or both in our future. I can see the poop filled diapers now. I can also see Matt gaging until he pukes while begging me to "please just change it this time. I will get it next time."

I can't wait!

Ovulating

I am embarrassed. I am a 31 year old woman and did not know the signs, the symptoms of ovulation until recently. I idioticly mistook them for premenstrual cramps therefore shooed Matt away like a stray dog. Oh my! I can't help but laugh otherwise I would probably cry. I did that for 17 months, people. No joke!

More than 5 years ago I was told that I may not ovulate per labs I had performed. Why those tests were done is story that I do not care to discuss. It is my past. In case you were wondering. The point is, shortly after I was given this news it did not matter if I was ovulating or not. And the issue was never an issue with me again.

That is until Matt and I started trying to conceive. That thought...me not ovulating...consumed my thoughts. I did discuss it with Matt, but we decided to just try on our own for awhile. He didn't want hear the details on why I thought I wasn't ovulating. Again, it is my past and he wants hear nothing of it.

Why after after over a year of nothing did it never occur to me that I may be ovulating now? I mean, that "possible" diagnosis was years ago. I've changed since then...why couldn't that change too? Hey Ang, why don't you search the Internet for the symptoms? Amazingly, that thought honestly never crossed my mind. I get on the Internet to find out other things. Silly things like why dogs eat poop. I will read Daniel Tosh's blog daily. But never, not one time did I ever attempt to read about ovulation. Maybe my sub-conscious was afraid of what I may read; that maybe it was true that I wasn't ovulating.

Regardless, I now know the symptoms and that I do ovulate thanks to Dr. Henry. And I can tell you that I am ovulating today, without a doubt. And I am so excited about that!

The Sweetest Thing...

I failed to mention something in my initial blog. How could I forget? It was the sweetest thing...

Since we've been trying Matt has seemed less than excited about the possibility of becoming parents. Sure, he went along with it. What man wouldn't? But after a few months of trying and nothing happening he began to act like he wasn't ready to be a father in the first place. He'd see me get upset after taking a pregnancy test and make every excuse in the book as to why "we're not ready" and that we have "plenty of time" to start a family. He'd bring up the money issue...that we won't be able to do the things we've been able to do...vacations...dinner and a movie every weekend...new golf clubs just because....once we have children. I honestly had no idea if he was really ready or he if he was just saying these things to make me feel better. That is until our appointment last week.

More than once I saw a glimmer of excitement in his eyes. Finally! After our consultation (and before the nurse came back in the room) he asked me..."So, if you get pregnant in July when would you have the baby." I responded with a swollen heart..."April, honey". It's all I could do not to jump up and give him a big smooch! Then on our way home he was speaking with a customer (Matt is a John Deere salesman) on the phone. Matt had told him the previous day that we had an doctor appointment first thing in the morning and that he would call him afterwards. From what I could decipher, the customer asked if everything was alright at our appointment (it lasted a couple of hours). And Matt's response was..."something great will come from this." Again...and if he wasn't driving in Indianapolis traffic...I would have jumped over the seat to kiss him!

I love Matt more than the sweetest words could ever express. And after that day, I am confident that my love for him will outlast even the greatest of romances. If at the end of this journey we are still just a family of two I will still love him until the world ends. He is my favorite!

Maybe Baby?

For so long I have sucessfully prevented it and now that I am ready...nothing. For 17 months...nothing. I am beyond frustrated. My husband Matt seems unconcerned that NOTHING has happened. He says we're not trying hard enough. And that frustrates me even more. So that is why I have stepped up and made the decision myself. We are seeing (or have seen) a fertility doctor. Scary...yes. Expensive...yes. But, I need help. We need help.

Last week we saw Dr. Michael Henry with Reproductive Care of Indiana for the first time. The consultation quite typical. The physician asked questions while I nervously answered hoping not to sound ignorant. Matt sat quietly and calmly next to me answering questions like he was in an interview. Of course he would be the one to have it together. I on the other hand began to sweat profusely. I am a nervous, anxiety filled creature. My ususal response is to cry, but thankfully that didn't happen...this time.

Lab work was done. The ususal (I've done my research)...FSH, LH, TSH, Estradiol, Progesterone, and Prolactin. We discussed a Hysterosalpingogram (say that 10 times fast). To my horror I was told that an HSG (performed between cycle day 5 and 12) is an x-ray of my fallopian tubes and uterus. And how is this performed you ask? A catheter (that word alone freaks me out) will placed in my cervix and contrast material is instilled. X-ray's will be taken as the contrast dye fills my uterus and the tubes. We were told process only takes a few minutes and may cause mild cramping. Oh, is that it. I am so looking forward to it. Can you hear the sarcasm?

And that brings us to yesterday. Also known as cycle day 5 in the infertility world. Known to me as H-Day (you know, instead of D-Day). Very sleepily Matt and I left for Indianapolis at 6:15 in the morning for our (he had one too...wink, wink) appointments. We arrived 30 minutes early into a part of the city that Matt quickly called the "high rent district." I didn't disagree. Just the word infertility screams money and from what we saw Methodist Medical Plaza North is anything but short of it. It is beautiful.

As I registered for my procedure, Matt was whisked away for his. A short time later a very friendly nurse named Jeri explained to me what was going to take place and confidently answered the questions I had. It must have been the look in my eyes as I waited for the doctor to arrive because several times she came to me assuring me that I would do just fine. Again, I am a nervous, anxiety filled creature. But this time, slightly less with absolutely no clue the pain I was about to endure.

Yes, pain. I'm not going to lie. It f#@*ing hurt. Menstrual cramps, huh? More like...well, I don't know. But thanks to Dr. Henry's quick work, what seemed like 30 minutes probably only lasted 3. I am so glad that Matt was able to be in the room with me. I would have cried like a baby if he wasn't. It was more than worth it though. And I would do it again in a heartbeat if I had to.

The results: Matt's sperm is spectacular. My uterus and fallopian tubes are terrific.

So, what's the issue, I ask? Dr. Henry thinks that because my period is so unpredictable it is difficult to determine when I am ovulating. But, there is a way to fix that...

The plan: On day 3 of my next cycle I will start 5 days worth of Clomid. Clomid is an oral medication used to help stimulate ovaries to make follicles (fluid filled sacs that house eggs). Followed by a transvaginal ultrasound on day 12 to check for follicle development. Mature follicles indicate that there should be an egg inside ready to be released with ovulation. If there are mature follicles I will proceed with an injection of Ovidrel (the only recombinant, liquid, ready-to-inject human chorionic gonadotropin approved in the world) followed by intercourse over the next 2 evenings. I am to take a home pregnancy test 16 days after the HCG injection. If it's negative we try it again...period, Clomid, ultrasound, Ovidrel. If nothing has happened by September we will do artificial insemination 36 hours after the HCG has been administered. Then again, a home pregnancy test 16 days after insemination. If that doesn't work...I don't know. I am certain Dr. Henry will have conceived a new plan for us to continue our journey into parenthood.

So now we wait. I "expect" my next cycle to begin July 4th. It's going to be a long 30 days.