Appointments This Week

Monday 8/6/12

4:00am - Awake, barely.  Not ready for this drive to Indy

7:00am - At the doctor's office...finally

7:30am - See my previous post.  It was like getting blood from a turnip.  My wrist is still bruised and very sore.

12:49pm - Voicemail from my nurse.  My Estradiol level is not increasing like it should.  Double my meds.  Buy more Menopur and Follistim.

Wednesday 8/8/12

4:00am - Up and at 'em for the drive to Indy.

7:00am - Arrive and wait, and wait, and wait

7:30am - Follicle ultrasound complete.  Only 5 follicles (where my eggs live) on my right ovary.  No follicles on my left!   None large enough to measure.  Disappointing.  My heart sinks.  But, the good news is the nurse only had to stick me once today.

11:08am - Voicemail from the nurse. Increase meds.

Friday 8/10/12

4:00am - Again

7:00am - What we do best in a waiting room...wait.

7:30am - 2nd follicle ultrasound complete. Just 2 more on my right, but there is 1 large enough to measure, 16mm.  To be considered mature and ready for retrieval they need to be at least 18mm.  I'm getting closer.  Still none on my left.  What's the deal?  Got blood on the first try.  

10:39am - Voicemail from my Megan. Increase meds.  Buy more Menopur.

Saturday 8/11/12

3:30am - Up and grouchy (both of us). We have a 6:30am appointment today.

6:32am - We made it, although late.  I had to stop on the side of the interstate and puke.  And had to stop again 10 minutes later.  Side effect of the medication.  I feel like shit.

7:30am - Finally, it's our turn.  The waiting room was full this morning.  I think they tell everyone to come at the same time.  In fact, I know they do.  Ultrasounds are first come, first served.  Which sucks, in my opinion.  Different tech today (actually I think she was an OB-GYN) with a med student tagging along.  More follicles on my right (1 that measures 18mm) and a small one on my left.  Tortured by 2 nurses this time to get blood.  

9:29am - Call from Megan (my nurse).  Meds to stay the same for now and they will see me again on Monday.  Joy.  I love getting up at 4:00am.

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So, if everything goes well tomorrow (meaning if I have more than 1 mature follicle) I am assuming that my HCG injection will be on Tuesday night followed by the retrieval 36 hours later.  I don't think they will bother with the retrieval if I only have 1 good follicle.  It's a procedure that requires me to be under anesthesia, given pain medication afterwards, and be off work for 2 days.  And I can't even imagine the chances that fertilizing only 1 egg will end up in a pregnancy; very low I am sure.  Especially for me.  

My sister told me the other day not to give up.  She reminded me that nothing in life has come easy for me.  This is true.  Life at times has been harder for me than I ever imagined it would.  Why should this be any different?  I'm not asking for pity.  I am just asking for prayers.  Please.

Appointment #2

Indy again at 7am for bloodwork only. For the first time ever I had to be stuck more than once. The 2nd time was in my wrist. It hurts and I am bruised.
Please give me a new nurse on Wednesday.

Appointment #1

Today was our first of every other day appointments for the next 10 days.  It was at 7am.  In Indianapolis.  Which currently, because of road construction, is a 2 hour drive.  So as I write this I am silently cursing my alarm clock.  4am and I do not get along.  Matt and I at 4am absolutely do not get along.  It has become almost a ritual for us to argue on Indianapolis appointment days.  Today was no different.  Is it a sign?  I don't think so.  We got over it pretty quickly.  I blame it on being up before the roosters.

Before I tell you more about today (because it's oh so exciting!) I should explain the last 12 days in the Fry household.  Almost 2 weeks ago I started my Lupron therapy.  Leuprolide acetate is used to  temporarily suppresses pituitary and ovarian hormone production.  Basically preventing ovulation from occurring.  This is all fine and dandy, but there are side effects.  And I am pretty sure I have had them all.  Hot flashes, dizziness, headaches, hot flashes, nausea or vomiting, hot flashes, and trouble sleeping are just a few.  Did I mention hot flashes?  I think I've experienced as many hot flashes than a menopausal woman.  It's not fun.  I am sympathetic.  Matt is not. 

Back to today.  I had an ultrasound to check for ovarian cysts.  None!  And I had blood work to check my Estradiol levels.  I have not done enough research (so unlike me) to know exactly why this is done.  But, I do know that the goal was less than 35.  Mine was 8.  Perfect, I was told.  What this now means is that I can reduce my Lupron to 10 units and start Follistim tomorrow morning and Menopur tomorrow night.  More injections. Ugh.  Good thing I am a pro at sticking myself now.  I could probably do it with my eyes closed.

Again, please wish us luck.  I need it...well, you know why I need it.  And wish Matt luck too.  Living with me the next couple of weeks could be hell.  Between my hot flashes and the crying for no reason Matt may run far, far away.  He just better be back by retrieval day.  He has an important job to do.  Other than being there for me, that is.

Injections, Injections, Injections

Injections, injections, injections.  When our IVF cycle is complete I will have been stabbed almost 100 times.  At this point, I am unafraid of needles.  By the end of August I will loathe them more than the worst chore there ever was...dusting.

Monday Matt and I went to our IVF Conference in Indianapolis.  We argued some on the way over.  I don't even remember what it was about now.  It was hot, we were sweaty and that definitely leads to irritability on my part.  Never the less, we got over it and arrived in (technically) Carmel with just minutes to spare.  Dr. Henry's waiting room is dim and quiet.  And just as I was getting ready to shut my eyes for a quick cat nap my name was called.

We were lead back to the conference room where more than a year ago we first discussed in detail infertility treatment with Dr. Henry.  The room is small with a nice wood table and chairs.  The walls are covered with pictures of babies the doctor has helped make their way into this world.  Oddly (or maybe not so oddly) I don't like to look at them.  Those photos of twins in their Christmas pajamas and triplets in Halloween costumes will consume me if I am not careful.  They make me too hopeful.  So, I look away.

A very polite nurse (her name has slipped my mind) follows us in the room.  She begins by going over the entire IVF process with us from start to finish; medications (injections) followed by blood work and ultrasounds on more than one occasion, and if my follicles are large and aplenty there's one more injection before retrieval day and then if there are any fertilized eggs (hopefully several) the transfer will follow3 to 5 days later.  She goes over in great detail on how to give myself the injections.  Lupron to start this Sunday (in the belly) for about 3 weeks.  On the 3rd Follistim will begin in the morning and Menopur in the evening (both in the belly) for 10 days or so. Doxycycline (an antibiotic) for the both of us twice a day for 10 days.  If When my follicles are adequate I will take (Matt will give) 1 injection of Novarel (in my rear end).  He was almost giddy when the nurse mentioned this news.  Men.  The last medication comes on the day of the transfer, Progesterone in Oil and more Doxycycline for me.  The oil will have to be given to me (in my rear end) for at least 10 days; more if I end up pregnant.  Ouch.

This evening I will start insulin injections (since I am diabetic) to replace the Janumet I am currently prescribed.  NovoLog Mix 70/30 FlexPen was my doctor's choice in insulin.  She gave me samples today.  Two pens, which is enough for about 2 weeks.  I am to take 12 units at dinner time.  I haven't taken it yet.  I am a little afraid; not of jabbing the needle into my belly, but of low blood sugar.  That is not fun.  But, as I type my stomach is starting to growl.  Wish me luck.

Actually, wish us both luck.  In about 6 weeks Matt and I could possibly, maybe, hopefully be 9 months away from baby Nolan or Abigail or Preston or Cecelia or Elliot or Leah or...well, we have time to decide on that.

Getting Closer

We are getting closer and closer to becoming parents ever day.  Tomorrow is our first of many appointments in Indianapolis over the next month and a half.  Today I am excited, confident and ready to get this started.  On the drive over tomorrow I am sure I will be nervous, anxious and sick to my stomach.  It drives Matt a little crazy, but he is a good sport and comforts me when I need it the most.  He never shows it, but I know deep down he must feel the same way.

So what has happened in the 3 weeks since my last post, you ask?

I have been on birth control (Loestrin FE) for a month now.  I hate it.  I have been spotting/bleeding for over a week.  I am so exhausted that I fell asleep sitting in a hard plastic chair at an auction yesterday.  My mood swings are almost out of control.  And acne...32 years old with acne.  Ridiculous.

On Thursday Matt and I had our infectious disease testing done.  Due to our (his really) work schedule he had to go to one lab and I went to another.  He was stuck at least 4 times and almost passed out.  I was stuck only once and made it back to work in less than 30 minutes.  Men are wimps.

Also last week I ordered my long list of medication.  Four of these had to be ordered though a speciality pharmacy called Triessent in order for my insurance to cover them.  Of course, they are the 4 most outrageously expensive medications I have ever been prescribed.

1) Menopur with Qcap 75IU (20 vials)
2) Follistim AQ 300IU (5 cartridges)
3) Lupron 2.8mL 1mg/0.2mL (2 amps)
4) Novarel 10,000IU (1 vial)

Together, without insurance these would cost about $5,000.  Less with my insurance of course, but I have yet to know the total cost.  Lets just say that my deductible will be met with that purchase.

The rest I purchased at the pharmacy in the clinic where I work.  They totaled about $75.

1) Progesterone in Oil 50mg/mL (2 vials)
2) Doxycycline 100mg (50 pills)
3) 3mL syringes with 22g 1 1/2" needle (quantity of 50)
4) Needles 25g 1 1/2" (quantity of 2)
5) Needles 27g 1/2" (quantity of 15)

Fun, fun, huh?  Instead of a summer filled with boating, swimming, and weekend getaways we get the summer of injections, mood swings, and in-vitro fertilization.  But all of the pain, the stress, and the (I'm sure there will be) tears will be forgotten if at the end of our journey we have a little Fry.  I cannot wait to be mother.  But I especially can't wait to see what an amazing father Matt will be.

The Packet

Last Friday Matt and I received our IVF packet in the mail.  Dr Henry's nurse called a few days before and casually mentioned to me that she should be sending it.  I assumed it would include our "calendar" and maybe some info on the drugs.  I was wrong.  Reading though the pages felt like I was in high school again studying for a final exam.  Lets hope I pass this test.

Not only does the packet include our estimated IVF schedule, it also contains lab orders for both of us for an infectious disease screening, drug information and consent forms.  And that's just one side of the folder.  The other side gives a step by step reading of IVF in a nutshell; pictures, detailed info on the retrieval and then the transfer and more than 10 pages of how to administer the medication I will be taking.  My head is spinning.

This is a long process.  Mine of course, longer than most.  According to my cycle the retrieval and transfer should have been the 3rd week of July, but because they are so busy making babies at Reproductive Care of Indiana we were not able to be fit into the schedule until the 3rd week of August.  Which is fine, I guess.  I mean, I've waited this long already.  Why not wait another month? All this means is that I will be constantly taking (active only) birth control pills a little longer and that I will (yea!) not have a period next month.  

We don't make the trek to Indianapolis again until July 16th.  On that day we will be meeting with our nurse for our IVF conference.  The patient checklist states to read the packet throughly and to ask a lot of questions.  What the nurse doesn't know is that I am a list maker and a question asker.  She may loathe me in the end.  I am definitely prepared for this journey.

Day 35

Today is my cycle day 35. This may mean nothing to you, but to me it means 3 things.

The first: I finally started; not that I wanted to. I was 2 days late with no symptoms of my period on the horizon. Usually the week before I am a bitch. And that putting it kindly. This time...nothing. In the back of my mind I kept thinking that maybe, just maybe I was pregnant. Three negative pregnant tests proved me wrong.

The Second: Thursday I will start taking birth control again. It may seem like the last thing I should be doing since we have been trying to get pregnant for so long; but it is part of the IVF process.

Lastly: We are one day closer IVF and to a baby or two! Today Dr. Henry's office gave me the estimated dates for the retrieval (August 13-16) and the transfer (August 18-21). It seems like a lifetime away. But after trying for 2 1/2 years a 2 months is a piece of cake.

Please wish us luck, cross your fingers, and say a prayer.

So It's In-Vitro

Today was our first appointment with Dr. Henry after a (too long) 7 month hiatus.  Never mind that he was running about an hour behind.  I would have waited another hour.  I probably would have waited even longer just so we could speak with him for 10 (literally 10) minutes.  Because today was the day.  Today was the day that we officially made the decision to start IVF treatments.  And although I am sad that we couldn't do it on our own, I am so excited and so ready to get this show on the road.  But for now we wait.  Ugh.

We wait for approximately 19 days for my cycle to start again. Then birth control (yes, birth control) for 3 weeks or so.  And... that's all I know so far.  This is the downside of not seeing the doctor at his main office in Indianapolis.  We are just left hanging until one of his nurses contacts me with the next steps.  I hate the unknown.  I want to know everything right then and there...first were gonna do this, then this, then on this day this is what will happen.  I need specifics people!  But that's not how it works.  So, we wait.  Very impatiently, we wait.  

Maybe I will hear from them tomorrow.  Until then...I will be so very anxiously...waiting.

Here We Go Again

So, it's been about 7 months since we put a halt on the whole infertility treatment thing.  It's wasn't working, I had no insurance coverage for it, and it was stressing us (mainly me) out to where I was crying every single day.  Today I am happy to say that we are starting the process again.  If there is one good thing about living in Illinois it is the Illinois Infertility Mandate.  You can read about it here.  Basically, it says that it Illinois insurance companies are required to provide coverage for infertility.  Lucky for me and thanks to Matt's employer I am now covered under such plan.

We have a consult on the 22nd with Dr. Henry to go over our options again.  Last time we talked the doctor decided that in-vitro would be our best option.  See my Decisions blog.  I expect he will say the same this time as well.  The only question that remains for me is...when do we start?  I think the only question Matt still has is...how much upfront?  I can answer that.  Using my insurance knowledge for good, not evil (working in the medical field had finally paid off)...I estimate that we will have to pay...at the most...$3000.  And that includes medication.  We can handle that.

I'm excited.  Things are looking up for us again.

*UPDATE:  I failed to mention something in this post.  I did finally have the nerve to call about the in-vitro fee schedule I received from Dr. Henry's office.  I think that was obvious.  Well...I wasn't the one who called.  A co-worker did if for me.  And I am so grateful she did.  I always jump to the worst conclusions.  Only the 20% my insurance doesn't cover has to be pre-paid.  Isn't that lovely.

Still No Baby...

We're still here and still without a baby.

The only thing that has changed in the last 6 months is that I am now on my Matt's insurance. It was a blessing, no doubt. At no cost to us I now have execptional infertility coverage. The only cost I am facing is talking Matt into starting this whole journey again.

My plan was to start up again after our much needed vacation in February. The farthest I have got was to call and get pricing information on In-Vitro. It's expensive. And (if I read the info on the paperwork correctly) to be pre-paid regardless of insurance coverage. I don't have the nerve to actually call to find out. I just burst into tears when I read it and asked Matt to call for a better explanation. That has yet to happen. We (meaning he) agreed to try, try, really try for 2 months; and if we didn't succeed we would start the treament again.

One month to go.