went back to the doc's this morning for more bloodwork (the nurse took a look at my poor abused arms and said, "wow, you're... colorful!") and a quick sonogram. the doctor said, based on the sonogram, that i definitely ovulated as predicted. i didn't have any doubt about that. she said i should start using the progesterone suppositories today, twice a day until i either get my period or don't. the progesterone is supposed to help with implantation and also keep my hormone levels regulated... low progesterone levels sometimes lead to early pregnancy loss. online talk says there can sometimes be some icky side effects to taking these, but we'll see. i'll do my first one tonight.
and then it's just waiting. the doc said if i don't have my period by two weeks from today that i should come in for a pregnancy test and they should be able to tell for sure by then. if i get it sooner than that, i need to go back in to start the next cycle of IUI. I am going out of town next week, which shouldn't interfere with anything unless my period comes super early. if it does, i might need to head home early, because if we don't get things going for IUI by day 4 i will have to skip a cycle, and i definitely don't want to do that. but i think the earliest it should come is next friday, so I should be fine. i feel pretty calm about the whole thing right now. somewhat optimistic, but definitely not over-the-top. i'm prepared for disappointment after this first attempt. not expecting it, but prepared for it. the past year and a half has done wonders for my level of acceptance of bad news. so until the time we get some kind of news, i will try to distract myself as much as possible. summer vacation should help with that! woo hoo!
Monday, July 25, 2011
Saturday, July 23, 2011
part 2
yesterday we did the second (and last) IUI attempt for this cycle. it went totally fine, after a tiny bit of difficulty, uh... collecting the specimen. the hubby's brain is SO WEIRD under pressure. but anyway, we got through that just fine and got the stuff to the doctor's office, where we had a wait a bit longer than the first day because we weren't the first in line. no biggie, though.
first, like the previous day, the doc did a sonogram to see how my follicles were doing. she sounded a bit disappointed to see that i hadn't ovulated yet. she didn't say that out loud, but we could hear it in her voice. she said the trigger shot that i gave myself on wednesday night typically insures ovulation within 24-36 hours. obviously i was running much closer to the 36-hour mark. which doesn't mean that thursday's IUI wasn't useful, because the sperms can live in there for a couple of days (especially the girl sperms, which are hardier and live longer!). but it would have been more bang for our buck had i ovulated in between the two inseminations. but anyway, the sonogram still showed the three follicles in my right ovary, ready to go. (the ones that were developing in my left ovary had already dissipated, but we already knew those ones wouldn't be viable.) she said ovulation should happen sometime in the few hours after the insemination.
then we just went through the same process as the first day. the only slight difference was that the "cleaning" out of my innards prior to the insemination took a bit longer because i had some spotting on the afternoon of first procedure and she had to get rid of all of that. of course i was a bit alarmed by the bleeding when i saw it on thursday, but i called the office and was told it's completely normal. so anyway, they took care of that, did the IUI the same as the first day, and that was that.
they told me that i need to come back on monday for a blood test to confirm that i ovulated and then they'll give me instructions for next steps. but she said i won't have to do any injections for the rest of this cycle. i'm done with the follicle stimulating hormone, obviously, and the other two injection meds that i have she said not even to worry about yet. she said if we have to do another cycle of IUI i may use them then, but for now it will just be the progesterone suppositories. and, of course, the vitamins and other awful metformin pill, which i had been doing much better on by taking it at night until i forgot to take it thursday evening and had a miserable nauseated day yesterday. i won't make that mistake again.
my ovulation monitor said i would ovulate yesterday or today, so it seems like all signs point to the same conclusion. the hubby and i gave it another try this morning, the natural and much more fun way, so we've definitely covered all of our bases. now it's just the usual wait-and-see. and so we shall!
first, like the previous day, the doc did a sonogram to see how my follicles were doing. she sounded a bit disappointed to see that i hadn't ovulated yet. she didn't say that out loud, but we could hear it in her voice. she said the trigger shot that i gave myself on wednesday night typically insures ovulation within 24-36 hours. obviously i was running much closer to the 36-hour mark. which doesn't mean that thursday's IUI wasn't useful, because the sperms can live in there for a couple of days (especially the girl sperms, which are hardier and live longer!). but it would have been more bang for our buck had i ovulated in between the two inseminations. but anyway, the sonogram still showed the three follicles in my right ovary, ready to go. (the ones that were developing in my left ovary had already dissipated, but we already knew those ones wouldn't be viable.) she said ovulation should happen sometime in the few hours after the insemination.
then we just went through the same process as the first day. the only slight difference was that the "cleaning" out of my innards prior to the insemination took a bit longer because i had some spotting on the afternoon of first procedure and she had to get rid of all of that. of course i was a bit alarmed by the bleeding when i saw it on thursday, but i called the office and was told it's completely normal. so anyway, they took care of that, did the IUI the same as the first day, and that was that.
they told me that i need to come back on monday for a blood test to confirm that i ovulated and then they'll give me instructions for next steps. but she said i won't have to do any injections for the rest of this cycle. i'm done with the follicle stimulating hormone, obviously, and the other two injection meds that i have she said not even to worry about yet. she said if we have to do another cycle of IUI i may use them then, but for now it will just be the progesterone suppositories. and, of course, the vitamins and other awful metformin pill, which i had been doing much better on by taking it at night until i forgot to take it thursday evening and had a miserable nauseated day yesterday. i won't make that mistake again.
my ovulation monitor said i would ovulate yesterday or today, so it seems like all signs point to the same conclusion. the hubby and i gave it another try this morning, the natural and much more fun way, so we've definitely covered all of our bases. now it's just the usual wait-and-see. and so we shall!
Thursday, July 21, 2011
IUI Day!
i have to admit i was a little more excited than i wanted to be.
woke the hubby up early, helped him out with his business (it's the least i can do...), and then tucked the "specimen" in its plastic container under my arm and headed to the fertility institute while the hubby showered and got ready. the nurse had told me it was super important to keep the specimen at body temperature during transport, which wasn't difficult considering it was already pretty humid and sticky outside and i didn't catch a bus. i gave it to the receptionist, who gave it to one of the nurses, who took it upstairs to the lab.
then i settled into the waiting room, read some Game of Thrones on my kindle, and waited for the hubby to arrive. he just made it; punctuality -- exact punctuality -- is his thing... he came through the door about 15 seconds after the nurse called my name. then we went into one of the exam rooms. the nurse brought in the "washed" specimen in a little test tube and gave it to me to hold. she told us that it had been a "really good specimen," 41 million sperm. the hubby was very proud of this, even though (as we both know) quantity has never been an issue for him. but when i repeated a couple minutes later, "wow, 40 million..." he was quick to correct me: "forty-ONE. that's a whole million there." ahhh, men and their manhoods. the nurse took some blood (of course... i look like a junkie these days) and the doctor explained how everything would work.
she did another sonogram and we could see that -- WHOA! -- there had been some serious follicle growth since yesterday. the one that was big yesterday was huge. and there were two more, right next to it, that were also really big. we had to explain all of this to the hubby, since he had no idea what he was looking at on the screen or what any of it meant. boys have no idea how girl bodies work, by the way. NO idea. the doc said the two biggest ones were pretty much ready to go (i.e. the egg is ready to burst out) and the third one could be ready by tomorrow, and that would likely be it for this cycle. but three! three is good odds.
then she did some "cleaning" of my insides, which just felt like a cool rinse. then the catheter was inserted through my cervix -- felt like a little pinch just like everything else they do to your cervix. then i passed the doctor the specimen and she inserted it in the catheter and started the insemination.
it took a minute or two or maybe three to actually insert it all into my innards. i didn't feel much during that time but definitely could tell something was going on down there. the hubby was sitting next to me and we made small talk. with the nurse and the doctor in the room, totally silent, possibly getting me pregnant. it was kind of awkward, but kind of sweet. then i had to lay down and rest for five minutes during which they left us alone. i think we were both more excited than we wanted to admit. it was nice to have that time together. knowing now how it all happens, i would have been pissed at him if he wasn't there.
and that was it! they gave us another specimen cup for tomororw, and we go in the morning to do it all again. in the meantime, i don't have to give myself any injections, which is a bonus. so now i'm just trying not to get my hopes up TOO high... though a little optimism surely never hurt anyone. :)
woke the hubby up early, helped him out with his business (it's the least i can do...), and then tucked the "specimen" in its plastic container under my arm and headed to the fertility institute while the hubby showered and got ready. the nurse had told me it was super important to keep the specimen at body temperature during transport, which wasn't difficult considering it was already pretty humid and sticky outside and i didn't catch a bus. i gave it to the receptionist, who gave it to one of the nurses, who took it upstairs to the lab.
then i settled into the waiting room, read some Game of Thrones on my kindle, and waited for the hubby to arrive. he just made it; punctuality -- exact punctuality -- is his thing... he came through the door about 15 seconds after the nurse called my name. then we went into one of the exam rooms. the nurse brought in the "washed" specimen in a little test tube and gave it to me to hold. she told us that it had been a "really good specimen," 41 million sperm. the hubby was very proud of this, even though (as we both know) quantity has never been an issue for him. but when i repeated a couple minutes later, "wow, 40 million..." he was quick to correct me: "forty-ONE. that's a whole million there." ahhh, men and their manhoods. the nurse took some blood (of course... i look like a junkie these days) and the doctor explained how everything would work.
she did another sonogram and we could see that -- WHOA! -- there had been some serious follicle growth since yesterday. the one that was big yesterday was huge. and there were two more, right next to it, that were also really big. we had to explain all of this to the hubby, since he had no idea what he was looking at on the screen or what any of it meant. boys have no idea how girl bodies work, by the way. NO idea. the doc said the two biggest ones were pretty much ready to go (i.e. the egg is ready to burst out) and the third one could be ready by tomorrow, and that would likely be it for this cycle. but three! three is good odds.
then she did some "cleaning" of my insides, which just felt like a cool rinse. then the catheter was inserted through my cervix -- felt like a little pinch just like everything else they do to your cervix. then i passed the doctor the specimen and she inserted it in the catheter and started the insemination.
it took a minute or two or maybe three to actually insert it all into my innards. i didn't feel much during that time but definitely could tell something was going on down there. the hubby was sitting next to me and we made small talk. with the nurse and the doctor in the room, totally silent, possibly getting me pregnant. it was kind of awkward, but kind of sweet. then i had to lay down and rest for five minutes during which they left us alone. i think we were both more excited than we wanted to admit. it was nice to have that time together. knowing now how it all happens, i would have been pissed at him if he wasn't there.
and that was it! they gave us another specimen cup for tomororw, and we go in the morning to do it all again. in the meantime, i don't have to give myself any injections, which is a bonus. so now i'm just trying not to get my hopes up TOO high... though a little optimism surely never hurt anyone. :)
Wednesday, July 20, 2011
countdown to the (1st) big day
went back to the doc's again this morning for another sonogram (i've been calling them ultrasounds, she said sonogram this a.m.... not sure what the difference is and don't have time/energy to google it right now). anyway, she could tell that the one follicle in my right ovary is definitely ready to go. this data agreed with my ovulation monitor, which gave me a "high fertility" signal this morning, indicating that ovulation would probably happen tomorrow. so tonight i will give myself the hcg "trigger" shot (to make sure that i definitely ovulate tonight, and tomorrow is the1st big day... i can't help but feel a little excited.
the only thing that i'm slightly disappointed about is that i only have the one follicle so far, which means only one egg. i was hoping with all of these injections i'd have more, to increase our chances, but that's why (as i learned today) they do more than one insemination per cycle! they don't want to miss this first egg, which is why we're doing one tomorrow, but there is at least one other one that she says might be ready by friday... so chances are i will go back friday morning for another insemination. the doc said they nearly always do two inseminations per cycle (sometimes three, and sometimes only one, depending on follicles and hormones).
the hubby and i have the plan for the morning all worked out, and he's going to come with me for the procedure (which i'm happy about). hopefully all goes smoothly...
the only thing that i'm slightly disappointed about is that i only have the one follicle so far, which means only one egg. i was hoping with all of these injections i'd have more, to increase our chances, but that's why (as i learned today) they do more than one insemination per cycle! they don't want to miss this first egg, which is why we're doing one tomorrow, but there is at least one other one that she says might be ready by friday... so chances are i will go back friday morning for another insemination. the doc said they nearly always do two inseminations per cycle (sometimes three, and sometimes only one, depending on follicles and hormones).
the hubby and i have the plan for the morning all worked out, and he's going to come with me for the procedure (which i'm happy about). hopefully all goes smoothly...
Monday, July 18, 2011
not quite yet, but soon...
i went in for another ultrasound this morning and the doctor says the hormones are definitely working, because my follicles are growing at a steady pace and i've got a bunch of 'em nearly ready to go. she actually thought from the look of them that i might be ready for insemination as soon as tomorrow, but said the bloodwork would let us know for sure. i had to call them this afternoon for those results, and the nurse told me that i still have a couple of days to go. i have to go back on wednesday morning for another ultrasound and check-in, and at that point they should know exactly when our go-day is. maybe thursday or friday. until then, i'm to continue with the medicines as directed. the injections are going fine, but that metformin is killing my stomach. i'm still only taking one a day and it's miserable. i asked the nurse this morning what i should do, and she said just to continue taking one. she said it would be great if i could get up to two, but one is better than nothing. so for now... that'll be the deal.
they gave me a consent form to sign and a cup for the hubby's "specimen" today and explained to me how that will work when the time comes. for some reason i assumed that he'd come into the office with me and do his business there. i guess it makes sense to do it at home, but the idea that i could just bring his spermies in with me and he wouldn't even be present for the insemination seems so weird. i guess i can drag him along with me anyway. i kinda feel like this is a marathon that i'm running and that he will just jump up from the sidelines and run through the tape with me at the end. i suppose that's just the way it is, but i can't help but feeling a little bit resentful.
they gave me a consent form to sign and a cup for the hubby's "specimen" today and explained to me how that will work when the time comes. for some reason i assumed that he'd come into the office with me and do his business there. i guess it makes sense to do it at home, but the idea that i could just bring his spermies in with me and he wouldn't even be present for the insemination seems so weird. i guess i can drag him along with me anyway. i kinda feel like this is a marathon that i'm running and that he will just jump up from the sidelines and run through the tape with me at the end. i suppose that's just the way it is, but i can't help but feeling a little bit resentful.
Saturday, July 16, 2011
drugged up
today is the third day of the injections, and i've got it down to a 5 minute process. i'm going to see how much more time i can shave off as we continue on. my friend from work, who has (sadly) been doing this for months, explained the one part that was tricky for me yesterday; i did remember correctly that the nurse tipped the vial upside down to withdraw the solution into the syringe. i just didn't have the needle positioned correctly, so it wasn't working for me. but now that i know you have to put the needle just above the surface of the solution and then pull the plunger back, it's all easy peasy.
i started taking the two other new prescriptions (pills) yesterday and today. i took the super duper folic acid this morning for the first time and don't anticipate any problems from that. the metformin, though, i was supposed to ease into because it often causes stomach upset. eventually i'm supposed to take two a day, but the nurse told me to start with one. so i took one last night and another this morning, and i think i may be suffering the effects of it now. my stomach has felt a little weird for hours, and then it transitioned into some cramping and finally diarrhea. sigh. so we'll see how that one goes, i guess. other than my belly putting a damper on our saturday night, things are going well.
i started taking the two other new prescriptions (pills) yesterday and today. i took the super duper folic acid this morning for the first time and don't anticipate any problems from that. the metformin, though, i was supposed to ease into because it often causes stomach upset. eventually i'm supposed to take two a day, but the nurse told me to start with one. so i took one last night and another this morning, and i think i may be suffering the effects of it now. my stomach has felt a little weird for hours, and then it transitioned into some cramping and finally diarrhea. sigh. so we'll see how that one goes, i guess. other than my belly putting a damper on our saturday night, things are going well.
Friday, July 15, 2011
morning procedure
this morning i did the FSH (follicle stimulating hormone) injection at home, by myself. well, mostly by myself. i ended up making the hubby come and help. i wasn't nervous about the stabbing part; having done that once yesterday i knew it wasn't bad. but the procedure of mixing and preparing the syringe is fairly complicated, and i was a little anxious about doing it all correctly. as it turned out, i did need a little husband moral support, and it took me a lot longer than i'd planned. but i documented the steps for your information and for my own guidance and reminders, so i think after today i'll be an expert.
this is all of the stuff that you need for the injection. it all comes together in a little package, except for the alcohol swab and gauze. and the needle in the bigger plastic case is a special one that the nurse gave me a bunch of because they're easier to use and dispose of than the ones that come in the prescription pack.
ok, so first you have to put on the big, fat needle to mix the solution. the drug comes in a powder form (you can see the white powder at the bottom of the vial) and the syringe is filled with water. you attach everything as so, and then inject the water into the vial and mix it carefully with the powder. it dissolves really quickly and easily. you can't shake it because that makes it bubbly, so you just twist it back a forth a little bit to help it mix completely.
you can see here how the drug turned into a clear liquid in the vial. the next step is using the same big, fat needle that injected the water in to remove the medicine from the vial and store it in the syringe. this was the part that i had a lot of trouble with. i tried it a bunch of times but some of the liquid was always left in the bottom of the vial. one time i pulled the stopper right off the top of the syringe trying to pull it back far enough to suck all the liquid in. i just couldn't figure out how to do it. i tried at least three or four times at different speeds and angles. i'm pretty sure that yesterday the nurse did at least part of this by holding the vial upside down, but that didn't work at all. (and given what i know about gravity i don't see how it worked yesterday, either, so i must be mis-remembering.) this is when i enlisted the help of the hubby, who pretty much just stood there sleepily while i experimented. but i felt better talking through it with him, and eventually when i held the needle at a severe angle, like totally diagonal in the vial, it worked. hopefully this method will work again tomorrow.
once the solution is in the syringe, you remove the big, fat needle and put on the one that you're going to use for the actual injection. like i said before, the nurse gave me a bunch of these special ones that are pretty easy and safe to use. before you do the injection, you have to make sure that there are no air bubbles in the syringe. you can tap them out, but as an extra safety measure you are supposed to squirt a tiny bit out of the syringe, like i did in this photo, so that when you put it into your body you know that liquid is going to come out and not air.
and then you give yourself the shot! this is what the needle looks like... it's not so bad. it's almost as thin as an acupuncture needle, so you feel it, but it doesn't hurt. injecting the solution feels a little weird, like someone's contracting your muscle. like yesterday, i'm still a little sore. i did it in the opposite leg today, and will probably switch again tomorrow. but, all in all, it's not so bad. a tiny inconvenience for a greater cause.
this is all of the stuff that you need for the injection. it all comes together in a little package, except for the alcohol swab and gauze. and the needle in the bigger plastic case is a special one that the nurse gave me a bunch of because they're easier to use and dispose of than the ones that come in the prescription pack.
ok, so first you have to put on the big, fat needle to mix the solution. the drug comes in a powder form (you can see the white powder at the bottom of the vial) and the syringe is filled with water. you attach everything as so, and then inject the water into the vial and mix it carefully with the powder. it dissolves really quickly and easily. you can't shake it because that makes it bubbly, so you just twist it back a forth a little bit to help it mix completely.
you can see here how the drug turned into a clear liquid in the vial. the next step is using the same big, fat needle that injected the water in to remove the medicine from the vial and store it in the syringe. this was the part that i had a lot of trouble with. i tried it a bunch of times but some of the liquid was always left in the bottom of the vial. one time i pulled the stopper right off the top of the syringe trying to pull it back far enough to suck all the liquid in. i just couldn't figure out how to do it. i tried at least three or four times at different speeds and angles. i'm pretty sure that yesterday the nurse did at least part of this by holding the vial upside down, but that didn't work at all. (and given what i know about gravity i don't see how it worked yesterday, either, so i must be mis-remembering.) this is when i enlisted the help of the hubby, who pretty much just stood there sleepily while i experimented. but i felt better talking through it with him, and eventually when i held the needle at a severe angle, like totally diagonal in the vial, it worked. hopefully this method will work again tomorrow.
once the solution is in the syringe, you remove the big, fat needle and put on the one that you're going to use for the actual injection. like i said before, the nurse gave me a bunch of these special ones that are pretty easy and safe to use. before you do the injection, you have to make sure that there are no air bubbles in the syringe. you can tap them out, but as an extra safety measure you are supposed to squirt a tiny bit out of the syringe, like i did in this photo, so that when you put it into your body you know that liquid is going to come out and not air.
and then you give yourself the shot! this is what the needle looks like... it's not so bad. it's almost as thin as an acupuncture needle, so you feel it, but it doesn't hurt. injecting the solution feels a little weird, like someone's contracting your muscle. like yesterday, i'm still a little sore. i did it in the opposite leg today, and will probably switch again tomorrow. but, all in all, it's not so bad. a tiny inconvenience for a greater cause.
Thursday, July 14, 2011
and it begins
that, friends, is the stockpile of prescription drugs that is now in my house. i started a cycle of IUI with ovulation induction today, and boy, are there a lot of meds involved.
i started spotting tuesday night, and sure enough by yesterday at noon my period had started. i called the fertility institute and they told me to come in this morning. meanwhile, my meds were being delivered to school in their HUGE boxes. i was a bit taken aback by exactly how much there was. i think the security guys at school are pretty curious about what on earth i had delivered in three fairly large boxes. i brought some of it home yesterday and the rest today, since i couldn't carry it all on the train at once.
last night i was pretty freaked out. just seeing four out of the five drugs that i was getting and knowing that three of them are injections, and seeing the sheer number of needles in my possession was overwhelming to say the least. the hubby and i went out to dinner and shared quite a bit of wine to ease my nerves... one of the only benefits of getting my period!
but this morning i went to the doctor bright and early and got the lowdown from one of the lovely nurses, and i am feeling a lot more calm about the whole thing. they did an ultrasound to make sure my uterus and ovaries and everything were still looking normal (they were) and took some blood to check my initial hormone levels and make sure all was well there. (it mostly was. more about this in a bit.) next the nurse pulled out my huge file labeled with my last name and "IUI CYCLE 1." she gave me an inventory sheet that i had to bring home and fill out with the exact numbers of all the drugs i have. she told me that the reason i have such an ungodly amount is because they sort of play a game with the insurance. she said they up the prescriptions to their max so that patients can actually get more than they need for each cycle, meaning that they actually have the drugs for more cycles. so my worries about only being able to afford 1.75 IUI cycles may be put to rest.
so for right now, i only need to give myself one injection a day of the follicle stimulating hormone that will help my ovaries get more than just one egg ready to possibly be fertilized this cycle. that drug is called gonal. i also have another one (also an injection) called ganirelix, which prevents premature hormone surges that could mess up my cycle, and another one (also an injection) called enoxaparin (brand name lovenox) that helps make sure early pregnancies aren't miscarried. i don't have to deal with either of them for now. i also have a progesterone vaginal suppository (not sure when i start using that) and i will be getting the ovulation trigger shot (HcG) soon. those are the ones that had already been ordered. today the nurse prescribed me two more... you know, because i didn't have enough as it was.
the first new one is metanx, which is a super duper folic acid and b-vitamin supplement. apparently the regular folic acid i've been taking doesn't cut it. and then she also prescribed me metformin, which is a drug for the control of hypoglycemia. she said that the bloodwork they ran this morning showed one of my levels slightly elevated, and it was completely a precaution but just in case i have to take this additional drug. sigh.
then she told me she'd help me administer my first injection. mind you, i haven't been too nervous about that. i'm not squeamish. she showed me how to get the solution ready, which is kind of like a chemistry experiment. there's a vial of powder and a special needle and a syringe filled with water. first you inject the water into the powder and mix it around. then you take that big needle off and put on a different one. she gave me some to use instead of the ones that came with the meds because they're safer to use (they have a safety cap). you put that needle on, make sure there are no air bubbles, and then inject it into your thigh, right in the middle on the top of your leg. easy enough, right?
it was so much harder than i imagined. as my friend said, it's kind of unnatural. we spend a lot of our lives trying to avoid getting stabbed by things. doing it intentionally feels... well, wrong. i actually tried three or four times and just couldn't do it. then, finally, i made myself think and chant in my head, "baby, baby, baby..." and bam -- i did it. and it was like nothing at all, the stab itself, anyway. the injection of the medicine was a little more uncomfortable. it made my muscle sore and achy immediately. that lasted for a couple of hours. but then it was over. and i don't have to do it again until tomorrow morning.
i felt a bit light-headed and a little nauseous for much of the day, but i'm feeling mostly normal now. and i have no clue if the meds are to blame for that. could also be nerves or my period or the that i had coffee this morning (the other good part of getting my period!) who-knows-what else. i go back to the doctor on monday, when the presumably will fill me in on the next steps of this process. that will be day 5 of my cycle. my friend who's gone through this process a bunch of times said they will probably do another ultrasound to see how my follicle are developing and maybe alter my doses of the injections based on that (another reason i have so many extras). i won't be thrilled if i have to start giving myself more than one a day, but i am prepared to do whatever at this point. more to come!
Tuesday, July 12, 2011
drug deals
yesterday, in the midst of trying to teach summer school, i made or received six different phone calls about IUI prescriptions. i still hadn't heard from the insurance company as of yesterday morning, and since my period is due any second i was concerned that the drugs wouldn't arrive in time. i stopped by the doctor's office when they opened yesterday morning and they gave me the direct number to reach the fertility people at my prescription company, saying (of course), "yeah... medco sometimes takes a bit longer than others. we'd better stay on them." they gave me the name of the woman at their office that i should contact if medco gave me "any trouble."
thus began my string of phone calls throughout the day. there was a lot of being on hold, waiting for calls back, and then me calling back because i got impatient waiting. but by 6pm when i was standing outside of the subway station waiting for all of the calls to end so i could go underground and go home, everything was taken care of. and it's a whole lotta stuff. it seems that even though i normally ovulate just fine, they're going to do the whole thing artificially to make it as predictable as possible. which is guess is ok. fewer variables can't be bad.
there are five medications in total. i don't remember the names of most of them. three of them were no problem for my prescription insurance company to fill. but for one of them -- HcG, the ovulation "trigger" shot -- they had to call my doctor's office to get a paper prescription because it's a controlled substance. and for another -- vaginal progesterone suppositories... ugh -- they simply couldn't get the drug so they sent it to another specialty pharmacy called Freedom that will fill it (and they had to call me also, of course, to figure out all of those details). i have to call the doctor's office today to make sure the paper prescription was sent out, but otherwise i think all is in order. since a number of the prescriptions need to be refrigerated, i am having it all delivered to school tomorrow. which should be day 2 of my cycle, so i'll have everything in time to start on day 3. (though i still haven't gotten my period, so i may have even more leeway than i need.)
if it doesn't work the first try and we need to order everything again, i just have to call the prescription company for refills, since i was prescribed three of everything. but i probably won't be using the third refill, because we'd have to pay for those drugs out of pocket. i didn't know that until yesterday. i asked the representative about my copays, which aren't tiny but aren't terrible (this round will cost a couple hundred dollars in copays), and she gave me that info and also let me know that my insurance has a cap on fertility prescriptions. a lifetime cap, not an annual cap like the fertility assistance benefit that pays for the actual IUI procedure and all of that. when she told me the cap was $15,000, i thought that sounded totally reasonable. until she told me that this round of drugs cost over $9,000. so my $15k cap won't even pay for two full rounds of IUI. i think we will shell out the extra couple of thousand for a second try if we need it, but it's doubtful we'd pay for a 3rd. so our already limited number of tries to give this artificial stuff a shot is even more limited than i thought.
man alive.
so that's where we're at. i got my typical pre-period headache last night, and today is really the day it should come... although i will admit i am still (of course!) holding out hope that it just won't show up. sure, i already paid $300 or something for prescriptions. but seriously... i think i'd deal with that in return for not having to go through this whole process. i guess, as always, there's nothing to do but wait and see.
thus began my string of phone calls throughout the day. there was a lot of being on hold, waiting for calls back, and then me calling back because i got impatient waiting. but by 6pm when i was standing outside of the subway station waiting for all of the calls to end so i could go underground and go home, everything was taken care of. and it's a whole lotta stuff. it seems that even though i normally ovulate just fine, they're going to do the whole thing artificially to make it as predictable as possible. which is guess is ok. fewer variables can't be bad.
there are five medications in total. i don't remember the names of most of them. three of them were no problem for my prescription insurance company to fill. but for one of them -- HcG, the ovulation "trigger" shot -- they had to call my doctor's office to get a paper prescription because it's a controlled substance. and for another -- vaginal progesterone suppositories... ugh -- they simply couldn't get the drug so they sent it to another specialty pharmacy called Freedom that will fill it (and they had to call me also, of course, to figure out all of those details). i have to call the doctor's office today to make sure the paper prescription was sent out, but otherwise i think all is in order. since a number of the prescriptions need to be refrigerated, i am having it all delivered to school tomorrow. which should be day 2 of my cycle, so i'll have everything in time to start on day 3. (though i still haven't gotten my period, so i may have even more leeway than i need.)
if it doesn't work the first try and we need to order everything again, i just have to call the prescription company for refills, since i was prescribed three of everything. but i probably won't be using the third refill, because we'd have to pay for those drugs out of pocket. i didn't know that until yesterday. i asked the representative about my copays, which aren't tiny but aren't terrible (this round will cost a couple hundred dollars in copays), and she gave me that info and also let me know that my insurance has a cap on fertility prescriptions. a lifetime cap, not an annual cap like the fertility assistance benefit that pays for the actual IUI procedure and all of that. when she told me the cap was $15,000, i thought that sounded totally reasonable. until she told me that this round of drugs cost over $9,000. so my $15k cap won't even pay for two full rounds of IUI. i think we will shell out the extra couple of thousand for a second try if we need it, but it's doubtful we'd pay for a 3rd. so our already limited number of tries to give this artificial stuff a shot is even more limited than i thought.
man alive.
so that's where we're at. i got my typical pre-period headache last night, and today is really the day it should come... although i will admit i am still (of course!) holding out hope that it just won't show up. sure, i already paid $300 or something for prescriptions. but seriously... i think i'd deal with that in return for not having to go through this whole process. i guess, as always, there's nothing to do but wait and see.
Friday, July 8, 2011
phase 2, cycle 2 limbo and logistics
today is day 23 of my cycle. my period should arrive monday-ish. and i'm completely in limbo. if i do get my period, then the IUI protocol begins right away. i have to call the fertility doc ASAP and let them know, because on Day 3 of my cycle i will have to start the injections for ovulation induction. they'll also do bloodwork then to make sure my hormones are doing what they're supposed to do. i will give myself injections for 4 or 5 days, then when the monitor says i'm ovulating, i will go in for an ultrasound to make sure it's for real, and the next morning we'll go in for the insemination. i know there are other drugs and tests and procedures other than that, but they've been good about only telling me what i need to know for the immediate future and not overwhelming me with all of the next steps. in fact, i know i will be receiving five drugs, i think the nurse said, but i only know what the heck i'll be doing with the one. so really... much of this is going to be the great unknown.
my insurance will cover $5k per calendar year of treatments, although they've told me the medications aren't covered. i haven't yet been able to determine if that's because all of my prescriptions are covered by a different benefit plan, or if that means i'm going to have to pay out of pocket for them. the nurses and receptionists at the fertility institute have been -- as always -- amazingly helpful and on top of things, and i have been assured that the meds were ordered and they did have my prescription plan info. the medications will be delivered to me by a specialty pharmacy. from what i've been told, they will have to be refrigerated, so i think i'll have them sent directly to work to make sure nothing happens to them. and then i'll just have to figure out how the heck to give myself an injection. i'm not squeamish, but i've never done that before. and the hubby is certainly not a candidate for helping out. squeamish is an understatement for his reaction to anything related to needles.
i've been on the phone with someone from the fertility institute or from my insurance company every day for the past week. I had to be "authorized" to begin receiving the fertility assistance benefits provided under my plan, which consisted of me being read what i'm allowed and required to do: making sure my doctor was in their good graces, instructing me that i must have at least three rounds of insemination before they'll cover IVF, etc. it also consisted of me answering a whole bunch of questions (about 15 minutes' worth) about my medical and fertility history and getting a lot of detailed instructions about what i have to do and what i have to have the doctor's office do. have them call to get the authorization code, call them with the bloodwork results on day 3, call the second i know i'm pregnant... it all feels very artificial (no pun intended) and weird, weird, weird. but mostly just stressful. there are so many logistics to keep straight.
but at last, finally, i think every last detail is in order. but still... i can't know for sure what's going to happen. it's really bizarre to think that it's possible that we've taken all of these steps and set this whole chain of events into motion and that it might not even be necessary. my therapist asked me if i have any feelings about my possible pregnancy... do i have a hunch? a gut sensation? and the truth is i don't. i have stopped dwelling on symptoms, i have stopped paying attention and freaking out. i've been better about coffee (for general healthy reasons) but have had several glasses of wine and sangria over the past few weeks. I feel like i'm making an effort to live my life as if i'm not pregnant, rather than in the state of constant insane wondering in which i lived for many months. so for now i'm mostly just waiting. but as the end of my cycle gets closer i find it harder to keep my hope quiet. but we shall see, very soon indeed.
my insurance will cover $5k per calendar year of treatments, although they've told me the medications aren't covered. i haven't yet been able to determine if that's because all of my prescriptions are covered by a different benefit plan, or if that means i'm going to have to pay out of pocket for them. the nurses and receptionists at the fertility institute have been -- as always -- amazingly helpful and on top of things, and i have been assured that the meds were ordered and they did have my prescription plan info. the medications will be delivered to me by a specialty pharmacy. from what i've been told, they will have to be refrigerated, so i think i'll have them sent directly to work to make sure nothing happens to them. and then i'll just have to figure out how the heck to give myself an injection. i'm not squeamish, but i've never done that before. and the hubby is certainly not a candidate for helping out. squeamish is an understatement for his reaction to anything related to needles.
i've been on the phone with someone from the fertility institute or from my insurance company every day for the past week. I had to be "authorized" to begin receiving the fertility assistance benefits provided under my plan, which consisted of me being read what i'm allowed and required to do: making sure my doctor was in their good graces, instructing me that i must have at least three rounds of insemination before they'll cover IVF, etc. it also consisted of me answering a whole bunch of questions (about 15 minutes' worth) about my medical and fertility history and getting a lot of detailed instructions about what i have to do and what i have to have the doctor's office do. have them call to get the authorization code, call them with the bloodwork results on day 3, call the second i know i'm pregnant... it all feels very artificial (no pun intended) and weird, weird, weird. but mostly just stressful. there are so many logistics to keep straight.
but at last, finally, i think every last detail is in order. but still... i can't know for sure what's going to happen. it's really bizarre to think that it's possible that we've taken all of these steps and set this whole chain of events into motion and that it might not even be necessary. my therapist asked me if i have any feelings about my possible pregnancy... do i have a hunch? a gut sensation? and the truth is i don't. i have stopped dwelling on symptoms, i have stopped paying attention and freaking out. i've been better about coffee (for general healthy reasons) but have had several glasses of wine and sangria over the past few weeks. I feel like i'm making an effort to live my life as if i'm not pregnant, rather than in the state of constant insane wondering in which i lived for many months. so for now i'm mostly just waiting. but as the end of my cycle gets closer i find it harder to keep my hope quiet. but we shall see, very soon indeed.
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