How can someone be "unexplained" in yet another damn medical category?
Yesterday morning I woke up at 2am with a terrible, localized pain in my abdomen. It felt better when I sat up, but I couldn't lie down at all, which also meant I couldn't sleep. I spent a couple hours tossing and turning, while intermittently getting up to google my symptoms to figure out what was wrong. Finally, I called the advice nurse, who decided it was best to go to the hospital.
One urine sample, several blood tests, an IV bag, several medications, and one CT scan later ... nothing. They can't find anything wrong except some constipation, for which they gave me medication. But as far as the localized pain - no idea.
Now it is a little over 24 hours later, and while the medication did its thing, I still have that small localized pain (to a lesser degree) and a woefully upset stomach due to the meds. The only good that will come out of this is that I'll finally be forced to get myself a doctor and have a check-up, and maybe I can address a few things that have been bothering me (my on-again, off-again stomach issues, insomnia, and a shoulder that occasionally aches to distraction).
On the bright side - having a day off yesterday was great, even if I was exhausted.
On the down side - I'm going to have to go back to being much more careful about what I eat, including fried food, coffee (including decaf - I don't usually drink anything caffeinated), alcohol, desserts, and junk food in general. Sigh.
Thursday, May 21, 2009
Tuesday, May 19, 2009
Breaks are really fantastic
CanI just say that I'm really enjoying this month off?
Last weekend, the husband and I went to the northern California coast for a two-day bike trip, parking our car in a valley about 10 miles from the coast and doing a 73-mile loop with a change of clothes, some water, and our wallets in our backpacks. It was crazy hot (we had a heat wave this weekend), but absolutely amazing to ride along the Pacific Coast Hwy 1, stay in a gorgeous hotel right on the ocean, have a fantabulous 6-course dinner with matching wines, and just spend some time outside away from infertility. Almost makes me not want to have kids!
Seriously, though, I'm enjoying the time off, without the constant obsessing. Being able to think about other things, like my garden and triathlons and time with friends. It feels good and it feels healthy and relaxing.
It's also making me realize that I can't stay in my job forever. I assumed that at some point I'd take maternity leave, and if i came back, I'd try to come back only part time. Having to contemplate staying in this job long-term, with no break in sight - well, it's depressing, horrifying really. So that's good to know and something I'll have to think about a lot in the coming weeks and months. (Also, I just popped a couple of keys off my keyboard to clean it and now it feels weird - I can't put up with that forever, you know).
So anyway - I'll be posting and commenting less for a month while I enjoy my "time off". And my posts may be about things other than infertility, because I'm realizing (even if I don't always remember) that there are other things in life besides infertility.
Like wine.
Last weekend, the husband and I went to the northern California coast for a two-day bike trip, parking our car in a valley about 10 miles from the coast and doing a 73-mile loop with a change of clothes, some water, and our wallets in our backpacks. It was crazy hot (we had a heat wave this weekend), but absolutely amazing to ride along the Pacific Coast Hwy 1, stay in a gorgeous hotel right on the ocean, have a fantabulous 6-course dinner with matching wines, and just spend some time outside away from infertility. Almost makes me not want to have kids!
Seriously, though, I'm enjoying the time off, without the constant obsessing. Being able to think about other things, like my garden and triathlons and time with friends. It feels good and it feels healthy and relaxing.
It's also making me realize that I can't stay in my job forever. I assumed that at some point I'd take maternity leave, and if i came back, I'd try to come back only part time. Having to contemplate staying in this job long-term, with no break in sight - well, it's depressing, horrifying really. So that's good to know and something I'll have to think about a lot in the coming weeks and months. (Also, I just popped a couple of keys off my keyboard to clean it and now it feels weird - I can't put up with that forever, you know).
So anyway - I'll be posting and commenting less for a month while I enjoy my "time off". And my posts may be about things other than infertility, because I'm realizing (even if I don't always remember) that there are other things in life besides infertility.
Like wine.
Friday, May 15, 2009
Plans
I'm not even sure where to start with this. Let's just say I was smart to be nervous about yesterday's ultrasound.
I had a big ol' cyst on my left ovary, so we paid about $300 to be told that we won't be doing anything at all this month. Actually, it turned out to be worthwhile anyway, because (after I cried for a bit), the doctor took us to her office for a consultation, which was quite useful because we got to ask all our questions and then some.
First, somehow there's never been a really good test of my husband's sperm morphology. I have no idea how this happened - I thought everything had been tested and was pretty darn good. So we are doing that next week.
Then the doctor said that she would recommend only one more clomid + IUI cycle before moving on. She said that typically you move on after three cycles, but since we missed our IUI in cycle #2, she thought it would still be worth one more shot (if the SA comes back ok).
After that, she suggested two options. First is to move on to IUI + injectables, BUT she would want me to have a laparoscopy first. The other option is to move on to IVF, without the need for a laparoscopy.
Let's break this down, shall we?
Option #1 - Laparoscopy with 1-3 cycles of IUI + injectables. The laparoscopy costs, apparently, about $4000-$5000, PLUS the doctor recommended a week off of work (yikes!). The injectables cycles are also about $3000-$4000 each, with only about a 20% success rate. To get to the same success rate as IVF, we'd probably need three IUI cycles. Total cost (worst case) is $17,000.
Option #2 - IVF. One cycle is $8500, plus meds, another $3000 = $11,500. The package plan includes one IVF, followed by up to 6 FETs (or as many frozen embryos that there are left), and once the frozen embies are gone (but not before), a second fresh cycle. $14,500, plus meds ($3000 to $11,000, depending on how many IVFs and FETs we'd need) = $17,500 - $25,000.
We're both thinking IVF will be the better option.
To make things more complicated, if I'm not pregnant by fall, I was hoping to maybe get my knee surgery done and out of the way. I calculate that between our break month, our last clomid cycle, and I assume another break month before IVF, it will be almost fall by the time we'd be able to get started. I would seriously consider putting off IVF by another month or two to fix my knee. I don't know if it would be a bad idea to put my body under that much stress for several months in a row (drugs and surgery, followed by rehab and IVF), but it would be nice to get it all over with.
It's way too much to think about, and I think I'm going to need some time off to actually do that thinking. In the meantime, I'll be reading Mel's Navigating the Land of IF, and trying to enjoy my time off.
And hopefully training for a triathlon on June 6.
P.S. Advice, while not necessary, is always welcome.
I had a big ol' cyst on my left ovary, so we paid about $300 to be told that we won't be doing anything at all this month. Actually, it turned out to be worthwhile anyway, because (after I cried for a bit), the doctor took us to her office for a consultation, which was quite useful because we got to ask all our questions and then some.
First, somehow there's never been a really good test of my husband's sperm morphology. I have no idea how this happened - I thought everything had been tested and was pretty darn good. So we are doing that next week.
Then the doctor said that she would recommend only one more clomid + IUI cycle before moving on. She said that typically you move on after three cycles, but since we missed our IUI in cycle #2, she thought it would still be worth one more shot (if the SA comes back ok).
After that, she suggested two options. First is to move on to IUI + injectables, BUT she would want me to have a laparoscopy first. The other option is to move on to IVF, without the need for a laparoscopy.
Let's break this down, shall we?
Option #1 - Laparoscopy with 1-3 cycles of IUI + injectables. The laparoscopy costs, apparently, about $4000-$5000, PLUS the doctor recommended a week off of work (yikes!). The injectables cycles are also about $3000-$4000 each, with only about a 20% success rate. To get to the same success rate as IVF, we'd probably need three IUI cycles. Total cost (worst case) is $17,000.
Option #2 - IVF. One cycle is $8500, plus meds, another $3000 = $11,500. The package plan includes one IVF, followed by up to 6 FETs (or as many frozen embryos that there are left), and once the frozen embies are gone (but not before), a second fresh cycle. $14,500, plus meds ($3000 to $11,000, depending on how many IVFs and FETs we'd need) = $17,500 - $25,000.
We're both thinking IVF will be the better option.
To make things more complicated, if I'm not pregnant by fall, I was hoping to maybe get my knee surgery done and out of the way. I calculate that between our break month, our last clomid cycle, and I assume another break month before IVF, it will be almost fall by the time we'd be able to get started. I would seriously consider putting off IVF by another month or two to fix my knee. I don't know if it would be a bad idea to put my body under that much stress for several months in a row (drugs and surgery, followed by rehab and IVF), but it would be nice to get it all over with.
It's way too much to think about, and I think I'm going to need some time off to actually do that thinking. In the meantime, I'll be reading Mel's Navigating the Land of IF, and trying to enjoy my time off.
And hopefully training for a triathlon on June 6.
P.S. Advice, while not necessary, is always welcome.
Thursday, May 14, 2009
Twice in one day!
I am really nervous about my ultrasound this afternoon.
First, because it is going to be the first cycle with a higher dose of clomid, and I'm just praying it makes a difference. This should be the month for my right ovary, which has had two good follicles each time previously, so I'm really, really hoping a higher dose of meds will produce a couple more follicles. I'm thrilled that I should be starting the meds tonight - I HATE the time periods in which I'm not doing anything.
Second, I'm nervous because my husband is coming along and we're going to ask the doc some questions. I don't know if she'll have us make a follow-up consultation to discuss things, but I am really starting to want some answers. Here are some of my questions:
1. Why do you think that nothing has worked so far?
2. Should we do any more testing? If so, what do you recommend? (i.e. hormone tests, laparoscopy, more SAs, genetic testing)
3. Do you think I could have endometriosis?
4. Do you think that maybe there is a problem with my eggs?
5. What do you think our next step should be if this round doesn't work?
6. What do you think about IUI with injectables?
7. How would you compare IVF to IUI with injectables, in terms of costs and outcomes, keeping in mind our ages (30 and 34) and diagnosis (unexplained)?
I think it's a pretty good list, hopefully I remember it all!
Any other ideas?
First, because it is going to be the first cycle with a higher dose of clomid, and I'm just praying it makes a difference. This should be the month for my right ovary, which has had two good follicles each time previously, so I'm really, really hoping a higher dose of meds will produce a couple more follicles. I'm thrilled that I should be starting the meds tonight - I HATE the time periods in which I'm not doing anything.
Second, I'm nervous because my husband is coming along and we're going to ask the doc some questions. I don't know if she'll have us make a follow-up consultation to discuss things, but I am really starting to want some answers. Here are some of my questions:
1. Why do you think that nothing has worked so far?
2. Should we do any more testing? If so, what do you recommend? (i.e. hormone tests, laparoscopy, more SAs, genetic testing)
3. Do you think I could have endometriosis?
4. Do you think that maybe there is a problem with my eggs?
5. What do you think our next step should be if this round doesn't work?
6. What do you think about IUI with injectables?
7. How would you compare IVF to IUI with injectables, in terms of costs and outcomes, keeping in mind our ages (30 and 34) and diagnosis (unexplained)?
I think it's a pretty good list, hopefully I remember it all!
Any other ideas?
Insurance
Can I just say, to those of you who have infertility insurance coverage, that you are some very lucky gals?
Even though I work for the State of California, I stupidly decided to go with my husband's insurance and give up my fantastic insurance options through my job. I don't have the option to get it back until 2010 (unless I have a baby, of course). Let me just say that I have no idea what the infertility coverage through my work insurance options is, because I dropped my insurance way before I knew we were infertile. Still, I don't think it can be worse than my husband's options.
My husband is a co-owner of his business - he owns around 45%, the other major partner owns 45%, and then there is a third guy who has about 10% ownership. The reason why this matters is that any company expenses are paid halfway by us. Including the employer's share of the insurance premiums.
We're switching insurance right now. Our old insurance had a $2000 lifetime limit for infertility, and our clinic is out of network. I still haven't submitted our claims, so I don't know if it will cover anything we've done. I really need to do that soon.
Our new insurance ... sucks. If we do the HMO option, we get around a $1500 lifetime limit, BUT it doesn't cover IUI or IVF! (But it does cover GIFT?! Who makes this shit up?) Um ... really? WTF does it cover, then? Ultra-sounds and meds?
If we do either the PPO or HMO option, there is an "optional rider" my husband's company can purchase. It has a lifetime limit of around $1500 to $2000 (depending on the plan), and will cover 50% of costs for 6 unmedicated IUIs, 3 medicated IUIs, and I think one round of IVF (up to a maximum of $1500 to $2000, which is to say a fraction of what we'll have to pay). But premiums for the entire company for a year will easily cost MORE than the benefit for us. Considering that just about everyone in the company either already has kids or is a young single guy - we'd be paying the premium for everyone pretty much to cover only ourselves.
To make it worse, to get the optional rider, we'd be basically telling everyone in the company that we're infertile, AND underhandedly having the other partners pay for our (useless) infertility insurance. So it's not really an option.
So there you have it - basically, no coverage at all. Really, what's the point of even having infertility coverage in these plans? For appearances?
Does anyone know how to get involved in political reform? Isn't this kind of thing an absolute crime? Really - anyone out there in the state of California who knows how we can fix this? On the other hand, after the recent octuplet incident in our fair state, I'm guessing this would get shot down before it got off the ground.
Oh, and to add insult to injury - the insurance agent told us that our premiums were so high BECAUSE WE'RE OF CHILD-BEARING AGE. I didn't know whether to laugh or cry.
Even though I work for the State of California, I stupidly decided to go with my husband's insurance and give up my fantastic insurance options through my job. I don't have the option to get it back until 2010 (unless I have a baby, of course). Let me just say that I have no idea what the infertility coverage through my work insurance options is, because I dropped my insurance way before I knew we were infertile. Still, I don't think it can be worse than my husband's options.
My husband is a co-owner of his business - he owns around 45%, the other major partner owns 45%, and then there is a third guy who has about 10% ownership. The reason why this matters is that any company expenses are paid halfway by us. Including the employer's share of the insurance premiums.
We're switching insurance right now. Our old insurance had a $2000 lifetime limit for infertility, and our clinic is out of network. I still haven't submitted our claims, so I don't know if it will cover anything we've done. I really need to do that soon.
Our new insurance ... sucks. If we do the HMO option, we get around a $1500 lifetime limit, BUT it doesn't cover IUI or IVF! (But it does cover GIFT?! Who makes this shit up?) Um ... really? WTF does it cover, then? Ultra-sounds and meds?
If we do either the PPO or HMO option, there is an "optional rider" my husband's company can purchase. It has a lifetime limit of around $1500 to $2000 (depending on the plan), and will cover 50% of costs for 6 unmedicated IUIs, 3 medicated IUIs, and I think one round of IVF (up to a maximum of $1500 to $2000, which is to say a fraction of what we'll have to pay). But premiums for the entire company for a year will easily cost MORE than the benefit for us. Considering that just about everyone in the company either already has kids or is a young single guy - we'd be paying the premium for everyone pretty much to cover only ourselves.
To make it worse, to get the optional rider, we'd be basically telling everyone in the company that we're infertile, AND underhandedly having the other partners pay for our (useless) infertility insurance. So it's not really an option.
So there you have it - basically, no coverage at all. Really, what's the point of even having infertility coverage in these plans? For appearances?
Does anyone know how to get involved in political reform? Isn't this kind of thing an absolute crime? Really - anyone out there in the state of California who knows how we can fix this? On the other hand, after the recent octuplet incident in our fair state, I'm guessing this would get shot down before it got off the ground.
Oh, and to add insult to injury - the insurance agent told us that our premiums were so high BECAUSE WE'RE OF CHILD-BEARING AGE. I didn't know whether to laugh or cry.
Tuesday, May 12, 2009
Onward and upward
So no break after all. I had a confusing discussion with my husband last night. Here are some of the points he made:
1. How can we, in the year 2009, be diagnosed with unexplained infertility? He can't believe that there is such a thing, with all the advanced technology there is today. Aren't there more tests we can do to discover what the problem is? How can the field of assisted reproduction be so vague and badly understood?
2. Since we have been diagnosed with unexplained fertility, what is the point of continuing to do IUIs? According to him, it's like making up a solution to a problem about which you know nothing, and then crossing your fingers and hoping it works. Are the doctors just trying to make money off of us by having us to one IUI after another?
3. What is the point of taking a break? We already know it won't get us anywhere (even if we don't know why).
4. Why do I think it's worth it to keep trying? He's ok with me saying I want to do another IUI, but he doesn't understand why I think it will work. I had told him when we first got started that typically if a treatment is going to work, it will work in the first three tries. I think since we didn't have an IUI on cycle #2, and we had a poor response (one follicle) on cycle #3, this time we might have a better chance with a higher dose of meds and an IUI.
5. What will we do if this doesn't work again?
All of this is a little ironic because he tends to not like to worry about the future until we have to. I.e., don't worry about being infertile until we know we are, then don't worry about IVF until IUI has failed, etc. No planning ahead whatsoever, but now that we're in this place, there's so much I wish we had discussed. I've taken it upon myself to research and study and read blogs and stories from other people and I feel like I understand our situation, so he relies on me to inform him, but he questions me as if I am somehow responsible for all of these ideas and treatment plans.
Can you tell I'm frustrated?
So anyway, AF arrived last night and I'm calling the RE today for a new cycle. Hopefully at the ultrasound I can ask what she recommends if this fails. Hopefully my husband will come along and ask his own questions, too.
Hopefully this works so that I'm not just postponing the inevitable until next month!
1. How can we, in the year 2009, be diagnosed with unexplained infertility? He can't believe that there is such a thing, with all the advanced technology there is today. Aren't there more tests we can do to discover what the problem is? How can the field of assisted reproduction be so vague and badly understood?
2. Since we have been diagnosed with unexplained fertility, what is the point of continuing to do IUIs? According to him, it's like making up a solution to a problem about which you know nothing, and then crossing your fingers and hoping it works. Are the doctors just trying to make money off of us by having us to one IUI after another?
3. What is the point of taking a break? We already know it won't get us anywhere (even if we don't know why).
4. Why do I think it's worth it to keep trying? He's ok with me saying I want to do another IUI, but he doesn't understand why I think it will work. I had told him when we first got started that typically if a treatment is going to work, it will work in the first three tries. I think since we didn't have an IUI on cycle #2, and we had a poor response (one follicle) on cycle #3, this time we might have a better chance with a higher dose of meds and an IUI.
5. What will we do if this doesn't work again?
All of this is a little ironic because he tends to not like to worry about the future until we have to. I.e., don't worry about being infertile until we know we are, then don't worry about IVF until IUI has failed, etc. No planning ahead whatsoever, but now that we're in this place, there's so much I wish we had discussed. I've taken it upon myself to research and study and read blogs and stories from other people and I feel like I understand our situation, so he relies on me to inform him, but he questions me as if I am somehow responsible for all of these ideas and treatment plans.
Can you tell I'm frustrated?
So anyway, AF arrived last night and I'm calling the RE today for a new cycle. Hopefully at the ultrasound I can ask what she recommends if this fails. Hopefully my husband will come along and ask his own questions, too.
Hopefully this works so that I'm not just postponing the inevitable until next month!
Monday, May 11, 2009
Thanks and I'm sorry
Thanks for all the comments on my last almost-post. I haven't really felt like writing anything, and although I've been reading your blogs I haven't had the time or strength to comment. I'm not sure how I feel right now. I of course told my husband about the negative tests, and he didn't say anything, and we haven't really had any time alone together, so we haven't talked about it. I'm not sure what we'll decide to do.
I know, for my part, that I could use a break of at least a month or two. I'd like to focus on eating healthier, getting in better shape, and maybe doing a triathlon in June. I'd like to spend some time with friends and maybe even some quiet time at home.
I'm not sure who I'm kidding, though. I know I will be subconsciously calculating ovulation dates, and secretly hoping for a BFP instead of AF at the end of the month. If there's one thing I've learned about myself from infertility (and there are plenty of things), it's that I can't fool myself and I can't be someone that I'm not. I'm finding that not being able to fool myself is one of the hardest things to deal with.
Yesterday was especially hard for me. I'm very grateful to Mugsy for her gift and kind card, which made my morning so much better. I actually had a good time with my mom and my sister, and I felt at peace with visiting the cemetery. A few times during wine-tasting, though, I felt like I had been kicked when the wineries made a big deal about Mother's Day - free champagne at one, free tasting for mothers only at another. Seeing my little niece and nephew, who are so cute, was bittersweet, too.
I'm sorry, this is a rambling nonsense post. I'll add more when I can straighten out my thoughts. Hope everyone is having a good Monday.
I know, for my part, that I could use a break of at least a month or two. I'd like to focus on eating healthier, getting in better shape, and maybe doing a triathlon in June. I'd like to spend some time with friends and maybe even some quiet time at home.
I'm not sure who I'm kidding, though. I know I will be subconsciously calculating ovulation dates, and secretly hoping for a BFP instead of AF at the end of the month. If there's one thing I've learned about myself from infertility (and there are plenty of things), it's that I can't fool myself and I can't be someone that I'm not. I'm finding that not being able to fool myself is one of the hardest things to deal with.
Yesterday was especially hard for me. I'm very grateful to Mugsy for her gift and kind card, which made my morning so much better. I actually had a good time with my mom and my sister, and I felt at peace with visiting the cemetery. A few times during wine-tasting, though, I felt like I had been kicked when the wineries made a big deal about Mother's Day - free champagne at one, free tasting for mothers only at another. Seeing my little niece and nephew, who are so cute, was bittersweet, too.
I'm sorry, this is a rambling nonsense post. I'll add more when I can straighten out my thoughts. Hope everyone is having a good Monday.
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