Thursday, May 21, 2009

Not a great break after all

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.

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.

Friday, May 15, 2009


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.

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?


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.

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!

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.

Sunday, May 10, 2009

Tuesday, May 5, 2009

Fathers (11 dpo, 2-3 days to go)

I have a little secret, in a way, that I've been keeping from my husband. Have I mentioned it before? I don't think so.

After my dad died, I was the only one willing to go through his things. I was actually very close to my dad, or at least as close as a person could get to my dad. He was a very introspective, reserved, intelligent guy, and I wish I had taken the time to really speak with him during the last few lucid years of his life. I always thought I'd have more time, you know?

He was an older father, he divorced his first wife and then remarried my mother and had children unexpectedly. (Ironically, my mother had been told she couldn't get pregnant, and then had identical twins - my sister and me - followed soon thereafter by my brother.) It was a time in his life when he should have been expecting only grandchildren (and in fact he was already a grandfather to my older half-sisters' kids). When he was young, he fought in World War II. He went to both Berkeley and Stanford, and worked for some of the major tech companies in the Bay Area/Silicon Valley. I'm sure he had a lot of interesting stories to tell that I never got to hear.

When I was in college, a couple hours away from my parents' house, my dad elected to have surgery to insert a stent into an artery near his heart. I don't know a lot of the details of the procedure or what happened next, but I do know that hours after it was supposedly successfully complete, he went into cardiac arrest and suffered brain damage. After that incident, he began suffering from vascular dementia, which is similar to Alzheimer's disease . He lived for 6 more years, gradually getting more and more difficult to take care of, more forgetful, and eventually he needed constant care so he wouldn't hurt himself or anyone around him. It was really sad to watch, although it made his death less painful because he had been sick and not really himself for so long.

I am grateful that I spent a lot of time with him in his last few years, even if he didn't always seem to know who I was. I visited him at his nursing home and frequently took him out to lunch. I helped arrange for him to come home for visits, especially for holidays. Even though my husband never met him when he was still lucid, I am so happy that my husband regularly came with me to visit my dad and spend time with him.

My sister spent quite a bit of time with my father as well, although she seemed to be too uncomfortable to really do things with him like I did. My brother NEVER visited him in the nursing home except for very rare occasions such as holidays. He's also never been to the cemetery since the burial four years ago.

When I was going through my dad's things with my mother a while after his death, I found a t-shirt we bought him when we were little kids. It's black and it says "Best Dad in the World" in kid-style writing. It was like a connection to my childhood and the feelings I had for my father. I took it home with me and hid it, hoping to give it to my husband at some point during my surely upcoming pregnancy (when I tell him I'm pregnant? First ultra-sound? On Father's Day? So many possibilities! or so I thought). I thought it was such a great way to share a part of my life that my husband was never able to experience, because my dad died when I was so young.

I still have that shirt, hidden in my closet. I hope the moths haven't gotten to it by now. I really, really wish that I can give it to my husband some day soon.

What are your plans for Sunday?

I'm curious to know what others usually do and will be doing this year for M____ Day. Besides participating in OMG You Rock! Day of course.

Here's my situation. I don't really feel like I can get out of celebrating because I still have a mother, even if I so far haven't managed to become one. My sister, mother, and I are going to the cemetery to see my dad's grave, then we're going wine-tasting (my participation will depend on my HPT that morning, of course), and then to my mom's house to make her dinner (which she won't be happy about because she prefers to be taken out to expensive dinners, but my sister can't afford it).

(Just for some background and reference, I don't get along well with my mother. She is demanding, manipulative, controlling, and insincere, and she would be incredibly offended if I didn't plan a huge day with her on Sunday, despite my current condition. She also treats my SIL terribly because she believes my brother "married below his class and status"(!) So if I sound snide when discussing her, it's usually because she deserves it.)

I don't know if my brother, his wife, and their two kids will participate in any part of the day with us or not (even though they live a few blocks away from my mom). My family is a bit disfunctional, obviously.

On Saturday morning before M_______ Day, I usually go to the Farmer's Market and buy two bouquets of flowers - one for my dad at the cemetery, and one for my mom. I honestly don't remember if I've ever gotten anything for my SIL, but I'm guessing I have. However, I'm feeling particularly bitter about it this year. Not bitter towards her personally, just bitter about the fact that they're pretty much done family-building at the tender ages of 22 and 28, and I can't seem to even get to the starting gate. I don't really see why I should have to get her flowers. But I don't want to look like a b!tch.

So my questions are - What do you do for M_________ Day? Do you celebrate with your mother (if your mother is still alive)? Do you celebrate with other women in your life (i.e. sisters and/or friends) who are mothers? If you celebrate with multiple family members, do you honor them all, or just your own mother? Or do you avoid it all entirely (and if so, does your mother understand or does she feel slighted)?

Monday, May 4, 2009

8 dpo, 6 days to go

Can I just say that Mondays suck? Not for any particular reason, just because I am here at work and not at home or doing something fun.

I had an amazing weekend! I had a great time at the California Academy of Sciences in San Francisco, can I say that this place ROCKS?! We got there around 10:15, 45 minutes after they opened, and spent the entire day there, to the point where we had to rush through some things. We probably spent too much time in the huge swamp/aquarium section, which had a coral reef, all kinds of weird creatures, and a white alligator(!). Then we checked out the photos of our universe taken from telescopes and satellites - they were amazing! But again, too much time. Next, on to the living roof (in the sprinkling rain) to see the skylights, California native wildflowers, and bees that were buzzing around the flowers. It was beautiful. Lunch was quick and delicious. Then a section on climate change in California that we both enjoyed, but I thought could have been more informative.

After that, there is an exhibit on evolution with specimens and information about the Galapagos Islands. Then on to the African Hall to see stuffed animals in beautiful re-created and painted scenery. After that, a half-hour planetarium show which really put the size of our existence into perspective and also explained more about the search for life on other planets. Then we had to rush through the rainforest exhibit, a four-story humid dome inside the museum filled with birds and butterflies, and a variety of rainforest animals. Finally, we barely made it on time to the 3D movie about insects in Borneo. Wow - what a busy day!

A night on the town followed (great Italian food, and since my husband is Italian and he always talks to the waiters in Italian and makes friends with them, we got FREE beverages and tiramisu), but unfortunately the concert I wanted to see was sold out, which was disappointing. Sunday morning we did a quick trip to the Ferry Building, where we bought some seafood, cheese, heirloom tomatoes, and arisan bread before heading home. I got the last energy out of my system by scrubbing the house from top to bottom before we made a feast with the amazing (expensive) food from the Ferry Building.

Last night a sore throat developed, which is worrying me a bit. I'm not freaked out about swine flu like so many people are. It would suck to get it, but mostly because it would just suck to BE sick. I rarely get sick, and while I'd like a few days off of work, this isn't the best time to be sick, I'm guessing. I'm just going to keep crossing my fingers and hoping.

Now that the diversions of the weekend are over, I'm taking up my plodding, unwilling pace through the two-week-wait again. I'm actually planning to test on Saturday with an ultra-sensitive expensive test because otherwise Saturday will drag by, and if I get the bad news on Sunday, well, that would suck. Especially because, on top of it being Mother's Day, we always go visit my dad's grave that day - it's right between his birthday and the day he died. I don't need my BFN on the same day as the cemetary AND Mother's Day, thank you very much.

Hope everyone else had a good weekend and that for those of you in the 2ww, time is flying by.