I heart socialized medicine - Updated

Sorry for the long absence and delay in posting -- I've been navigating the Canadian health care system, and it hasn't been all that easy.

Although I tested yesterday, results from the lab were not available until this morning. So I walked into the walk-in clinic this morning, before the nurse could look up to say hello, I saw the printout with my name on it.

My beta as of 13dp5dt is... 1326!

Holy shit!

I appear to still be pregnant, and am thankful, relieved, and still in a state of complete disbelief that this appears (for the moment at least) to have actually worked. Maybe it's because for month after month there was just so much defeat and disappointment I am having trouble actually accepting that this is working, but it seems completely theoretical and like it's happening to someone else.

I spoke to my RE's office and the plan is to get an u/s in 1-2 weeks. I'm presently scheduled for next Tuesday, but think I am going to swap to the following week so that we can see my RE. It just seems like such a long time to get no news, after a process where I am monitored every 24-48 hours. 7-14 days? Are they kidding? But I'd rather see my RE, so I think we will hold out. But I'm not sure I can wait. I'll sleep on it before I make a decision to switch (yeah, I know, it's a lot of thinking for a relatively small decision).

So now we are on the far west coast of Vancouver Island with slightly easier internet access than we have had for the last 3 days in Vancouver, so I will try to catch up with reading.

Thank you to all for your wonderful support and comments.

Updated with symptoms, per request :-)

I have very few. Seriously, this is all a great mystery to me, as my boobs hurt more after the trigger shots than they do now.
I do have persistent unslakable thirst (and the corresponding repeated trips to the bathroom from trying to quench it). Otherwise, I got nothin'. (There is some crampiness that feels like ovulation cramping but in the center, but since I only feel it on the days I get the beta numbers, we are convinced it is completely psychosomatic.)

Ummm...

I appear to be pregnant.

My beta is 254. It's 10dp5dt.

Holy Shit.

We are heading to Vancouver tomorrow and so I'll get a second test on Monday there. Then an u/s when I get home on the 6th or 7th.

Have I mentioned that my husband and I had no expectations that this would work? That I have already gone to orientation for my new clinic? That I ordered the bcps to start on day 2 and have already packed them? This is crazy. It's the first time I've had a beta >5.

The best thing that I have done in a long time is call my husband and say "I'm pregnant." It was awesome. I could hear him smiling.

My heart is beating at 100mph and I can't stop smiling. I know we have a long way to go, and that 1000 things can go wrong, but for now, I am happy. Crazily, stupidly happy.

Good timing

Email I received today:

"To celebrate the start of summer, parents of the under 12 set will be bringing our kids into the office for part of the morning on Thursday, July 1^st for fun, games, snacks, sing-along with Jill and otherwise barely controlled chaos."

Since about 40 percent of the staff at my organization has kids in that age group, and another 50 percent are young single women under 30 who just loooove babies, this place is going to be a zoo. I will literally be the only person who isn't either accompanying a child or fawning over one.

Thankfully, I will be an entire continent away for all of next week. I feel like I dodged a bullet. Sometimes, the gods smile.

Mrs Crabbypants

That's me. Turns out that when I am anxious and can't exercise and jamming progesterone up into my nether regions 3x daily I get a wee bit cranky.

What else has been making me cranky?
My dog has been sick, so that's freaked me out a bit. On transfer day (Tuesday) while I was parked on the sofa I noticed that he was straining to stand up, and had some weird facial twitching. He'd been pretty lethargic for a day or so, but we figured it was the heat. And so when I saw his hind legs were weak, I freaked out into a huge, sobbing, hysterical mess. Because if anything were to happen to the dog I'm pretty sure that right now I would die. Because my dog is the object of all of the love and affection that I would focus on a child (although I do NOT dress him in silly outfits), and he is also the best. dog. ever. and makes me incredibly happy.

So dog illness caused a bit of a wrinkle in my "relax at home transfer day," but the Boy took him into the vet the next day and as it turns out he caught Lyme disease when we were up the country roaming through the woods. I learned an important lesson: apply the tick medication every 2-3 weeks if you will be in high tick areas. So note to you dog owners -- the ticks in Connecticut are not messing around.

The peanut (our dog) was better after only a few doses of his antibiotics, and all symptoms have now totally disappeared and he's back to himself, but it was really really scary for us to think about something happening to him, especially at a time when we rely on him so much.

Other reasons for cranky? The Boy has been on my very last nerve. There is no good reason for it, and I suspect that I am just being sensitive and difficult (that's his position, at least), and he has been really quite great about being supportive during this infertility thing, but jeeesus has he been bugging the living daylights out of me. I know he's just being himself, but sometimes "himself" is a pain in the ass.

Since he reads this I'll leave it at that (Note: if you are reading this, if you haven't acquired and taken your vitamins I am going to lose my shit and start forcefeeding you the ones we have like a goose being fattened up for fois gras). So I let the bad mood spread and that was pretty much no fun at all. We've recovered mostly, but I did create a bit of a scene Saturday and yesterday, which leached some of the fun from our weekend.

Otherwise? Otherwise I am just not exercising, not drinking booze, and not feeling anything that could even potentially be a side effect. Not even the progesterone is having a physical effect on me. Emotionally, it's made me a basket case (see above) but physically I feel fine.

We will see how things shake out on Friday. Until then, I'm just pretending that nothing is going on at all. Check back with me Wednesday to see if I've gone crazy yet.

it's done

We transferred the last (one)of our frozen embryos today.

My first cycle in November 2009 resulted in 3 5day blastocysts. We initially transferred one (because it was of course going to work) and then transferred one frozen in Feb.(Again, did the elective single transfer to avoid twins. We laugh about that now.) This was the last of that batch.

I'm trying so hard to be hopeful, and my sweet lovely husband keeps reminding me that this could possibly work, but I'm afraid of getting hurt. I'm trying to let hope sneak in just enough so that the positive thoughts make it down to where it matters in my body, but not so much that I am devastated by the failure. Its pretty much an impossible balance, and I've resigned myself to more pain.

Good thing is, we have a plan in place and are switching clinics and will start again in July. I liked my RE, but need to shake things up a bit. And since we've maxed out on our IF benefit, it's self pay either way. I'm super excited (there is sarcasm there, in case you can't hear it) to start dealing with my savings account being depleted, but am not worrying about that yet, because there is really nothing to do about it except give up, which is not an option.

So today I am resting on the sofa, per my lovely husband's request. He made me lunch and is in charge of dinner. I'll go back to work tomorrow, and then have my next acu appointment (went yesterday, too). But no more gym or yoga. Do any of you exercise in the 2ww? Can you tell me what you do/ don't do? I just want to keep up with my yoga and cardio, but think that's verboten. What do you think about mat pilates? I need positive stories! Please? The exercise is really the only thing that keeps me sane and from blowing up like a balloon, so giving it up is hard.

Its been 1.5 hours and I'm bored with resting already. Getting knocked up is getting to be a drag.

Where I'm not

If my first IVF cycle had worked, I'd be 28 weeks pregnant by now.

If my FET had worked, I'd be 18 weeks pregnant.

If my second IVF cycle had worked, I'd be 10 weeks pregnant.

Instead, I'm waiting for FET #2 next week so that I can find out 2 weeks later that I am not pregnant again.

I know that I'm torturing myself by looking up due dates and such, but I am just losing hope that this will ever ever work.

Fuck, do I hate this.

My new friend Brenda

Brenda has become my new bff.

Who is Brenda? Brenda is the manager for my company's account at Cigna, our insurance carrier, and she and I are going to get to the bottom of why my infertility coverage is so fucked up.

The whole thing started bad last year when I was first looking into it. When I called to ask about coverage for specific procedures, the clever operator forwarded me a benefits letter that they had sent to a colleague that indicated that retrieval, transfer and other testing were not covered. Which was surprising because the policy stated that I had $30K of infertility coverage. So why the discrepancy? Apparently the colleague who wanted to get pregnant was a gay man interested in using a surrogate. And while personally I think his course of action should have been covered, too, it shouldn't have taken me 30 minutes on the phone to explain why my situation was a tiny bit different.

So I have $30K of coverage, and since we've done 2 IVF and 1 FET with a preferred provider, we've had mercifully little out of pocket so far, but figured our luck, and coverage, was likely running out.

And so here's where the fun begins. When I asked for the balance in April, I was told I had used $28K. And so I asked for an itemized listing of all of the charges that added up to $28K. That took a week. And then it only added up to $25K, and some of the items on there were clearly not IF related (my annual mammogram? my annual physical? my dermatologist to check on a mole?).

The front line rep (Sandy, the very same one who sent me the incorrect memo 12 months ago) basically said that there was nothing that she could do, but that the system couldn't be wrong because, well, it was "the System" and the codes that it pulled were only IF. When I explained to her that there were clearly some issues with what she sent me, she blamed the physicians for coding it incorrectly.

So then I started talking to her boss, Brenda. And Brenda has been awesome, and basically agrees with me that unless they can itemize the charge, it should not count against my maximum, and she has been unbelievably helpful in pulling off charges that are clearly not IF related, and has allowed me to get new bills for things that appear to have been given the wrong diagnosis code.

But there are some charges, such as all of the blood tests I just took on clotting and the full karyotype that is still at the lab, that I was told by both my RE's office and a cigna rep -- I read the rep every single code -- would not count against the max. These tests actually are IF-related, but I might not have done all of them if I knew they would burn through my increasingly scarce resources. So I'm going to the mat with Brenda on these charges, which are about $1K total. And right now, it looks like I am winning.

It's a fuckload of hassle for only a few thousand dollars, but there is principle involved (I can't imagine how many other women have gotten screwed out of some of their benefit) and it is actually enough to cover this FET and perhaps some monitoring next time, so I guess it's worth it.

But I hate having to lay all of these charge out there and talk about it with Brenda. Because even though she is really nice, and very helpful to my cause of getting the numbers right, she is probably thinking "this woman is a crazy person. she's 40 and trying to get pregnant and yet is arguing with me over pennies -- how pathetic." And so that bugs me. I don't want to be judged, or pitied, or to even have my situation known, and yet I need to go through every line item of this pathetic story with her to get to a point where I think it is fair. Yet none of this is fair. I shouldn't have to do this, or know Brenda, or have my medical history laid out for all to see. It's profoundly unfair, and I am getting to the point where I really resent everyone who isn't or hasn't gone through this. I even resent the women who got pregnant on their first IVF, and then seem to have forgotten all about the infertility that led up to it. I'm just bitter and resentful and angry. But I'm not giving up on my search for justice with Brenda. Because someone, somewhere owes me something and there's only so much getting screwed over that I am willing to take.

A whole lot of nothing

Not a whole hell of a lot to report from these parts, except that (gasp) I am still not pregnant. Period came and went, and so now I am prepping for our last shot with our frozen embryo.

The Boy and I have spent a lot of time talking about what's next and making plans, since we never thought we would get to this place and still find ourselves somewhat surprised to be on the statistical short end of the stick.

What have we recently learned?
- After putting back in 4 embryos (2 5day and 2 3day), I am still not pregnant, although I did manage to have a very low-beta chemical pregnancy.
- My hormone levels are all still good (my FSH is under 7, for chrissakes)
- My thyroid appears to be working too hard, as my TSH was 4, but all other thyroid and antibody levels normal. With daily synthroid, I'm at 2.1.
- I am heterozygous for the MTHFR mutation (no, I don't know which one), so am now also taking folgard and baby aspirin in addition to my prenatal.
- Despite everything, I continue to have clockwork cycles and ovulate regularly.
- We have blown through our insurance coverage, and will soon be paying out of pocket for everything.

So what are we going to do?
- We are going to switch doctors from the "very convenient, like our RE, like the nurses, takes our insurance, really don't like the clinic overall" to the "across town, very smart very nice RE, great lab, nicer space, more individualized attention, noticed some things in my chart that he would do differently" but can't start right away because their lab closes for a while this month.
- In the interim, we are going to do a non-medicated FET and use our last frozen 5-day blast this month. In fact, it's CD8 and I am all estrogened out (2x daily) and then will go in Friday for a lining check. Transfer date scheduled for June 15. Really looking forward to the 3x daily progesterone suppositories. I should buy stock in whomever makes pantyliners, since I'm keeping them in business. (I hate that word -- panty. It's ridiculous. Makes the whole situation seem like something out of a 1960's era sitcom.) Incidentally, I think it's pretty entertaining that they consider 2x daily estrogen, 3mg cetr.otide, and 3x daily progesterone to be unmedicated. I guess it's the lack of lu.pron that earns it that label?

How do I feel about all of this?
The FET is a throwaway -- I have no hope that it will actually result in a pregnancy or child, but I figure I might as well use the embryo since I already have it. I was kind of hoping to have 2 shots on goal, and be able to try naturally and transfer the embryo back in, but apparently they frown upon that at my current clinic, so this weekend I will be shooting up with cetrotide to prevent ovulation. I think it sort of stinks, but I'll live.

I'm anxious about switching clinics, not because I don't think they will do a good job, but because I know that I will expect it to work the first time there. And that's a lot of pressure on me and on everyone else involved in this process. And, although this is probably weird, I feel bad about leaving my RE, as she has been really quite nice and pretty responsive most of the time. I wanted our relationship to end with me heading off to the OB with a healthy pregnancy, and somehow I feel disloyal for even meeting with other REs. That said, I can't keep doing the same thing over and over, and so need to go with something different. But I feel bad, all the same.

Am I excited about any of this? Hard to say. I'm starting to believe that this never is going to work.