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Archive for December, 2006

CD Whatever

So, here’s the thing. Wednesday could easily have been described as “full flow” making it CD 1. And then most of yesteday? Almost nothing. Today? Full flow is definitely a good description.

So is this CD1 or 3 or whatever?

Well, whatever it is, I went in for CD3 monitoring this morning. They managed to draw my blood in just one try today, which is nothing short of miraculous since Dracula had the day off. And I got to see my beloved Margaret, the super sonographer. My one bright spot in this whole ridiculous ordeal of having to do this all over again is that I get to see Margaret again. M is responsible for my blog name, you know. She always refers to my ovaries as “perky” because they’re always full of antral follicles, which, yes, I get is a good thing, but it was, for a time, disconcerting to hear my ovaries referred to as perky. They felt slightly mocked at first, you see, which is (I’m certain) why the first IUI didn’t work (though it doesn’t explain why the 2nd and 3rd didn’t work… surely by then they were used to the good-natured ribbing?).

MY POINT… if I ever had one in the first place, is that I adore Margaret. So while I wasn’t entirely PLANNING to see her again until April or so of 2008, I’m happy to see her now, even if it’s because my body sucks.

Anyway, today was no terrible shock. My ovaries, true to form, are definitely perky. I couldn’t count the number of antral follicles even in one single view, let alone by seeing it all the way through. So I think it’s safe to say that I’ve got good ovarian reserve. Shocker. Also that if I were to do IVF I’d be a super responder. Another shocker. But it does rather accentuate why it is that IUI is such a dragged on process for me. With that many eager follicles, they’ve got to be careful to bring just one or two to the front and ditch the rest. So teeney, teeeney, teeeeney doses of follistim for me. (More than last time, though, 66IUs) Assuming, of course, that my E2, P4, and Beta all come out indicating that it’s appropriate to start stims. And they had BETTER come out saying so, because I just spent scads of money on Follistim. Which brings me to the one surprise of the morning:

I stopped at the pharmacy on my way out to pick up my Follistim. I’m fairly certain that I have a vial at home, but I’d hate to get home and find out it was no good or had been misplaced, or had expired, or whatever after I got home. Shabbos comes in at 4:30 today, so there wouldn’t have been time to find a more local pharmacy to take care of it. So I stopped to pick up a vial just in case. Anyway, my insurance had rejected the Follistim because it didn’t “match the existing authorization.” My insurance has paid for probably 30 vials of Follistim in the last year, but I think the problem is that there was an intervening order for Gonal-F back in November, which I decided against using, because it’s such a pain in the neck for non-standard dosing.

I’m certain the insurance will pay for it once it’s resubmitted, but in the meantime I had to pay out of pocket for it. Not the end of the world, fortunately, but not inexpensive. Since I’m taking such a tiny dose, one vial should get me through about 5 days, possibly 6. And that one vial cost me $300. I know people who take 5 vials PER DAY for IVF cycles (I’d never be allowed to take that much for fear of OHSS). That’s $1500 PER DAY. If they take stims for the standard 12 days, that $18,000 in drug costs alone for an IVF cycle. Actually, that’s $18K for JUST ONE of the many necessary medications. Holy Schmoly! Suffice it to say, I’m thrilled that I have generally good health insurance and that it covers the medications as well, despite this temporary hiccup.

(I do know that the pharmacy I use heavily discounts their Follistim for out-of-pocket IVF patients. They didn’t discount it for me, because they know that the insurance WILL cover it in the long run and because it was “only” one $300 vial. So at least I know they give a lot of folks a bit of a break, but even so, I can’t imagine how devastating the costs must be for someone with no insurance coverage in need of that high a dose of stims! Ugh!)

So, um, let the fun begin!

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CD Whatever

So, here's the thing. Wednesday could easily have been described as "full flow" making it CD 1. And then most of yesteday? Almost nothing. Today? Full flow is definitely a good description.

So is this CD1 or 3 or whatever?

Well, whatever it is, I went in for CD3 monitoring this morning. They managed to draw my blood in just one try today, which is nothing short of miraculous since Dracula had the day off. And I got to see my beloved Margaret, the super sonographer. My one bright spot in this whole ridiculous ordeal of having to do this all over again is that I get to see Margaret again. M is responsible for my blog name, you know. She always refers to my ovaries as "perky" because they're always full of antral follicles, which, yes, I get is a good thing, but it was, for a time, disconcerting to hear my ovaries referred to as perky. They felt slightly mocked at first, you see, which is (I'm certain) why the first IUI didn't work (though it doesn't explain why the 2nd and 3rd didn't work… surely by then they were used to the good-natured ribbing?).

MY POINT… if I ever had one in the first place, is that I adore Margaret. So while I wasn't entirely PLANNING to see her again until April or so of 2008, I'm happy to see her now, even if it's because my body sucks.

Anyway, today was no terrible shock. My ovaries, true to form, are definitely perky. I couldn't count the number of antral follicles even in one single view, let alone by seeing it all the way through. So I think it's safe to say that I've got good ovarian reserve. Shocker. Also that if I were to do IVF I'd be a super responder. Another shocker. But it does rather accentuate why it is that IUI is such a dragged on process for me. With that many eager follicles, they've got to be careful to bring just one or two to the front and ditch the rest. So teeney, teeeney, teeeeney doses of follistim for me. (More than last time, though, 66IUs) Assuming, of course, that my E2, P4, and Beta all come out indicating that it's appropriate to start stims. And they had BETTER come out saying so, because I just spent scads of money on Follistim. Which brings me to the one surprise of the morning:

I stopped at the pharmacy on my way out to pick up my Follistim. I'm fairly certain that I have a vial at home, but I'd hate to get home and find out it was no good or had been misplaced, or had expired, or whatever after I got home. Shabbos comes in at 4:30 today, so there wouldn't have been time to find a more local pharmacy to take care of it. So I stopped to pick up a vial just in case. Anyway, my insurance had rejected the Follistim because it didn't "match the existing authorization." My insurance has paid for probably 30 vials of Follistim in the last year, but I think the problem is that there was an intervening order for Gonal-F back in November, which I decided against using, because it's such a pain in the neck for non-standard dosing.

I'm certain the insurance will pay for it once it's resubmitted, but in the meantime I had to pay out of pocket for it. Not the end of the world, fortunately, but not inexpensive. Since I'm taking such a tiny dose, one vial should get me through about 5 days, possibly 6. And that one vial cost me $300. I know people who take 5 vials PER DAY for IVF cycles (I'd never be allowed to take that much for fear of OHSS). That's $1500 PER DAY. If they take stims for the standard 12 days, that $18,000 in drug costs alone for an IVF cycle. Actually, that's $18K for JUST ONE of the many necessary medications. Holy Schmoly! Suffice it to say, I'm thrilled that I have generally good health insurance and that it covers the medications as well, despite this temporary hiccup.

(I do know that the pharmacy I use heavily discounts their Follistim for out-of-pocket IVF patients. They didn't discount it for me, because they know that the insurance WILL cover it in the long run and because it was "only" one $300 vial. So at least I know they give a lot of folks a bit of a break, but even so, I can't imagine how devastating the costs must be for someone with no insurance coverage in need of that high a dose of stims! Ugh!)

So, um, let the fun begin!

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First: I decided to go ahead and keep my appointment tomorrow and continue under the delusion that yesterday was Day 1. I did eventually have enough, ahem, well, you know, going on that I think I can make a reasonable claim that yesterday had full flow, even though today it’s all gone again. Whatever. Anyway, I think the point is for some reason I feel like I need to be at CD1. It’s important to me to feel like I’ve moved on. For whatever reason, getting my period December 1 didn’t make me feel like I’d moved on from the miscarriage… it felt like one step backward, because it was too soon to deal with a new IUI cycle (my hCG had only just bottomed out and I hadn’t finished getting my infectious disease testing and all that re-done). Something just isn’t sitting right with me.

Second: I’m not quite sure what my deal is or why I can’t just get over myself like I should, but I’m really having bad days lately. And nothing is going on to make them especially bad. I just feel like I’m having a rotten day. It’s obvious I’m a bit blue… but what to do about it? I don’t feel depressed, per se, and I don’t think this is anything but a transient feeling, so I don’t see the need to go on antidepressants, but gawd I really need to get over myself.

Third: I still can’t get out of my head thoughts that we’ll just never achieve baby-status. Then I can’t stop thinking about our foster son… we’ve had him for two years and it looks like we’ll likely have him for the rest of his childhood and adolescence. He’s three now. But… his birth monster could theoretically come back at any time and petition to have him returned to her. And I know that’s her theoretical plan (though it’s been her theoretical plan for a LONG time and she’s never done anything about it). She hasn’t seen him in over 8 months, nor has she called, written, sent a card, acknowledged his birthday, worried about him when he’s sick (she wouldn’t know he’s sick if she doesn’t call, right?), emailed, asked for a picture, or sent smoke signals in all that time. And I keep thinking about her taking him back and whenever I go down that road, I burst into tears, because MY GOD how could a woman NOT want to know everything about this sweet, precious, beautiful boy? How could a woman NOT want to know how tall he is, what his favorite food is, what his favorite color is, whether he likes dogs, if he’s sick, what size he’s wearing, how much his personal lexicon has expanded (exponentially, that’s for sure)? How could she not spend every waking moment wondering about him? I used to feel sorry for her. I used to imagine how hard it must be to be in her position. Now I think she’s selfish and cruel. She says she loves him. She says she wants him back. But she doesn’t even know that he needs lactaid milk or soy milk instead of regular milk. And she doesn’t know that if you don’t read his stories in the right order at bedtime he won’t go to bed. And she just… doesn’t even appear to care.

Fourth: Tomorrow, being my Day 3 baseline ultrasound and bloodwork, also known as the day I get to resume sticking myself with a needle every night ought to feel like a step toward progress. But it doesn’t feel that way. I feel like I’m now just going through the motions because I don’t know what else to do with myself. Yeah, that’s pretty much it.

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First: I decided to go ahead and keep my appointment tomorrow and continue under the delusion that yesterday was Day 1. I did eventually have enough, ahem, well, you know, going on that I think I can make a reasonable claim that yesterday had full flow, even though today it's all gone again. Whatever. Anyway, I think the point is for some reason I feel like I need to be at CD1. It's important to me to feel like I've moved on. For whatever reason, getting my period December 1 didn't make me feel like I'd moved on from the miscarriage… it felt like one step backward, because it was too soon to deal with a new IUI cycle (my hCG had only just bottomed out and I hadn't finished getting my infectious disease testing and all that re-done). Something just isn't sitting right with me.

Second: I'm not quite sure what my deal is or why I can't just get over myself like I should, but I'm really having bad days lately. And nothing is going on to make them especially bad. I just feel like I'm having a rotten day. It's obvious I'm a bit blue… but what to do about it? I don't feel depressed, per se, and I don't think this is anything but a transient feeling, so I don't see the need to go on antidepressants, but gawd I really need to get over myself.

Third: I still can't get out of my head thoughts that we'll just never achieve baby-status. Then I can't stop thinking about our foster son… we've had him for two years and it looks like we'll likely have him for the rest of his childhood and adolescence. He's three now. But… his birth monster could theoretically come back at any time and petition to have him returned to her. And I know that's her theoretical plan (though it's been her theoretical plan for a LONG time and she's never done anything about it). She hasn't seen him in over 8 months, nor has she called, written, sent a card, acknowledged his birthday, worried about him when he's sick (she wouldn't know he's sick if she doesn't call, right?), emailed, asked for a picture, or sent smoke signals in all that time. And I keep thinking about her taking him back and whenever I go down that road, I burst into tears, because MY GOD how could a woman NOT want to know everything about this sweet, precious, beautiful boy? How could a woman NOT want to know how tall he is, what his favorite food is, what his favorite color is, whether he likes dogs, if he's sick, what size he's wearing, how much his personal lexicon has expanded (exponentially, that's for sure)? How could she not spend every waking moment wondering about him? I used to feel sorry for her. I used to imagine how hard it must be to be in her position. Now I think she's selfish and cruel. She says she loves him. She says she wants him back. But she doesn't even know that he needs lactaid milk or soy milk instead of regular milk. And she doesn't know that if you don't read his stories in the right order at bedtime he won't go to bed. And she just… doesn't even appear to care.

Fourth: Tomorrow, being my Day 3 baseline ultrasound and bloodwork, also known as the day I get to resume sticking myself with a needle every night ought to feel like a step toward progress. But it doesn't feel that way. I feel like I'm now just going through the motions because I don't know what else to do with myself. Yeah, that's pretty much it.

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CD1? Who the heck knows.

I don’t know if I ever blogged about it or not, but I had a period on December 1st. That was followed by an appointment with Dr. Amazing (I know I blogged about that part), who agreed that my timeline really can’t sit around waiting, so he recommended five days of provera starting December 18th in hopes of bringing on CD1 around Christmastime and getting started with a new cycle sooner than later. No problem.

On December 14th (aka CD14), I had a vague notion that maybe (for the first time in years) I was ovulating (without medical assistance). Now, clearly this was some ridiculous fantasy, because, well, this is ME we’re talking about. Nevertheless, I held out a teeney bit of romantic hope that it was true. On the 18th, I had my progesterone levels tested to see if I could start Provera. My P4 levels came back giving me the go-ahead to start Provera, meaning that no, I had not ovulated on my own. (Well, duh!) And so, I commenced taking Provera. Which is evil, as we all know.

Friday (12/22) was my last dose. Friday morning I began spotting. Spotting was still present on Saturday. This is an unusually quick turnaround for provera, as it usually takes 3-7 days to bring on a period after stopping it. By Sunday, there was nothing. Nada. No spotting. Yesterday it was back. Last night, it was constant enough and continued into this morning, so I decided to randomly call today CD1. Accordingly, I scheduled my Day 3 ultrasound/bloodwork for Friday at 7am. And now I’m back to nothing. Nada. Zilch. No spotting, no bleeding. And not certain what to do. I don’t typically have spotting before my period (not that I have that many, so what do I know?)… it just tends to start up all of a sudden. In fact, the only other time I’ve had spotting was when I found out I was pregnant. I had what I thought was a really odd period, and I went in for what I thought was Day 3 US/BW, and found out I was pregnant, whereupon the spotting turned into actual bleeding and continued that way for the next three months until I had a miscarriage.

So I’m really not certain what to think. Should I cancel my Day 3 appointment? Or should I just call it close enough and go anyway and let them figure out if I screwed up? BTW, I have no illusions that I’m pregnant. I’m certain that I am not, and besides that, I have peed on a bunch of sticks just in case, so no need to waste keystrokes suggesting I might be preggers, because I’m not.

What to do, what to do…?

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CD1? Who the heck knows.

I don't know if I ever blogged about it or not, but I had a period on December 1st. That was followed by an appointment with Dr. Amazing (I know I blogged about that part), who agreed that my timeline really can't sit around waiting, so he recommended five days of provera starting December 18th in hopes of bringing on CD1 around Christmastime and getting started with a new cycle sooner than later. No problem.

On December 14th (aka CD14), I had a vague notion that maybe (for the first time in years) I was ovulating (without medical assistance). Now, clearly this was some ridiculous fantasy, because, well, this is ME we're talking about. Nevertheless, I held out a teeney bit of romantic hope that it was true. On the 18th, I had my progesterone levels tested to see if I could start Provera. My P4 levels came back giving me the go-ahead to start Provera, meaning that no, I had not ovulated on my own. (Well, duh!) And so, I commenced taking Provera. Which is evil, as we all know.

Friday (12/22) was my last dose. Friday morning I began spotting. Spotting was still present on Saturday. This is an unusually quick turnaround for provera, as it usually takes 3-7 days to bring on a period after stopping it. By Sunday, there was nothing. Nada. No spotting. Yesterday it was back. Last night, it was constant enough and continued into this morning, so I decided to randomly call today CD1. Accordingly, I scheduled my Day 3 ultrasound/bloodwork for Friday at 7am. And now I'm back to nothing. Nada. Zilch. No spotting, no bleeding. And not certain what to do. I don't typically have spotting before my period (not that I have that many, so what do I know?)… it just tends to start up all of a sudden. In fact, the only other time I've had spotting was when I found out I was pregnant. I had what I thought was a really odd period, and I went in for what I thought was Day 3 US/BW, and found out I was pregnant, whereupon the spotting turned into actual bleeding and continued that way for the next three months until I had a miscarriage.

So I'm really not certain what to think. Should I cancel my Day 3 appointment? Or should I just call it close enough and go anyway and let them figure out if I screwed up? BTW, I have no illusions that I'm pregnant. I'm certain that I am not, and besides that, I have peed on a bunch of sticks just in case, so no need to waste keystrokes suggesting I might be preggers, because I'm not.

What to do, what to do…?

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So you girls all know what Provera is, right? It’s Progesterone.
And you all know that one of the things that causes “morning” sickness during pregnancy is Progesterone, right?

Yeah, so here’s the thing: I freaking HATE Provera. I don’t care if they’re only making me take it for five days this time around, it is evil and I feel gross and I don’t like it. I don’t even think it affects my mood all that much (I’m crabby regardless, so I can hardly blame it on the medication), but feeling this icky DOES make me even crabbier than usual.

Bleh. On the bright side, maybe I’ll lose a pound or two. On the less bright side, I’d need to lose a whole lot more than that to be at my so-called “ideal” weight.

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