Archive for November 20th, 2008

No Zen This Week

This week I went alone to our parenting class because our babysitter couldn't make it and I wasn't able to find a back up in time.  So I was driving along to the class and I was nearing my exit on the highway when the exit signs started to get blurry.  Then the license plates on the cars in front of me got blurry.  I could still see well enough to distinguish cars and lanes and such, but things weren't clear enough to read.  I got off the highway and my vision cleared up.  I called Seth and he suggested that it was probably a migraine aura, indicating I was about to get a migraine.  He was right, of course, but this was a very unusual aura for me.  I was only a few blocks from the class, so I got to the building and parked, got out of the car, and everything went completely blurry again.  If things had been this blurry while I'd been driving, I absolutely would not have been able to continue driving.  I got into the lobby of the building and the doctor teaching the class was standing there and he asked how I was and I said, "You know?  Not so great; I've got this funny vision thing going on and I really can't see anything."  I explained that I was fairly certain it was a migraine coming on and I needed to take medicine and see if that stopped the migraine from coming on, but that there wasn't much else to be done.

We got up to the board room, and I dug through my purse for pain medication.  I handed the bottle to Dr. S. and asked him what it said (I really couldn't read it) and he confirmed it was what I was looking for, so I took two, and sat down and class started.  I must say, I have absolutely no idea what was said in that class.  I know some questions were asked.  I know I answered some of them.  I was sitting right next to Dr. S.  I interacted.  I listened.  I didn't read my handout, because it hurt my eyes to try.  And I retained absolutely nothing from the entire class. 

Halfway through the class, I called Seth and told him that although my vision was clearing up, I was in excrutiating pain and wasn't sure whether I'd be able to drive by the time class was over.  I was afraid if I waited until the end to decide, I would find myself stranded there.  Fortunately, his mother had just come back with J, so she was able to stay at the house with all the kidderoonies, while he came to pick me up.  I sat through most of the rest of class trying to absorb some of the details of the class, but not really able to focus through the pain.

Finally, just as Dr. S was finishing up his portion and right before we broke into the parent discussion session (the last half hour is just parent discussion facilitated by a social worker, without Dr. S.), Seth arrived.  Seth handed me two tylenol with codeine, and then we went outside to assess whether I could drive home with him following me.  Dr. S. came out and suggested that this would be a very bad idea.  I didn't want to leave my car out there because it would make things very difficult for me the next day, but I also knew that driving probably wasn't really wise in case my vision went all wonky again.  Fortunately, Dr. S. doesn't have an advanced degree for nothing, and he was smart enough to suggest that another couple in the class might live near us and probably drove together. 

Indeed, they did drive together, and they were kind enough to drive my van home after class had finished, so Seth and I went home in his car. 

Later I read the handouts from class and realized that the topic of discussion was "Motivation through Positive Attention" – giving lots of positive attention and praise to your child for positive behaviours.  Fortunately, this happens to be one of my strong suits as a parent already, so I think I'm good.  Plus, I'm seeing Dr. S. tomorrow, so I can always ask him any questions I need to. 

In other annoying medical news, today I had to get a steroid shot in my hand because it has really hurt to bend my pinky for about 2 months.  Now it really, REALLY hurts to bend my pinky.  Thanks a lot, Doc.  (I'm hoping that the LONG term effect is an overall positive effect and that the pain from the shot is temporary)

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dye with HSG

Hey this may seem really stupid, but does anyone know what kind of dye is used with an HSG? And do you know whether there’s any problem breastfeeding after an HSG? My guess is there’s no problem since it’s injected into the uterus, not into the bloodstream, but, of course, it goes out through the fallopian tubes (assuming no blockages) and absorbs into the body, so who knows.

Clearly I can ask my doctor this, and obviously the two best doctors to ask this are the radiologist who does the HSG and my pediatrician… but I’d rather ask before the day of which means the radiologist isn’t the best candidate and I can’t really ask my pediatrician without knowing what kind of dye they use. I guess I’ll go acquaint myself with Dr. Google…

Clearly if I manage to wean before then, this will not be an issue.

Edit: As Chris noted, it’s an iodine dye used, either water based, or oil based. I can’t find any article suggesting that there’s any issue with breastfeeding, but I’m sure my husband will be able to answer that for me in about two seconds once he gets home. I can’t, for the life of me, think of ANY reason why iodine would be incompatible with breastfeeding, though occasionally (rarely, even) women have allergic reactions to the dye, so I guess your babies could too, if there was any way it could be excreted in the breastmilk, but my guess is that even if it could be excreted in the breastmilk it would be in such a small concentration it would be nearly irrelevant.

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I talked to the financial coordinator at The Hatchery on Tuesday. She went over my benefits for fertility coverage. We’re covered so long as my husband and I have been married for at least a year (check) and he’s been employed by the hospital for at least two years (check). I have to fax a copy of our marriage license to her to prove we’ve been married at least a year (are you KIDDING me?).

  • We are covered for 4 IUIs, with no dollar limit on those. No thank you. Not walking down that road again.
  • We are covered for IVF up to $30,000: approximately 2 IVF cycles.
  • We are covered for $10,500 for medications.
  • We are NOT covered for embryo freezing and storage ($1100 for freezing and $540/year for storage).
  • We have a $1000 copay per IVF procedure.

This is very good coverage, but far less than I had under my previous coverage. Since we’re hoping to do single embryo transfers, being limited to two covered IVF’s is a bit daunting, but it’s definitely better than nothing. I am somewhat concerned about it, but I’m trying not to let the financial consideration get in the way of the medical data that I know supports my stance on this matter.

I had my CD3 and Infectious Disease Labwork drawn yesterday. I don’t think they’re planning to call me with the results of all of that, since I’m not actively cycling. I did schedule my HSG for next Tuesday, so maybe while I’m there, I’ll ask how it all turned out. I like to know these things. It was a two hour ordeal to get it drawn, between the 50 minute drive up there, the 45 minute wait, the 15 minutes sitting in the chair, getting it drawn, and getting out of the lab, stopping over at my husband’s office a block away to get a bottle of water and some moral support, and the 50 minute drive back. Yippee.

I spoke with the Infertility Nurse Coordinator yesterday morning before I went out there for my bloodwork and scheduled the HSG, as I noted already. She said I could just do a sonohystogram (sp?) if I’d prefer, because the only reason to know whether my tubes are unblocked would be if we convert my IVF cycle to an IUI (over my dead body) and since I’ve had an HSG before, they could assume my tubes are unblocked unless something’s happened since then. But I’d just as soon know what we’re working with. The HSG didn’t bother me so much the first time around, and frankly, even if it had, uncomfortable tests don’t bother me. It’s not about my comfort, it’s about the end result. I want the baby in the end. The singleton, preferably.

After I get my next period in December (assuming that happens), I’ll start birth control pills, and sometime in January, I’ll start my IVF protocol. Holy cow. This is a huge deal.

One more point before moving forward. I’ve decided that in light of Dr. McBrusque’s preference to do a two-embryo transfer and in light of the fact that I have a limited number of IVF attempts in front of me, which might, unfortunately, affect the game day decision for how many to transfer… I’ve decided that I definitely need to have a pre-pregnancy consult with my perinatologist. I had been planning on doing this regardless, but I felt fairly stupid doing so with the prospects of most likely having a singleton, but if we’re facing much higher odds of twins, I am a little more worried. I had such a horrendous pregnancy (not that I didn’t love it, mind you!), and I don’t know how much of it was attributable to the high order multiple factors, how much of it was attributable to just being a multiple pregnancy in general, and how much of it was attributable to my body just not doing pregnancy well in the first place. There was some thought throughout my pregnancy that I probably would have had serious contraction activity, even with a singleton, but I imagine there’s no way to predict whether those contractions would have affected my cervical length so drastically in a singleton pregnancy. I also don’t know if I’m at a more significant risk of developing preeclampsia in a subsequent pregnancy now that I’ve had it before, and if so, whether that risk increases if it is a multiple pregnancy (I’m sure the risk increases if it is a multiple pregnancy). I do think these are questions that at least need to be asked before I go putting myself at a very real risk of ending up with a twin pregnancy. If my perinatologist says “Twins would be a very high risk for you,” then that ends the debate; there will be no game day decision to make, and we’ll only consider SET’s (Single Embryo Transfers) .

The important thing to note is that the more removed I get from Monday’s appointment, the more I realize that it wasn’t an all together negative appointment. I had a two-hour post-mortem lunch with LJ and it really helped me put a lot of it into perspective and focus on the positive. I know that a lot of what is colouring my opinion of the whole thing is the 40mile commute, and I definitely didn’t love his bedside manner. But he is otherwise an excellent doctor with a lot of experience and I do trust his medicine, even though he doesn’t always do things in the way that I’m used to having things done. Change, after all, is not always a bad thing. It’s just that I don’t always deal very well with change, so it’s taking me some time to adjust.

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