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Archive for March, 2009

So I found out today that in IVF#1, Ye Olde Fertility Clinic did Assisted Hatching on George. Who knew?

Well, my financial services coordinator knew. My nurse didn’t know, though.

I had called to find out the status of my account, make sure I didn’t owe any more money (because based on the EOB’s I’ve gotten from my insurance company, it looks to me like I should owe another couple hundred dollars in addition to the deposit I gave them last month), and to find out what my deposit for IVF#2 should be. The financial services coordinator said that they’re just waiting for the insurance company to pay for the transfer and the assisted hatching.

I’m sorry, the… the what?

The assisted hatching.

Um. What assisted hatching? Yeah. So apparently George had a little extra assistance. Which is fine and all. I’m just sayin’. A girl should have been told. And maybe I would have been told if I hadn’t had my huge FREAK OUT over SuperDoc’s little joke about transferring eight embryos they might have told me. But probably it got lost in the shuffle of my panic attack. So I’m not assigning blame here. But seriously. Assisted Hatching? Why?

A girl needs to know! So you can be darned skippy sure I’ll be asking that question next week!

And, I mean, no big deal, right? Except, um, there’s the small little detail of assisted hatching increases the risk of monozygotic twinning. And I get that it’s still a minute little tiny itty bitty risk. But any little itty bitty increase in that risk, I want to know about! Just sayin’!

(All this being said, one of the things I agreed to in my consent forms ahead of time was that if the doctor and embryologist believed it was necessary, they could go forth with assisted hatching without seeking additional consent from me, based on their medical opinion, knowing that there may be additional expense to me. So no one did anything wrong here.)

Meanwhile, I may still owe a little extra money for IVF#1, but the total amount is unknown as they’re still waiting for the insurance company to pay up, but I did pay my deposit for IVF#2 today. Gah. Like I needed to spend more money today.

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The Georgia Senate actually passed that damn bill.
http://www.legis.state.ga.us/legis/2009_10/sum/sb169.htm

Resolve has posted that they will review the revised version of the bill and post a full analysis as soon as they know more.

Okay, found the revised version of the bill:

Here’s the bill as passed:

http://www.legis.state.ga.us/legis/2009_10/fulltext/sb169.htm

It essentially took out all the provisions relating to numbers of embryos created, numbers of embryos transferred and ownership of embryos.

It leaves in all the language that would ban use or donation of embryos for stem cell research.

Still completely offends me, but at least it doesn’t essentially ban IVF all together, which the original bill practically did.

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The Georgia Senate actually passed that damn bill. http://www.legis.state.ga.us/legis/2009_10/sum/sb169.htm

Resolve has posted that they will review the revised version of the bill and post a full analysis as soon as they know more.

Okay, found the revised version of the bill:

Here's the bill as passed:
 
http://www.legis.state.ga.us/legis/2009_10/fulltext/sb169.htm

It essentially took out all the provisions relating to numbers of embryos created, numbers of embryos transferred and ownership of embryos.

It leaves in all the language that would ban use or donation of embryos for stem cell research.

Still completely offends me, but at least it doesn't essentially ban IVF all together, which the original bill practically did.

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What's the Plan?

Anonymous asked, “So, what is the intended schedule for the next few weeks?”

Since I assume “get a lot of blinding headaches, have a retrieval and a transfer in there somewhere, and get devastatingly bad news at some point” isn’t quite the answer you were looking for, I’ll run down the projected protocol my nurse confirmed with me.

3/11 – Lupron starts. Got it.
3/13 – Last BCP. Thank heaven.
3/16 – Expect menses. (I hate that word. I don’t know why.)
3/17 – Lupron Eval. (BW/US). Start Stims (Follistim 166 Units, Luveris 50units). Drop Lupron dose to 10 units (confirmed today)
3/26 – Trigger Injection (projected)
3/28 – Retrieval (projected)
3/31-4/2 – Transfer (projected)

Note the cosmic joke, here… another Saturday retrieval projected. Last time I had a projected Saturday retrieval, I thought, “Yeah, but what are the odds of that actually going as planned?” And I even got my period a day earlier than projected and I thought, “Ha! See? No Saturday retrieval for ME!” And then? I still had the Saturday Retrieval. As planned.

Now seriously. If something simply must go as planned, can’t it be the “getting pregnant” part?*

————–
*I actually have to give credit to Decemberbaby for that line.

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So the good news is that I confirmed with my doctor that I am doing a 20-10 decrease on the Lupron once I start the stim protocol. My poor nurse. I made her check with him about 6 times. “But you’re sure he knows that last time I did 20-20, right?” “No, I mean, really sure because I think he thinks I did 20-5.” “Okay, but you’re absolutely certain that my record reflects 20-20, right?” “I mean, definitely he knows I did 20-20, and even though he said increase on the phone, he actually meant decrease, right? He *does* know what he’s doing, right? RIGHT?”

Um.

Not like I didn’t think SuperDoc knew what he was doing or anything.

I, um. I mean. Of course SuperDoc knows what he’s doing!

Um.

Ohmygod whatthehelliswrongwithme? When did I turn into *that* patient? I must be stopped. Hopefully they just think it’s the Lupron talking? Maybe they just think I’m a little knackered? A lot? Surely they *must* know these drugs make their patients crazy, we don’t all start out this way. Right?

The bad news is my head hurts. Shocker. Maybe when I decrease to 10units, life will be dandy again. I can dream, right?

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Like a sword

The pain ripping through my head is like a sword stuck into my head. Through my eyeball, perhaps. The pain is palpable.

I forgot this was what it would be like. My head hurt so much and I couldn’t figure out why. Not my normal migraine. And then, then I remembered what I did this morning.


The news I’ve been trying not to say out loud, in case SuperDoc rips it away from me next week, is that it appears I’ll have a reprieve this cycle. Last cycle I took 20 units prior to stims and stayed on 20 units after starting stims. But despite his original statement to me that this cycle we’d increase or stay the same on Lupron… it appears that this cycle I’m decreasing the Lupron dose to 10 units once I start stims.

That…. that would be lovely. If it happens. I hope it happens. I’m afraid it won’t.

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L – 1

Lupron starts tomorrow.

You have been warned.

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You know, I think I can just give up on March right now.  Let's review:

March 1:  Ellie gets admitted to hospital.  Diagnosed with Reactive Airway disease.
March 2:  Ellie spends the entire day in the hospital and is eventually released (admittedly this is a bonus).  That night is not a great night.
March 3:  I get rear ended.  My husband's car breaks down in B'more.
March 4:  Abby gets really sick.  Like, I almost took HER to the emergency room kind of sick. 
March 5:  Abby still sick.  Ellie still getting nebulizer treatments.  But at least I'm back from work.
March 6: Hallelujah!  Ellie's back to normal.  Abby's on the mend.  I'm totally exhausted, but no one is in crisis.
March 7:  Lovely day, guests for lunch, fun walk with the triplets in the afternoon.  All good.
March 8:  All hell broke lose in the morning.  I did not handle it well.  The afternoon redeemed itself.

Which brings us to yesterday.

We knew we had a plumbing issue because the last quarter of 2008 our water bill was near $700 (our normal quarterly water bill is ~$130).   Our sump pump has been running regularly, which it has never done in the 4 1/2 years we have lived in our house.  Never.  Not once.  Not even in torrential downpour that has flooded all the other neighborhood basemements.    We had our handyman out to check to see if there was a problem inside the house.  Nope.  No problem.  He shut off all the water and noticed that he could still hear water coming in the pipe into the house.  He walked around the house and found that, in fact, there was a soggy ground all around the side of our house, despite there having been no rain or snow in the several weeks prior.  He postulated that the pipe between the water meter and the house was broken.  But he doesn't fix that kind of problem.  The last time he knew someone with that kind of problem it was 5 or 6 years ago and it cost about $3K to fix.  Crap.

We had our water company come back out to confirm that there really was a problem.  Yes, Houston, we had a problem.  We are using a thousand gallons of water a day.  Clearly, there's a major leak somewhere.  In older houses like ours, they didn't, for whatever reason, put the water  meter at the front of the house where the plumbing was going to run into the house.  Rather, they put the water meter at the back of the house and ran the pipe all the way to the front.  65 feet of pipe where that leak could have happened.  Now we needed to find a master plumber.  That's where yesterday comes in.

We had two plumbers come out yesterday.  The first quote came in at $6500.  It would involve digging a 65 foot trench, 43 inches deep, and replacing the pipe, having it inspected, all the permits, closing up the trench, etc.  *gasp*  He could start Monday.    The second quote came in at $5850.  They have a different way of doing things…  they'll go through the masonry inside the house, and dig underground with an air piston for 62 feet and only dig for the last 3 feet to the meter.  This involves less damage to my yard, which is good since we spent a considerable amount of money regrading the yard and redoing the landscaping last Spring.  And of course, none of these costs cover the cost of redoing any of our landscaping after they destroy it.    They could start the next day (today, Tuesday).    We signed the contract and hired them.  Six thousand dollars.

Oh.  My.  Gawd.

 
Um, but on the plus side, no children in the hospital this week.  Right?  RIGHT?

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We went to Playwise kids today to meet up with some friends, and got the first family photo that we've had in 4 months taken. It's always difficult squeezing all six of us into a photo, but this one wasn't too bad!

The kids had a great time, though the triplets were definitely tired, having skipped their morning nap, and since we were there during their normal afternoon nap time… but it was worth it, as usual. Some quick highlights:

Abby getting ready to go down a slide
J-man having fun with sand.

Sam was not nearly as enamored with sand as the J-man. Sam was PETRIFIED of the sand and quite mortified to find it sticking to his hand. He was quite offended by it and didn't like it one bit. I felt a tiny bit guilty taking this picture before comforting him, but it was worth the guilt.

Ellie was the only one who really loved the sand pit. Abby spent the entire time in Abba's lap, but Ellie dug in the sand, and had a grand old time.


And here's Abby – where she spent the entire duration of her stay in the sand pit – in Abba's lap. My little adventuress.
Sam-man showing off.

J-man built this awesome T-rex.

Brotherly Love. Sam had a great time sliding down with the J-man. The triplets fought over the opportunity to have a slide trip with big brother, and big brother couldn't get enough of the attention, either.

Ellie flying!

Abby posing.

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Once we reached the melt-down stage at Playwise Kids, we packed up the monsters and headed toward home. The triplets napped enough in the car that we were able to stop for dinner and when we got home, the babies went down for bed at their normal bed time, not even noticing that daylight savings time had snuck in so their normal 6:30 bedtime was really 5:30 on their natural biorhythm. They were tuckered, regardless!! Thank goodness!

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So last summer I went for my, uh, we’ll call it annual physical with my PCP. Yeah. Annual. That’s right. Something like that. And I was pronounced in good health, post delivery of HOMs. My weight was down significantly from my pre-pregnancy weight (though, of course, I could still stand to lose weight, my doctor was thrilled with the weight loss and never ever tells me I need to lose more – I love her), my cholesterol was down, my triglycerides were down, my blood pressure (as usual) was low, I’m not diabetic. The perfect picture of health.

So when she asked if I had any other questions, it would have been easy to just skip right on out of there and go on with my life… but something odd had been happening every month, like clockwork. Since delivering my babies, I’d been having a period every single month. As if that weren’t odd enough, for the 10-12 days before my period would arrive, I was … not myself. Raging lunatic would be a better way of putting it. Crying, depressed, incapable of coping with even the tiniest disruption in my expectations for the day. Screaming at my husband. Big, fat, rolling tears at every little thing. Sensitivity to every change in routine. This wasn’t a little PMS. This was PMS on crack.

Without even a little hesitation, my wonderful PCP diagnosed me with PMDD – premenstrual dysphoric disorder. Now, I’d never really noticed it before because except for the medication-induced periods, I’d had very few periods in my adult life. But you know? Come to think of it, before each treatment cycle began before I finally got pregnant? I did pretty much fall apart – screaming, fighting, rip-roaring angry for no good reason, crying at the drop of a hat, etc. All about 10-14 or so days before I’d go in for CD3 monitoring for each of my cycles. I always worried that my husband would say, “That’s IT, clearly this is all too much for you, we’re not doing any more of this crap, we’re DONE! because that would have just made everything that much worse!

Fortunately, I have the world’s most wonderful husband, who would never suggest such a thing and he just sits there and takes it. Mostly.

And here I am, a few days before I start Lupron. About a week before I’m going to get my period, and where am I? Crying. Screaming at him. Unable to cope, pretty much at all, with every little change in our projected schedule for today, and NOTHING worked out today the way I’d anticipated. Everyone melted down, including and especially me. Surprise! My old monster of a friend, PMDD. I’d forgotten about her. That dark monster who lives inside me. That black, gooey friend who seeps into every pore of my being and doesn’t let go until the last second.

I never did anything about it last summer because I was breastfeeding and usually you treat PMDD with SSRIs (e.g. Prozac) and Prozac and breastfeeding are… well, not necessarily incompatible, but not really great either. And then I stopped breastfeeding the same week I met with the Doc at the Hatchery, so it wasn’t really the best time to do anything about it then either. And then I started my IVF cycle, and that seemed like a really bad time to start it then, because what if I get pregnant? And really, if I get pregnant, problem solved anyway, because it’s really only those 10-12 days that I need anything regardless (many women with PMDD take SSRIs all the time because they can’t predict their cycles, but most take them only for the second half of their menstrual cycle). But then the cycle failed. But it’s on to the next one, right?

It’s a vicious cycle. How many cycles are going to fail before I do anything about this, do you think? I wonder what SuperDoc would say about me starting an SSRI. Will I have the cojones to ask him about it? Probably not.

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