ChezPerky

The Plan and the Insurance Sitch

November 25, 2008 by chezperky

First, see my previous post for the latest on my girly parts.

Second, here’s the latest on the insurance situation:

I am definitely switching to the insurance at Big Large Corporation (BLC). It is unquestionably better coverage. If I exhaust my coverage under BLC, I can go back to my husband’s insurance and then exhaust his coverage. Sneaky, eh?

Unfortunately, the insurance with BLC, which uses Well Known Insurance Company (WKIC), does not include Dr. McB as a preferred provider. In order to continue seeing him, I would have to see him as an out-of-network provider, which would completely defeat the purpose of having kick-ass benefits under BLC/WKIC. This is, of course, not an all together bad thing, what with the 30-40 mile drive (depending on whether you’re driving from my house or my office), but you know? I had really begun to like Dr. McB. And we had a plan. And a timeline. And we were moving forward. And it was all good. Except the geography. But everything else was pretty good. Okay, so his SART Stats weren’t great, but SART Stats, to be honest, aren’t everything. Even SART says flat out that the stats can be deceiving because some clinics have a habit of purposely weeding out patients that will pose a greater challenge, and some clinics specifically see those patients that are more of a challenge, so their stats may be lower. So you see? It’s all a little deceiving.

That being said, even the raw data for my old clinic is better – over 10% of their transfers are elective single embryo transfers, which is well above the national average of 3%, and well above the Hatchery’s 0%. And the number of cycles initiated is vastly bigger – nearly 1200 compared to 36 in my age group. Bigger isn’t necessarily better, but it does make their data easier to interpret since their sample size is bigger. There is defintely something to be said for the smaller clinic and the single doctor who isn’t going to forget me. But I never felt like my doctors didn’t know who I was at the big clinic, either. I never felt like a patient number at the old clinic (though I still know my patient number by heart).

Anyway, it’s the right decision to make – to go back to the old clinic. Geographically, financially, and probably in terms of success rates. But it sucks because I had a plan, and now the plan has changed and because I really did like Dr. McB as it turned out, and I think he would have done good things for us. I hate that money stands in the way of the things we want in life. Or in this case, money and geography.

So the plan:

1. Get HSG done – either clinic could use the same HSG results anyway – CHECK
2. Schedule a pre-pregnancy consult with perinatologist – CHECK (Dec. 15th)
3. Schedule consult with Dr. Amazing at old clinic – CHECK (Jan 5th)
4. Go on BCPs when next period starts – I’m still going to do this in anticipation that Dr. Amazing will be on board with my plan to go forward with IVF and that way I won’t be delayed in waiting to start a cycle – I’ll already be on BCPs. Sneaky, right?

And now we wait.

Posted in pre-cycling | 5 Comments »

The Plot Thickens

November 25, 2008 by chezperky

So I had my HSG today. Truthfully, an HSG wasn’t strictly necessary, since we knew we were going to do IVF no matter what the HSG indicated, so I could have just done a sonohystogram, since all Dr. McB really needed to see was the uterine cavity, but he left it up to me to decide what I wanted to do. Me being me, I’d prefer to know what the status of all the girly parts is whenever possible, even though my last HSG was totally clear back in 2005 and there’s no reason to think anything has changed. But really, my last HSG didn’t cause me any true discomfort, except when threading the catheter through my cervix and that was short lived, and I’m not really all that concerned about the invasiveness of the procedure. Truly, you don’t get much more invasive than a high-order-multiple pregnancy and subsequent c-section, to be honest. Frankly, my comfort level for one procedure is not my main concern here – getting the baby on the other side of all of this is my main concern. So bring it on, doc.

Which brings us to this morning. I hauled my tushy all the way up to The Hatchery, 33 miles away, arrived 30 minutes early (whoops), and waited. And waited. Okay, I didn’t wait that long – they were running about 10 or 15 minutes behind, so it wasn’t so bad, but considering how early I was and the fact that I’d failed to bring any books with me and the Radiology Center at the University doesn’t have any decent magazines… it sure did feel like forever.

Doing the HSG at The Hatchery is different than at my old clinic (I’ll have to think of a new pseudonym for the old clinic…). The Hatchery uses the University hospital services for everything they do – so the HSG is done downstairs at the radiology center, retrievals and transfers are done in the main hospital (I think in a regular OR, but I could be wrong about that). The old clinic was a self-contained unit – everything they did was in their own suite, their own labs, their own surgical center, their own facilities, period. So I was taken to a changing area where I changed into a gown, but then from there I had to walk down a hall to a room where they took a flat, pelvic xray, and then down the hall to another room where they did the actual HSG. Both times I walked through the hall, there were several gentlemen sitting in chairs waiting in the hall. Not really who I want to be walking past as I’m walking in a gown with nothing covering up my nether-regions ifyaknowwhatImean… (I mean, I know the GOWN covered up my nether-regions, but I still felt a might bit TOO exposed for comfort’s sake.

The equipment that this radiology center used for the HSG was different than my old clinic, also. Rather than being on a bed with stirrups, I was on a flat x-ray table, and rather than having this adjustable floaty thing above me that was attached to a computer screen showing my uterus in real time and all that like last time, there was a more normal x-ray machine (just smaller) that slid out over me when the time came (still attached to a computer thingy with live shots, but they took several still shots rather than having the computer capture the pictures). It seemed… less modern, but it did get the job done, so I don’t know if it was less modern, or just different. I am certainly no doctor, and I will say that my husband works at this hospital and is the pharmacy manager for technology and they are anything but archaic in the pharmacy department, so I can’t imagine that this was archaic – it was just different.

Dr. McB came in and was really very pleasant. Honestly, I really feel badly for calling him brusque after our first meeting – in retrospect, while his manner was quite matter-of-fact, he was probably at least partly responding to my manner, which was pretty much, “I know why I’m here, I don’t need you to hold my hand through this, let’s get on with the show.” It’s just that any consult with an RE is a bit… I dunno… demeaning in a way. It feels like it strips away a bit more of my femininity each time I walk into an RE’s office and I get a bit more defensive each time, I think, even though I don’t mean to, and I know it’s not their fault I’m there.

Wow. Tangent, much?

Anyway, Dr. McB came in and gave me my consent form and ran down the list of risks that there are associated with an HSG, but I’ve been there, done that. Kudos to him for explaining them very clearly and explaining exactly what they do to mitigate those risks. Needless to say, I wasn’t worried before, I am not worried now. We joked around for a bit as everyone was getting ready and then it was time for me to assume the position, which isn’t as easy as it sounds on a totally flat table, but whatever. I told him that this was certainly MY idea of a good time on a Tuesday morning, and he said it’s certainly a typical Tuesday morning for him. It’s only my second HSG, but I sure hope it’s not just his second… he assured me that although I was only his second of the day, I was not his second HSG ever.

Now, next bit of kudos to Dr. McB – he did a really good job of always letting me know what he was about to do next, which I really appreciate in a doctor. Not all doctors think to do that, but it’s a nicety that really helps patients feel like they matter. So if any doctors ever read this blog – by golly, take that as a lesson to you! He told me he was about to insert the speculum and I said, “You do what you need to do, doc!” But holy smokes, that hurt. And it didn’t stop hurting until the end of the procedure when he pulled it out. Could it have been pushing against my cervix or something? Whatever it was, it hurt! “Now I’m going to wash your cervix with betadine,” he said. “Okay, hold it right there, doc. Now I think you’re getting just a little too up close and personal, don’t you think?” Hang on there, kiddo, it’s about to get a lot more personal than this! Then he told me he was going to give me something to numb the cervix. Hey, I don’t remember my old clinic doing that – apparently he’s just nicer than them. “You won’t even notice this…” YEOWCH! Big huge, horrible, ouchy pinching! “really? The last woman didn’t even notice me doing that!” Clearly, I’m just a sensitive soul.

He let his resident inflate the balloon, which she seemed to have a little bit of difficulty with, but I have no problem with that – you have to learn somehow, right? And he was in total control of the situation the whole time, which was abundantly clear, so I wasn’t in the least bit concerned. There was some discussion about catheter sizes. Apparently my cervix wasn’t as cooperative as one would l ike. Tell me about it. I felt exactly the same way when it shortened from 4cm to 1cm overnight while I was pregnant. Uncooperative, indeed! Mind you, all the while I’m still in some pretty fine pain from the damn speculum. Dr. McB asked a couple times “How you doing up there?” “Just as great as could be, doc!” “Well, I just like to keep the lines of communication open down here!” And good for him. How dare I judge him at our last appointment? No really, how dare I?

And then came the dye. At my last HSG, the worst of it was getting the catheter through my cervix. After that, it was smooth sailing and I never noticed the rest of the procedure. So I figured that the rest of this procedure would be a piece of cake. Not so.

Holy Crap! They actually had to remind me to breathe, because I really couldn’t move a muscle it hurt so much. I wanted to squirm but knew I shouldn’t and I wanted to writhe, but knew I couldn’t. They started taking pictures and I said yeowch a few times (as calmly as I could) and Dr. McB said, “Well there’s an obstruction there on the left side.” Huh wha? Excuse me? That’s a new development. And so not okay. Well, said Dr. McB, it doesn’t really matter since we’re doing IVF anyway. But that certainly doesn’t mean I wanted there to be something else wrong with me just for the
heck of it, now does it? He kept taking pictures and asked if I could roll a bit over on to my left side and I swear I was in so much pain that I couldn’t remember which side was my left side, but I did figure it out in time. Yep, definitely obstructed.

WTF, people?

I mean, seriously! I’m supposed to be doing this IVF thing because IUI works too well – not because I actually need IVF! Okay, that’s a little harsh, since I almost moved on to IVF twice the last time around, so clearly I did have indications for IVF regardless. But it does change my perspective a little bit. Somehow, I feel just a little bit more “legitimately infertile.” This is ridiculous, of course, because the 5 years of infertility, the $20K, the 5 cycles of clomid, the 6 IUI with Follistim cycles, the miscarriage, the hundreds of injections I gave myself – those all should have been clues that … hello? I’m infertile. (And don’t anyone go pointing out that I have a gaggle of kids so I must not be infertile – infertility and barrenness are not the same things – I am SO tired of people saying, “You’re not infertile, look at all those kids!”)

So it turns out that I need this IVF thing after all. Not just to avoid another set of multiples, but because without it, I’d only have a chance at getting pregnant whenever there was a dominant follicle on my right ovary. What a pain in the tushy.

Meanwhile, the plot thickens on the insurance front also, so more on that later – this post is long enough in and of itself.

Posted in HSG, pre-cycling | 5 Comments »

SCREEEEEEECH!

November 24, 2008 by chezperky

Change in Plans.

Let me back up.

I’ve been working at my current job as a subcontractor to BIG LARGE CORPORATION (BLC) since January. As a subcontractor, I did not have medical benefits (or any benefits, for that matter), which was fine, because I have medical benefits through my husband’s employer. I was recently hired on as a regular employee with BLC. Before I agreed to explore permanent employment with BLC, I reviewed their benefits packages to see what I was in for, just to see if there was anything exciting about it. The corporation is based in a state that mandates fertility coverage so my hope/expecation was that they would cover fertility treatment. Alas, it appeared that BLC “self-insured” and it said quite clearly on their benefits summary data sheets that fertility coverage was specifically excluded from their plans.

In fact, the exact wording under “What is Not Covered” was:

Actual or attempted impregnation or fertilization including, but not limited to, in vitro fertilization and artificial insemination, ZIFT, GIFT and injectables, except for initial diagnosis

That seems pretty clear that fertility treatment is excluded, no? However, when I was looking at the plan information back then, I was looking at information that described the BLC “Total Health Plan” which was pretty clearly a “self-insured” plan.

My first official day at BLC was last Monday and in my over-the-phone orientation with my HR manager (I work several states away from my manager), she kept talking about plans with Well Known Insurance Company (WKIC). I couldn’t for the life of me figure out how they were getting around my state’s mandated insurance coverage if they weren’t self-insuring. Over the weekend I finally got my benefits package in the mail and was able to access the website today with all of the plan data on it.

I searched and searched for the information about fertility coverage, but found nothing. NOTHING. Nothing about coverage, but also nothing about exclusions. What could this mean? I couldn’t find anything anwhere on the site that talked about plan exclusions at all. And the summary plan descriptions were pretty high-level and just didn’t give me enough information to know whether fertility treatment was covered.

Soooo…. I called the Benefits Service Center (BSC) at BLC and asked them if they had a listing anywhere of Plan Exclusions. The representative helping me had no idea what I was talking about and referred me to the summary plan descriptions. No, I countered, those are too high level and don’t really explain exactly what is covered, nor do they address plan exclusions. She didn’t have any further information for me, but would be happy to research the information for me and get back to me. Meanwhile, if I wanted, I could contact WKIC directly if I wanted. Oh! That would be lovely, thanks.

I called WKIC directly and spoke with an absolutely lovely representative who was happy to help me sort this all out. No, they didn’t have a list of plan exclusions, but was there a particular service I was looking to find out about? Ahem. Well, yeah, actually, there was. What about fertility treatment? Oh, well, fertility treatment is covered just like any other medical claim – same copay, coinsurance, deductible, etc. There’s a $100K cap on coverage for fertility treatment/medications, etc. A limit of 6 IUIs per lifetime. Limit of 3 IVFs per live birth. No coverage for ICSI or Assisted Hatching. No coverage for freezing or storage of embryos (this is pretty typical).

This is way better coverage than my husband has, particularly when you factor in that I’m not limited to the one clinic that is 40 miles away, which makes life logistically difficult. So the choice is clear. Or it should be. I mean, obviously, I’ll switch to BLC’s insurance pronto.

It’s just… Gosh. I’d really decided that I do like Dr. McBrusque. And that while his manner may not have been perfect, I did like that he was willing to hear me out and he was willing to think about doing single embryo transfers despite the fact that he’s never done them before, and the fact that he had an innovative solution to the hyperstimulation problem. I liked that he called me himself about the metformin/breastfeeding problem. The things I didn’t like were basically out of his control. With Dr. McBrusque, I have a protocol laid out, a timeline set, and all I have to do is wait for my next period, and we’re ready to get started as soon as the first of the year rolls around.

I don’t deal well with change. So obviously, I’ll change plans and start over, but it’s going to mean delays and changing mindsets and reorganizing my thoughts, so it’s going to mean a bit of whinging on my part. I apologise in advance.

So here’s the current plan:

I will still have my HSG tomorrow.

I still plan to schedule a pre-pregnancy consult with my perinatologist to determine whether it would be wise to even consider allowing more than single embryo transfers.

I will schedule a consult with another RE… I have to decide who this will be – should it be my old clinic? Should it be someone entirely new? I don’t know! And if it’s my old clinic, should it be the first doctor I saw there, or the second doctor? I love them both, but one moved to a location further out, which is the only reason I stopped seeing her. The second doctor was great, but he definitely didn’t love that I didn’t reduce the HOM pregnancy. I dunno.

I will find out if the current clinic (the one that is 40 miles away) accepts the insurance that I’m switching to. If so, I’ll continue to proceed as planned with them, until I determine whether I should be switching to a clinic closer to home.

That’s the plan so far. I can work with plans. I always need a plan. This can work, right? I mean, after all, it’s GOOD news that I’ve got coverage, and that I’ve got better coverage, and that I can now have my choice of clinics, even though it throws off my entire timeline, right?

Posted in Plan B (not THAT kind of Plan B), pre-cycling | 7 Comments »

Sam and his Elephant

November 23, 2008 by chezperky

The J-man never had a "lovey" or any specific toy or blanket or anything that he was totally attached to. We even tried to get him attached to different things to help him with transitions, but he would have nothing to do with it. So I've never directly experienced a child's attachment to a lovey before.

When the babies were born, one of Seth's coworkers gave us the cutest little baby blankies with these little stuffed animals on them. A blue elephant for Sam, and pink bunnies for the girls. They were an Avon product, which Seth knew because his coworker is an Avon Rep, and has been for years. They were adorable, but I didn't think much of them other than the fact that they were cute. After all, we received a lot of cute little things like that when the babies were born, and you never know which things your kids will become attached to later, do you? There's this adorable little dog that Sam was given that I've been trying to get him attached to, because it's so cute, but no dice.

As it happens, now, a year later, Sam will not put that elephant down. He carries it everywhere. He will not let go of it for anything. I loves that blankie. The girls like their bunnies just fine, but they aren't attached to them in nearly the same way, they just like them the same way they like any of the other lovey-type toys they have. But Sam – he loves that blankie. He won't go to sleep without it. He wakes up looking for it. He walks around with it. He holds it close. He wants it whereever he is.

Well, you know this has left me petrified that he will lose it. Or wear it out (it's rather disgusting right now and I can't wrestle it away from him to wash it). And I just am so worried that he will accept no substitute! (Truthfully, he'll take the bunnies as substitutes perfectly fine, but he DOES prefer the elephant)

So I started searching Avon's website, and while I do like Avon a lot, I have to say, their search engine on their site sucks and their categories of products aren't so helpful. But! Miraculously! I found the blankies! They are called Rock-A-Bye Baby Blankies:

You can not imagine my glee upon finally finding these blankies! Because, boy are we going to need a couple extra elephants! (We're good on bunnies, but elephants? I don't know, would it be overreacting to buy a dozen?)

I've already sent off an email to Seth's coworker asking if we can order a couple extra elephants from her, and letting her know exactly how in love with it Sam is. Otherwise, I'll happily order them directly from Avon's website. Because although a parent can never predict which of the myriad of gifts we receive will become THE toy that our children get so attached to, we certainly can stock up once the attachment happens!

And now for your Lovey 101:

Don't make the same mistake that many parents make and just keep a brand new back-up lovey in the closet for when the inevitable happens. As soon as I receive my back up loveys, I'm going to give one to Sam and wash the old one. Then when it comes time to wash the one he's got, I'll give him the other new one, and wash the one that he'd had. Then I'll start evenly rotating them in and out so that they are all equally good and worn – because otherwise, he will come to favor one over the others, and THAT completely defeats the purpose!

Posted in motherhood ... at last, Sam man | 16 Comments »

A Few Too Many, Indeed!

November 23, 2008 by chezperky

So, we went to Target today. All six of us. Brilliant idea, right? Ahem.

Most of you reading this don't know me in real life. So most of you have never seen me out and about in the real world. But those of you who have can vouch for the fact that I'm generally pretty put-together. I'm not all harried and stressed out looking – most of the time. My kids are usually very well behaved – all of them. (In public, anyway) I usually have a smile on my face when we're out in public, because, really? What else can you do when you're getting all those stares than just plaster a smile on your face and accept that you're a bit of a freak show?

So *most* of the time, we get sweet comments, or just simple nods of acknowledgment at our notable family. We get a lot of "God Bless You" comments. We get a lot of people saying, "Oh my gosh, are they twins!?" and they nearly pass out when I say, "no, actually, they're triplets!" We have many people who tell us how cute or beautiful the babies are, or how lucky we are (we know). We get the occasional "You sure do have your hands full" comment or "Better you than me" comment (darned right! I wouldn't trust you with my babies!). I obviously get hundreds of "are they natural?" remarks. This is one that every HOM mom needs to decide for herself how to answer. I suggest having a catalogue of several stock answers to use depending on context and what kind of mood you're in – everything from the truth (either, "yes, they were spontaneous" – if that's the case for you, or "yes, we had some fertility assistance" – if that's the case) to humour ("well, they're not made of a space-age polymer, if that's what you mean") to evasion ("all babies are natural") to pointing out the etiquette error ("We prefer not to discuss the means we used to conceive our babies, just as I'm sure you'd prefer not to discuss your sex life with me").

Most of the time, people's comments do not bother me. I know that – for the most part – people mean well and don't realize when they've overstepped a personal boundary. Few people have encountered triplets in their lives. Personally, before I became pregnant with triplets, I had never encountered a set of triplets, though I now know about 50 sets of triplets. So it's not surprising that sometimes people don't know how to respond appropriately when they see triplets gallavanting around in public. We do create quite a spectacle, especially when you add in the fact that we have a fourth child as well. And let's face it, our kids are so freakin' cute that it's hard not to notice them. I understand this, and I understand we have a certain obligation to our adoring public.

So there we are in Target, minding our own business. We've already gotten a few nods and smiles and "Oh my's" as we've made our way about 50 feet into the store. I was pushing the double stroller with the girls strapped in and I was wearing Sam in the mei tai. J was walking next to me and Seth was pushing the cart in front of us. J was distracted by the gift wrap aisle all of a sudden because he noticed that one of the gift bags had a Transformer on it, so the triplets and I stopped to "ooh" and "aah" at it with him while Seth waited ahead of us. I told J that a boy would be very lucky to receive a present in that gift bag, but we weren't going to buy it today. We were in the aisle for about 15 seconds, before I turned to get back out of it.

Standing behind me, obviously annoyed that we were blocking the aisle was a woman and her (presumably) husband probably in their late 50's or early 60's, blocking me in. I excused myself and asked if we could get by so that we could let her get through. No sooner was my back turned and I was probably no more than a foot away from her, did she turn to her husband and say, "Well that's just a few too many!"

Excuse me? Huh Wha? My four perfectly well behaved children were doing exactly what to grate on your nerves? Because really, I woke up one morning and thought to myself, "Golly, I think I'd like to have an extremely high risk pregnancy and have three babies all at once just so that a year later I can annoy a lady in Target." How dare she? Couldn't she at least have waited until I was out of earshot? Or at least until my five year old was out of earshot? What a witch!

But all was not lost. We got the things we went in for, and bless Target for having enormous elevators that can accommodate 2 adults, a five year old, a shopping cart, a double stroller, and another baby strapped to mama. We got lots of smiles and coos and happy comments. And on our way out, one woman with a single infant passed by me and said, "Congratulations! It must be so hard for you!" I smiled and said, "Oh no! They are easy, and so much fun!" And I meant it.

A few too many, indeed.

Posted in motherhood ... at last | 10 Comments »

Weaning

November 23, 2008 by chezperky

Well, I know that it had been my plan all along, but my babies are weaned now. And I hadn’t really meant for it to be today, but they decided it all on their own. I was figuring that we’d get down to the day I started BCPs with me gnawing my fingernails off trying to figure out how to get them to stop without traumatizing them. I had these grand plans of how I was going to gradually reduce their feedings, but it didn’t really work that way, I still let them nurse whenever they wanted to, but you know? I think they just knew it was time to stop nursing, because they really stopped wanting to nurse, even when I was offering. Yesterday they nursed sort of fitfully for the last time, but really weren’t all that interested and kept pushing me away. Today, no one was remotely interested.

So I guess that makes things a lot easier. And certainly means I don’t have to worry about the HSG (which, by the way, is absolutely not a problem with breastfeeding, and yes, I do have to stop taking the metformin for the HSG, which means it was completely stupid for me to START taking it on Wednesday, but whatever… I have to stop taking it Sunday and resume taking it Thursday… Gah!).

I wonder what I’ll do with all this free time on my hands now? No more pumping, no more nursing. All done. 14 months of my life suddenly over with no fanfare whatsoever. Do I get some sort of award for this? A good stiff drink, perhaps?

Posted in breastfeeding | 9 Comments »

Batching

November 21, 2008 by chezperky

One thing I keep forgetting to post… when I spoke with the infertility nurse coordinator on Wednesday she cleared up one thing that had really, really, really bothered me about The Hatchery and made me feel much, much better.

The Hatchery batches their IVFs, which really bugs me because it gives me less control over my timeline. It especially bugs me because they used to batch their IVFs quarterly! I was feeling incredible time pressure with a quarterly timetable. I had forgotten to ask Dr. McB if they still batch their IVFs quarterly when I saw him on Monday, but when he was talking, he’d made it clear that he batches his patients, so clearly, something was up.

Still, he’d said some things that made it sound all so flexible, like, “So when do you want to get started?” and “What kind of timeline do you want to look at?” And then when the nurse called me on Wednesday she was also asking me similar things… she was asking me if I wanted to start BCPs this month to do my IVF next month or if I was waiting. Finally, after all my important questions had been answered, I asked if they still batch their IVFs. “Yes, we start cycles every two weeks now.”

Wow. Every two weeks. Well, that’s practically all the time! That kind of batching I can totally handle. No time pressure, I can still pretty much pick when I start. She said this just helps him control his schedule a little better, because it gives him one procedure weekend and one ultrasound weekend. Whew. With only one doctor in the practice, I can totally understand that. I’m really all about it.

Glad I cleared that up.

Posted in pre-cycling, protocol | 6 Comments »

Metformin

November 21, 2008 by chezperky

Metformin? Sucks.

Posted in medication side effects, pre-cycling | 7 Comments »

No Zen This Week

November 20, 2008 by chezperky

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)

Posted in migraines | 9 Comments »

dye with HSG

November 20, 2008 by chezperky

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.

Posted in breastfeeding, pre-cycling | 3 Comments »

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