Tuesday, December 9, 2008

Updates

We are headed out to Denver tomorrow for my post op appointment. I am scheduled for a diagnostic hysteroscopy so Dr. Schoolcraft can see if my uterine cavity looks any bigger now. 

While we are there, DH needs to give a sample which they will freeze as a backup sample for our IVF cycle. 

Also while we are there, we are meeting with the finance / insurance people in CCRM's business office. I am going to carry with me the benefits summary that my HR manager has sent me. If my HR manager can get any more information out to me today, I will take it all along as well. We just want to make sure that we talk everything out and know our options. We also need to know how much we will end up paying out of pocket if things don't fall in place with the insurance. 

After we are done with everything at CCRM, we plan to go to the hotel that we're booked at to see the size of the rooms, and to see what they provide in the kitchen etc. That way we can be prepared better when we go there at the end of this month. 

My goodie bag (IVF meds) will be shipped tomorrow, and I will receive it on Thursday. It's like a Christmas present for me - I'm that excited! :-)

It does finally seem like everything is getting set and put into place. My last IVF was in June 2008. I have been waiting 6 months to get started again. The last 6 months have been absolutely crazy! But the amazing part of the journey has been the knowledge we've gained. I know so much more now than I did even 6 months ago. And I definitely know SO much more than I did 6 years ago. Not just about the topic of infertility, but about life, about who we are as people, and about relationships. 

I'm keeping my fingers crossed for tomorrow. Will you guys do the same please? 

Monday, December 8, 2008

One set of footprints

This whole past year, I have struggled with my faith. A lot. I have never been a very religious person, but I have always had a faith which was strong enough. 

This year, that faith faltered. I could not come to terms with the fact that God was putting me through so much. He knows I'm suffering. He knows I'm doing my best. He still chooses to test me. 

I prayed, I promised, I fasted, I cried. Then when things went wrong again, I sulked, I got angry. Finally I stopped knowing how to communicate with God, and my silence filled the house. 

Today, I have a strong feeling of God being with me. Today I feel like He is telling me to leave it to Him. I feel like He will take care of it all. 

I spoke with CCRM this morning. They said they would need written authorizations from the new insurance that my IVF will be covered. But they also said that the insurance company will not give them written authorizations until I am an active member. They wanted details of the benefits plans and any subscriber id or account number that I could get. They said if I followed up myself after 1/1 for the written approvals, we will probably get them quicker. If CCRM asks the insurance company, it could take weeks for the approvals to come. So of course, I will personally follow up with the insurance. 

CCRM also said that they do participate in BCBS programs, so they will figure out which one in particular my coverage will come through. 

My HR manager has sent me the summary of the benefits, and is working on getting the other information for me. 

I am currently waiting to hear back from the nurse at CCRM to see if they will help me increase my prescription or if they suggest that I pre-fill my refills. We shall see how that goes.

For the first time in this entire struggle, I feel like God will carry us on His shoulders through all this. He has thrown a hurdle in our way to make us look up and realize that he is, in fact watching out for us. 

I don't know how everything will pan out, but I feel like it will. Somehow. It will. 

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I have been tagged, and I also have a blog award to talk about. I will do that soon. I promise! In the meantime, I am also getting set to go to Denver on Wednesday for my post op hysteroscopy. Lots happening here!

Saturday, December 6, 2008

Looking for the door He opened when He closed this one on us.....

I broke down yesterday. Threw my hands up in despair, cried, panicked and decided it was all over.

I wrote a pathetic email to my ex HR manager, telling her briefly what I had gone through in the months after quitting my job in Feb this year. I told her that I had a lot invested into this last IVF, and that I was at the end of my rope. I said that I understand that the company need not base its decisions on my needs, but I really need to know how to move forward now. I even said if I could not figure the insurance bit out fairly quickly within a few days, I was going to have to cancel my IVF because I can’t fight any more.

I couldn’t sleep till late into the night – I was so stressed with the mess that we were in.

I woke up this morning a little more calm. Some of my fighting spirit seemed to be back. Deep breath – ok, let’s figure this out. It’s a shock alright, but we’ve dealt with so much, we will deal with this too.

My HR manager (ex) called me this morning and was in tears. She said she did not realize how much I had gone through, and will personally do what it takes to help me through. She told me to proceed with the IVF – she will work with both the insurance companies and figure out and tell me the smoothest way to transition.

Tori – thanks for your suggestion about the continuity of care – you rock! I asked my HR lady. She said the new company had not offered it in their discussions so far, but she will talk to them personally on Monday morning and come back to me.

She said she wants me to talk to CCRM and see if they are under network for the new company. (CCRM’s website does not list their name, but their website lists Dr Schoolcraft’s name.) Once I find that out, I will tell her, and she will work with the new insurance company and make sure there is no lapse / problem in my treatment.

I am feeling a little more confident now. Like some of you suggested, I will talk to CCRM and see if we can order more medication now itself, or order refills asap.

For anything that is falling out of network, or cannot get pre-approved, we will probably pay ourselves and figure out getting re-imbursed later.

I am so fortunate to HAVE coverage in the first place. I should not let the inconvenience of administrative glitches throw me off track. I am re-grouping my thoughts, putting together my to-do list for Monday, putting all my questions in place to figure out how to work through this.

Possible blessing in disguise? Random thought here – what if with the new insurance, I get 4 more IVFs covered? When I joined my job, the insurance covered 4 fresh IVFs. I did one, and my company changed insurance carriers. My count automatically got re-set. I got 4 more. So far we had done 3 of those and the 4th one was coming up now.

DH and I are wondering if this is God’s way of saying “OK, you guys are fighters, and I know I’ve given you a tough road on this, so here are 4 more cycles.”

God, I hope I don’t need 4 more cycles, but it is a comforting thought that I may get the coverage. Wishful thinking perhaps, but hey, hoping is what has brought us so far, hasn’t it?

Now what do I do?

Every step forward we take in the TTC journey takes us back 2 steps. It’s like walking on a landmine. Every step forward sets one off! So many people in the world skip and hop along life smoothly. Why not us? Why must we have to fight fate at every step?

I’m tired. Exhausted. Out of steam. I don’t know what else to do now. I’ve kept my chin up through the entire last year, through every disappointment, through every piece of bad news. DH and I have held each other’s hand and plowed forward through every problem that arose.

Most of you know the hoops and loops we’ve gone through in the last year. We are finally at the stage where we are getting set to start our last and final IVF. I did not expect to find out what I found out today. And I’m devastated.

CCRM had called in my prescription to my insurance company’s specialty pharmacy (if I get my fertility medication from anywhere else, they do not cover it). I was calling today to check on the status of my medication, to make sure everything had got approved and we were all set, and to see when they were shipping the meds out. While I was on hold, I logged into their site to make sure I had all the information ready for them when they answered.

I was completely caught unawares by what I saw on the site – “Coverage end date: 12/31/08” WTH?????? I am on COBRA – I pay a hell of a lot of money every month to keep my insurance going so that I have IF coverage. I am eligible to be on COBRA for at least 8 more months. I don’t understand why my coverage is lapsing.

I contacted my ex-employer’s HR department, and found out they are changing insurance service providers wef 1/1/2009, and of course nobody thought it important to inform an ex employee who is on COBRA, and quite frankly, at this point, whose life depends on that COBRA coverage!!

I don’t know what to do now. If I roll on to the new coverage, it will not be effective till Jan 1. And if I am not a member till Jan 1, CCRM can’t even get pre-approvals etc for my IVF. I am supposed to start stims at the end of Dec and ER happens early Jan, ET mid Jan.

Not just is the treatment coverage at stake now, but also the prescriptions – the refills! Per my prescription, and my discussion with CCRM, I am sure I will need to get additional doses of Gonal F, and till I am a member I will not even know how the new insurance company covers fertility drugs. Also my prescription has already been sent to my current insurance. Sending a new prescription after Jan 1 will mean waiting for the entire approval process etc etc etc.

At this point, I cannot afford to pay out of pocket for this IVF either. I'm completely at wit's end about what I can do now.......

How on earth am I going to do this IVF? I feel like the wind just got knocked out of me – entirely deflated! I’m tired, and I really cannot fight any longer. I’m tired of crying, and I’m tired of figuring out how to fight fate any more.

I wanted to go into this IVF with a calm state of mind. How am I supposed to be calm now?

My whole bloody life works on Murphy’s Law : If something can go wrong, it will.

Thursday, December 4, 2008

Mr. Simba

I thought I would share with you guys some pictures of our little puppy Simba. He's really not very little any more, but he thinks he is. He doesn't realize he weighs about 90 lbs, and can easily knock either one of us down on our butts. 

Simba LOVES going to the beach. His sole purpose in life is to play fetch, and he knows he will get undivided "fetch" time at the beach. Every visit to the beach is complete excitement for him. He runs and plays till he is so exhausted that he can barely stand any more, but he's not one to give up and sit down. Oh the beach! Simba LOVES the beach!

At home, he thinks the whole world revolves around him. He has his own little cosmos going on in his head. You wear a jacket, he thinks it's time for him to go out. You pick up the car keys, he thinks he's getting to go on a drive. You look him in the eye when it IS time for him to go out, and he will be all over you in excitement. 

We tried pretty hard to teach him the "no climbing on furniture" rule. So guess what - he doesn't climb on the family room stuff, which is what we use most of the time. But the formal area - aah, whole different story! Nobody told him THAT furniture was off limits too! Here he is:


The poor baby used to be very car sick as a puppy. His stomach would churn each time he was in the car for over 10 minutes. He'd be sick all over the car, and would be miserable for hours afterwards. Now he's figured that if he acts restless in the backseat, we roll down the windows for him (to distract him - and it works! He hasn't thrown up in the car this entire year). He sticks his head out and enjoys the breeze (never mind that our ears are popping with the noise on the freeway at the time!). He's also figured that he can keep going from one window to the other on the backseat, and we will keep rolling the window down on whichever side he is. So it's a constant oscillation - left, right, left, right!! Drives me insane, but he loves it :-)

He's our completely goofy, lovable, VERY VERY COMMUNICATIVE little baby. He listens to Dad (DH), but he knows Dad listens to Mama (me) (hehehehe). So when he thinks it's time for him to be taken out to play, he whines in front of Dad a couple of times, and then comes and puts a paw on my lap, as if to say "OK Mom, time to do your magic. Dad needs to get up and take me out NOW".

And needless to say - he has been a complete lifesaver for us as well. Nothing takes away stress as does a dog wagging his tail at you, looking at you with those imploring, guilt inducing eyes. Gotta love it!! 


Tuesday, December 2, 2008

Going with your gut...

Of late, a lot of my IFer friends – cyber, and IRL, are beginning to go with their gut on part of their treatments.

I have always been a very strong believer of believing in my gut. If I feel something is wrong, I believe the best thing is to find out if it is wrong. Specially with IF and other health related issues.

Nichole recently talked about taking the plunge and setting up an appointment with her doctor to see if she could possibly have the endo that she suspects she does.

Yesterday one of my friends IRL called and said she has decided she wants to request her RE for a laparoscopy because she is not convinced that “nothing is wrong”. She has been through several IUIs, 2 IVFs – all BFN. Her DH had varicocele surgery, and after that, her RE wanted them to do IUI for a few cycles before moving ahead with another IVF. My friend though has a feeling that the doctors are missing something. She plans to ask for a lap to see if her gut was right.

Another friend from one of the message boards did just that. She has had 4 losses, and with her pregnancies and losses, the doctors discovered that her tubes had got blocked. They recommended IVF to her. She did one IVF, got pregnant, and unfortunately lost that baby too. The RE said she could proceed with FET of her frozen embryos. Before that she decided to request a lap. Her RE did not think it would help, but she insisted. Guess what? They found stage 3 endometriosis, cysts, and endometrioma. They cleared all that up. They also managed to unblock both her tubes!!

Shelby recently is feeling let down by the NP at her clinic for handling her IUI cycle not as well as it could have been handled. She too says she will question and maybe cancel her next IUI if she feels her questions are not answered.

2 years ago, in Nov 2006, I remember re-grouping with my then RE. Our first IVF had failed in 2005, and to me, that was the end of the world. IVF was the mother of all treatments – how could it not work? And something about the “All your tests are fine, this is just pure bad luck that none of your treatment cycles are working out” reasoning that the doctors were giving us was not right. I “knew” there was something more, and beyond “Is there any other test we can do”, I did not know how to question the doctor’s judgment. During that regroup meeting, I did ask. I was furious from all my failures, and I wanted answers. DH was holding my hand under the table to calm me down, lest I get too aggressive with the RE. I finally asked the doctor “What if there is something in us on a more genetic level, and what if my eggs and his sperm are just making bad embryos?” He said “Well, there is one test, but nothing comes of it most of the time. Since you are insisting, let’s have you do this test.”

The test was a karyotype. A simple blood test – yes a little expensive, but in the grand scheme of things, considering how much we had spent by then, an additional $800 didn’t seem very large. DH’s result came back with a translocation. That RE all but dropped us like hot potatoes telling is to give up and go adopt.

I wonder today, if I had not asked that day, we may have not known what we know today. We would have continued with FET, maybe more IVFs with the same RE, not knowing how bad things could turn if I did get pregnant with a baby with an unbalanced translocation!

There are way too many patients (of IF and otherwise) who “feel” something is not right, but they don’t ask their doctors. All of us have the hesitation that stems from the feeling that the doctor is the medical professional, and he will know what is right and what is not. How can we, as patients, question a diagnosis or a treatment plan?

The thing is, we know our bodies so well. Specially us IFers. We are so in tune with every twinge in the body that we sometimes feel and know things that doctors cannot see. We have to step up and help our doctors diagnose and treat us well.

When in doubt, ask. When you feel you have been given too little medication, or too much, or when you feel you have a nagging feeling about something – ask. In the worst-case scenario, you will be wrong. That may not be that bad a scenario after all, right?

The author of “How Doctors Think” also says this in his book. He says we should help our medical professionals chart our treatment plans. Sometimes we may unwittingly hold back information, which, while seemingly unrelated, may change the entire treatment perspective!

So speak up my friends. Speak up if you think something is being overlooked, or if your gut tells you something isn't right.

Monday, December 1, 2008

Is it worth it...

Is it worth trying to save or salvage a relationship with a fertile friend? A friendship lost in an effort to protect myself from feeling let down in front of my friend’s lack of emotion. A lost friendship that I miss dearly.

I’m torn. On the one hand, I feel incensed that she doesn’t get it. And I have tried to explain, not once or twice, but several times. On the other hand, I miss the friendship.

So what should I do? Pretend I’m fine, and be “friends” with her? Or accept the fact that things aren’t fine, and if she doesn’t get it and doesn’t feel any emotion for my situation, and me then I should be willing to move on?

Why must an infertile always end up making the effort to pretend things are great, just to “fit in” in the world of fertiles? Why can they not see things from our perspective?

Is it that hard for a friend to say: “I’m sorry” ? And I am not one to expect it again and again. But is it wrong for me to expect a “I’m sorry” one time over the course of a year and 3 pregnancy losses?

I’ve told her in these words “The last year has been the most difficult one for us so far. (DH) is busy with (work) and I’m busy trying to keep myself sane.” (This was part of an email exchange last week). And it’s not like she does not know of my struggles or losses. She does. But doesn’t say anything because she says “I don’t know what to say”. Her response to this last email was “Whatever it takes to keep one happy – that should be our goal.”

This is a friend who decided to “go for baby no. 2” when I told her I was finally pregnant last year. This is the friend who had that second baby 3 months ago and has not even sent us a birth announcement.

After this email exchange she sent me a link with pictures – full of her 2 kids. I had to scroll through 60 pictures to even get the name of the new baby.

What am I expected to do? Say “Ooooh what a cute baby – congratulations?” Maybe I should also keep quiet and if asked, say “I don’t know what to say.”

What would you do? Why am I letting this get under my skin and make me so mad? Why is it so hard to just close this chapter and move on?

PS: Have I totally lost it? I recently had a dream that I took a very fertile friend to the pharmacy and bought her birth control pills. I haven’t seen this friend in over 4 years. Go figure…. ☺