Costs

The hysteroscopy is going to cost as much as an IUI cycle.  I didn't want to think about it, but I raised the question of what if we decided to just stop here and not get into all this, but Papa Bear said he would want me to do the hysteroscopy and remove the polyp anyway because of the fear of cancer.  I don't think my mom's cancer was genetic, but it was such a freak kind of cancer that we don't know for sure.  Now we're having to look at which of the trips we had planned this fall (related to volunteer work but also then involving seeing friends we never see) we can cut so we can afford this shit.

Where to next?

Yesterday was our follow-up consult with the new doctor, now that testing is all done.  I felt too shitty about it to post last night, so I'm taking the plunge on that now.  We knew about the SHG and needing the hysteroscopy and still being scared of complications.  What we didn't know until yesterday is that my AMH has dropped from 0.87 in August 2016 to 0.47 in July 2017.  We also didn't know until yesterday that here in Georgia an IVF cycle costs twice what it did in Maryland 5 years ago.  Because of that, we're going to try IUI for a round or two, despite the odds only being 10-15% with my age and only one ovary.  I don't have much of any hope of it working, but we can at least afford to try it by then.  If it goes to IVF, we only get one shot.  We had to finance a car in January when we hadn't been planning to.  We might be able to get financing through a medical financing group to finance the cost equivalent of one brand-new sedan for a single cycle.  I highly doubt anyone in their right mind would finance us for the equivalent of two or more brand new cars, even with it being a medical loan rather than a commercial loan.

I hate my body for betraying us in this way.

Antral Follicle Count

The clinic called today with the results of my day 3 ultrasound and confirming the SHG results.  I had 9 antral follicles, which the nurse called "really good" for only one ovary.  I'm used to having more, but I know I was younger then.  For 35, is that actually good or is she trying to make me feel better?

The nurse did also confirm that the doctor wants to do a hysteroscopy to remove the polyp.  She said we don't have to rush to schedule it immediately, that it can wait until after our next appointment on August 8 (we're going out of town next week, and we have the older kids the week after).  I know Papa Bear and I are going to have a LOT of questions for the doctor, so I'm glad he can come to that appointment.  Another reason I'm glad to have moved to a clinic closer to home.  We had been talking about doing the hysteroscopy on a Thursday or Friday when we won't have the older kids that weekend so I can rest without worrying them, but we're going to have the kids every weekend in August.  There's also the question of how much it will be, given the deductible issue.  Overall, Papa Bear is freaking out as much as I am, if not more, and for the same reasons.

#MicroblogMondays: SHG Results

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I had an SHG for the first time today.  I have a small-to-average polyp at the top of my uterus, and a band of tissue that may be endometrial overgrowth.  The nurse practitioner thinks the doctor will want to do a hysteroscopy and remove the polyp.  I'm terrified, and so is my husband.  The last time I went under anesthesia for a "minor 30-minute procedure" I woke up 2 1/2 hours later to find out I no longer had an ovary or tube on the right side.  And to add to the fun, right after we met our deductible and found out the IVF coverage had been raised, my husband's company got sold and we now have a new deductible and no coverage for IUI, IVF, or medicated cycles/monitoring.

NIAW 2017: Listen Up - I Will Not Be Silent

I wasn’t sure what to write for National Infertility Awareness Week this year.  I haven’t been having much time to blog, and I haven’t been very connected to the ALI community online, which doesn’t seem to have the vibrancy that it did several years ago.  But I still need to do something for NIAW, and at this point that means writing.

The theme for this year’s NIAW is Listen Up.  That theme says a lot to me because of where I’ve been and where I’ve come on this journey.  I originally started my blog to encourage people to listen and to not be part of the problem of silence and shame that surrounds infertility.  Along the way, I encountered a wide range of willingness to listen and understand.  There have been people who told me they were glad I was speaking up because they did not feel like they could do the same.  There have been people who were supportive and glad to learn more.  There have been people who have shared information for me to listen to, and who listened in return.

There have also been a large number of people who don’t want to listen, who just want me to shut up and be a good little girl and not talk about things that people don’t want to hear about.  The people who told me that no one really wants to know how I feel.  The people who told me that infertility isn’t something to be open about.  The people who acted like they wanted to listen, told me they wanted me to talk to them about how they felt, and then hid from me, talked about me behind my back for being open, used my feelings and my needs against me.

To them I say, Listen Up.  I am here, I am open, and I am not going anywhere.  I will not sit down and shut up and let you pretend that infertility is a dirty little secret that people deserve or that nice people don’t talk about.  I refuse to be silent, because in silence hides shame.  I refuse to be ashamed for having a medical condition, and I refuse to be ashamed for wanting a child or for wanting another child.  I refuse to be ashamed of my feelings and my experience.  So Listen Up.

http://www.resolve.org

*facepalm*

Quote of the day: "If you want to have kids, you should try using Depo.  I got pregnant with 2 of my 4 kids while I was on it, and a third one while I was on the Pill."

#MicroblogMondays: In the Minor Leagues

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We are taking this month off from going to the RE, but not taking this month off from trying.  I hadn't mentioned it before, because I've been too busy dealing with the aftereffects of it, but I was in an accident on December 14 that totaled my car.  (I was lucky enough to not be majorly injured, but still have some bruising a month later and need PT for my back now.)  We are still finishing up buying a car, and the logistics of trying to get to the RE while sharing one car are prohibitive. (Mel, since the Beltway and the Perimeter are the same size, it's as if I lived in Gaithersburg and worked in Poolesville while the clinic is where 95 and 495 meet by College Park.)  We both have mixed emotions about skipping the medicated cycle.  Since we're back to a deductible, it lets more of the HSA build up before we try (although an ER visit for one of the kids may have killed both the deductible and the HSA balance).  And Papa Bear wants me to have more time to recover and start the PT sessions before adding more medications to my body again.

But it feels weird to have a new plan and be waiting to implement it.  Remember how we had 4 eggs in November and was told not to try and tried anyway?  Well, in December, we did 2.5 mg of Femara instead and got FIVE eggs.  Because my body is that damned crazy.  So now my RE wants to cut the smallest Clomid pills in half and do 25 mg of Clomid.  But we're not doing it this month.  At least no one can tell us this month that we have too many eggs and can't try!  I may be benched in the major leagues, but at least I can play in the minors?

#MicroblogMondays: Perspective

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In the midst of feeling like crap about this cycle failing, I got a jolt of perspective.  There's a woman who had been a part of my church before I joined, while she was a professor at the nearby college.  She had become Christian in America, and when she returned to her home in China, she shared her faith with the people that she encountered.  Because of this, she has been jailed and beaten multiple times.  I first learned about her on Friday night, when the choir and orchestra were told that she had been jailed and beaten again and that she was pregnant.  On Sunday morning, we learned that she had lost the baby due to the beating.  As horrible as my experience has been, especially with losing Otter and how the surgery had gone, it's nothing compared to hers.

What am I worth?

For a long time, I've judged my own worth based on what I do for others.  Which sounds like what a good person should do until you add in my depression and anxiety pointing out that there's always more to do, which means that what I can do and therefore what I'm worth is never enough.

I'm a therapist, so it's my job to help people see their own worth.  But I'm not very good at it when it comes to myself.  A pastor I had said to me that "Love your neighbor as yourself" also means "love yourself as well as you do your neighbor," and it really hit home with me.  I use that line in therapy a LOT, as a matter of fact.  But I still am not very good at it when it comes to myself.

I give others the benefit of the doubt about getting things done while I rip myself to shreds for what I leave undone.  Housecleaning is a big one for me when it comes to that.  I constantly hate myself for not doing more.  I hate myself for not being at home at night helping Papa Bear take care of the kids and the house, even while I know that most of the reasons are because I'm working and bringing in the money that we need.  And at the same time I hate myself for not bringing in enough money for us to be more comfortable financially and to be able to live somewhere where we're not cramped.

I wonder sometimes if the reason why God won't give us another baby is because I'm not worth enough because I don't do enough, don't do well enough, at taking care of the family that I do have and the child that He did give me already.

I think that's part of why I find it so hard to forgive myself, forgive my body, for this cycle.  I'm not just failing myself, I'm failing my whole family.  Papa Bear makes it clear that he loves me and loves my body regardless of whether I can conceive (more on that in another post), so that doesn't come from his attitudes about me/infertility at ALL.  But I'm not the only one that wants this.  Patrick doesn't know one way or the other, but the older kids have both made it clear in various ways that they would like for us to be able to have more kids.  And if I'm failing to do this for them, where is my worth?

I'm a Failure Again

We tested today.  Papa Bear was getting even more antsy than I was about testing.  He first wanted to test on Friday morning after the kids were gone, but then he wanted to test this afternoon when we could both be home for lunch.  I didn't mind testing, since I wanted to know.  But I knew right away that it was a no, as the control line got dark right away with nothing else showing.

Papa Bear is more sanguine about this BFN than I am.  He sees it as more information to work with, that maybe we really need the progesterone that I had been prescribed with the Clomid before in order for a baby to stick.  He still has hope for next month and, if necessary, the ones after that.

I don't.  I had hope this month.  I really thought that with FOUR eggs, we had a chance.  I thought that we would be likely to become pregnant and that the biggest question would be how many babies there would be.  I was still scared of a no, more scared of it than Papa Bear, who was much more scared of higher order multiples.  But I thought there could be a yes.  I had hope.

Not anymore.  It feels like hope is a finite resource and I blew it all this month.  I used too much, and now I have nothing left.

The Waiting Game

I've been resisting the urge to test.  I'm at 12 DPO.  Last month, I started spotting on the Friday night and had a full CD1 on the Saturday.  So if this cycle didn't work, I expect to find out this weekend.  Which will be a pain, since I have orchestra concerts on Friday and Sunday.  At the same time, if this cycle did work, since the concerts are with my church, I would have people to pray with me for a healthy pregnancy, even before I would know how many babies are in there.  I haven't had any implantation bleeding, but that doesn't necessarily mean anything since I did with the first pregnancy but did not with the second.

Last weekend, we had the birthday party for the now-10-year-old, and today we had an appointment for one of the kids that I had been thinking about a lot.  Now that those are past, I do have the concerts this weekend with rehearsal tomorrow and Thursday nights.  However, that's the only thing major enough to distract me from thinking about whether I have a baby inside me or not.  I have a huge convention coming up at the end of the month that I'm looking forward to, but I can't see anything past this weekend and the concerts and finding out whether this cycle worked.  I have plenty of things I SHOULD be working on, but I can't see anything past this weekend and the concerts and finding out whether this cycle worked.

I think about whether this cycle worked when I'm going to sleep and Papa Bear has his arm around me resting on my belly.  I think about whether this cycle worked when I'm driving to work.  I think about whether this cycle worked when I'm tending my toddler, wondering whether I will be able to give him a sibling (or more than one).  I think about whether this cycle worked when I'm piddling around on Facebook and playing my silly Game of Thromes game.  I even think about whether this cycle worked during client sessions (along with thinking about what my client is saying...ahh, the magic of ADHD).

But I'm resisting the urge to test.

#MicroblogMondays: Good News and Bad News Leads to What?

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I hadn't had time to blog this last week because I was leaving town, but I had my mid-cycle follow up last Tuesday.  The Femara worked...a little too well.  I had FOUR follicles maturing.  The doctor asked whether we would consider selective reduction if we went forward with the cycle, and both Papa Bear and I could not do it.  She then offered to use a needle to aspirate two of the eggs that day, but Papa Bear did not feel good with it ethically (I wasn't sure how I felt about it, but if he's not comfortable with it we won't do it).  So we were told to use protection for the rest of the week.  I talked to my parents about it (who made my sister on the 7th or 8th treatment cycle), and they thought we should try anyway because two of the follicles were smaller than the other two and because the chance of higher order multiples is still pretty low.  I prayed about whether we should try or not.  Man, I wish God gave clear yes/no answers.  The next day was my birthday.  We had made it to New York for the holiday and, through a twist of fate, got a second suite comped to us at the Residence Inn for the kids so that we had a king-size bed/room to ourselves with no kids on the other side of the wall.  Seemed like a sign for sure.  So now we wait and see.

New Protocol

I had my follow up with the RE today, on CD4.  Despite the fact that this last cycle didn't work, the appointment started with great news...my AMH was up from 0.87 to 1.6!  Papa Bear was able to come with me this time, so he got to meet the RE and form his impression (most awkward appointment ever in his book).  Since we've now had 2 Clomid cycles not work, despite 2 really good-looking follicles last month, she's switching me to Femara 5mg.  Who all out there has done Femara?

No shots of any type with this cycle (especially since we'll be out of town for Thanksgiving at BD time).  We will see how it goes, but it's nice to be making progress.  Before leaving for the holiday, I'll have an appointment for a mid-cycle ultrasound, and we'll be able to get results from more testing for me and Papa Bear both.

For the record, I absolutely adore the phlebotomist at this clinic!!!!  I have a HUGE needle phobia, but she has now stuck me twice without me wanting to cry, even with my vein not cooperating today!

#Microblog Mondays: The Quest for Invisibility

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I first started this blog as part of my commitment to be part of the solution instead of part of the problem when it came to stigma and silence.  But lately I've been wondering whether that effort leads to anything positive or whether I should just shut up.  I've been hit again with the observation that no one IRL actually cares who I am or how I feel except a few people: my immediate household, my parents, my cousins, and two or three friends.  People act like they care when I'm right in front of them, but any other time I'm either gossip fodder or invisible.  I'm the one that reaches out because if I don't run into people in person, they forget about me.  I'm the one that tries to get to know people better and make acquaintances into friends; I'm not interesting enough for people to want to get to know me.  When it keeps happening over and over, that tells me that I'm the one that's the problem, that my needs are inconvenient to others, that it would be better if I were to just shrink myself and my needs until, to everyone outside my family and my job, I just...disappear.

#Microblog Mondays: Fear and Trembling

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I keep swinging back and forth between being glad we have a chance to try and being certain that nothing good is going to happen because my only remaining ovary is too broken.  I think I've been reading too much on the internet/FB (I know, irony, right?) and seeing people told that Clomid won't help them and maybe they should try egg donation.  Papa Bear feels like that would defeat the purpose of having a baby that was the two of us.  I want to be pregnant and carry a baby, I think even if it weren't my eggs, but I can't justify that much of an expense for a possibility when we have three kids to provide for both now and in the future.  But I still want a second child that is MINE, that calls ME Mommy and Papa Bear Daddy.

One Small Step

This is a really weird post to write.  I thought about writing it last night, but I didn't have the emotional energy to be able to.  I still can't believe I'm here.

I took my first pill of Clomid yesterday.  That puts me farther in some ways on the fertility journey than I've ever been before.  My ex and I had prepared to do IVF, but one thing after another kept getting in the way right before we could start the first shot.  So I have never actually taken a fertility medication before yesterday.  I've had a box of medications and syringes on my dining table for months on end before, but until yesterday I had never gotten to take a dose.

I almost didn't get this far.  I almost got stopped again right before I was going to be able to TRY something instead of sitting on the sidelines waiting for my turn.  My AMH level came back over the weekend and, because the doctor was in surgery on Monday, did not get read until late in the day Tuesday (my day 2, when I was to start Clomid on day 3).  The nurse had called me, but I wasn't able to call back before 5 because I was with a client.  She left the message that she needed to talk to me.  So of course I was panicking all night Tuesday night, and I was right to.  Yesterday morning, the nurse called to tell me that my AMH was 0.87.  According to the website I had been looking at, "low normal" is 0.7-0.9 and "normal" is 1.0 and above, although it said there was disagreement about where the borders between categories really should be.

Through the nurse, the doctor first said that he was not going to prescribe the Clomid and that I should see an RE.  I completely broke down sobbing on the phone with the nurse because I was pretty damn sure that there was no way we could see an RE this calendar year, between leave for Papa Bear (especially with his boss about to go out on paternity leave) and the question of whether appointments would even be covered, even with an endometriosis diagnosis.  And all the while that we can't get in, months and cycles are ticking away.  We had to wait months to be able to afford the HSG before having a chance to try, months of eggs dropping away unused, and now it was going to be even longer, making my ovarian reserve worse!

I was lucky that the client I was on my way to see canceled, so I went to church to talk to one of the pastors.  Just before the pastor prayed over me, my phone rang, but I let it go to voicemail.  As I left church, I checked my voicemail, and it was the nurse.  She said that she talked to the doctor again and reminded him that we really couldn't go see the RE, and he decided to write the Clomid anyway.  He said that he did not think our chances were good, so he would rather we work through the RE for their expertise.  But since we can't, he's at least going to let us try.  We also have estrogen for days  8-12 and progesterone pills for after day 18.

Papa Bear asked me how I felt after taking the first pill yesterday.  I didn't really know what to say.  I didn't feel bad, but I was afraid to feel good.  The best description we could come up with between us for how I felt was "guarded."

We're trying to get information on what is and is not covered (after our massive deductible, of course) if we can see an RE.  The first answers we have on that raise some questions for us, and especially Papa Bear to address.  It turns out that IVF is covered at 80% (which a lifetime max benefit of $2000, so it's like they pretend to cover IVF and really don't give a fuck), but IUI is not covered at all.  Papa Bear is Catholic.  IVF isn't allowed by the Catholic church.  Amusingly, IUI is, but only if the sperm is gathered from a condom after sex.  That could make getting samples in the little room at the clinic interesting, since even if we can't do IUI, there's still the testing for him that the clinic will want.

So yeah, it's been a weird couple of days.

Sped-Up Alphabet Soup

Turns out that with my CD1 being on a Thursday and the clinic only doing HSGs on Wednesdays, they want to do it tomorrow instead of next Wednesday.  So it has been a mad rush trying to get the right form sent in by my doctor and get the antibiotic called in and picked up and the insurance information in.  And now I find out that I have to pay for it tomorrow rather than being able to have a little spare time while they ran it through insurance, since there's still thousands of dollars left on our deductible.  I was hoping to be paying it AFTER rent was paid; I just felt more comfortable that way.  So much for that.

And now I'm scared.  Scared that the pain will be worse than I remember.  Scared that it will be bad enough that I won't feel up to orchestra rehearsal that night.  Scared of even getting there on time because I had to put in a client appointment at noon when I have to be there at 1:45 and the clinic is an hour away from my office.  And scared of what they will find.  Scared that my other tube is broken too.  Scared that I'm going to need more surgery to "fix" the endometriosis.  Scared that even with more surgery my tube won't be salvageable.  Just, scared.  I found myself crying as I was driving today.  I don't remember being scared before my last one, but before that one I was so desperate for answers.  Now I have enough answers to know that having more answers may hurt more than it helps.

Alphabet Soup

Today is essentially day 1, since it started late in the evening yesterday.  Last night was pretty miserable.  I kinda just sat there like a lump after the kids were in bed with random tears rolling down my face at random times.  And today I had a random weird cramp that I've never had before, where the pain radiated down to my big toe.

But the one good thing about day 1 is that it meant I could call GRS (the big local fertility clinic) to schedule my HSG.  I got voice mail on the scheduling line and they never called back, so I need to call again tomorrow, but at least we're in the cycle where I can get it done.  It looks like it will be on September 7, since that clinic only does them on Wednesdays.

One thing that I'm scared of now, though, is the possibility of the dye flinging endometrial cells around my abdomen in the process of finding out whether my remaining tube is plugged.  I have no idea whether that's a reasonable fear or not.

#MicroblogMondays: Christmas

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Don't worry, I haven't seen decorations in the stores yet!!!  My husband and I are watching an episode of Cake Wars so old that it's Christmas-themed, and all the commercials are Christmassy as well.  Last year, Papa Bear and I basically went through the minimal motions on Christmas for the kids and punted the rest of the effort to my parents, since we went there for the day.  The baby we lost had been due right at the beginning of January, and so we had been expecting to spend Christmas getting ready for a birth.  We also had the tree fall twice and break a lot of my deceased mom's ornaments on the first year we had them to put on the tree.  So we were just DONE with Christmas.  I was afraid that Christmas would be forever ruined, which would really suck because of how much I loved Christmas before.  But seeing the commercials tonight, I'm actually kinda excited about Christmas for this year.  I don't know how I'll feel when we get closer to it, but for now, it's a good sign.

#MicroblogMondays: Wading Into New Waters

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I've been seeing an ad on my Facebook for MyEndometriosisTeam, a social network for women with endo.  I've been thinking about joining and just not having the time, but from when I first saw it until my computer had to restart, the tab was open in Chrome waiting for me.  Tonight, I clicked to join, and now my anxiety is in full swing.  I'm sitting here typing and playing a silly Facebook game and not saying anything out loud to my family while my skin feels too tight for my body and my muscles are rigid.  I don't know why I'm reacting this strongly.  Maybe it's my social anxiety and the fear of putting myself out there to meet new people and people not being interested in connecting with me.  Here, most of my connections are people I've known for years on here, even if I was gone for a long time.  And here feels safe.  It could also be fear of what I'll find out, or of not learning and gaining anything useful.  I don't know.  But here goes, I guess.