March Photo Challenge - Days 13-17

Maybe at some point I'll get to posting pictures every day! 

Day 13: Glow.  Sunset our first night in Costa Rica.

Day 14: Design.  I like playing with line and design in photographs.  I took this one lying on a bench under the Gateway Arch in St. Louis.

Day 15: Build.  I built this set of steps for a theater class in college.  We built the steps in pairs, actually, but the other person I worked with didn't want them so I got to take them home.  Throughout the rest of my time in the dorms, I used them to get up into my bed since I had it raised some.  After that, I kept them even though DH thought I was weird for it (as opposed to the other reasons he knows I'm weird), initially as a conversation piece/extra seating.  When we moved to this house, the steps went outside on the patio where the cats like to sit on them.  Kechara especially liked the steps...I would go outside and see him sitting or lying on them.

Day 16: Morning.  This was the view from our breakfast table in the hotel we were at for our honeymoon in Poipu, Kauai.

Day 17: Green.  This was my garden last summer.  I had some MASSIVE zucchini and yellow squash!!  It seems like every year I have one crop that goes gangbusters.  The first year it was cukes, the second year it was jalapenos, and last year was the zucchini.  Anyone got guesses on what this year will be?  If you suggest something I haven't grown, I might add it in...

Whew

I heard back from my nurse today.  She got ahold of the PGD lab, and she now has orders for the sample processing.  Because of stuff not being fully open over the weekend, we'll be going in to give samples on Monday, and the lab will get the samples from my clinic on Monday.  That means they will have 3 weeks and 4 days to create a probe that takes 3 weeks to complete.  If nothing goes wrong.  Still nervous, but not quite as scared.

Keep Calm and Carry On

I've been not-quite-almost-trying-desperately-to-keep-from-panicking for much of the past week. 

Before I left for Costa Rica, I was calling the PGD lab and the fertility clinic and then calling around to insurance trying to get the auth changed from the California PGD lab to the Maryland one.  The Maryland lab was telling me the fertility clinic was supposed to submit the changed auth because they don't get auths from insurance even though they do take insurance payments.  The fertility clinic was telling me they had done their part and that the PGD lab was supposed to get the auth and that if they didn't than I was supposed to.  The insurance company was saying that the fertility clinic was supposed to do it.  And so on. 

I wanted to get it done before I left so that DH and I could get the samples submitted and the probe could be made, since it takes 3 weeks if nothing goes screwy, and I started CD 1 for the cycle before our treatment cycle the Saturday before we left.  Finally, the Friday before we left, I reached G in the local office of the care management division of the insurance company.  She said she would get it taken care of by the Monday before we left.  I didn't hear back from her that day, but I had so much to do getting ready that I had to just go on faith and hope it was getting done.  Yeah, right.

Fast-forward to getting home, and a day or two after getting back last week, I reached G again.  She hadn't been able to get a call back from the person at my clinic that she needed to talk to.  She wasn't going to be in the office Friday and would get back to me on Monday.  Yes, Monday that's a week and a half before CD 1 of our treatment cycle.  On Monday I couldn't get ahold of her, and yesterday she said she still hadn't heard back after bugging the woman at the fertility clinic again.  I explained the time crunch, and she said she was going to talk to her boss to see if she could make it happen without the fertility clinic calling back.  Later that day I was told that she could, and this morning she called me with an auth number.  Whew.

So now I can call my clinic and be able to go in tomorrow with DH to give our samples, right?  Wrong.  There are no orders on file for what to test for, since the Maryland lab didn't contact my nurse to give her that info.  My nurse called me again today (we also spoke yesterday after I called her in my not-quite-almost-trying-not-to-panic) to say that she's going to make a pest of herself with the lab until they tell her what they need from the samples.  Every day that ticks away has me more freaked out, though, even while I celebrate having the auth switched. 

If I can't cycle this month and I know that within the next week, I can't cycle one month from now unless the nurse agrees to use extra pills to move the cycle by a couple weeks, which she wasn't keen on.  I can't cycle 2 months from now unless she agrees to use extra pills to move the cycle by about one week.  So missing this opportunity could mean waiting 3 more months.  In both cases, this is because of things I already committed to.  I'm trying not to commit to much right now because of the possibility of treatment cycles, but how do I find that line between being available no matter what changes and putting my life completely on hold?  If I can't cycle this month and I find that out sometime after I start the pills, all bets are off as to timing because I'll have to completely figure out again when my CD1's will be for the upcoming months.

But of course I keep calm.  Right.  Or at least I carry on.  That's all I can do.

Music Monday #11 - Girl Scouts

As an update from last week, I wasn't exactly a cowboy in the jungle, but I did ride a horse through a tropical dry forest, so I think I still made a good prophetic selection!

Today's theme is Girl Scouts.  One hundred years ago today, Juliette Gordon Low held the first Girl Scout meeting with 18 girls in Savannah, Georgia.  The first video below, "Make New Friends," is so common it might as well be the official Girl Scout song.  The middle video, "White Coral Bells," was my favorite Girl Scout song as a little girl. (Although I did have a soft spot in my heart for one that went, "Black socks, they never get dirty.  The longer you wear them, the blacker they get. Someday maybe I'll launder them; something keeps telling me 'Don't do it yet.'")  I didn't come across the bottom song, "On My Honor," until Cadettes, but I thought it was lovely, and it's been a favorite ever since.

Validation of Purpose

One of the questions that has been ranging around the ALI blogging community over the past week or so has been the question of why we blog, why we comment, and what our purpose is in each.  At this point, I'm more focused on why I blog (and why I post sometimes about infertility on Facebook, since the reasons are the same), since that's more important to me than why I comment. 

I blog (and post about IF on Facebook) to do my part to stop the silence.  A couple months before starting the blog, I had read an article in Self Magazine about infertility and the silence that surrounds it, and I decided that I wanted to be part of the solution instead of part of the problem.  I had no idea how many blogs there were out there about IF, but I wanted to be a resource for others.  Even when I found out how many there are and that I'm just a small drop in the bucket, I continued to want to be a small part of the solution.  Eventually I found connections to other bloggers that I value greatly, and I value the support I give and receive in our interactions, but other bloggers weren't my original audience.

For that reason, I also post on Facebook about infertility at times, most prominently during National Infertility Awareness Week (NIAW).  The first time I posted about NIAW, someone I had known from middle school messaged me to say that she was infertile too.  We hadn't been particularly close in school, and we had drifted apart since and just kept in touch on Facebook, but since then she has become my closest IF friend.  Even if there had been no other benefits (though there were), speaking out was worth it just for that. 

I got a further validation of why I do what I do last night.  An acquaintance from college messaged me for advice and information as he and his wife look at where is best for them to continue treatment.  We ended up talking for a while, and I'm probably going to end up getting together with him and his wife at some point to talk more.  It struck me at the time, this is why I am out there.  Someone that I don't know well at all, who I had last had contact with over a year ago, came to me because he knew about my infertility, because I hadn't been silent.  I had been part of the solution.

March Photo Challenge - Days 9-12

I was really busy this weekend, so y'all get another chunk of photos.

Day 9: Soft.  Since my mom and I like to joke that we're both part feline, my DH called this photo Four Sleepy Kitties.  This couch is soft and comfy enough that when one friend stays with us, she's at least as likely to sleep on this couch as on her bed!

Day 10: Love.  Two of the things I love most, Christmas and one of my cats.  Yes, I could have used a pic of DH for this, but he's more private than I am, so I consciously leave him out of this blog.

Day 11: Living.  These snails are on the rocks at the beach we were at in Costa Rica.  They have waves crashing down on them, people walking around on their rocks and on them, sun or rain depending on the season, and still they keep surviving and hanging on.

Day 12: Eat.  I LOVE baking!!  That set of cookies is from when we had a blizzard in December of 2009.  By the time we dug out enough to get to the store, I had gone through all my flour and on the last batch used my cake flour and whole wheat flour to make up the difference.  And that was with having bought extra baking supplies before the snow!

Random Question for the Blogoverse

If we're born with all the eggs we'll ever have (absent the ovarrian stem cell advances), since Clomid cycles and especially IVF produce a lot of eggs, does that mean we run out sooner since we're (in some cases at least) still putting out an egg in non-treatment cycles?  Do we get menopause sooner?

March Photo Challenge - Days 1-8

Since I was away for the first week of March but was drawn to the posts people have made with this set of prompts, I'm going to catch up now.  In the process, you guys get a little bit of the Tour de Tamarindo!

Day 1: Self-portrait.  I tend to be at least somewhat of an adventurous person, so when they let one person do the last zipline upside down, I said I wanted to do the same.  It was a blast, and it was the only one of the ziplines that I screamed on!

Day 2: Feet.  This pic didn't turn out as well as I had hoped, but it's what I could get holding a drink in one hand and the camera in the other.  That's a little pool in the rocks in front of my foot.  I wanted to get my foot/feet close to water.  Despite being a fire sign, I'm innately drawn to water, since I grew up right on the edge of the Chesapeake Bay.

Day 3: Domestic.  This is the typical breakfast in Costa Rica, rice and black beans with a fried egg (or two in this case) on top.

Day 4: Illuminate.  I really love how the rays of light work in this photo from our last night there.

Day 5: Commute.  This was our commute out to our dive site on Friday.  No, that's not DH in the pic, just another guy on the dive with us.

Day 6: Challenge.  The biggest challenge of the trip (aside from not getting more sunburnt than I did and actually getting on the plane to go home) was getting set up for the upside down zipline because I was supposed to hold onto a strap with my legs while hanging upside down.

Day 7: Purple.  The sky behind a papaya tree just outside the complex.  Now I know what papaya trees look like!

Day 8: Heal.  This is a 106 degree hot spring that I'm in.  Man, that helped to heal sore muscles!!

Music Monday #10 - Cowboy in the Jungle

No, people, don't worry, I'm not spending a bunch of time on Blogger when I should be relaxing on the beach, I wrote this before I left!  At the time I'm writing this, I'm still not sure how much jungle there is in Costa Rica or how close the jungle comes to Tamarindo.  Still, I thought it would fit.  I just hope that at the time this posts my skin still is as white as paste and isn't bright red!!  It's actually a good thing I wrote this post, because writing that last sentence reminded me that we hadn't packed sunscreen yet!

Music Monday #9 - Boat Drinks

In honor of my impending trip to Costa Rica, you all get a little Buffett to brighten your day.  I was going to emphasize the line of, "This morning I shot six holes in my freezer; I think I've got cabin fever."  But then I was pushing up my sleeves outside the grocery store tonight in 61-degree weather in February.  Still, I'm very glad to be leaving for a place where the low will be 66-68!!

Funny Way to Explain Infertility (or Unfilfilled Fertility)

Now you guys get to see the other post from someone else that's been open on my computer all month!  Joey at The Childless Mom posted a really cute set of videos that were created to explain infertility for people that have not been there.  I think the best one is the first one she had posted, so I'm going to repost that one here.  The bird and bee costumes just make them so much better!! 

 While I was finding the above video I came across another one I hadn't seen before and had to add that one because it's so true!

ICLW Madness

Now that I've got less than a full cycle to go before my treatment cycle, I actually found myself thinking as I was commenting that I'll be starting IVF "soon."  At the same time as that made me a little nervous and worried that something will still come along to get in the way, it feels good to think of it as coming soon.

Also, I'm seeing if I can reach Iron Commenter this month.  We'll see if I can manage it despite the packing.  One thing that keeps hitting me, though, it how freakin annoying those captchas are!!  Do people really have that many issues with spam commenters?!?

Infertile Families

First of all, today at work was obviously better than yesterday.  It was still hard, especially doing 2 sessions with clients who were grieving and checking in on a couple others, but having a quiet afternoon and staff being able to lean on each other for support both helped. 

I've been meaning to write this post for a couple weeks now, leaving the post that inspired it up on my Firefox window.  The Cornfed Feminist wrote a really interesting post about the effects of infertility on others in our families, specifically on our mothers.  My mom has been really great and supportive, and I know how she feels about the impact of the infertility on me (and on the use of the word infertility...she wants a more positive term that reflects that fertility has not been achieved yet).  Before reading this post, though, I never thought to ask my mom how she feels about not being a grandmother yet.  Mom?

Loss and Fear

Today I got hit really hard with two huge reminders that even if I can get pregnant with a non-SMA baby, even if I can make it through the first trimester, nothing is ever safe or secure.  I was pretty sure that one of them was coming, from posts from others in the ALI community: Mo from Mommy Odyssey lost her son Nadav after her water broke two weeks before viability and did not replenish.  As I've watched other bloggers count the days to viability while on bed rest and make it there, my heart breaks for Mo and her husband.

The second reminder is really hard to write about...since I finished the last paragraph, I've made another Egg McMuffin, chatted with friends, and watched a full episode of Gossip Girl.  My workday started like normal, went in and saw a couple of clients.  I was looking for my 11:00 client when one of the other therapists came in and told me to stay put.  She came back and told me that one of our coworkers had died this morning.  I didn't even know she was pregnant, but apparently she was 5 months along when she had an abdominal aortic aneurism.  I keep swinging between denial and tears, including during today as the clients were informed and reacting.  I asked one of the nurses at work and one I go to church with if AAAs are genetic, since my grandmother had one fixed a couple of years before she died.  Apparently some are, so I'm going to be asking my RE whether I should have a scan to make sure I don't have one.  I would ask my PCP, but I don't get to go to my real one thanks to him not being on the panel for my current insurance, so I have a name out of the provider directory that I've never seen on my card as my PCP.

Going to bed once this episode of Gossip Girl is over.  We'll see how tomorrow is at work.  Thank goodness for Costa Rica.

ICLW #6

Hi, everyone, and welcome to my happy home (or something like that).  Basic overview is that DH and I are waiting a month and a couple of days to be able to start IVF #1 with PGD.  We have unexplained IF, but we found out as we were getting ready to try to have IVF #1 last summer that I'm a carrier for spinal muscular atropny (SMA).  A few months later, we found out DH is as well, leaving us with the options of IVF with PGD or continuing to try naturally and taking our chances with the 1 in 4 odds of having an affected baby.  Needless to say, we're going with Option 1.

However, insurance didn't agree with us at first.  We had been planning on starting this cycle at the first of the year when my insurance company denied the IVF because we hadn't tried IUI first.  The especially crazy part of that is that they had authorized the PGD while denying the IVF!  I appealed the insurance decision after having to wait a month to get my letter of medical necessity from my RE, and we got the word that the appeal had worked about 2 weeks ago.  So now we wait.  Fortunately, one week of the waiting will be much less onerous, since we will be going to Costa Rica with DH's father and his father's boyfriend.  We're really looking forward to leaving next Tuesday!!

Music Monday #8 - I'm Not That Girl

OK, so I've been listening to the Wicked and Book of Mormon soundtracks a lot since I got them.  DH calls me obsessed with them, and he may be right, but they're both so good!!  I was listening to Wicked on Friday, and this song caught my ear and my heart more so than usual. 

I'm not that girl, and we're not that couple.  I'm not that girl who can just want a family and make one with her husband.  I'm not that girl who can even know why, beyond believing that God wanted her and DH to find out about the spinal muscular atrophy before having an affected baby.  I'm not that girl who can trust that a scheduled cycle will actually begin, even after starting the BCPs.  I'm not that girl who can trust that she'll get to use the box of meds in the dining room.

The last verse of this song begins, "Don't wish, don't start, wishing only wounds the heart."  That's been my mindset for a year now.  But on an old episode of Private Practice that I finally got to watch tonight, Addison said that the biggest muscle that she had needed to strengthen to take the first step of her first IVF cycle was hope.  I don't know how to do that.

Getting to Know You, Getting to Feel Free and Easy

Meme time!  I got tagged by ScubaGirl.

1) post the rules
2) answer the 11 questions from the person who tagged you
3) create 11 NEW questions for the people you tag (I have a feeling this is going to be the hard part!)
4) tag as many people as you like and link them to your post
5) let them know they have been tagged

1. Where is your most favorite place that you have traveled?

Paris!  I wish that I had gotten to spend more time there, but I was lucky that I got an extra couple of days there at the end of the city-a-day tour of Europe that my aunt sent me on when I graduated from college.

2. What is your favorite food?
My mom's spaghetti.  She puts kielbasa in the sauce, which gives Italians conniptions, but it is SOOOOO good!!

3. Who cooks at home?
About half and half between me and DH.  We both really enjoy cooking, although we both prefer having time to play in the kitchen rather than the "It's 7 PM, what are we having for dinner" type cooking.

4. How often do you go out to eat?
Maybe a couple times a month?

5. What is your most favorite movie of all time?
Probably Love Actually at this point.  My top 5 consists of that, Somewhere in Time, Princess Bride, Ever After, and Good Morning, Vietnam.  Cue sing-songy voice: One of these things is not like the other...

6. Cat or dog?
Cat, hands down.  My mom and I like to joke that we are part feline ourselves.  That said, I do also love big dogs (NOT a fan of small dogs except for Corgis, who are big dogs on small legs).  DH and I do want a dog at some point, but even several years ago, before we started TTC, we had agreed on baby before dog.  That way we don't get the dog until after having a baby has already slowed down the amount that we go out of town, so we don't have to worry about a dog-sitter or a kennel as often.

7. What flowers were in your wedding bouquet?
Heck if I remember what types they were beyond roses.  The most important part was that my mom and I went shopping together for fake flowers and she made my bouquet.

8. How many of the 50 states have you been to?
36...I'm missing Alaska, Arizona, Arkansas, Idaho, Iowa, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oklahoma, South Dakota, Utah, and Wisconsin.

9. What decorations do you have on the walls of your bedroom?
A really cool-looking print of a lightning strike, DH's Beta Theta Pi paddle over his side of the bed and an Alpha Phi Omega paddle (not my official one, because my chapter does something different with paddles) over my side of the bed.

10. Where did you go on your honeymoon?
Hawaii, specifically the island of Kauai.  DH had been to Hawaii a bunch of times, and in fact the idea of us getting married first came up when I expressed jealousy about this and he was like, "Oh, we can go for our honeymoon."  So I held him to that!  Since he had been so many times, though, he wanted us to stick to one island and do Kauai, which is quieter, so that we weren't feeling a ton of pressure to island-hop and see everything.

11. What is your favorite sport to watch? To play?
To watch, football, especially college football.  That comes out of my years of marching band, where I had to learn to like football or get really bored!  To play, baseball.  Not softball, baseball.  I play softball when it's available, but only because there aren't a lot of pickup baseball games or baseball leagues out there.

My next victims are:
Kayla at Life is Simple, It's Just Not Easy
Joey at The Childless Mom
Mag at Witty Infertility
Katie at The Zawislaks
Mrs. E at TTC Baby E

Your questions:
1)  What is your favorite book/series and why?
2)  What extracurricular activities did you like in high school/college?
3)  What type of music is on your radio most often?
4)  What is sitting on your DVR?
5)   If you were (are) on bedrest, what would you miss the most?
6)   If you were (are) on bedrest, what would do the most to keep you sane(ish)?
7)  Who on tv do you find the hottest?
8)   If you could get any question in the world answered, what would that question be and who would it be for?
9)   If you could have dinner with anyone, who would that be?
10) What type of food is your favorite?
11)  What is one thing (besides parenting) that you've never done and have always wanted to do?

Music Monday #7 - When You Say Nothing At All

I've always thought this was a beautiful song...if for some reason I'm just listening and not singing, I prefer the duet version that I've posted here.  Most of the time, though, I prefer to listen to the Keith Whitley version and sing Alison Krauss' part myself.

The song doesn't entirely apply to me and DH, since he and I are both Words of Affirmation people as well as Physical Touch.  For those who are not familiar with Gary Chapman's book The Five Love Languages, the basic premise is that we as humans express and relieve love in one or two of five different languages: Physical Touch, Words of Affirmation, Quality Time, Gifts, and Acts of Service.  I highly recommend the book for anyone who has never read it...I learned a lot about myself and others from it, and the knowledge I gained helped to improve several relationships in my life. 

It's Baaaack!!

As I work on being fulfilled in other areas of my life while I wait for a baby, tonight saw the return of my secondary blog, SnarkFood a team-written blog that snarks on various food shows and personalities.  I snarked the premier of Worst Cooks in America and then an episode of Iron Chef America.  Check it out!

This Roller Coaster is Making My Stomach Hurt!!

So last night I was jumping up and down and crying and wanted to frame the approval letter (especially after having gotten one the day before that extended the amount of time they had to decide further than it had already been extended).  And last night I was sobbing on the kitchen floor after opening another letter.  And today things are ok again.  No, I'm not Bipolar, I promise.  This process is, though!

The second letter came from the PGD lab in Maryland.  The one that had told me that they took my insurance and were in-network.  The one that my insurance company had confirmed was in-network (not that I trust CareFirst for anything anymore).  The letter said that the lab did not take insurance payments, only check or credit, and that the cost was $6250.  It's a good thing DH was home already when I opened this one, because I think that's what kept the meltdown from being fairly epic, him calming me down (kinda).  As it was, I was still trying to figure out how many years this would set us back.

My mom pointed out when I talked to her about it that all was not lost and that this didn't necessarily mean that insurance wouldn't pay and that I could possibly pay out of pocket (possibly with a loan from Dad) long enough to get reimbursed by the insurance company.  I still don't trust CareFirst for anything, so this made me nervous, but I was up for talking more to Mom about it over the weekend to explore the possibility.

This morning, I got a call from my nurse, who said she had spoken to the people at the PGD lab and they needed my insurance information.  Wait a second, what??  I thought they had just said they didn't take insurance payments!  So I called the finance person at the PGD lab, and she said that they do actually take insurance payments, they just prefer not to since many insurances don't cover it.  As I gave her my insurance info, I sagged in relief, which is probably what kept me from hitting the roof at them having frightened me like that for nothing!  I'm still pissed about it.  I wish I could just tell them what to do with that letter, but they're my only chance of being able to do a day 5 biopsy without freezing the embryos with money we don't currently have, since they're right across the hall from my clinic and can therefore get and test the samples in time for a day 6 transfer.

DH thinks that by the end of this, I'll end up writing a book about the finances of infertility.  Mom thinks I should see if there are organizations out there to help couples with the insurance issues of infertility and start one of my own if there aren't any.

INSURANCE APPROVED THE APPEAL!!!

There's a longer post coming, but I wanted to let everyone (who didn't see on Facebook) know!

Music Monday #5 & 6

OK, I just realized a day or two ago that I was bad last week and never did my Music Monday post!  However, an app that I have on Facebook that gives me daily suggestions to improve my life had the suggestion today to listen to 2 of my favorite songs.  So, y'all get to go along on that journey with me, and we'll combine 2 Music Monday posts into one.  The theme for today is what I have and what I want.

The first song is Everything I Do (I Do It For You) by Bryan Adams.  I tried to post the video, but the insert video function wouldn't find the right video on YouTube, and I didn't want to post anything other than the official music video for this one, so you get the link to go watch it in another window.  This song represents what I have, since it is DH's and my song, has been since the first summer we were together.  For those that don't know, when DH and I got together, I lived in Maryland and he lived in Michigan.  That first summer, before I was back on campus with better phone and internet access, we more than maxed out the 180 minutes a month I had on the cell phone my aunt was paying for.  At some point during one of those conversations, I mentioned that this was my favorite song, and DH said it was his, too.  Not that long later, he told me (I think in one of the letters we were also sending, both to keep the phone bills down and because I had time on my hands while lifeguarding) that the night before, he had heard our song on the radio while he was driving.  It's been our song ever since.

This next song covers both what I have and what I want.  It's Little Miss Magic, by Jimmy Buffett, and I thought it was beautiful the first time I heard it.  What really made it special for me, though, was that I was riding in the car with my dad (who got me into Buffett), brother, and baby sister and mentioned that I loved the song, and he pointed at me and Catie and said, "Little Miss Magic 1 and 2."  This was later the song that my dad and I danced to at my wedding.  At the same time as this song represents what I have in terms of my relationship with my dad, it also refers to what I want.  Even as I was looking at YouTube to pick a version to put up here, I didn't even consider clicking on any that had babies in the thumbnails.  I want to have a Little Miss Magic or Little Mister Magic of my own, and I don't know if I ever will.

Ants in my Pants

It's too early to be antsy about the appeal.  I know it's too early to be antsy about it.  They just got it on Monday and they have 30 days to decide.  And even if they decide sooner, I still don't want to try and start a cycle at the end of February because the timing would be bad all around.  I'd be trying to get the first appointment in as I'm going to an APO conference 3 hours from home and then leaving for Costa Rica a couple days later...there would be only one day to hope the timing worked for the appointment.  Besides, then if it worked I'd be due at Christmas, which would add in a whole other set of bad timing.  So my goal is to start at the end of March, which I can still do even if they take the whole 30 days to process the appeal.  And besides, it's way too early to be antsy.

But my cousin (who's been one of my partners through this journey) said, "Yah-hooey! Be as antsy as you want! You only get one life!"

Thank you, Leah!  Because damnit, I am antsy.  I'm trying to focus on other things.  I keep looking for more work to do in APO.  I'm doing more stuff with the MD Defense Force.  I'm going to Maryland basketball games (and watched the Dook game from the floor where I was making signs for last night's women's game that got me serenaded by the band).  I'm working on cleaning stuff in the house now while I've got some spare time.  I'm working on wearing out the 2 CDs I got from Amazon yesterday.  I've even gotten to the point of replacing broken purse handles!  But I'm still antsy.

Book Review - What He Can Expect When She's Not Expecting

I got this book a while ago for DH, and he read it at that point, but it was not until a month or so ago that I picked it up.  It was written by comedian Marc Sedaka, with a supporting role played by Dr. Gregory Rosen, one of the RE's that Sedaka and his wife saw during their IF process.  DH thought the book was well-written, but he does not think every husband entering the IF journey should read it because anyone that was like him would, if reading it too early, become convinced that their wife would want to spend $250,000 on interventions like the Sedakas did.

I decided to pick the book up again after I came home worrying that I was so far up in the crazy tree that I could see for miles.  DH told me that as long as I wasn't considering kidnapping, I wasn't topping out the "Wife Psycho Level" scale and pulled out the book to show me what he meant.  Now, I can see some people getting offended at the idea of there being such a scale in there.  Not me.  As a therapist, if you get offended by stuff like that, or are even just not able to laugh at it, you won't last long in the field without getting really burnt out. 

The book is very clearly written for guys.  It uses a lot of sports comparisons (which was fine with me!), and does a lot of boiling things down into what the guy needs to know, what the guy needs to do at a minimum, and what the guy can do to earn extra brownie points.  Dr. Rosen interjects into what Sedaka is saying to add in the medical details and to tell Sedaka when he is dumbing it down too much.  Throughout the book, Sedaka does an effective job of weaving his story in with the knowledge that he wants to convey while making sure the book still flows well.  I definitely recommend it for couples, especially couples where the husband is not one to assume the worst scenario presented will be the definite outcome.

Music Monday #4 - Shades of Gray

Well, here's a Music Monday that I know my mom will like!  She very definitely raised my brother and me on the Monkees.  I chose this song tonight for a couple of reasons.  One of them is the passing of JoePa.  This article does a very good job of looking at his situation and emphasizing that for many people this is not a black and white situation and that we cannot effectively be defined as people by one decision or set of decisions.

The other reason I chose this song is the verse about how, "It was easy then to know...how much to protect your heart and how much to care."  That's something I've really had to work on and work out at different times in the infertility process, and it's coming up again as we have the potential to be making progress again.  How much do I protect my heart as we hopefully go into IVF?  I won't really know until I get there, but my natural inclination now is to guard myself.  That sure as hell wasn't my inclination 2 years ago, but it has become my MO.  I'm afraid to care because every time I have in this process, I've been crushed by that.  Typing this reminds me of a Bible verse that was given to me when I was going under anesthesia for the first time and was scared: "For the Lord did not give us a spirit of fear, but of faith, love, and a sound mind." 2 Timothy 1:7.  Unfortunately, though, going in with faith, love, and a sound mind (or as sound as mine ever has been!) led to nothing but heartache, so I have to find the shades of gray that work for me at any given time.

For my mom and any other Monkees fanatics, I'm putting in two videos of the same song.  One is from 97 and actually has all four Monkees together, which is why I'm including it.  The other is from 2011 and shows off Peter both singing a solo and breaking out the French Horn.  Since he always played the lovable fool on the show, it's easy to forget that he was one of the musicians, not one of the actors.

Let the Countdown Begin

The appeal packet was delivered to CareFirst and signed for at 7:46 AM today.  Now they have until February 21 to make a decision.

In other "about damned time" news, our Christmas tree came down tonight thanks to DH.  And the two younger cats are in mourning.

ICLW #5

I'm in a very different place in my process from the last time I actually wrote an ICLW post, two months ago.  At that point, we were waiting for the results of DH's genetic screening, but I didn't really think that it would come back positive.  I figured we would be doing IVF for our first try, but only because we already had the meds and the insurance rep had (falsely) told me we didn't have to do IUI before IVF.

Now, I write this looking back on a month that has left me lucky to still have hair I haven't pulled out.  DH turned out to also be a carrier for spinal muscular atrophy, so we prepared for IVF with PGD, hoping to start our first cycle on 12/31.  On 12/20, the insurance denied the cycle because we didn't count as IF because of having had a miscarriage in the last year.  Funny, since I've never been pg.  Then they denied me because we hadn't tried IUI first.  Never mind that they had approved the PGD and you have to do IVF to get the embryos to test through PGD.

I had to wait 29 days to get the letter of medical necessity that I need for my appeal of the denial.  I got it this past Thursday and mailed the appeal on Friday with signature confirmation.  Tomorrow evening, I'm going to see if it was received yet so I can start counting down the 30 calendar days they have to make a decision.

As far as the PGD, my clinic really wanted to use a lab in California because they don't like the local lab anymore.  The lab in California would have cost us an extra $1000-1500 or so out of pocket and would have taken over 8 weeks to make the probe, so we're insisting that they use the local lab.  My nurse said on Thursday that she's going to put in the referral for that lab, and hopefully that can get going while I wait on the appeal.  The Maryland lab will only take 3 weeks to make the probe once we get whatever samples they need to them. 

I'm really hoping we can start a cycle at the end of March...that would work out nicely timing-wise (if it takes, of course) around stiff that I have going on at different times this year.  I'm still afraid to have hope for actually getting pregnant, but it feels safe to be able to hope for that, since there is a deadline on how long CareFirst has to decide on the appeal and medically there's no reason for the appeal not to work.  Then again, medically, there was no reason for the denial in the first place, so who knows.

Sent

I mailed the appeal today as I was on my way from one office to the other.  I made sure to get signature confirmation on it so that I know just when their 30 days to make a decision starts.

On a side note, why is the Priority Mail flat rate envelope costing less to send than the base rate listed for Priority Mail?

I Have the Letter!!!

FINALLY, after 29 days, I have the letter of medical necessity in my hot little hands.  I hope it's good enough.  I wrote a cover letter for it and copied the supporting documentation, and I'm heading to the post office on my way in to work to overnight it to CareFirst (or whatever will get it there early Monday) since I don't have their fax number and I haven't had a chance to call and get it.  Then they have 30 calendar days to decide on the appeal.

In the meantime, my nurse at the fertility clinic is putting in the referral for the Maryland-based PGD lab.  So they'll get the referral, look at it, and call me to discuss what they need from us to create the probe, and then that takes 3 weeks to create once they get what they need.

WHY do I have to fight so damned hard for what other people have the luxury to take for granted???

Like I said in the last post, this weekend (along with Monday) was a nice interlude where the whole IF thing and the whole fighting-with-insurance-and-the-clinic thing weren't bothering me so much.  It was a good break, but definitely bracketed by a lot of frustration and struggle.

When last we saw Our Heroes, they had just learned the various downsides of the California lab for PGD and were planning to make an appointment to figure out why the heck the RE would be wanting to use that lab.  Our Heroes had also at that point been waiting for 2 1/2 weeks for the medical necessity letter from the clinic to appeal the IVF denial (which I am now comparing to an insurer authorizing bypass surgery without authorizing the opening incision).

Well, we're still waiting for that letter.  The nurse called last Wednesday and said that she was going to follow up because she didn't see the letter in my chart.  I left yet another message for her today because I haven't heard anything.  I'm going to follow my one friend's advice and start calling the doctor instead, leaving messages every day until I get the letter.  I shouldn't have to do that, but nothing gets done if I don't.  Oh, wait, nothing was getting done while I had been calling the nurse every day either. 

I had called to make an appointment to try and get some answers, and got an appointment for the 25th.  Then DH told me that day was bad.  So while I was making calls today, I went to change that appointment.  Best I could get was the second week of February, and it had to be Friday the 10th since the other days that week I will be in a class in the mornings. 

Since I hadn't been getting calls back from the nurse for days at a time, I called the Maryland PGD clinic to try to get some answers.  They can do the testing without a $375 courier fee and without samples from our parents that we pay out of pocket to get tested and without taking 8 weeks to make the probe.  It would take them 3 weeks to make the probe, but that would all be covered in the cost billed to insurance, and 3 weeks is a hell of a lot better than 8 (plus the time to get samples to them from Egypt and several places in the US).  I also found out that this lab and Shady Grove have...differences of opinion...that are why they don't prefer to work with each other anymore.  I was afraid that SG was going to refuse completely to work with them and force me to go to another clinic (which would require 25-30 mile drives in rush hour traffic for monitoring appointments), but my nurse did say when I had caught her last Wednesday that they would work with the lab if people's insurance didn't cover the California lab.  So I'm going to insist that they work with this lab whether they damned well like it or not.  Just as I'm going to have to insist that they do the day 3 biopsy and day 5 transfer if they want my business, since we just can't afford the day 5 biopsy and later FET (especially not after having to spend another $300 on stuff from last plan year now that the insurance stuff from then got straightened out).

So now the plan is to badger the RE till I get my letter, appeal CareFirst's moronic decision, and insist on the RE using the Maryland lab and doing a day 3 biopsy.

And while all this is happening, I've been lapped by yet another person.  Maybe, if I'm lucky, now that I've gotten these posts out (I was going to write most of this last week, but every time I was going to it just seemed like it would take too much energy) I'll be able to concentrate on what I started trying to do 5 hours ago and have to get done before bed.

Music (Tuesday) #3 - Our God (Is Greater)

Sorry this is late, but I got home too late last night to do anything but go straight to bed.

I caught just the end of this song on the radio Friday morning on my way to the airport and cranked it up.  The middle to end has a great rhythm buildup that makes me want to dance and come as close to headbanging as I'm ever likely to.  The beginning is nice, but it's the second part that really lifts my mood and makes the song for me.  I would have posted it to Facebook as soon as I got to the gate, but I barely made the plane.  So I listened to the whole thing a couple times over the weekend and decided to use it for this post.

Over the weekend, I was doing really well and this song felt empowering.  I was having fun with friends I rarely get to see and making new friends.  I was able to talk about the IF without getting upset, and I was even able to talk about IVF matter-of-factly, just as something that had the potential to affect my schedule and what I would do when.  That ended up being a shorter-term respite than I would have liked, but I'll get into that in another post.

Music Monday #2 - Here Comes the Sun

I haven't gone to bed yet, so as far as I'm concerned, it's still Monday, damnit!

The last couple of days have actually been pretty good, despite the looming issues of the IVF authorization, the PGD clinic issue, and a lingering insurance/billing issue from the last plan year.  Friday night, I got to visit some friends at DH's curling club and then played fun music and watched my Lady Terps come back from 20 points down to beat Georgia Tech.  Saturday, an APO thing that I expected to take about 6 hours was done in 4, and I then got a great deal at WalMart on something for my office and then baked 3 batches of cookies.  Sunday I got a lot of Christmas un-decorating done and also had a great band rehearsal.  Today I got a lot of office organizing done (mostly at work, but some at home), figured out where the above insurance mistake was made, and then came home and made a healthy version of eggplant parmesan.  Little things, overall, but nice.

The real highlights, though, are that twice in the past day or so I've seen that my work and abilities are recognized and valued.  Yesterday afternoon, I got an email asking if I was still interested in helping out with logistics for a quizbowl tournament.  In a follow up email, I found out that he wants to put me in charge of a major aspect of the planning process.  I hadn't heard anything for a while after offering last year to help, since it wasn't planning time for it yet, and it was nice to hear that my efforts were still wanted.  Then tonight I found out from another friend that a project I worked very hard on for my local region of APO (for those who are new to the blog, I still volunteer a lot with my service fraternity, Alpha Phi Omega) was considered good enough to be adopted on a national level with very few adaptations and is about to be published.  Working on this project had been a new and really great experience for me.  I was working outside of my comfort zone, creating something that had not existed before within APO (at least not that I could find) and doing so within an area that I did not feel like I had much experience in.  I was proud of what I created, though, especially when I had passed it on to someone who I thought would find it useful and it then got passed on to and praised by the higher-ups that didn't really know me.  For those that have read The Five Love Languages, my two primary languages are Physical Touch and Words of Affirmation.  Being a Words of Affirmation person, it's important when people I know and care about tell me I did a good job, but it's a whole different level of impact when someone who I respect but who doesn't really know me praises my work.  And now, in addition to that praise, I have the knowledge that I added something of real value to the fraternity as a whole.

As if all that wasn't enough, it snowed today!  Yes, I know it's funny to post about snow given what song I'm highlighting, but I'm a huge kid when it comes to snow, but it brings metaphorical sunshine to my life.

I don't know how long the sunshine is going to last.  But in this moment, I'm able to enjoy the sunshine and not worry about how long it will last.  I'm not sure how long that ability is going to last either, but I'm going to ride it while it does!

Fading into the Distance

The last couple of days have been...well...educational.  I ended up finding out that CareFirst, in their infinite wisdom, had denied the IVF for not trying IUI first while still approving and authorizing the PGD!!  (For those who aren't aware, it's impossible to do PGD without doing IVF.)  Between DH and a couple of friends, we've come to the conclusion that CareFirst's decision-makers are the monkeys that weren't smart enough to be locked in the Hamlet-writing room.

To make life more fun, I had a scheduled phone call with one of the genetic counselors at the PGD lab in California that my clinic wants to go with.  (Why they want to go to one in California when there's one they talk about on their website that's across the hall from the main clinic in Rockville, I don't know, but that's a question for another day.)  Apparently this clinic doesn't work with the genetic testing place that has a patent on actually looking at the gene, so they have to look at whether DH and I transferred the chromosome 5 from our moms or our dads.  To do that, they have to get genetic samples from at least one of my parents and at least one of DH's.  Then they get the same testing on those that DH and I got to see which of each of our parents is the carrier.  When they look at the embryo tissue, since they can't look at the gene itself, they have to look at, for instance, "OK, in this one Jessie's chromosome 5 came from her mom, so that one's the carrier.  DH's chromosome 5 came from his mom and she's not the carrier, so that makes that embryo a carrier but not affected."

So that adds into things time for them to send the sample kits to our parents, time for the sample kits to get back (when one parent out of four is overseas), time for those samples to be tested, and time for them to then create the primer (also with blood from me and DH).  Oh, yeah, and my insurance isn't going to cover getting those samples tested.  That's out of our pockets unless what insurance our parents have will cover it.  As is the $375 courier fee to get the eventual biopsied cells to California.  Yes, a $375 plane ticket for 20 cells or so.  Again, WHY do they not want to use the place across the hall??

At this point, it seems like all Shady Grove wants to do is make us spend more money and time.  Now there's no way we'll get in 3 cycles (if they're needed, obviously) on this round of deductible and out-of-pocket max.  DH was asking if it might be worth going with another clinic, but the closest clinics other than Shady Grove are in DC and Baltimore, and that would SUCK in terms of going there for monitoring!!  I am going to make an appointment for another consultation, though, to try and figure out why the hell the doc wants us to go with the California people.  If I get the answers I need before the appointment, I can always cancel it.  Oh, yeah, and I still haven't gotten that letter of medical necessity for the IVF appeal from him!

Judgment Day

I've been thinking a lot lately about how how judge the people around us.  Several things have been contributing to that.  Katie at From IF to When had a great post a couple of weeks ago about judgment, bouncing off of another post by Mel from Stirrup Queens.  Like I said yesterday, the Creme de la Creme list is out, and seeing my Infertility Manifesto on there reminds me of the judgments that led me to write that post.  And I had an experience recently that made me feel very judged and reminded me of the unfairly high standards that infertiles are expected to meet, as compared to people who become pregnant easily.

I highly resent being judged, particularly by a different standard than that used for other people.  Yes, I realize that by having this blog, I open myself up to be judged by more people than I otherwise would.  However, aside from a couple of specific circumstances, I haven't encountered judgmental statements from people about what I post.  People may be thinking them, but I haven't had to deal with it because they have rarely been shared with me.  Besides, I believe in the importance of shedding light on the experience of infertility even more than I hate being judged, so this is worth the price of being judged to me.

Now, I know I can be judgmental, too.  The biggest reason that I had been thinking about Katie's post is that I have been reading Inconceivable, by Julia Indichova.  I'll get more into this when I finish and review the book in another post, but the book definitely sparked judgmental feelings in me that I had to grapple with.  The author conceived on her first try at about 40 and then dealt with secondary infertility related to age and extremely high FSH.  It helped me to deal with my feelings about this that she recognized she was "going back for seconds" before so many infertiles had been served once, but I did still struggle with anger at what felt to me like naivete and selfishness/greediness on her part.  It's never likely to affect Julia, because she's never heard of me and will probably see this blog, but it still struck me that I was being judgmental of her and that it wasn't fair of me.

Back to a couple of days ago, DH and I were essentially told that we really shouldn't be parents because at this point, while we don't have kids, we engage in activities that involve travel and being away on weekends, and we haven't committed to giving every bit of that up before even conceiving.  Who said this is immaterial here, it's the point itself that really had my blood boiling.  It is nobody's right except mine and my husband's to determine how is right for us to live our lives.  Unless there is a reason to suspect abuse or neglect, it is nobody's right except mine and my husband's to determine how to raise our future children. Unless there is a reason to suspect abuse or neglect, it is nobody's right except mine and my husband's to determine whether we "should" be parents to a hypothetical child that may never even exist.

DH and I both know that if we are able to have children one way or another, our lives will change drastically.  We know that what we are able to do, the amount of traveling we will be able to do, and the breadth and depth of our activities will change drastically.  Doing all of the things that we do to the extent that we do them will be impossible for a time.  Whether that time is two years or twenty, we have no idea and will not be able to know until we get there.  Doing absolutely nothing except work and parenting would be impossible for us as well, though.  I have seen that kind of parenting in action, and it's not what I want for my child, let alone for myself. 

All that said, though, I don't owe you or anyone else that explanation, and neither does DH.  It's none of your business what discussions we have had between us about how to schedule things and how much we will continue to do unless we choose to share information with you about it.  It's not even any of your business whether we're even had those discussions unless we choose to share that information. 

You wouldn't tell a woman who is already pregnant that maybe she shouldn't be a parent.  Don't say it to me.

Music Monday #1 - Mission: Impossible

One thing that is done every year in the ALI (Adoption, Loss, Infertility) blogging community is Creme de la Creme, a list of personal best posts of each year.  As I was reading through the list for 2011, which was just posted, I came across Tanya's idea of Music Mondays.  Because imitation is the sincerest form of flattery (and because I found this on the first Monday of the new year, which makes it even more fun), I'm snagging her idea.

So far all this IVF thing feels like is Mission: Impossible.  After getting the answer about the out of pocket max last Monday, I haven't been able to make any real progress since thanks to the damned holidays.  So far 2012 has been nothing but more obstacles, except for getting some stuff done at work today.  It's mostly been little things, but it just adds insult to injury, which I really don't need right now!  So far there sure hasn't been anything to give me any reason to believe that 2012 will be any better than 2011 or 2010 or 2009.  So that's my song for today, damnit.  Maybe later I'll have a song that's sunshine and rainbows and unicorns, but that day is not today.

Addendum to Last Post

Part of not knowing who I should be mad at now is also still being mad at myself for not having given the clinic my new insurance card earlier.  I don't think it would have made a whole lot of difference, since we only found out it would have to be IVF about 2 weeks before our appointment, and I don't think the RE would have had the finance person request the IVF/PGD auth earlier than the appointment, but maybe it still would have gone a little faster.  And maybe I was just stupid and naive to think that because getting authorization had gone smoothly and quickly once, it would be smooth and quick again (yes, with a different insurance company, but with a company that had treated my coworker right with her IVF and that doesn't have such a bad reputation for denying needed treatment).

I Don't Even Know Anymore Who I'm Supposed to Be Mad At

One thing that I forgot to mention yesterday was that I tried to check with CareFirst and make absolutely sure that the PGD had been requested along with the IVF, as I had been told by the fertility clinic's finance person, hereafter referred to in this blog as Finance Bitch.  (No, I don't usually go around calling people a bitch in anything other than a momentary expression of frustration.  But this woman seriously is.  I'm not expecting her to be all bleeding heart about the subject because she gives almost as much bad news to people as their doctors/whoever calls with beta results, and as a therapist I can see how it would be too hard to get emotionally caught up in every couple.  But by the same token, she does give a lot of bad news, and that warrants an attitude at least a little more considerate than one that says "oh well, sucks to be you.")

So anyway, since I was already calling CareFirst to try for the second or third time to find out who was in network for PGD, I asked about the status of the authorization request for the service.  The woman I was on the phone with said that she did not see an approved authorization for it.  I asked about pending/denied authorizations, and she said there was one open request.  I asked specifically what procedures had been requested in that auth, and she said that she couldn't tell me.  I asked to speak to someone who could, and she said that no one could tell me what had been requested, even if they could see the information.  Why, you ask?  Apparently because I'm only the patient.  They're only allowed to discuss that information with the provider, not with the person whose body the procedures would be done on.

Today I come home from a day of work that involved helping others through a loss there that I'm also grieving myself, and I see that I got the denial letter from CareFirst.  It says that authorization has been denied for the procedures of IVF, assisted hatching (a necessary component to the PGD biopsy), and ICSI (intracytoplasmic sperm injection, recommended for us both because of the PGD and because of an extremely minor thing with DH's numbers).  Nowhere there is PGD mentioned.  I really hope that's because that's considered a separate authorization request that is still pending.  Because if it was never requested, I'm going to blow a gasket.  Because it might be Finance Bitch's fault that I won't be starting my first IVF cycle this weekend.

At least the basketball game was good.  My throat hurts from yelling, but my Terps looked good out there, and I was impressed with our 7'1" freshman that started for what I think is the first time tonight.

One Major Answer Acquired!

I was feeling really bitchy and whiny about having to go into work today with no time off at all.  After all, I avoided retail jobs so I wouldn't have to do that shit!  In the end, though, I'm glad I went in today (although I'm also glad I went home a little earlier than planned and took a nap).  Why am I glad I went in?  Because when I opened my work email, I saw a message from the CareFirst lady (not the one I had been dealing with all week, the one I had gotten some answers from back in September).  Now, the amazing thing is, she emailed me back on Saturday.  I could have checked my email from home, but I didn't expect her to email me back after not being able to reach her for days!  She does earn back some of the points she had lost for being impossible to reach by emailing me back on Christmas Eve, whether she celebrates or not.

So, which answer did she give me, out of the many I have been arguing/begging for?  The Out of Pocket Max DOES apply for infertility treatments!!  And unlike when she told me it should back in September, this time she attached a PDF of the 150-page plan booklet AND told me where in there to look!  So now I have a listing of what the exclusions are for the OOP max, and infertility is not on there.  I'll take a copy of that section over to the clinic on Wednesday.  I also need to call/email my nurse tomorrow and check on the status of the letter of medical necessity for the IVF appeal.  And check with CareFirst about who's in network for PDG now that I have a better idea of what companies to ask about.  And get the process started with whoever is in network.

But the important thing is that now I know that I can go ahead with those, secure in the knowledge that the amount we had budgeted and put in the FSA will be enough for anything and everything non-cryo-related.

Coming attractions in this space: Book review of What He Can Expect When She's Not Expecting, by Marc Sedaka.  DH read this a while ago, but I just got around to reading it after DH pulled it out to explain that I wasn't at the top of the Wife Psycho Scale even in the middle of last week.

Wow, That Came Out of Nowhere

I had A Christmas Story on for background while Santa was wrapping presents, and I was just about to be ready to go to bed when one of those SPCA commercials came on.  One of the kittens that they showed reminded me of Kechara when he was a kitten, and I just lost it.  I started sobbing so loudly I woke DH up.  He was sweet about that and hugged me, but I still felt bad for waking him up.  Usually when something reminds me of Kechara, I've been able to smile sadly and keep going, maybe with a tear or two in my eyes, but nothing major.  Not this time.  I don't know if it was because I've been more emotional lately or because it was a kitten looking like him instead of an older cat or what, but the strength of my reaction definitely surprised me.

The Nightmare Continues

For those visiting from ICLW, I'm currently fighting with my insurance to get approval for my IVF #1 with PGD.  I've got a diagnosis of unexplained infertility, but DH and I are both carriers for spinal muscular atrophy.  Yesterday, my authorization request was denied because they don't think I'm infertile since I had a miscarriage in 2011.  The "funny" part of that is that I've never actually been pregnant.

The first thing I learned today is that the request is still denied, despite the fact that they corrected the incorrect information.  Several hours later, I learned that the reason for the denial had changed (which CareFirst didn't bother to tell me).  Now, it's being denied because I hadn't tried IUI first.  Which is confusing the hell out of my RE's office, since they figured they made the case for why we had to go right to IVF in the information they submitted at the same time requesting authorization for the PGD.  Also interesting is the email I have from the CareFirst sales rep assigned to our account, from back in September, when she said that she checked the contract and could not find any language requiring IUI to be tried before IVF.

So now I have to appeal the denial.  The denial letter won't even be processed to be mailed to me for 5-7 business days, but fortunately I was told what I needed to say to start the appeal process before I get the letter.  So I called, and I have an address in Kentucky to send an appeal letter to.  I emailed my nurse to get a letter of medical necessity, and she forwarded it to me RE to do.

To add to the fun, when the finance person at Shady Grove ran my insurance, the report came back that infertility costs don't count towards the Out of Pocket max of $3000.  The email I have from the sales rep says that it does.  At the same time, the sales rep also told me on Monday that there was no preapproval needed for IVF, so now I don't know whether to believe anything she says!

If infertility costs don't count towards the OOP max, then we just plain can't afford to do the IVF cycle at all, probably not at all this year.  But now we have $1500 in DH's FSA for 2012, and without the cycle, I'm not sure if we can use up all of that and avoid losing any.  Probably, since DH and I both wear contacts and are running out, but I'm not sure.

Then again, I'm really not sure of anything right now.

Oh, You Have GOT to be Kidding Me!!

Hey, y'all, check out the email I just got back from the insurance company:

Hi Jessica,
I'm sorry this has taken so long to get information to you. But I just heard from our case management area. They have reviewed a copy of the contract today. The contract states a member must have a documented history of infertility of two years duration. The clinical information provided indicates you had a miscarriage in 2011, and therefore does not meet the criteria outlined in the contract. The request will be denied based on the terms of the contract. Your provider will be notified by phone today and letters will be sent to the provider and you. You may appeal by contacting Member Services.
Again, I'm really sorry for the result of the outcome of your request but you do have the option to appeal.
Thank you for your patience.


It's nice to learn that I had a miscarriage in 2011.  Hell, it's nice to learn that I was pregnant in 2011.  Wouldn't you think that I'd learn that from someone other than my insurance company?!?  I emailed back asking where it was in the clinical information, and I just left my nurse a message as well.

*Headdesk* so many times that I would have splinters in my forehead if my desks were real wood

I Used to LIKE Roller Coasters!!!

So I got a voice mail from my nurse this morning.  My RE had been out yesterday when we were playing phone tag, but she grabbed him this morning and found out that he wants to just do the day 5 biopsy and FET rather than giving us the option of the day 3 biopsy and day 5 transfer.  ARGHHHHHH!!!  I left her a voice mail asking if we can insist on the day 3 biopsy and day 5 transfer, because we really just can't afford the cryo costs.  So at this point, the answer to whether we can insist on the day 3 biopsy and day 5 transfer is also the answer to the question of whether we can go forward with a cycle anytime soon.  Of course, just to make life more fun, it's too late to change the amount that we put in DH's FSA, so we can't raise the amount to be enough to cover cryo, but we also can't decrease it based on not doing IVF at all.  So if the RE continues to insist on the day 5 biopsy plus FET, we may be in the position later in 2012 of deciding whether we want to spend a couple thousand we can't afford on cryo or lose the $1500 that's in his FSA because of not doing a cycle.

Querying the Blogoverse

OK, now that I'm ready to talk about Friday's appointment, I have questions for those who have done PGD.  When I was reading online, I only saw information about PGD done on day 3, with a day 5 transfer.  My RE was talking about that option, but also about doing a biopsy on day 5 and freezing the embryos for later FET.  Did y'all have that option?  Did y'all do day 3 biopsies or day 5?  Did you get more/better embryos to transfer by doing day 5 biopsy?  At this point, we might have to insist on day 3 biopsy and day 5 transfer because our insurance doesn't cover freezing, and we can't afford the cost of freezing, storage, and thawing.  Everything else is covered by insurance, but not that.

I did find out from the insurance company today that there is no waiting for approval for IVF since we're using an in-network clinic.  Now I just need to hear from the case managers at the insurance company about where is in network for PGD and fertility pharmacies, as well as whether a day 5 biopsy and later FET would count as 1 cycle or 2, since apparently insurance companies differ in how they count that.  Since we get three cycles per live birth covered, that is a key question!

Advent Message for Infertiles

The sermon that we had today at church really struck me as important for the infertile community as well as anyone else who is having a tough time with the holidays.  I've seen many people, both infertile and not, saying that the holidays are a hard time this year, partially because of everyone else seeming happy and excited.  The pastor spoke of how many people put on a happy mask while experiencing, in the words of Angela Lansbury, "rivers of pain inside." 

Pastor Kathy pointed out that, while we tend to romanticize the manger and stable, the first Christmas came out of hardship and struggle.  While those of us that have never been able to be pregnant can't really imagine it, Mary's journey by donkey when she was about to pop had to have hurt.  Chances are they didn't get to stay in inns on the way; a blanket roll on the ground was a very real possibility.  Mary didn't have a midwife to help her through the labor, and I'll bet the hay they got to sleep on poked all of them through the coverings they had.  None of it was how Joseph, or even Mary, had imagined it would be, just like none of creating a family is how we thought it would be.  But still, Joseph and Mary made time and space in their hearts for awe and wonder, just as we can in the midst of our own struggles.

This doesn't make Christmas feel more real for me, especially since I'm not sure why I feel separated and there's no definite link to other people being happy when I'm not.  Still, I thought it was an important message and one worth sharing.

Ugh

I guess I should eat something today.  Scratch that.  I know I should eat something today.  But before the appointment it was way too early for my stomach to want food.  I was going to get an Egg McMuffin after the appointment, but then my stomach was in knots.  Then I went to bed again and woke up and still haven't eaten.  I guess I'm hungry.  But damnit, it's so much easier to sit here playing Minesweeper with a cat purring on my lap.

Orange Crushed

Wow, I feel like a fucking idiot.  I didn't give the RE's office my new insurance card ahead of time, so I got into the finance office all excited about starting a cycle on about January 1 with almost perfect timing (if nothing was screwy with the genetic testing people) and found out that insurance companies take 4-6 weeks to approve IVF.

I think it was 20-30 minutes before I stopped crying.  Mostly.

DH was really supportive, telling me I haven't ruined everything and that I didn't know, it's not like I did it on purpose.  I feel so stupid, though.  I should have known.  I should have given them the new card when my insurance changed.  Or gone over there with a copy of the new card when I made the appointment (even though that was still less than 6 weeks from when we wanted to start a cycle, I think it was more than 4).

I called in crazy to work, at least for the morning.  I'm already 3 hours ahead on the pay period anyway, the two clients I had for the morning are ones I can easily reschedule, and I'm just not in a state at the moment to be emotionally present for clients.  I know I will be ok, but I'm not ok right now.  I told my boss I'll decide about the afternoon once I see to what extent a couple hours of kitty therapy (and a nap) help.

Advent is a Time of Waiting

This Christmas season has been a little weird.  Christmas is always my favorite time of year, but even though I've been enjoying my tree and lights and Christmas music, it still hasn't felt quite like Christmas.  I'm not really sure why.  One thing I'm glad of, though, is that I'm together enough this year that Advent sermons about preparing aren't making me fall apart thinking of how I was preparing for nothing to happen.  That's probably some combination of the therapy this spring and the fact that we're actually getting somewhere this winter, even if we don't have anything to show for it yet.  I don't really care to analyze it too deeply, though; I'd rather just sit back and appreciate it.  I guess part of the weird feeling is that I feel like I'm doing a lot of that, sitting back and watching, rather than really being in the middle of things.  I'm not sure why I'm doing it, and there may be many things contributing, but I am.

OK, now that I'm done psychoanalyzing myself (for the moment, at least!), there are a couple of cool things I wanted to share on this, the eve of my next RE appointment.  One of them needs some background info unless you already know me pretty well IRL.  For those who have never met my dad, it pretty much says it all to say that he was a Marine Corps Drill Instructor at Parris Island before I was born and is currently a Command Sergeant Major with the National Guard, in his third deployment.  Although he and my stepmom needed ART to have my sister, he doesn't approve of me doing this blog because private information should stay private.  Because of this, it meant a LOT to open up Facebook on Monday to see a file he had sent me that was his receipt for donating to RESOLVE.

The other thing I wanted to share was a really powerful quote that ScubaGirl had posted:

The English language lacks the words to mourn an absence. For the loss of a parent, grandparent, spouse, child or friend, we have all manner of words and phrases, some helpful some not. Still we are conditioned to say something, even if it is only “I’m sorry for your loss.” But for an absence, for someone who was never there at all, we are wordless to capture that particular emptiness. For those who deeply want children and are denied them, those missing babies hover like silent ephemeral shadows over their lives. Who can describe the feel of a tiny hand that is never held?" ~Laura Bush


For those who stuck with me through the rambling, congratulations!  I'll post another update after the RE appointment tomorrow morning.

Finally Getting Answers!!

I got a call from the RE himself on Wednesday with the results of DH's genetic testing.  DH is a carrier for exactly one thing.  To quote Love Actually, you may have guessed it, but you may not believe it, it's SMA!

So now we get to learn a lot about pre-implantation genetic diagnosis.  The article I just linked to provided some really good information.  We still have a bunch of questions for the RE when we meet with him next Friday, though.  One question that I have for anyone who has needed PGD is how significantly it impacted the number of embryos they still had to transfer/freeze, whether they still had enough.

The biggest impact that the news has on me is that I finally have some sort of answer to the cosmic question of WHY.  Why we had to deal with infertility.  Why we couldn't have our first cycle when we were supposed to.  Why we weren't able to do what so many other people can do so easily.  The question of why is still on the list of questions I have for God when I get a chance to ask him, but it's moved a lot farther down the list.

The Death of Fantasy

There was something else I was going to write about tonight, but plans changed, so instead you'll get that post tomorrow.  The plan changed when I read this post by Keiko Zoll of Hannah Wept, Sarah Laughed.  Here's the part of the post that jumped out at me the most:
  
"I’ve always fantasized about how we would tell our parents we were pregnant. In this perfect fantastical world, we’d time everything perfectly so we could do the big reveal over the winter holidays. I always wanted to have both sets of parents open gifts that said “World’s Best Grandparent” and make the big reveal that way.

It’s not terribly original, but it’s my fantasy....
 
But… [the fantasies have] changed. A lot. There’s no surprise element when I blog publicly about my personal journey. As of right now, I plan to blog about every step of the way. That might change. But for now, that’s the plan.

And Larry and I maintain the kind of relationship with both sets of families that they’ll be in the loop every step of the way as well. When we go for a beta, they’ll know only shortly after we do, because they’ll have been following along because we’ll have shared it all with them anyway."

I very definitely understand the difficulty with the loss of fantasy.  I fantasized about telling parents at Thanksgiving, and then at Christmas.  And then at the next Thanksgiving and the next Christmas.  Like Keiko, I'm open about my blog and our process, so parts of our families will thus know right away.  So I gave up on the idea of any sort of big special reveal.  But I still haven't thrown away the Grandparents' Day cards that I bought for all 4 sets of parents as an announcement.