Old School

I've been doing my homework with the pharmacy. It's a good thing too -- nobody else would have managed to find out in time that some of the meds I need can't come from the mail-order pharmacy, and then arranging for them to be sent to a local pharmacy instead. And why, oh why does the insurance cover expensive fertility meds, but not progesterone in oil? It's a mystery to me!

The other mystery is why my RE ordered Repronex instead of Menopur, and Novarel instead of Ovidrel. Last time I used Menopur and Ovidrel with complete success, so I am a little dismayed at this.  In case you aren't as entrenched in this as I am, I'll tell you why.

Twenty years ago, when they were just starting into ART, doctors and scientists needed to make new drugs with human hormones in them. They figured out they could get these hormones form the urine of post-meonpausal women. They purified as well as they could and put them into an injection. These injections weren't ultra-pure, and because of that and other factors I don't totally understand, these injections have to be given intramuscularly (IM). With an IM injection, there's no easy pinching of your tummy to stick in a tiny needle. Instead, it means getting that gluteus maximus out, and getting someone else to help you stick a Hi-C straw into it, making for a bruised, sore glut.

Thankfully, ART has come a long way over the past 20 years. Part of the progress has been to create a process to either make these same drugs in an ultra-purified state or a synthetic (but still effective) state which can be injected subcutaneously (tiny needle in a pinch of skin with just a small bruise if anything).

So why does my RE use the old-school method? Is this insurance-driven? Is the clinic just old school? You better bet I'll be asking these questions when I meet with him this week.

Meanwhile, the Repronex and Novarel will be arriving shortly.

I wonder, can I twist myself far enough while relaxing my gluteus well enough to give myself IM injections? Last time Scott did the IM injections of progesterone for me, but this time I may have to do the progesterone as well as the Repronex and Novarel injections on my own with S's work schedule. All I can say to that is yikes!

Pharmacy Wondering

I called nurse M with my pharmacy information Monday afternoon, and had not received a call from her or the pharmacy by this afternoon. Having realized nobody else is keeping things in line for me, I called the RE's office today to made sure she'd gotten the message. The receptionist didn't put me through, but asked Nurse M, who said she had called everything in. I guess this means I get to call the pharmacy tomorrow to see what's happening. In addition to the issue of copayment, the arrival of my meds is extremely time-sensitive for two reasons. One being it has to start on a particular day, but since that is still a few weeks off, the more important one being some of the meds have to be refrigerated and will be shipped overnight from the South, so I'll need to get them into the house quickly.  I'm so glad I've been through this before and know what I'm doing. I seriously wonder if I would have a successful cycle with this office it I wasn't my own advocate.

A Ray Of Sunshine

In figurative speaking, the sun poked through the clouds today.

Going back in time...two-and-a-half years ago, when we first decided to try IVF, I scheduled an appointment with Dr. H. The meeting was hopeful and I felt an extremely powerful spiritual confirmation. All day long I felt as if the sun was shining just for me and everything was right with the world. I had no question in my mind that this was the right thing to do. Thankfully, the results were just as sunny.

This time, the decision to do IVF was very different. Again, I sought a spiritual confirmation, and felt it was a right time. However, there were no angels singing in the clouds this time. Even after my first and second appointments with Dr. M, I came home feeling gloomy, not sunny.

Today it felt like the sun finally poked through the clouds. First, my sonohydrogram and trial of transfer had a short wait and a positive tone. I met with a different doctor today, and had a positive experience with him, including his mentioning he knows Dr. H from The Land of Hot. I found my rewards at friendliness with the office staff reciprocated. Then, when I went to talk with the billing staff, they reported that my insurance had approved the IVF cycle!

All in all, a very positive experience at the clinic today. It is nice to finally turn to the sunny, optimistic side of myself. Once again, this can work and I'm getting excited to get started.

The IVF Influence

Ten years ago I studied abroad in the middle east.  This evening I was contacted by a fellow student who is organizing a ten year reunion. While it was a life-changing experience, I won't be traveling to a faraway state to attend the reunion. They asked for contact information, and I provided a minimal amount. If someone really wants to get ahold of me, they will be able to from what I provided.

I also provided a picture of my family. I didn't provide details, like my husband's name or occupation, names or ages of children, or location. They'll have to guess that from the picture.

Then, I thought about who I am inside, wishing perhaps some of it could show from the picture.

Since that study abroad, I've lived in one other country and 5 other states. I've struggled through infertility including months upon months of trying to conceive naturally and the emotionally jarring repetitious failures; 6 clomid cycles; 4 IUI's; 1 IVF and I'm about to embark upon another.

I come from a culture where children are common; expected; plentiful.

While statistically there must be a few who have "been there," all of the others are still oblivious.

Do they know I'm strong? Do they know what I've opaquely sacrificed for those transparently far-spaced children? Do they know the dark, sad moments? Do they know what it takes to support my husband and his unique career?

I am shaped unchangeably but where I've been and what I've experienced.  I don't wish upon anyone to have to struggle through IVF, but I want to be understood for who I really am.

Repeat

It's commonly known that men don't understand the inner workings of women. I have to admit, sometimes I don't understand the inner workings of my body as well. Specifically, I don't understand why it insists to start cycling on the last day of my vacation which had to be spent in airplanes and airports.  This also gave me just a one day break from vacation before finding myself at the clinic, getting started. I thought I'd have about a week.

Maybe some higher power is speaking?

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Anyway, day 3 ultrasound and blood work today was a little unbelievable again. 45 minutes waiting in the waiting room and 20 more waiting in the exam room.

Again, the office staff was less friendly. I knew more than the financial person. Yet when I tried to be friendly, the financial person was really helpful. The nurse and lab tech and doctor were friendly. What needed to be done got done. I'm going to have to cool my jets and get used to this.

When the nurse called in the afternoon, everything made good sense because I've done this all before. In fact, when I told Nurse M that Dr. M had waived the IVF Orientation and Injection classes, she said that was very unusual. I must sound like I know what I'm talking about.

I think I really do know what I'm talking about, in a non-arrogant way. I could be wrong, and sincerely hope I'm not.

I'm generally a fairly optimistic person, so I'll try to write in a more optimistic tone soon. I promise.

I'll start birth control pills (BCP's) Saturday, and have a hydrosonogram and trial of transfer Monday.

I feel so much more relaxed about things this time, and it's definitely a better way to be.