Thursday, May 31, 2007

Waiting on Miss Priss

So, while I'm here in limbo-land, waiting on my prissy period to deign to grace me with her presence, I thought I'd post about something inspiring I heard today.

I attended a funeral today, for my best friend's father-in-law. He was interred with military honors at Quantico Cemetery at the Marine Corps base in Quantico, VA. It was a beautiful service, and the presiding chaplain delivered rather unique remarks, in my opinion. They were the most upbeat and joyful remarks I've ever heard at a funeral or interment service, and I've been to far too many.

In addition to the typical, "he was 81 years old, he lived a long, full life" type of stuff, the chaplain also admonished the rest of us to take joy in our own lives and loved ones - to wring the most out of every life experience we have, each and every day. While smiling a big infectious smile, he said (and I'm paraphrasing here), "We don't have much time here, any of us - so love your family and friends with your whole heart. Forgive everyone! For everything! Life is too short to harbor resentment. Let the love pour out of your heart at every opportunity! If you love someone, tell them! Try to be conscious of the joy in every life experience!"

I was particularly uplifted by this, and have been thinking about it all day. It helped to reset my perspective a little, which is always a good thing. His sentiments remind me of a passage that is very dear to my Mom. She has it framed by her bedside. (I believe we first heard this in a benediction delivered by our most beloved Dr. P, the former minister of our church, and the man who married R and me two and a half years ago):

Life is short.
We do not have much time to gladden the hearts of those who travel with us.
So be swift to love,
and make haste to be kind.

I think that says it all, folks.

Wednesday, May 23, 2007

8 random things about me...

I apologize for yet another post that falls under the category of ME, ME, ME! Tagged again by Jen at The Mama Wannabe to come up with eight random things about myself:

  • I have an ear for foreign languages. I whizzed through French in high school with straight A's, and always received compliments on my accent. The summer between my junior and senior years of high school, I spent a month in Germany, and learned a shitload of German. My senior year, I enrolled in First Year German (which was directly across the hall from my Fourth Year French class). During the second month of school, my German teacher came down with laryngitis. I ended up teaching the next month's worth of classes for her, in German. For several years after that, I thought I wanted to be a foreign language teacher when I grew up. I majored in German in college because all my German classes were easy and required the least amount of effort on my part. If I had it to do all over again, I would have gotten a business degree. I've never once spoken anything other than English in any job I've ever held.

  • I made a lot of extra money in college by translating German "business writing samples" for a guy who worked for a major stockbroker in downtown Richmond, VA. I now suspect the "writing samples" I translated were the work product of either colleagues or competitors that he somehow stole. He always paid me in cash.

  • I'm the girliest girly-girl you'll ever want to meet - I won't go to the mailbox without makeup on. I wash/blowdry/curl my hair every morning. I feel absolutely naked and uncomfortable and anxious if I leave the house and forget to put on perfume, jewelry, or lipstick. It takes me a minimum of 1 hour to get ready to leave the house in the morning. (much to R's dismay, since we usually carpool most of the way into work together.)

  • *I grew up in a family of hunting men. I am the only daughter and only female grandchild on my Dad's side of the family, which is a farm-living, horse-raising, salt-of-the-earth, southern Virginia hospitality-having, God-fearing family. The men of this family, including my Dad, his uncles, his brother, his many male cousins, etc. grew up hunting quail and dove in the marshy ever-encroached upon fields and farmland of southeastern VA. When I was born, my father took one look at me and told my mother to prepare herself, for her daughter was going to take to the woods with her Daddy, if he had anything to say about it. On the much heralded occasion of my 12th birthday, my paternal grandfather presented me with a 12-gauge shotgun. I've never been more honored by any birthday gift, before or since. The times I recall out walking in the woods with my father, my grandfather and our bird dogs (you haven't seen anything until you've seen an English Springer Spaniel or a Brittany Spaniel standing stock still, tail rigid as a board, pointing a covey of quail - it gives me goosebumps thinking about it) are some of my most precious and treasured memories of my father, who passed away when I was only 17 years old. I wouldn't trade those times for anything in this world.

  • My maternal grandfather was an identical twin. When I was younger (and oooooh so naive) I always fantasized that this would ensure side by side bassinets, dual strollers, and double trouble for me when it came time to have children. Now I worry that my chances of doing double midnight feedings are great, but for entirely different reasons.

  • I have an incredible ear for recognizing famous voices. I'm constantly harrassing R with this question, every time we happen to see a TV commercial (which is not that often, since we have DVR now, which - hearken, friends and neighbors - Changes.Your.Life!): "Who's voice is that, honey? Huh, huh? Do you know? Do you want me to tell you??" My favorite are those cartoon movies with laundry lists of famous people for me to discern - like, Over the Hedge, or Happy Feet, or Monsters, Inc. (that's my favorite!!) I try not to listen to any of the previews so that I won't have any unfair information before the movie comes on. If I hear a voice that I recognize, but can't place, it feels like a puzzle I'm solving. If I can't get it at first, usually I'll think of the voice in my head, and I'll "hear" another phrase that has been spoken by that voice which has somehow stuck in my brain. From the context of that recalled phrase, I can almost always figure out who belongs to the voice. If I could somehow make a living using this skill, I would quit my project management job in a heartbeat.

  • Ever since I was little, I've always been able to remember lots of song lyrics, and I can remember them for a loooong time. I got satellite radio in my car (my Christmas gift from R, two years ago) and sometimes I'll catch a song from the 80's that I haven't heard in 10 years, and I can still sing every word. My best friend Monica still makes fun of me because of this dorky ability.

  • If I could come back in another life as someone else, I'd want to be a female vocalist. And I don't mean a pop star. I mean like a traffic-stopping, a capella-capable, Barbra Streisand kind of vocalist who can hold a high C for 5 minutes and bring tears to your eyes. I LOVE, love, love to sing, and can't think of anything better than doing it for a living. (On alternate days I think I'd like to come back as the female lead singer of a rock band who can actually sing. I'd have to come back in a previous decade though, a la Heart, or even Pat Benatar. That would be a lot of fun too. But in a different way.)

Similar to my invitation at the end of the "I Am" post - this has been all around the world and back again, so rather than naming anyone in particular, I will just say, if you haven't been tagged yet - consider this your formal invitation to participate!

*I realize I will alienate some readers with this tidbit about hunting. All I can tell you is that my Dad's family has never hunted for pure sport; I grew up eating Sunday "bird dinners" prepared by my grandmother, which were great feasts of dove and quail, breaded and fried and delectable, served with collard greens, butter beans, and fried cornbread. I believe God made those birds delicious for a reason. But, I'm conflicted, because I'm also a huge animal lover, and could NEVER, EVER kill anything that I thought was cute - not deer, not rabbits, not even squirrels. Birds and fish I have no problems with, probably because I don't have even the slightest desire to cuddle them. And, bc they taste so good.

Tuesday, May 22, 2007

IVF. Huh, I guess we're really doing this?

So, I got this big package of information in the mail over the weekend from the new clinic: A Guide to IVF. A booklet to track the timing and details of your treatment. A giant checklist of all the things we have to accomplish BEFORE we can start the cycle: Blood work for me, blood work for R. Genetic screening bloodwork for me. Fax results of annual gyn exam and pap smear. Fax results of R's semen analysis from previous clinic. Fill prescription for Provera, BCPs, and prescription pre-natals. Schedule mock embryo transfer, schedule injection class (injection class? puulease, I feel like I could TEACH the damn class.) Etc., etc., etc.

As I'm going through all this rigamarole, every now and then I catch myself thinking: Holy shit. We're doing IVF?

For some reason it still hasn't really sunk in yet! Everytime I think of it, I think - My God, this could actually work. The first IVF cycle actually DOES work for some people. It really, really does. I could actually be pregnant by the end of the summer. (Shout outs to Faith and Watson!)

This is very quickly followed by harrowing thoughts of how devastating it will be if it doesn't work. There's so much pressure riding on this, because we're paying fee-for-service for this cycle. At the end of it, we'll have used up all of our remaining insurance benefits, and burned through all of our "extra" money for all the drugs. If it doesn't work, we'll be faced with some big financial decisions - how to come up with $20K for the shared risk fee, plus drug money for each and every cycle. Take out a loan? Borrow against the house? Stage a bank heist? Ugh.

I've never been much of a new age-y sort of gal, but I'm thinking I'll need to take up some sort of relaxation activity to ease this stress. I can practically hyperventilate right now if I let myself think about how important it is for this cycle to work. And I haven't even started blasting hormones into my system yet! Can you imagine what a wreck I'll be in a month or so???

If I had the money, I'd definitely do acupuncture. If I were more flexible, I'd take up yoga. If I were Watson's mother, I'd inhabit a pod...ahem, excuse me, Life Vessel. If I had more control over my brain, it would be enough just to get on the treadmill. (Unlike most people who zone out while exercising, I tend to sharpen my focus on all the things about my body that I hate, including my reproductive inadequacies.)

Too bad I can't just resolve to drink more alcohol. That would be a lot more fun than acupuncture needles.

Friday, May 18, 2007

I am...

OK, Samantha and Jen both tagged me for this, so here goes:

I Am

I am happy, kind, empathetic, and generous to a fault.

I am the kind of person who cries and laughs easily and often.

I am a child of God, and a big believer in His mercy.

I am the wife of a man with whom I wanted to be my whole life, even before I had ever met him.

I am acutely aware of how lucky I am to have such limitless and complete love for my husband, and to have a husband who loves me as deeply and unconditionally as he does.

I am the only-child daughter of a widowed only-child mother who has been my closest friend and confidante since I was teenager.

I am a senior project manager for a financial services company....and I dream of being 'independently wealthy.'

I am blessed with several especially close friends who are my family in every respect except blood lines.

I am a lifelong dog lover, and the daily recipient of doggy kisses that make my heart swell from our Westie, Murphy. I am certain I would not be able to get out of bed for a month if something bad happened to him.

I am a worry-wart, and have a constant movie scene of worst-case scenarios playing unrelentingly in my mind.

I am a 'soon'-to-be Mother, even though I have no idea if or when our next fertility treatment will work.

I am delighted when cooking and entertaining and surrounded by family and friends in my home.

I am striving to be more grateful for all of the joy and wonder in my life.

Now, this seems to have run around the blogosphere several times over. So, if you haven't yet been singled out to perform this little exercise - consider yourself tagged!!

Tuesday, May 15, 2007

K to IUI: So long, sucka. Oh, and thanks for the OHSS.

So, my much anticipated consult with the new RE was today. It went really, really well. I really liked Dr.G - he seemed very kind. Unlike Dr. D, he looked me in the eye the whole time we talked. Also unlike Dr. D, Dr. G made me feel as if he had all the time in the world to talk to me. I hadn't realized until today how important that quality is.

He seemed very positive about our plight, and could see no reason why we shouldn't have hope that IVF might work for us. He said he thought it would be unwise to continue with IUIs, as I've proven that I'm prone to OHSS. He was very surprised that no one at my previous clinic had mentioned the idea of converting our long-ass hyperstimulated cycle to an IVF cycle. He said that they do not, as a rule, perform "follicle reduction" procedures at the new clinic. In fact, he has never performed one. Ever. They don't 'believe' in them. Rather, when someone over-responds the way I did, and produces a shitload of mature follicles in an IUI, they either convert the cycle to an IVF cycle.....or they cancel it.

He told me that in their practice, I never would have been allowed to stim for 65 days. He said he would have called a halt to things at 17, 18, or perhaps 19 days, if nothing was happening, and induced a period. Then we would have started all over again with a different dose, different drug combo, or something else.

He basically said that he thought further IUIs would be a waste of time for us, because it would be highly likely that I'd end up over-responding, and end up converting the cycle to an IVF cycle anyway. Why not just do an IVF cycle in the first place, is the logic, I guess.

His opinion was that it would be better to do IVF, and then if I end up with severe OHSS, we'd do the retrieval, cryopreserve the embryos (assuming there were some of high enough quality) and do a frozen cycle once the OHSS had resolved on it's own. (Much like the experiences of our good friend Samantha) According to the good Dr. G, I can anticipate success rates of around 20% for an IUI cycle, 50% for a fresh IVF cycle, and btw 35 and 40% for a frozen cycle. So, a frozen cycle still holds more promise than IUI, any way you slice it.

Another interesting tidbit he offered is that for those prone to hyperstimulation, he likes to use a generic form of hCG, rather than the Ovidrel variety. Ovidrel apparently only comes in a pre-measured, pre-filled syringe in pre-determined amounts - 10,000 somethings? ius, maybe? I dunno, but since hCG is often the catalyst that propels someone into hyperstim mode, he likes to use less than the traditional dose - not as much as comes in the Ovidrel one-size-fits-all shot, but juuuuust enough to get the follicles to do their thing and release the eggs. The generic form can apparently be ordered up in whatever size dose he chooses. Probly cheaper too? A girl can hope.

The other good news, financially, is that at the new clinic, one is not precluded from participating in shared risk if one has previously gone through an IVF cycle. This is not the case at my previous clinic. I thought that seemed unfair, and apparently the new clinic shares that perspective.

Dr. G said he thought it made perfect sense to use the rest of our insurance money towards the purchase of a single IVF cycle - why in the world would we leave that money sitting on the table if we didn't have to? If the first cycle works, great. If it doesn't, we will essentially have used the first cycle as a diagnostic tool to better understand if IVF is a good choice for us. We'll have more information, based on my response, and the outcome, to decide if it will be advantageous to proceed with shared risk.

I told him my only worry about proceeding at this point is that we were trying to plan a vacation the second week of September. He first said that he thought we could definitely get in a cycle before then. Then I think he realized that I'm coming from a place of having stimmed for SIXTY FIVE DAYS, and he said that of course, the safest course of action - in terms of not interfering with our vacation - would be to wait and start the BCPs and Lupron in August. Then, I suspect he saw the look on my face, and he hastily added that of course, waiting and treading water for the rest of the summer might be, emotionally and mentally - not the wisest choice. Ha! I told him I wanted to start right away, and that we would take our chances with the vacation situation!

He said worst, worst case would be that I could end up with severe OHSS and end up in the hospital, which would of course preempt our vacation, if the timing lined up with that week. But of course, there's really no way to pinpoint the timing, bc we don't yet know exactly when we'll start the cycle, we don't know exactly how long it'll take to stim, we don't know how bad the OHSS will be, we don't know the exact timing btw retrieval and transfer, etc., etc.

I'm really inclined to book the damn vacation, and pray for the best. But, does that create even more pressure when that's the last thing we need? I don't know. I just feel like I'm so sick and goddamn tired of putting every fucking thing in our lives on hold in order to accommodate infertility.

At any rate, I now have in my hot little hand a doctor's order for some pre-conception genetic screening bloodwork (apparently the new clinic does a more thorough genetic screen than my previous clinic), a scrip for Provera to induce a period once they get the results of the genetic screen back, and the business card of the nurse who has been assigned to my case. I'm to call her as soon as I've completed the blood work. She said it takes at least 2 weeks to talk to the financial coordinator and get all the insurance details squared away (that seems a little ridiculous to me - 2 weeks, for cripes sake? but, I'll deal with it, I guess.) Then, I assume that after my period arrives, I'll have a baseline sonogram and bloodwork, and then be cleared to start the BCPs (there's something so totally demented and twisted about taking birth control as a part of this process, don't you think?)

The ONLY thing I'm apprehensive about, as far as treatment goes, is those damn intramuscular shots. I've only had to contend with the subcutaneous variety thus far. I could be remembering this wrong, but I think Dr. G said today that the Lupron was IM? I hadn't realized that, until now. I knew that the infamous progesterone-in-oil shots were IM. Dr. G said I'd be looking at around 3 weeks of PIO shots??? Good God. I can't imagine how sore my ass will be after all of that.

So, anyway, it feels good to be almost out of limbo, and be working towards a specific goal again. I'm thinking I'll probably go to the lab sometime this week and get the blood work out of the way. The sooner we get this show on the road, the better. I'm dreading the lab though - is it me or is going to one of those places somewhat akin to spending your afternoon at the DMV? If I didn't know better, I'd swear that LabC0rp and Quest Diagn0stics were both government agencies.

Tuesday, May 8, 2007

Thanks for your kind comments...

Just wanted to say how enormously I have appreciated all of your kind words of support since last week! I was incapable of posting anything for several days after the last cycle ended, mainly because I was just so damn angry. I knew no matter what I set out to write, it would come out as venomous, bitter, nasty....

I have more perspective now. We're concentrating on what the right next move is. It is largely a question of finances, as it is for so many others dealing with infertility. I'm lucky enough to have some insurance coverage, but when it comes to the cost of IVF, it's a mere drop in the bucket.

I have not gone back for any kind of follow up with Dr. D. I know, logically, that the failure of the IUI was not his fault. But for some reason.....I just feel like I'm done with him. I called the Nurse's line at Dr. D's office on Thursday morning to tell them that there was no need for a beta on Sunday, as I was most definitively not pregnant. The nurse said something about not seeing anything written on my chart indicating what Dr. D would want me to do next - did I want to make an appointment for a consultation the following week? And I said, you know what - don't call me. I'll call you. Maybe.

I'm much more energized about meeting with the new doctor next week. I want to lay my whole history in front of him and find out what his perspective is. Does he think IVF is the right next option? Does he think there's any point in doing another IUI? Will he agree to start stimming me at the 150-200iu range? Or will I have to start back at those little drippy doses again, and stim for another 2 months? God forbid.

Even knowing how painful the OHSS is, and knowing that it is highly likely I'll end up right back there again.....I'm still eager to begin treatment again. Every day that goes by I feel like I'm losing precious time. I feel anxious not having a plan. As ridiculous as it was to take 65 consecutive days of shots, mostly without seeing the slightest hint of progress - at least I felt I was DOING something, taking action, following a plan every night at 10pm. There's something darkly comforting about the ritual of shooting up every night in the bathroom. I still catch myself watching the clock at night, counting down until it's time to 'do my shot.'


I guess right now we're concentrating on how the hell to come up with the money we'll need to continue. Weighing our financial options. If we go whole hog, and sign on for the Shared Risk plan, we'll get 6 tries - 6 fresh cycles plus any frozen cycles that come out of those, if we're lucky enough. But, we'll have to plunk down somewhere around $20K - $25K before we can begin.

If we opt to pay for one cycle at a time, we can use our remaining $7K of insurance money, and just pay the balance out of pocket - which would be somewhere around $5K, I think.

OR, we could continue with another IUI, which could be completely covered by our remaining insurance money.

In any and all events - we're all out of pocket for drugs. At my highest doses of Follistim and Menopur there at the end of the last cycle, I was at about a $1500 per week habit. That's going to add up awfully quickly.

So, if we're going to pay the same for drugs no matter which option we choose - I kind of feel like it would be smarter to do an IVF cycle. I would really hate to do 2 more unsuccessful IUI cycles, and then realize we spent $10K or more on drugs that we could have spent towards IVF.

The trick though, is that if we opt for the Shared Risk plan - which is appealing for many reasons, not the least of which is that it relieves some of the intense pressure for that first cycle to be successful - we'll have to leave $7K of insurance money sitting on the table. It's hard to walk away from that. (The rationale is that if you are doing "Shared" risk - you have to personally bear all of the risk on your end without any help from insurance money.)

And then of course, there's the gamble factor to consider: What if we pay as we go, pay $5K to supplement the rest of our insurance allotment, and we're successful. That's a bargain! What if we opt for Shared Risk, borrow against our house or something for the $25K, and then end up having a successful first cycle? That's NOT a bargain, and wouldn't we be so regretful that we didn't just pay out of pocket for one cycle to see if it would work? But what if we get to the end of the 6 tries (and frozen cycles) and we're still unsuccessful? How amazing is it that we could actually get that money back in order to use it for adoption fees?

Oh God, I don't know what the right answer is. I keep going over and over and over this in my mind, and R and I have had at least 4 conversations about it since Thursday. I just don't know what the right answer is? I'm trying to open myself up to feel what the right path is for us, but I'm still struggling to know just what it is that God means for us to do.

I still wonder if we should give up? Are we meant to adopt? Is that what this is all about? People always talk about "letting go, and letting God." I have never figured out how to do that, exactly. Being a control freak, it's a foreign concept. I'm trying to just get - quiet. Calm down and see what thoughts creep in when I open myself up. We'll see.....

Thursday, May 3, 2007

It's a bust.

I started my period in the wee hours of last night, and have had ridiculous cramps ever since.

Isn't it just hilarious that my body, who, heretofore always acted oblivious of the appropriate time to begin bleeding, suddenly THIS time decided to do it right on time?

I've been up since about 3am. Had a long hiccup-y cry with R when he woke up at 5:15.

Mostly I just feel so foolish for being so hopeful and fantasizing for these (almost) two weeks about how wonderful it was going to be, telling R we had finally done it, it was finally our time, calling my mom to tell her, celebrating Mother's Day this year, how and when we'd tell the rest of our family and friends when the time was right, etc., etc.

65 consecutive days of shots for nothing. God only knows how many monitoring appointments and blood draws and fighting traffic to get the RE's office and being late to work for nothing. A week's worth of laying in bed with OHSS pain for nothing.

My body has made a fool of me once again.

Not sure what we're going to do next.