Wednesday, October 31, 2007

Can I Get A Side of Salt for My Wound Please?

I am still raw from yesterday.

Of course, it started with the BFN. I know that there are people out there that get positives later on, but for me, that has always been my threshold. Sure, I always hope that I am wrong, I even POAS this morning, because the tests are only a dollar, you know. BFN.

I tried to pull it together and did a pretty decent job, I thought. I had an early morning appointment and it was an important one. I didn't have time to cry or mope. I did manage call my RE's office and left a message for my doctor's medical assistant.

Surprisingly, friends, it was that message that would later become my undoing. See, here's the deal: This was our sixth medicated cycle. I have been doing A LOT of research and what I have found is this: if oral meds don't work within the first three cycles, they probably aren't going to. The success rates go down dramatically after that third cycle, and they aren't crazy high to begin with. This was only our second IUI, but the doctor had suggested doing two OR three cycles with oral meds before moving on to injectibles.

So my message to the medical assistant asked when Dr. M thought we should do next. I asked if we needed another face to face consultation or just a phone one.

T called back about two hours later and the conversation went like this:

Me: "So, it is 13 DPO and I got a negative pregnancy test today. Having been pregnant many times before, I know that I always get my positives by this point. I am pretty sure that this cycle didn't work. What does Dr. M think that we should do next?"

T: "Well, we always say, our patients know their bodies." (Said with a little undertone, meaning, I think, that I shouldn't give up hope yet for this cycle).

Me: "I won't stop taking the progesterone until tomorrow, just in case I had a late implanter, but I really think it didn't work."

T: "Okay. What can I do for you then?"

Me: "I wanted to know what Dr. M thinks we should do for the next cycle."

T: "I am reading your chart from your last appointment and it says that you wish to do two or three more cycles and then move to injectibles."

Me: "But what does Dr. M think?"

T: "I just told you. Two or three more cycles."

Me: "But I am not a doctor. Does she think that we should do another oral or just move to injectibles now?"

T: "I am reading your chart."

Me: "I know. I know what it says, but I would like to know what Dr. M says now that the two cycles have gone by. Does she recommend a third cycle?"

T: "It says that you wish to do two or three more cycles. So, I guess it's up to you."

I won't bore you with the rest of the conversation, which wrapped up in me making an appointment to start an injectible cycle. Here's the deal, though. Why am I making these decisions? Why isn't my RE being more proactive, taking the bull by the horns, and saying, "Let's go!" Why do I always have to be the one to pull the trigger on these things. Much as I consider myself the "expert," I am not. She is. So why can't she have a frickin' opinion? I even asked the MA what injectibles would do that oral meds hadn't done. She said that was a question for the doctor. Um, yeah, do you think I could talk to my doctor? Not a chance.

The other really frustrating thing for me about this cycle is that we cannot try in November. Usually, that is what gets me through a BFN. I ovulate early on meds, so our follicle scan is Day 10. I may be sad, but I can live ten days to try again. Unfortunately, a work meeting is Day 10 - Day 15. We will not be able to try this month.

So, December, here we come. Logically, I know that it will go by quickly, but emotionally, it sounds so very far away.

One more grain of salt to throw into the wound is that I have had amazing fertility insurance until this point. And I have never taken it for granted. I always have felt so fortunate to be able to make decisions without having to be too concerned about the financial portion. As of January 1, that all changes. We are going to be responsible for a huge portion of all of our fertility related medical procedures. Part of me wonders if we should just say screw it and see if we can't squeeze an IVF cycle in before January 1.

But I am scared to do IVF. It's the "last step." I have watched others be defeated in IVF and I have always wondered if I am strong enough to do it.

Sorry this post is so jumbled. I guess it's just a reflection of my feelings today. It's so hard to believe how happy I was last Halloween, seeing sweet Gummy Bear on ultrasound for the first time. And now I am so, so sad.

Thank you for listening. Thank you for caring.

21 comments:

Melissa said...

Gosh, you have too much on your plate at the moment, don't you?!
I can see why you'd want to jump to the IVF before your insurance switches over. Mine covers nothing and it is PAINFUL. Makes those BFNs about 10 times worse, too. I think you're right to consider that. Even injectibles are so expensive when they aren't covered, so either way it's going to be a big pill for you to swallow.
As for your worthless RE, I understand that as well. Have you considered seeking out anyone else??
I have my fingers crossed, hoping that you can find peace on it and make the right decision for you.

Polka Dot said...

Katie I'm sorry. I know that doesn't begin to cover it, but I am.

Pardon me for a second ... you need a new RE. I know, I know. But I've felt that since I started reading you and it pains me to see you constantly battle with her and her office. You deserve such better treatment, consideration, and answers.

Self-pay sucks. Hard. We're lucky in that our RE bills the office stuff (labs, u/s, etc..) under my pcos, so all we're left with are the meds and iuis. But even that runs about $800-$1000 a cycle.

If you go to injections, my recommendation for drugs is to order online through ivfmeds.com. They're the same stuff, but WAY cheaper. What normally costs $50 a vial here and in Canada is only $12.75 there (they're in the UK). I've used those meds for every cycle and I respond just fine and it's less painful on the wallet.

Missy said...

Katie, I'm sorry you're having such a bad week. I can totally agree with your feelings of IVF, but I would suggest maybe trying it before your insurance changes. Stupid insurance companies... like we choose to live this way.

I agree with the girls that you need a new RE. This lady doesn't seem to have the compassion that you need during a time like this.

Know that I'll be suffereing through the month of November with you, as we have to wait at least a month before trying again. I'm sending you lots of hugs today.

alison said...

I'm so so sorry for the way this week is starting out! I totally hear you with the incompetant office staff at the dr's office. You're right, you SHOULDN'T be the one making these decisions. Let's say you're just the average woman who goes to that clinic - most women don't do nearly as much research as you have - it would be impossible to make an informed decision without the doctor's opinion. If you decided you wanted to do 12 cycles of IUI, then it sounds like the doctor would be all for it if it was your choice. That seems wrong to me. I mean what's the point of having a doctor in the first place if you're the one calling the shots?

I'm praying for peace and clarity for you. These decisions suck! I'm also sending you some virtual french fries so you can put that salt to good use. :)

Ally said...

Oh, Katie, I'm so sorry. The BFN is bad enough, but it's even worse when you throw in your RE's office and your insurance concerns.

I don't blame you for considering jumping to IVF before your insurance switches over. I know it's a huge leap, but it may be a warranted one because of the costs.

As for your RE, I'm wondering if she is related to my RE. I only see her when I schedule a specific appointment with her and that usually takes WEEKS. Sigh. I hear and understand your frustration there.

Please know that I will be thinking about you and sending good thoughts your way. You so deserve some sunshine in your life.

Fertilize Me said...

I am sorry that you continue to receive bfn's and I am sorry that you feel your RE is not doing a good enough job. It just sucks all around. My assvice is that if you have already a mindset to mis the november month because of work, try and schedule a face to face with your RE and discuss injectibles and other options, odds and stats. If you are not satisfied, move on, get a new one. You will not miss out on anything anymore than the usual because you already have a plan to have to skip this cycle. It gives you time to digest this info and research and find a new Dr you like in the month of Nov.

I got my injectibles from shrafts.com. they were the absolute cheapest from bravelle. better than ivfmeds, fertilitylines, freedom and all other companies. I did alot of research before i bought my injectibles. I am sending happy happy thoughts your way. I am so sorry that you are dealing withall of this.

infertility just sucks said...

I have similar issues with my RE. I asked abotu next steps yesterday too and all I got was a nurestelling me that "we hope you do three rounds of IUI."

Like she was hoping I would join her for drinks later...She acted like the whole thing was optional and I simply want to know what's mandatory to end up pregnant in 28 days.

Argh. I think that perhaps the sad truth is that IF is just like the rest of healthcare. You have to be ultra-vigilant and assertive and advocate for yourself at all times.

Baby Steps to Baby Shoes said...

I hate that so many of these decisions have to be based on finances rather than comfort level or readiness or whatever.

I know you think ivf is the "last step." But it really doesn't have to be. It's merely a step in this terrible journey. If you have coverage that you won't have later, it might be worth looking into, just so you don't regret it.

Mrs. B said...

1st I have to say "left testicle ruptured"?? O.K. Now THAT made me laugh. Thanks for seeing my side of things!

2nd I say throw caution to the wind and do the IVF ASAP while your insurance will still cover it. I have known 2 ladies who got PG on their 1st cycle of IVF so it CAN happen. Why not at least try it now, while someone else is footing the bill, and get it over with? Your chances may be higher the 2nd time you do it and that way you only have to pay for 1 cycle. At a cost of about $12 grand per cycle I would go for it.

But that's just me and we all know I haven't done anything right yet so...

Manda said...

You are not crazy...December DOES seem far away!
And as far as your RE goes, a lot of times doctors COMMAND that NO ONE give any advice or information to patients over the phone (or at all). She may have been intentionally evasive because the doctor doesn't want to get his or her butt kicked later by a patient who got bad advice or info from an underling. You know? Just a thought.
In conclusion, all of this sucks. I'm so sorry this is happening.

Laksh said...

I would say take the time to decide and if IVF seems like something you will consider in the not too recent future, then go for it while insurance still covers it.

I know it seems like IVF is the last step but I have been through two cycles with nothing to show for it and have basically started from scratch again since October this year.

So, there really is nothing like the last step. It is how much you are willing to invest emotionally, financially in this whole process.

In Search of Morning Sickness said...

You're not crazy, once we started seeing an RE, I thrived on being able to continue on after a BFN with the next cycle. When we finally moved 1000 miles from our clinic, that month was SO depressing. I got AF the very day before we moved, and it sucked.

Waiting out a cycle seems to be 30 days of hopeless despair. Why, why, why?

I don't know if you can do this, but would they let you stay on progesterone so that AF would come later and you could O past that day 15??? You may want to ask. Afterall, clinics use birth control to get all their women to be on the same IVF start cycle day, so why not?

I'm sorry about how your RE is being though. It's hard.

You're so good at keeping us up to date. You're such a great blogger.

jenna sais quoi said...

A lot of good ideas here.

Please schedule a F2F with your doctor. Give him the rundown. See if they can get your work schedule and your cycle to reconcile with each other (You know, using drugs or voodoo or something.)

I guarantee tat if you say you're ready for IVF, he will want to go ahead with it. And you should definitely do it while you have the insurance coverage!

Also, ladies, thanks for the drug website recs. If I ever get back into this game again, I am going to do my research.

Geohde said...

Your clinic sounds about as helpful as mine....

J

Tracy said...

Ugh. Nurses can be so aggravating. You'd think they'd be more sensitive, but they are the exact opposite. They are desensitized to the whole thing. Just awful. You should read my blog today. Scott took it upon himself to call the nurse, frustrated with my lack of info (as a result of them not giving me any). Of course, he can make no sense of the conversation he had with said nurse, so now we're probably only slightly less confused than before.

Our RE is great, once we get past the gatekeepers...but you obviously know how that goes.

I know moving to IVF is a big step...you have to follow your heart...but based on what you've been through and SURVIVED, I know you are strong enough.

XO

Stoltebaby said...

Not sure why your RE isn't at least giving you their opinion and then letting you have the final say.

IVF is scary. I was petrified when we made the decision to do it after 4 failed IUIs. It is the last hope to have our own biological child. It's a lot of stress too, but I say if I end up with a child (or 2) in the end, it'll all be worth it. Whether you should try to squeeze it in before your insurance changes is up to you. Our insurance doesn't cover IVF at all so timing wasn't an issue.

Good luck!

Mrs. Piggy said...

I may be in the minority here...but hey, if your insurance covers IVF, this may be your chance...My insurance does not cover it, and it was about $12,500 per cycle...all out of pocket, VERY painful! We are down about $25,000 at the moment. To me it's not that much more intrusive than an IUI with injectibles...just more appointments, and the yucky retrieval....
But I can totally see why you wouldnt do it...that is SO final...
BUT there are people who do IVF and revert back to IUIs!

SUCKY that you cant talk to your RE. Mine gives his cell #, just never used it :) I think having that relationship is comforting. Damn your RE.

Road Blocks and Roller Coasters said...

Wow, Katie, I'm sorry its been such a rough day. I don't think you're crazy about thinking about jumping to IVF next, especially if its covered. If I had the coverage I would do it in a heartbeat. But you have to come to that decision on your own and do what you in your heart know is best.

As for the RE, I had the same issue at my last office and that was why I left. My new RE hears me out on what I want to do and either says yay or nay. Having the input of your RE is SO important. Have you considered switching?

I'm sending tons of positive thoughts your way and hoping that tomorrow is a good bit brighter for you. HUGS!

My Reality said...

If it were me, and I had coverage for IVF for a limited time only, I would be jumping on the IVF bandwagon before the coverage ran out. I know it feels like the last resort, but you can get pregnant, you just don't stay that way. You could move on with IUI's or injectibles or whatever afterwards. IVF may be the last resort, but it isn't your only option.

Misty River said...

Katie,

Have you read the book "Surviving Infertility"? I can't remember the author, but in it, she actually recommends going with IVF before doing any other treatments. She said that by doing an IVF cycle, even if it doesn't work, that Dr. can detect any issues that were noticed with other diagnostic treatments.

IVF is totally out for us. Our insurance only pays for diagnostics. Our first IUI was about $2,000...and I am hoping like all get out that it worked.

If I were you, I would totally try IVF before your insurance changes. The success rates are supposed to be really good too...I've read around 70%.

Good luck to you!

Misty

Geohde said...

PS hon,

Not to stalk your blog, but did you get your cross pollination match ok?

Email me if the answer = no :)

xx

J