Glimmer of Hope

So, I had another ovarian ultrasound this morning (cycle day 12). I went into this one a little bit more hopeful, as I felt like I could tell the drugs were working.

I was on Femara this cycle, and last night, I was getting very sharp pains from the area around my right ovary. It also felt swollen when I would massage that area.

And sure enough, the ultrasound showed a 20mm follicle in my right ovary. A good sign, for sure. They look for follicles that are 18-20mm, and I've never even gotten close before. My left ovary, on the other hand, had a few tiny ones; but none that were viable to mature. But, they tell me it's normal for one ovary to dominate each cycle.

So, I drove home with a little sense of hope; immediately texting my husband to share the news, and then stopped at Starbucks for my own personal celebration of a smoothie and blueberry scone (but let's not dwell on that). I know it's still a long shot. But at least I know we can check one thing off the list of hurdles we need to overcome. Who knew that cancer medications and fertility yoga could actually get my ovaries to do something they're supposed to do?

I've been instructed to take my trigger shot tonight. This is super scary to me. I don't particularly like injections (who does?), and I really don't like the idea of giving myself one in the stomach. *shivers*

We won't really know if this cycle worked until early to mid March. So stay tuned.

By Thirty-Five?

Since my last post, I've taken some drugs, had an ultrasound, and just had another consultation today. So, allow me to walk you through it.

My cycle began on Christmas Day (just the gift I wanted.. lol).. so, they ordered me to start my Clomid a few days afterwards; making my expected ovulation date January 6th. To see if the Clomid was working, they ordered an ovarian ultrasound.

First, awkward. They sent me into a small bathroom, instructing me to strip from the waist down.. and wrap myself in what basically, was a large, thin paper towel.. that didn't even wrap all the way around my body. So, there I was. A shirt, my socks, and half a towel.. Trying to hold it as I waddle to table; which is sitting in a very dark room. You know the kind of table. The one with stirrups. Yee-haw!

She proceeds to show me the device she will be inserting. Lovely. "Aren't you at least going to light some candles?," I thought. Should I say it out loud? Nah. This lady doesn't look like she'd enjoy such humor at 8am.

So, there I was, looking at this black and white screen, as she showed me one ovary and then the other. It was a weird and unpleasant sensation.. but pretty cool, actually. She was able to essentially zoom in and out, and measure each follicle. The good news is that I had several follicles. The bad news is that none were the size necessary; and clearly weren't going to mature and release an egg.

And if you didn't recall, this was from the highest dose of Clomid. Which means, it's either stop here.. or move onto something else.

Dr. Henry had previously mentioned wanting me to get a dye xray of my fallopian tubes.. which is a pricey, and often painful, procedure. I feared that would be what he advised next. But given our budget, I was preparing myself to argue and plead to just try a different drug first.

My reasoning was that the xray isn't going to help me ovulate. It's only going to show if there's a blockage keeping the egg from getting to my uterus; or keeping my husband's swimmers from my eggs. Either way.. it's irrelevant if I'm not ovulating to begin with.

I arrived to my follow-up consultation this afternoon. The nurse walked me into an exam room; except in here, the exam table looked like it was from the late 70s, and since I wasn't getting an exam, it was bizarre to sit there.. on the one and only chair in the room. And, I had to wait there for 45 minutes before the doctor came in.

Not going to lie, I almost fell apart. It really isn't fair or nice to leave a woman in a room by herself with nothing to think about but her own fertility problems. I was staring out the window and thinking to myself, "Is it really going to come down to dollars and cents? So many people that have no business being parents, have child after child by accident.. and I may never have one, because I can't afford to even get a chance."

I was getting misty-eyed when I decided instead to start rehearsing, in my head, my argument to try the next drug on the infertility go-tos. It's called Femara, and sometimes works for women that don't respond to Clomid. It's more expensive than Clomid (almost double), but still less than the injectables. I proceeded to talk myself up. Be confident. Take control of your own healthcare. Yeah, screw this guy and his opinion!

He finally knocks on the door, and drags in a stool to sit on. He shakes my hand and awkwardly blurts, "So, yeah.. You didn't ovulate."

I just respond with an even more awkward laugh, and "Nope."

As he browses my file, not even looking at me, he starts describing his plan. "Well, I think we're going to move on to another drug and see if it works. Well, I'd like to get the fallopian xray done, but it doesn't matter if we do it now or wait. I'll leave that up to you. But we'll go ahead and do Femara next."

Whew... No confrontation needed. I just tell him I'd prefer to wait on the dye and xray, to see if Femara will even make me ovulate.

He agrees, and adds, "We'll try Femara for 3 cycles, and on the 3rd one, we'll do the xray."

Ehhhh.. sure. I'll argue about it later if I have to. Or just tell him we're done trying at that point..

He proceeds, "And if this doesn't work, we can try injectables, or just go right to invitro."

Woooooah! Slow down. Invitro? We're just getting to the second drug, and he's throwing out the full 15k procedure? I didn't have the heart to tell him that's never going to happen. It was just too depressing.

"You can decide though. Injectables will probably blow up your ovaries with follicles," he stated.

Blow up? That doesn't sound reassuring.. especially since ovaries literally bursting from overstimulation is one of the possible complications. :-/ But I try to ignore the bad word choice, as he clarifies that he meant the chance for multiples.

He then explains how the Femara will work (which I already knew, from my own research), "It's actually for breast cancer patients. Basically, it'll block your estrogen, so your ovaries will try to overcompensate." And added, "So, you won't get the hot flashes or mood swings with this one."

I couldn't help but think, "No.. I'll just get a beard."

One of his last statements was, "Our goal is to get you pregnant by 35; and I don't foresee a problem doing that." (Wish this came with a guarantee)

Well.. that gives me four years.. Unfortunately, he expects me to have 30-40k in order to try. :-/

I leave with a plan. Though, I'll only be able to stay on it for a few months before I have to call it quits. So please, if you're reading this.. knock on wood and cross your fingers for me. Time and money are both running out.

More Medications & More Money

So, starting today.. I'm taking the max doseage of Clomid (150mg); three times what I took before. And I had terrible side effects (rash, night sweats) before.. so this should be interesting.

I also just spoke with the office manager at my specialist's office. She informed me, that unfortunately, insurance will not be covering the cost of the ultrasound. So I have to pay $211 out of pocket, in full, on the day of the test (which is less than two weeks away). For those keeping track.. that means for the minimal treatment, and cheapest treatment, it's about $335 per month. And again, that's for the option that gives us the least chance for success.

What this tells me, is that we can't feasibly try this for more than a couple months; and there's really no way we can take it to the next (more expensive and invasive) level. Obviously, the idea of giving up is a real downer. But I feel like we won't have any choice. The doctor doesn't even do payment plans, so everything has to be paid in full before treatment or testing is provided. There's just no way...

Words That Sting

I had no idea what to say. It felt like someone just punched me in my ribcage. I could barely breathe, and I wanted to burst into tears. All because somebody, that I didn't know, asked me if I was pregnant.

They had overheard me telling someone that my stomach hurts, and they just blurted out, "Well, are you pregnant?" Is stomach pain really the first symptom? I found it hard to accept that pregnancy was the first thing that came to this person's mind in reference to a stomach-ache. And all I could muster back to her question was, "No." Not a jokey, "Oh heck, no!" or "No" with a chuckle. Just "No." I wondered if she even noticed how seriously in which I answered. It was definitely not how most people answer in casual conversation.

But the truth is, I wanted to go hide. I knew that the stomach pain was probably from the fertility meds.. but I couldn't explain that. Nor would this stranger want such an over-explanation. So, I just sat there.. quiet and hurt.

Sure, it's always unintentional. And usually, it pops up and hits you when you least expect it. But this wasn't the first time that somebody's words have left a sting.

It's always hard when someone asks us, "So, when are YOU guys going to have kids?" Ugh. If they only knew what I meant when I said, "Oh, well we're trying."

Next up, like the first example, are the folks that overhear a few symptoms that are usually from the meds themselves, and ask, "Are you pregnant?" Nope. Thanks for your interest. Here's my tip for people. Never casually ask someone if they're pregnant unless you're 100% sure they aren't and you're joking, and/or you know they aren't trying.

And the last one, that actually gets under my skin the most, is "If it's meant to be, it'll be." Seriously? Somebody is pissing rainbows. I hate this phrase. First, I don't believe in fate; as if everything is pre-determined. I believe you have to make things happen for yourself. Imagine where our world would be if people literally just believed that whatever was supposed to happen, would happen? Nobody would go to a doctor. "If I die, I was meant to." Nobody would go to school. "If I'm meant to have a great job, it'll just happen." Life definitely doesn't work that way. And throwing that phrase at people trying to get pregnant is about as useful as when it's told to people who are going through a rough patch in their relationship. It's not a destiny thing. It's something you work through, or you don't.

Secondly, "If it's meant to be, it'll be." actually implies that if we don't have kids, it wasn't meant to be. As if the universe has decided I just don't deserve to be a mother. Is that really supposed to make me feel better? And the truth is, maybe IVF would get us pregnant, but if I choose not to take it that far.. that means I chose it. Not that we weren't "meant to" have children.

Let me say here, though, that I get it when people are trying to be uplifting and hopeful. Or trying to get me to not worry about it. Just understand that when people are actively trying; seeing doctors and taking meds.. we have no choice but to think about it daily.. if not hourly. And the words you think are helping, just aren't. No matter how well intentioned, they kind of feel like a slap in the face.

Medications & Money

So, today, since I was off work.. I had time to call the 'recommended' mail-order pharmacy to get my meds for this cycle. According to the doctor, since they are a "specialized" pharmacy, they tend to be cheaper. They're called Freedom Fertility Pharmacy.

I only needed two medications. One is the Clomid. The other is the shot I have to take if the Clomid works, called Ovidrel. No surprise, insurance won't pay for either. They gave me the generic Clomid, but apparently Ovidrel has no generic counterpart. My out-of-pocket, for those two medications (that I'll take for a total of 6 days) is...

$120.35

Bleh.

Yeah, I know it's hardly earth-shattering.. and pales in comparison to the 15k needed for IVF. But still, it's a good chunk of a paycheck; especially around the holidays. Not to mention, we'll have to pay for an ultrasound for each attempt. Fingers crossed that this works.. because my brain and my wallet may not be up for anything more drastic.

Hey (Special) Doc

So, after a fun weekend of celebrating our one year anniversary, I was off to the reproductive endocrinologist..

First, props to my husband for taking time off of work to go with me.. though he only ended up answering one question for the doctor; which was, "Do you have any other kids?" (after I had stated I hadn't had any). Luckily, his answer was "no." If it had been "I don't think so." our appointment would have gone very differently. ;-)

Anywho, as soon as I walk into the waiting room, I see a few couples (one of whom was clearly knocked up), and a couple women sitting alone. Half of one of the couples happens to be a teller for the bank I go to for work; at least a few times a week. Ugh. What are the odds? Then later, I find out that one of the men went to school with my hubby. Definitely a small world.

About 40 minutes after we arrive, I get called. We walk back into a very nondescript office. Two barren desks, and a bookshelf with literally nothing on it. No books. No knick-knacks. Clearly, this is the floating office for visiting doctors.

The Doc comes in and shakes my hand. Takes a few moments asking all the usual questions: How long have you been trying? How old are you? What have you tried?

I tell him that my current OB/GYN had me try Clomid at the lowest dose, but was concerned about putting me on higher doseages due to possibly overstimulating the ovaries. Well, this doc clearly did not have that same concern.. as he immediately prescribed that I try the maximum doseage (3 times what I was on). He informs me, "Oh, and with this doseage, you may have some hot flashes and mood swings." Bad news, Doc. I had those side effects on the lowest doseage. So, this should be fun. (my poor husband)

Doc proceeds to inform me that "we do Clomid a little different here." Oh? Do tell. For that, he sends in his nurse, with packets of information. She tells me how we'll induce the cycle (like normal), then I'll take Clomid (like normal), but then instead of a blood test, I'll come in earlier for an ultrasound of my ovaries. Hmm.. Okay. And then, if it looks like I have a follicle ready, then it's injection time.

Ummmm.. what?

Yeah, injections. Fantastic. What's worse? It's the DIY of injections. The kind of injection they expect your husband to give you.. fresh out of the refridgerator, where you store it by the butter. Bleeeeeeeeh. Not sure I'm up for that part. I'm clearly going to have mixed feelings when it's time for the ultrasound.. hoping I have a follicle.. but wishing I didn't need any injections.

Then, lastly, they say.. "Oh. Let's go ahead and do some bloodwork while you're here." Hooray! Always my favorite thing. But I'll give it to them this time. The dear asian lady that took my blood didn't try to engage me in useless chit chat; which never distracts me. It just annoys me. She just did her thing, and I literally didn't feel it. Trust me, I always feel it. So, high-five, asian lady!

That was my 'consult' today. And on a good note, they believe insurance will cover the consult and possibly part of the ultrasound, since it's considered part of "diagnosis" and not treatment. So, here's hoping that the meds are the only thing completely out of pocket.. for the moment.

One Year

First, I want to thank every person who reached out to me after the last post. So many of you messaged me, texted me, emailed me, etc. Some of you could relate to my story. Some of you had been through it and succeeded. Some of you were still trying. And some of you took completely different paths. I appreciate all of you that took the time to share your stories with me. Thank you.

Which brings me to my current post:

In about a week, I will have been married for exactly one year. Which means, we've actually been trying to get pregnant for about one year... and not preventing for even longer. So, this is officially when the doctors will say you're "reproductively challenged." Nice term, huh? Like my ovaries are riding short bus to school.

In the next two weeks, I have two fertility appointments. One with my original doctor, to ask her to explain why she gave up so fast; after only two cycles on the lowest doseage of Clomid. Typically, they try for at least 6 months on increasing doseages before moving on to more intensive options. Then, the 'consultation' with the specialist to whom she referred me.

I'm looking forward to moving onto the next step, but I'm not really eager to go. These kinds of appointments are always kind of depressing. Why? Because you go in hoping they'll have figured it out. Cracked the code to your specific problem or imbalance. But, they never do. You just follow the regimented steps they learned from their med school textbooks. For example, my diagnosis was made from about 3 symptoms grouped together. There's been no real medical test to confirm or diagnose the extent of the problem. Nobody has even brought it up. I find it peculiar.. In that sense, it probably is better that I'm meeting with a specialist that does nothing but fertility.

It's also depressing when you get a new doctor, for the same old problem. You have to repeat everything, explain all your symptoms, go through your history of heartbreaks and depression. It makes you re-live all those times that you don't even want to think about. What's worse, is that 9 times out of 10, I'll be going alone... which sort of backhandedly reminds me that this is MY problem, not OUR problem.

What's even more depressing, due to timing at the moment, is that this appointment is actually going to kind of muck up our holidays and anniversary. After figuring out our bills, doing our holiday and birthday shopping, and then adding on the doctor's fees... we actually don't have enough left over to go back to the cabin like we intended. I even thought of us just staying in the hotel in West Lafayette that we stayed at the night of our wedding; just to get away and relax for a couple days.. but I'm not even sure we can afford that now.

But not to be too much of a downer.. On the bright side, I only have to work for maybe 4 days out of the next two weeks and half weeks. Had some vacation to take before the end of the year.

And the even better news is, even if I'm upset that we can't celebrate our anniversary the way that I would like... I do get to celebrate an anniversary. Sad as it is, plenty of couples don't even make it to one year. I'm thankful that we've made it work, and actually grown closer when things have gotten hard.

So, to my loving husband... I still choose you. Every second of every day.
I am so thankful to have you by my side through this journey.