Do you believe in "jinxing"?

And I don't mean saying something at the same time as someone else.

I find myself referring to my IVF cycle as "IVF#1", which makes me feel as if by saying "#1", there will be a "#2" or more. It seriously is scaring me! How silly of me to believe in notice such things. But still, I just can't find myself to be okay with referring to it as such.

I try to keep my taglines accurate in topics that I would want to go look back on. Like follie checks on certain days during my IUIs. I like to compare and for that reason, I use specific tags. My train of thought is to use a tag such as "IUI" when discussing anything about any IUI cycle and tags such as "IUI#2" when discussing something specific to my second IUI. For this reason, I'm trying to do the same thing with this IVF cycle too. When talking about anything specific to ~this~ particular cycle, I use the tag "IVF #1". And I really, really, really don't like to do it. But, damn it, the organizer in me won't let me stop.

If I have to study, will there be a test?

Just fresh out of my appointment with my RE's fellowship docs. They are the ones who my doc has brought over to take care of studies - nothing else.

Looks like I qualify for the lining study! They are collecting data on lining in IVF patients and I fit the criteria. I'm over 34. I have low FSH. I have a partner who has sperm (I found that one funny) and thanks to the docs, I have a uterus free of scar tissue and adhesions. There will be no different drugs, although there will be two groups of different ratios of the FSH and hMG drugs. The amount will be individually determined as what is best for each patient and if at anytime, the ratio is not in my best interest, I will be dropped from the study so I can be given the appropriate amount of stims. The doctors told me that even the low dosages isn't that low and they do not put anyone's IVF cycle in danger.

If I make it through the study, I'll get a big fat check of $1,000! Hopefully that will go along with a big fat positive, but only time will tell. If I end up getting dropped from the study, I'll get a pro-rated check, $85/"visit" (which is just an an additional u/s at my blood-draw only appointments and a few early u/s.)

Hey Tori ... I thought of you when C was bring me back to the library. She told me these doctors were learning their English (they are Dr Met's colleagues from Egypt) and if I didn't understand them, to ask them to repeat themselves. She made a point to tell me they know their English is not that good and they will not be offended if you ask them to repeat themselves. heh. Totally thought of you!

"This month"

I've been waiting to say it for awhile now and I can officially say it.

"I'll be doing IVF this month."

Insurance update.

Talked with insurance company.

Let me just say that I ~puffy heart~ this company. It's small and I have ONE contact who is the plan admin for my husband's employer. When I called, I introduced myself and she cut me off saying "I remember you Nancy! How can I help you?". Wow. She knew me by name.

She looked up my account and said it was not denied, it was simply pending for more information. Since I thought all information was already sent, she got me over to the woman on the authorization review team. She was just as nice as the first lady.

She told me the only medical records she's gone through were the ones from my OB. She said they were very thorough and saw had recorded I started with progesterone tests in Jan of 07. She then saw I had been prescribed clomid in January also, even though I didn't start that until my February cycle. What was missing was any record of an IUI, which they need completed before they would pay for IVF. We discovered she did not have any record from my current doctor, explaining I have had 3 IUIs, 1 hcg triggered monitored cycle, 3 surgeries and a butt load of appointments.

It scared me for a moment in that I thought they looked at the first IUI being 12 months prior to IVF eligibility. I asked her if the oral meds cycle I had completed over a year ago "counted", she said "yes."

The medical review lady calmed me down a lot. While I knew she couldn't give me an answer before she received the records, she did elude to the fact I'm starting my cycle in 5 days shouldn't be a problem. She said the process is already started, she's simply requested more info, and as long as she receives it soon, I shouldn't be in panic mode.

After getting off the phone with her, I called the billing girl at my RE's office. She told me that she did, in fact, send over my records, so she acted all defensive. Hey, I don't care who/what/where the records when to, I just need her to respond to the records request. I wasn't yelling at her or anything, so there was no need for her defensiveness - especially in her line of work. Billing for an RE's office must be tough. High emotions on the part of the patient probably have made her this way.

Anywho, I hope that all the records are sent over today and it's all figured out. I'll still start Lupron next Wednesday if I hadn't received all the approvals yet. I already have the meds, so no reason to not start it. Hopefully it won't be all for nothing.

insurance freak out.

RE billing office called. Insurance company denied IVF coverage due to not showing "12 months of less evasive treatments".

I'm thinking this is all due to a paperwork error, as I talked to insurance company on January 31st and made sure the first femara cycle in February 2007 counted. It did. I requested paperwork to be sent from OB's office to insurance company. Confirmed today that it was, in fact, sent out on February 1st. That was almost a full 4 weeks ago.

Insurance company is closed because they think it's perfectly okay to keep hours of 9a-430p CT. I will call first thing in the morning.

Yet, I still am freaking out. What if I have to cancel this cycle?

I lost out on the ivf study - updated!!

I was a perfect candidate except one little thing ... I needed to give cd3 blood work on the cycle ~before~ IVF. I was already on birth control pills by the time they got me on the initial list for the study.

My nurse just called me and apologized all over herself. She was so sorry for not catching this one provision when first signing me up. She didn't do anything wrong as I was already past the cd3 blood work possibility when we found out about the study.

Bummer. That's $1,000 I'm out. But, all in all, I'm still better off that a lot of women, so I have to keep that in mind. I'm only paying $2,400 for IVF now. Sure, it was only going to be $1,400, but still, I have to be thankful for what I ~do~ have and not worry about what I don't have.

$1,000 sure would have been nice though.

---
Update: My nurse called me back 30 minutes after I posted this and she told me there is another study she thinks I'd be perfect for. It's actually the study I thought we were talking about in the first place, but apparently there are a few studies going on. I have an appointment on Monday at 930am to talk to the fellowship doc who does nothing but studies. So I'm tentatively back on!

IVF Tips. (updated)

These were tips/suggestions given to me by my acupuncturist. I list them just to share what has been told to me.

updated: Like I had said, I'm just passing the info I was given along. I'm not suggesting it to you, I'm just sharing it with you. I am aware many women get pregnant without doing all of this, but then again, many women get pregnant without having to do ivf. I'll do what is comfortable for me and I'll do what I deem important. I'm ~not~ saying that you MUST do all or even any of these things for ivf to succeed. I'm simply passing along the information that was given to me. Oh - and my RE and acupuncturist work hand in hand. These recommendations are added to my IVF file too. So everyone knows everything.


~SUPPLEMENTS~
female protocol:
* deep sea fish oil 1200mg per day in divided doses
* prenatal
* additional folic acid taken away from prenatal. If you take prenatal at night, take the extra folic acid in morning.
* Greens Plus (helps keeps your system alkaline instead of acidic)
* Bee Pollen with Propolis (boosts egg quality)
* If you are taking metformin or glucophase, take EXTRA B vitamins because this medication depletes your body of B vitamins.

male protocol:
* Vitamin C 2,000 mgs/dat (ester C is good) in divided doses
* Vitamin E 800 IU/day
* Beta Carotene 100,000 IU/day
* Selenium 200micrograms/day
* Zinc 60 mgs/day divide dose to avoid tummy troubles (necessary for sperm production and testosterone metabolism)
* B12 1,000mg/day (involved in replication of cells)
* Deep sea fish oil
* L-arginine 2-4g/day (amino acid involved in cellular replication)
* L-carnatine 1,000-1,200mg/day (assists in sperm motility)
* Magnesium aspartate - 200mg/day (magnesium is intimately involved in cellular energy metabolism in the mitochondria)
* Because of sperm's susceptibility to oxidative damage, it is wish to use free-radical scavengers such as pine bark, red wine extract, grape seed extract and bilbetty extract. Pycnogenol (pine bark extract) enhances the effects of other antioxidants. Recommended dose is 125mg/day from various sources.

~ DIET for women ~
* eliminate all refined sugar
* don't eat refined carbs
* ELIMINATE caffeine, nicotine, alcohol, chocolate and soda pop.
* eat organic and hormone free whenever possible
* avoid dairy products such as milk, cheese and ice cream. Goat milk/cheese is okay.
* Eat fresh fruit
* Eat alkaline rather than acidic foods
* Get plenty of essential fatty acids
* consume lots of organic vegetables. Make sure they are COOKED! Do not eat raw foods.
* DO NOT EAT COLD FOODS. No ice cold beverages and ESPECIALLY avoid ice cream (she went on to say how anything cold will take blood flow away from uterus to be used in the belly to warm up anything cold you've eaten.

~ DIET for MEN ~
* Pretty much all the above, except dairy and sodas can be had in moderation.

~ GENERAL for WOMEN ~
* after retrieval, it's suggested to get a massage to help you relax and get circulation going
* laugh a lot, stay positive and rely on your support group to help out.
* stay hydrated
* again, no ice water or ice cream
* watch movies while on bed rest - don't watch horror, heavy or depressing movies. Mind set is important
* Always keep your feet warm, wear socks, never use hot packs on your low back or abdomen, hot packs on your feet are great and safe.
* use a fireman's roll to get up as added protection
* get up to go to the bathroom, make yourself something to eat and to get a change of scenery. It's strongly suggested you stay in a resting position with your feet up as long as your doctor recommends bed rest.
* keep pictures of your embryos nearby and visualize them implanting, promise them you will be great parents. Remember your belief needs to be strong right now and your body hears every thought you have.
* Be assured your embryos WILL NOT FALL OUT. The sides of the uterine wall touch and envelopes the embryos. Move around as you normally do, we want you to rest but also we want your blood to circulate. Don't be afraid to walk around and do things at a normal pace.

Acupuncture #1 complete.

Ahhhhhh.

That's what I have to say about it. Ahhhhhhh. It was ~so~ great.

The forms I had to fill out were immense. I couldn't believe how much "fertility" history I had to provide. They wanted charts. They wanted ovulation dates. They wanted LP ranges. They wanted a detailed history of all treatment cycles, even getting down to the details of what each of my follicles measured. They wanted symptoms of how I felt on bfn cycles, basically my pms signs. It was seriously like 6 pages of detailed questions - and that was just my fertility background! The medical questionnaire was another 4 pages (yes, less than the fertility stuff!)

There are 2 docs. One who's background is in western medicine who went over the hows/whys of what acupuncture does. Then the other is the eastern medicine one who went over the things she needs me and my husband to do during the IVF cycle - things like the ph diet, supplements to take, etc. Also the whole gamut of the dos/donts of health during IVF. It went from the science behind blood flow to the power of positive visualization. And honestly, it was great. Because I am a very scientific person, it was awesome to have someone there who talked the science to counter the eastern medicine part which I don't know much about.

I won't lie and I'll tell you I don't really "get" this who visualization thing. I mean, I understand thinking positive is going to create more positive things for a person than a negative thinker, but it's because a negative thinker doesn't go that extra step sometimes because of the "what's the point?" attitude. There is a science behind it. Visualization, however, doesn't have the science. And while I don't understand it, I'm definitely not shoving it aside. I'll try it and see how it goes, but I'm glad this practice isn't 100% bells and wind chimes. I get to latch onto the science part of it and allow the other part to come in small doses. I couldn't ask for more.

The treatment itself was fucking awesome. This session involved back of the calves and lower back needle placement, along with the electro stimulation. We talked in length about my lower back pain and he is including that in his treatment, so maybe I'll even get some relief on that end. It felt ~soooo~ good. The electro shocks running through everything was good, but my lower back was in heaven. With each pulse, I felt relief. Wow.

I brought my ipod because I'm not a very good relaxer during treatments like this. Even with massage, I have to talk. So left in a room by myself for 30 minutes to let the needles to their work, I knew I needed distraction. My ipod played some mazzy star, bob marley and even a bit of the cure's disintegration album. I have a lot of music I don't listen to much anymore, but it's all stuff I listened to at one time. The cure was total from my high school days, but it fit well into today's session.

One session down, 10 to go. Now to go read over all of the literature they gave me about improving my IVF outcome by changing my lifestyle in different ways. I'm up for the challenge.

IVF Acupuncture all setup.

(if you haven't guessed my lies and truths in the previous post, don't forget to do so! I'll be giving the answers tomorrow morning.)

Miss Swim got me thinking about acupuncture for my upcoming IVF cycle, so I went ahead and got the ball rolling. (by the way, if you know anything about acupuncture, Swim has some questions - please go and visit her post to see if you can give her a hand with some opinions).

I already knew I would be doing the acupuncture with IVF. I've heard such good things about it and it can't hurt, right?

I called up my RE's office and they gave me the info of who they work with. I then turned around and called the acupuncture office and had a really nice conversation with the girl who answered the phone.

They offer an "IVF" plan which consists of 11 sessions, 9 to be taken in the weeks before IVF, 1 to be taken immediately before ET - the night before or the morning before, and the last to be done promptly following ET - meaning you are to call them at the moment you walk out of the RE's office and get the heck over there.

Everything during the weeks before ER will be so hectic, I'm glad I called now to get this started. They want me to group most of my appointments right before egg retrieval, so I'm getting in 2-3 appointments per week for the weeks I'll be doing stims, but I do get to have 3 weekly appointments before that, starting this saturday! I'm thrilled at the aspect of starting to relax sooner rather than later.

The only appointments that are not scheduled are the ones immediately before and after egg transfer. I bet if I let them in the stirrup room, they'd want to be poking me with little teeny needles while I felt a breeze on my cervix. When I find out when ER is, I'm to call and they'll fit me right in.

All of this is going to cost a little chunk out of my wallet, but I am not complaining at all. No complaining even allowed from someone in my position. If I was someone else looking in at my luck with insurance and saw me complaining about acupuncture, I'd have to punch me in the face. No doubt. It's not really that expensive anyway. $625 for all 11 sessions, which is $57 per session. I will gladly pay $57/day if it helps my future embryos implant themselves into my maternalness.

We talked about our "next step"

Me and the hubby talked about the next step.

It really started out as him not knowing what to do with me this morning. I was obviously upset and he sat next to me, just to hold me. Which, of course, made me cry.

I sobbed "I'm sorry I can't give you another child. Your chance for a son." His reaction startled me. He told me that he will never be upset with me if I can't give him another child. He said that although he ~wants~ another one, if it doesn't happen, he won't be devastated. He'll be happy with what we have. And while I also will be (and I am happy with what we have), I will be devastated when we come to the end of our journey. How can you not be? How can you work so hard at something and have to quit, without being devastated? I know I can still have a great life with this as our ending in search of #3, but I'm not going to be happy with the ending itself.

Anyway, I talked about how the next step is going to be a big one. It's going to be even more emotionally draining on me. It's going to be expensive. It's also going to be tough on him with the lifestyle he'll have to abide by for those 6 weeks up until retrieval. He told me that if I am up for it, so is he. He'll do everything he has to do. But if I don't want to take the next step, he won't push me. While I'm happy he's so open, it does make me feel that he doesn't want this as much as I do. But I know that's not true and he's just being a good husband.

I called my RE's office and they are calling the insurance company today, for pre-approval. (And let me just say that I thank my lucky stars for this new insurance everyday. It fell into our laps when I never thought we'd have IF coverage in a million years.) I have to submit some documentation myself, as does my OB's office, to prove I was in "treatment" a full year ago. Easy enough to prove, I just have to jump through the hoops. Once all the information is with the insurance company, they will go to review and will give me a pre-approval letter and then I can start my first IVF cycle. I'm unsure how this timing will work, but I sure do hope it works out without too much of a wait. My time is running out and I need to start this sooner rather than later.

Wow. I'm going to do IVF.

When did I become "that woman"?

I've mentioned my upcoming IVF plans a few times recently. Here, in private conversations and on some private and public message boards. And I talk about how it's so strange that I'm ~here~ and already in the pre-authorization process. Like it's NO BIG DEAL to have IVF coverage.

Do you know that I've been insanely jealous of women with coverage for years? Even when IVF wasn't in part of my plan? Although I must admit that I would have probably gone for IVF earlier in ttc #1 and now for #3 if I had coverage - so I've always been a little miffed that IVF wasn't an option for me because I just couldn't see spending $12,500 out of pocket.

But seriously - whenever I saw anyone mention their IVF coverage casually, I got a little pissed off. I wanted each and every women WITH coverage to add onto each and every WORD about their IVF coverage with the caveat - "and I count my blessing everyday for this coverage because I know I am one of the few with coverage".

It's like I wanted covered people to bow down and feel humbled for the coverage they have. I ~know~ this is unfair though and it's why I never verbalized it to anyone. I would never ever of scoffed at anyone for not saying how they were lucky, although I know I quite frequently would have to add in "you sure are lucky" to any of my comments to these people.

And here I am. With coverage. Talking about it. Without the caveats. Just talking about it like it's normal. Good lord, I suck big monkey assholes. I do. And I'm sorry. I've become her. THAT girl with coverage. Who isn't visibly counting her lucky stars (but believe me, they are being counted more than you could imagine).

Quick question. Is IVF covered for Candians? I know general health care is covered, but what about IVF? Can any Canadian just get IVF for free? Meds too?

Along these same lines about the ~need~ I've felt for women to humble themselves for their good fortune, hHave I mentioned how I've recently become free from the non-humbling actions of fertiles? For so long, it's bothered me that girls who got pregnant easy and had no views into the IF world weren't falling all over themselves with the knowledge they dodged a bullet. I've always known they wouldn't be able to understand how IF feels, but I always thought they should not only know, but they should SHOW they understand just how lucky they were to conceive easily.

I finally came to an understanding how I can't hold this against them when they really have no idea "it" even existed. It was pompous of me to think my feelings and journey should be sought out and understood and coddled when they wouldn't even know to begin to look for it. Although, once I explain it to them, I think my journey should be respected. For example, after I explain 35 months of my life has been spent TTC, they shouldn't respond with "Sucks to be you! Only took 3 months for me to get 3 kids!".

Yes, I have talked about this before because now I remember my example. It's like someone who loses their ability to walk. This person may be quite pissed off that everyone takes walking for granted. But for most, walking IS something we take for granted because we have had no opportunity to think otherwise. However, if we become aquainted with the issue, suddenly walking is something that is hugely on our minds and never again will we take it for granted.

And that is how I have to think about fertiles. Until they have a reason, I can't expect them to know.

Why am I explaining all of this when I'm just trying to explain that I understand just how lucky I am right now? Who am I equating myself with? The person who just innocently doesn't know about something? The person who is annoyed that someone else isn't humbled? Or am I the person who has been explained the situation, yet I say something really lame back?

I think I am trying to say that I feel like I may look like that last person, but I swear, I'm not. I know just where I am right now and I understand the gravity of it. It's not something I'm taking for granted. And I should be careful not to make it sound like I am.

My RE is on TOP of things (financially)

I saw him yesterday. I sat and talked to the finance guy before I left, telling him I will no longer be paying out of pocket for all things infertile (no, no, it's not all rainbows and sunshine). He said he'd bill for IUI and I'll have to pay up to $300 for what insurance doesn't pay for (and as I mentioned, I have a $250 deductible, so hoping the "up to" only means another $50 on top of that). I also mentioned I wanted to get pre-authed for IVF. I don't know if there is an official pre-authorization for it, but I know there are rules (12 months of infertility using other less expensive methods, letter of credible coverage from old insurance, etc) and I want them to all be in a row for if/when IVF is necessary. (good lord. IVF. Queue "I never thought it would be me" flashbacks).

My god, I ramble.

Anywho, I saw him YESTERDAY and I already got in the mail today a "just to confirm we will bill insurance for IUI and you'll have to pay up to $300. And I've talked to finance-girl-x and she will start the pre-authorization for IVF".

Day-um. He must have run back to his office to write the letter to get it in yesterday's mail. Maybe the poor guy's bored. Shouldn't be with the lines of people in and out of that waiting room.

Oh - and tell me. Is EVERYONE employed by your RE pregnant too? It's really annoying to find at least one VERY pregnant person waddling working there. Maybe they hire pregnant girls on purpose - kind of as positive reinforcement of their all powerful treatments. But it doesn't do much for me except piss me off. And I REALLY have to bite my tongue from asking "do you get an employee discount?"