Tuesday, February 26, 2013

As you suspected...

Of course I didn't get a call from the RE office yesterday.  They called me bright and early at 8am on my day to sleep in.  However, the nurse was very chipper today, saying, "As you suspected, you have not ovulated!"  Ooo, do I get an award for that?!? 

So, it's back to the Provera, except it's 10mg for 10 days this time.  Does anyone know what the extra three days of taking it supposed to do?  Last time, it was only for 7 days. 

Onward to the fun!  Maybe if my chin grows all sorts of crazy zits again I'll get a pic to post here.  At least document the beginnings of my kid ruining what I have left of my looks :).   In the meantime, I found this cute pic online, and think it represents my uterus's future feelings about all the drugs I'll be exposing it to as well as my plans for introducing an occupant to its currently unoccupied living accommodations.    

Monday, February 25, 2013

Vampires and headaches...

I'm sitting in the lobby of the U of M Reproductive Medicine Clinic for the last time (hopefully). I got an HCG and Progesterone level checked. I have to say I'm going to miss the lab tech; such a nice vampire :)!

The reason I have a headache is because of what happened after. It was my understanding that they would be prescribing Provera and Clomid today after my non ovulation was confirmed. Even though I'm not wanting to use Clomid at this point, I would like to have the script just in case. Provera is an easy one, but the Clomid I would have to shop around for. Because of this, I asked for a paper script. To get those scripts, I asked to wait until they got the levels confirmed so I didn't have to come back.

Apparently, this is something they have never heard of. "We don't usually have patients wait in the lobby," the snooty nurse told me. This is AFTER I hear her talking to another nurse in their office. Knowing full well I was standing in the hallway, she told her I went into a "long annoying story" about needing a paper script. Apparently, they are only going to prescribe Provera today anyways. Not what I heard, but ok.

Good riddance! On to Diamond Women's Center on Wednesday!

Saturday, February 23, 2013

Get over it. Grr....

I was so depressed last Thursday I could barely go to class.  I did, but I really struggled with it.  Here's why:  I went to the midwife again last Wednesday to check in with her on how things were going.  It turns out the scale at the RE's office was wrong and I have indeed only lost about 10 pounds.  Still an accomplishment, but not where I should be.  My goal was to lose the 25 pounds I would be gaining back during a pregnancy before I got pregnant.  So, 15 to go.

Apparently, that's not good enough for A.  Right when she came in,  she expressed what she called "concerns," which were more like extreme dissapointments.  She even acted a bit mortified that I am going ahead with TTC.  She basically said that if I get pregnant, I will pretty much be guaranteed to have pre-eclampsia and gestational diabetes, which will mean I have to deliver in a hospital where, under those circumstances, I will most certianly have a C-section.  Then she started freaking out over my blood pressure, which was 150/90 at the time.  I tried to explain that I have my B/P taken frequently, both at work and at all those Dr. apts I have been going to.  It's always aroung 110/70.  I had tripped going up the stairs to the exam room and I was incredibly stressed, which seems to happen every time I go to any doctor appointment these days.  Also, she used a wrist cuff, and those usually run high anyways.  I can tell she didn't believe me.  (FWIW, I took it later in the appointment, and it was 138/88.  Took it at work later on, and it was 128/88.  Took it this morning, and it was 108/78.)

So what does she do?  She recommends I go to Slimgenics so I can drop as much weight as I can before I have an IUI.  I researched it.  I spoke with them on the phone.  It's a crash diet.  Wait; you want me to go on a crash diet that incorporates supplements that include caffeine and speed right before I try to get pregnant?!?  That goes against any research I have done up to this point.

You know, I go out of my way to eat right.  I exercise frequently.  I don't sit all day at my job.  I don't have diabetes or high blood pressure.   I am not morbidly obese.  My research indicates that with my size taken into consideration, my pregnancy risks are still relatively low; they would increase IF I had any of those things listed above, which I don't.

Can I just meet one healthcare provider who believes in me and wants to do things on my terms?  Yes, I am taking care of myself, and yes, I will be heavier when I get pregnant.  Get over it.  Grr....              

Friday, February 15, 2013

Here's 50 bucks and a vein; just do it already!

It turns out that I had every right to be concerned.  I haven't been able to post about my visit to the RE on Tuesday since it has taken me that long to recover from it emotionally.  I can honestly tell anyone in MN to run screaming in the other direction from the U of M Reproductive Medicine Center.  Single or married/partnered.  I have no qualms about saying this AT ALL. 

I arrived at 9am, bringing coffee for dear old Dad.  Let me take a second to say that I am so grateful he came with me to support me, even after he had been at work all night.  I checked in, got weighed (~17 pounds lighter; may have been the scale, but I'll take it!), got vitals taken, etc.  Then the NP came in.  Where to start....ok I suppose with labs.  She did point out the FSH to LH ratio not indicating PCOS thing. But she refused to test any of the other hormone levels,  saying that you need to have symptoms in THREE categories for her to even do any further testing.  Since I only have poly cystic ovaries and irregular periods, but no other physiological symptoms, she won't explore PCOS at all.  All my research has indicated that many women won't have those other symptoms, and that blood work needs to be done to rule it out.  I have one doc who says it doesn't need to be done because I already have PCOS, and now this chick says I don't have PCOS so it's not necessary.  It's a friggin' testosterone level for pete's sake.  Here, here's 50 bucks and a vein; just do it already!  She did repeat the TSH, which is now 2.4, and also other thyroid antiboties.  Really not sure what to make of that.  I'm trying to get into an endocrinologist as we speak.  Something's up there.

After that, we talked about the imaging studies.  First off, the cloudy spot on the HSG is probably an air bubble.  When you look at the image progressions, it starts high and moves down.  I'm ok with that explanation.  She did her own ultrasound.  Thin uterine lining, right ovary still hiding.  It appears that my follie count is at around 13 on each side.  But, it looks like nothing is growing at this point, which was CD 9. 

The plan at this point is for me to come back on CD 21 for a progesterone level to confirm if I ovulated or not.  If not, which is very likely, I will take Provera to start my period.  Then I will take 50mg of Clomid for 5 days.  Then, continue to use OPKs and come in on CD 21 to confirm/deny ovulation.  If not, lather, rinse, repeat with 100mg of Clomid, then 150mg, etc.  I tried to talk to her about Femara, but she said that the only reason to switch is if it isn't working or if my lining is too thin.  I'm ok with the process of elimination at this point, especially since I'm not trying for the next cycle at least. 

So, this may seem like everything went fine for the most part.  Quite the opposite.  Now that I have the science out of the way, allow me to explain how they treated me.  A description of judgmental would be putting it lightly.  Let me start off by saying that this is the only clinic in the metro area that requires a psych eval before using donor sperm.  When I asked why that was required and what types of questions would be asked, I was told that they would be asking if I planned on telling the child, how I planned to parent alone, how I thought the child would feel about being donor conceived.  Like it was a test I had to pass to be inseminated.  First of all, those are questions they have no buisness asking.  I AM THE PARENT HERE!  It is MY decision to tell MY child about his/her orgions, and MY choice on how to parent MY child.  Will I tell my child?  Absolutely.  How do I think he/she will react?  Studies have shown that children who were brought up with open disclosure about how they came to be have done quite well.  They say that they know they were wanted and loved before they were even conceived, which as an unplanned child myself is something I struggled with growing up.  So, I told the provider that.  Do you know what she had the nerve to say?  "It's nice that you think that way, but you don't have a crystal ball to predict the future with."  I told her that no one does, and I will handle the challenges appropriately when and if they present themselves, because that's part of being a parent.  Allow me to pose this question:  Do I need to have a psych eval every time I choose to have sex with a new partner just in case a child comes of it?  No, probably not.  I can sort of see the requirement for adoption situations, since the children may be special needs for a variety of situations.  It's a good idea to make sure the parent(s) are prepared to handle it.  But for this, I really think it's motivated by profit and self-serving validation on the part of the clinic.

Then, there's how I was treated overall.  As soon as I would tell a staff person I was single and having a child on my own, their attitudes changed.  They spoke to me in a condescending manner and acted like they were giving me information because they had to, not because they were truly excited about my trying to have a baby.

There are so many other reasons why I don't want to continue there.  Their billing practices, the fact that you can't get a nurse on the phone right away, the provider being triple booked that day; the list goes on and on.  I want to thank local SMC Anna for recommending Diamond Women's Center to me.  I'm going there in a couple of weeks for a consult, and I'm really hoping that things will end up being better.   I'm also meeting with my midwife next week to get her feedback on the new information.  I was sobbing when I called her office a couple of days ago, and the doula was so sweet to me.  I keep telling myself that for every non-supportive person, there's ten who are.  So, I'm going to keep living my life, which tonight will involve all you can eat Sushi in belated celebration of my birthday.  I'll be in touch.             

Tuesday, February 12, 2013

"Your cervix is running away and hiding from me."

Well, I had my HSG today. It was interesting to say the least. I had to go to OB to POAS just to make sure I wasn't pregnant. I told them it was a bit redundant at this point, but I did it anyways. After the BFN was confirmed, I got to wander through the new part of the hospital and get lost on my way to radiology.
I waited around for awhile, then a VERY pregnant nurse came to get me. I went into the exam room and got undressed. I laid on an x-ray table and put my feet in their makeshift stirrups. I chatted with the nurse a bit and listened to the woman in the next room scream in agony. Foreshadow foreshadow....
The OB/GYN came in and the fun began. First came the speculum, which was freezing since it needed to stay sterile and thus couldn't be warmed. Next she scrubbed my cervix with pink soapy solution to remove any normal flora that was on it. She kept having to readjust the speculum, saying, "Your cervix doesn't like to be messed with, so it wants to run away and hide from me."
After that, she injected my cervix with lidocaine to numb it up. Little bee sting my ass! She tried to thread the catheter through, but my cervix, like me, is stubborn and doesn't give was easily. So, another massive bee sting and a dilator was needed to get the job done.
At that point, the radiologist came in to take the snapshot. He put the camera over my pelvis, being creative to work around my knees. Then came the dye. I quickly understood why the woman next door was screaming. Cramping is an understatement. I didn't scream, but I whined as loudly as I could. Thank god for nurses. They can hold hands and comfort patients like no one else can during a moment like that.
The pain stopped when the dye stopped , thank God. And, good news! Tubes open, no other concerns. I'm glad to know that this is the case, and all I can say is this kid better appreciate all I went through to give him/her life.

And now, I am pleased to present my uterus for your viewing pleasure, or lack thereof, whichever the case may be:

Saturday, February 9, 2013

A numbers game, or, rolling the dice...

Well, at this point, it is all about numbers.  Money, insurance, timing, and now, labs.  I feel like I'm gambling, rolling the dice, hoping for a seven, or whatever it is supposed to be (I only gamble with my life, never my money...the odds are better that way). 

Anyways, I worked a night shift and went in for my bloodwork bright and early the morning of CD 3.  The lovely resident didn't enter in the right lab code for the AMH, but the tech drew it anyways, saying she'd call him later to figure it out. 

I called that afternoon for the results, and no call back.  So, I called yesterday morning.  I got a call back from the nurse stating that my TSH was elevated at 5.9, but she didn't give me any more information than that.  So, I called back.  The nurse said she didn't have time to talk to me and would call me back, but . . . you guessed it, she never did.  So, being the pain in the ass patient that I am, I called the on-call today.  Now, I work in healthcare, and I work as many screwy hours as this poor on-call resident does.  I understand that this is not ideal.  If my appointments were further off, I'd have waited until early next week.  But, that's not the case.  I wanted the numbers so I could do the research.  Here's what I found out:

Prolactin: 9
LH: 2.1
FSH: 4.5
E2: 32
AMH: 2.1

TSH: 5.9
Free T4: 1.13

All of those values are within normal limits except for the TSH.  An interesting thing to note is that my LH is lower than my FSH.  In PCOS patients, the LH tends to be higher.  This doesn't rule out PCOS at all, but I'm taking any good sign I can get.  I am a bit irritated that Dr. Idiot didn't think that I need thyroid meds right now.  This resident I talked to today also said that they would only treat me after I am pregnant.  According to everything I have read, anything above 2.5 affects fertility.  So, how is not treating it logical?  Also, they won't order a free T3, which should be done at this point, given the free T4 was normal.  Grr...I really hope the RE office is better about all of this.  

I did, however, manage to get my HSG scheduled for Tuesday morning.  For those of you who don't yet know, the HSG is a test where dye is injected into your uterus to all for more detailed imaging of the uterus and fallopian tubes.  Mainly, this is used for checking anatomical abnormalities, like blocked tubes or uterine scarring.  Many women will try to get pregnant a few times before having it, but for those of us who are paying dearly every cycle, it's a good idea to check things out before trying in vain.  The disadvantage is that it can hurt.  The pain can range anywhere from mild cramping to all out jumping off the table pain.  I am not looking forward to this at all.  The one advantage I can think of is that an OB/GYN will be doing the test herself, so I should be able to find out what things look like right away and ask any questions I have, IF I am not in too much pain to think.

So, there you have it for now.  Any advice or feedback anyone has for me would be much appreciated.  I'll write again and let you all know how it goes.   

Murphy's law, or, happy birthday indeed....

So, who remembers Murphy's law?  Anything that can go wrong does?  Yup, he had a point.  After verifying that the RE clinic I was going to later this month was approved by my insurance AND the clinc, I get a call the from some insurance specialist from the clinic the morning of my birthday telling me that my insurance will approve payment, but the clinic doesn't have a contract with them.  Lovely!  Thanks for telling me about this when I made the appointment, TWO MONTHS AGO!!!

I got off the phone.  I screamed.  I cried.  I threw a pillow at my bedroom wall, completely freaking my cat out.  I took a hot shower, calmed down (somewhat) and made about two hours' worth of calls.  I came to find out that this is the case with almost every fertility practice in my neck of the woods.  My insurance will pay for it, but the clinic won't take it.  So, guess where I ended up?  The U of M.  The clinic I didn't want to go to at all.  The clinic that, according to reviews, likes "rich, white, and married" women as patients.  The clinic the asshat resident was trying to steer me towards.  The clinic that has a high volume of patients and not many providers.  LOVELY!!!

It seems I have no choice but to go there, so next Wednesday, I will be seeing one of their NPs for an intake consult.  I called up dear old Dad, and told him his enforcer duties are beginning early.  We have an agreement that during my labor, he is going to be the one to make sure that my plans are carried out, and that things are done according to what I want; i.e. he is going to be the enforcer.  If anyone tries to subject me to anything unnecessary that I don't wish to have happen, they will have to get through him first.  He already agreed to come with me to the other clinic for support, and he is coming with to this one now.  He is going to provide support and help make sure that all the questions I have on my list are answered.  I'm so lucky to have him.

At this point, I'm trying to make the best of a not so great situation.  I'm telling myself that it is only a consult.  When the testing is done, very little of my treatment will be covered by insurance, so I can still go where I want for my IUIs.  And, I will be meeting with an NP.  Nurses are so much better at treating their patients like people anyways.

Ugh, happy birthday indeed... 

Tuesday, February 5, 2013

That was fun...

So, that was fun....I went to the OB/GYN this afternoon.  I had origionally made the appointment last week, thinking I would need another round of Provera to bring on AF.  If I started taking it today, I would be on CD 3 when I went to the RE.  Well, surprise, she showed up on her own.  K, changes.  I asked for CD 3 labs.  I haven't been to a traditional OB/GYN for at least a year and a half.  Since it was a fairly short notice appontment, I got a new resident, not the doc I usually see.  I thought, "Fine, whatever; I just need labs." Oh if only it were that simple. 

First off, he acted like I should be going to the U of M RMC.  I told him that the clinic I am going to got better reviews than that one for women in my situation.  Then he argued that I didn't need an FSH, just AMH.  He asked me if I even knew what those tests were.   I told him I wanted both and why.  He told me he thought I was wasting healthcare dollars, but ordered both.  Then he didn't want to order an LH. He finally did when I told him that the clinic used it for a baseline.  He grilled me about the TSH, but ordered it given my borderline results in the past.  He agreed with the Prolactin and Estradiol, thank God.  But, when it came to the hormone levels to check for PCOS, he flat out refused.  He said that ogliomenorrhea and PCO (irregular cycles and cystic appearing ovaries) were enough to diagnose PCOS.  Correct me if I am wrong, but all my research indicates that hormones MUST be checked to make a definitive diagnosis and decide what treatment will be most effective.  But, I was tired of arguing with him at this point.  The RE can check those on any cycle day anyways, right? 

If only it ended there, it would be great, but it didn't.  He actually tried to counsel on me on proper pre-pregnancy nutrition, taking vitamins and exercise.  I asked if he had read my med list and the nurse's note.  He admitted he hadn't.  If he had, he would have seen all the vitamins, along with my exercise habits.  Then he wanted to tell me about what an HSG was for, but refused to order it.

Oh yeah, he also said I shouldn't be getting medical advice from an online forum (referring to SMC).
The best part was when he told me to come back and see him when I was pregnant.  I told him very politely that I had a midwife I planned on seeing if all went well.  He said freestanding birth centers are great IF you actually get to deliver in them.  WTF?  And people wonder why I didn't want to see an OB/GYN?!?  That is why, RIGHT THERE!

Ugh, well it's done at least.  Lab draws on Thursday.  Fingers crossed for good results.  Had a great day otherwise.  Just got home after class and drinks after.  I'll post when I get the numbers back.  Night everyone!   


She's here. ON HER OWN!!!!! OB/GYN appointment this afternoon. Details to follow.