In the Background

So my last few posts may have looked “zippity do da” like we’re just buzzin’ through life with fun filled weekends; which is partly true but there has definitely been activity in the background.

Back in Feb I posted about my fasting glucose test and all the other required tests to get a proper plan in place.  The result of that glucose test was a prescription to get back on Metformin 750 mg 3 times a day and switch over to the Paleo diet.   I never actually made it up to 750, I’ve been maintaining 500mg x 3.  I’ve been doing OK on Paleo, until about 2 weeks ago.  I literally thought I was going to vomit if I had to eat one more premade meal with caulirice.  So we put that delivery service on hold for this month and I’m cooking.

August 26 I officially changed from contract to permanent employee which means we have insurance!   They automatically sign everyone up for Kaiser, which I have nothing against but I like my own doctors and I hate having to go through the endless paper approval process.  So we switched over to Blueshield 90/10 plan, the most expensive (560 per month) but the least in deductible and included infertility coverage.

When I took this job the idea was to work 3 12 hr days a week.  That should have allotted me the time to go to the dr. Well HR wouldn’t approve that, the most they would agree to was a 4/10 schedule.   After a lot of back and forth and being completely burnt out I got assigned a normal 5/8 schedule.  I now work from 6-2:30.


Sept 25 I saw my regular Dr to have my yearly physical done and get all my stats updated.  My blood pressure was abnormally high, it was attributed to work stress.  

Oct 1 Went to get the remainder of my blood work done.  Was gone from work 2 hrs, there was a miscommunication on how I could break out my time, which turned in to a discussion with my supervisors on what I’m perusing and how much time I can take.
Basically they want me to make all my appointments after I’m off for the day, they are willing to let me take a hour lunch and stay until 3 pm to get my lab work done.   We have to meet again in 3 months.

Oct 7 Nurse called with lab results, said everything looked good except I was very low on vitamin D and needed good cholesterol.   Recommended 2000IU Vitamin D and flax seed oil.  Later that night I was curious about my BP and had hubby take it.  156/110, scary high.

Oct 8 Called Nurse back told her about BP, she insisted I see the dr right away.  Go to dr get prescribed BP meds and asked to take log of readings for 2 months.  Attending dr see’s we are trying to get pregnant in chart and thankfully prescribes a med that I can stay on through a pregnancy.

Oct 9 Go back and forth with our lousy PA Janet on lab results and missing tests.  Apparently she forgot to order 2 blood tests on top of needing my LH and FSH levels.  I had to have a baseline ultrasound done between cycle day 1-4 and she insisted it be done at their office between 7-9 am. And then there was the Sonohysterogram that needed to be scheduled before day 12.  Can you believe she told me "just send me a email on cycle day 1 and I’ll get all this scheduled for you?"
I call the dr’s office and ask to speak to anyone BUT Janet, thank goodness I did.  Ended up talking to a very nice lady named Lisette.  She explained that I could get my labs done at Quest or at any HRC office as long as they were same day results and that I can also get my ultrasounds done at any HRC office.  She helped me move my baseline to a 4pm apt in Newport and confirmed my sono with Dr Potter on 10/24, which Janet never scheduled!

Oct 15 Cycle day 1.  Email Janet (useless)

Oct 16 Cycle day 2, go to Newport for the most awkward ultrasound of my life.   I’ve done the internal deal before but never bleeding!  Who signs up for this job?  Gross.  It only lasted about 10 minutes.  He took pictures and basically said 10 words.  

“Healthy lining for day 2.  10 Follicles on each side, small. Ovaries consistent with PCOS.”
I wasn’t really sure what all that meant, this is what Dr. Google found.

This whole time I thought the cysts were on the outside of the ovary, not around the eggs. So then naturally I wanted to know how many follicles was normal.

So I guess I'm lower than average?

I also ran into Janet on my way out, who forgot to tell me to schedule an HSG (hysterosalpingogram) between day 6-10.  Do you see a pattern of forgetfulness here?

At check out; $323 for one ultrasound, 4 labs and 1 copay.  This is at 50% cost according to my plan, I double checked.   Dr. Potter wasn’t going to be able to meet up for a complete follow up until Nov 13. So the soonest we can start a cycle will be Nov 15.

Oct 17 Called our insurance to find a hospital with a radiology department in plan.  I still cannot believe I had to schedule this on my own.

Oct 21 Cycle day 7 Went to Whittier Community Hospital for HSG.  If you are squeamish stop reading here.

“During a hysterosalpingogram, a dye (contrast material) is put through a thin tube that is put through the vagina lady business and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg moving through a fallopian tube to the uterus.” – WEBMD

This had to be the most utterly horrifying experience in my life.   My nurse was really nice and sympathetic.  She showed me all the tools and explained the procedure. The Dr was the exact opposite.  I had to lay on a table similar to what you would for a pap accept completely flat on my back and totally exposed.   

He had to clean the “area” with iodine, then the speculum (which was not smooth or gentle), then he fed in the catheter which felt like a jab and then pressure and then extreme pain which made me yelp and nearly push off the table.   He said he made the balloon to big and had to start over.   I wanted to grab something.  My first instinct was to grab onto the thing nearest, which was the xray machine, so that was a no.  I couldn’t grab the table either.  I ended up balling my fists and covering my eyes and breathing.  The pain was so extreme when he put in the contrast, burning and pressure and cramping. I thought I might faint or vomit.   Just a few more minutes. More dye, more pain, more breathing. Then he stopped to look at the screen.  I could barely look at the screen myself.  “Right side completely blocked.  Left side blocked, no wait, dye is showing slowly.  A partial blockage.”   

(This is not my film, but mine looked very similar)

Then he leaves the room.  Nurse says all done and I say are you sure?  She says yes again.  And I say it still hurts, I feel pressure, are you sure he got everything out?  She says yes and that I will have cramping because there was some bleeding.  And I say No, there is pressure.  She tries to help me up. At this point I reach around all the draping and PULL out the speculum.  He left it in!!  I knew I didn’t hear the clicks of it being released.   The nurse looked totally humiliated and kept apologizing. She took the tool and we looked at the stand together as she recounted all the tools.  There was blood on most of it.  She helped lower the table so I could get off, my legs were quivering and there was a rush – the dye and whatever else coming out.  She gave me a towel and helped me walk to the bathroom.  I don’t know if I wanted to sob because of the pain or because of the results, but I had to hold it together long enough to get my films and get the heck out of there.  
I text hubby on the way out to go pick up my scrip for antibiotics and guess who forgot to call them in?

When I got home I soaked in the tub for about a hour. It was therapeutic, kind of like I was washing off what just happened.    There was lots of cramping and spotting for the rest of the night and following day.

Oct 24 Tomorrow my Sonohysterogram is scheduled and I’m totally freaked out about it.  It’s a similar procedure with the cath and inserting saline.  This time hubby can go with me.   I’ll update this post either Friday or Monday.

Lab Worked Over

So Fridays lab work didn't turn out quite like I thought. I actually didn't have any blood drawn at all, this is why:

The PA that issued my lab orders failed to tell me my fasting glucose test was going to take 3 hours and that I needed to have a high carb diet for 3 days prior to the draw. (Yea I had a salad for dinner)

Seeing I had to go back to work I asked what else I could get out of the way so the trip wouldn't be a waste. Here's where it got hairy, the remaining hormone and infectious disease tests came up to $900 and they wanted payment up front. Turns out that Quest only takes payments for people who have been approved for financial aid.

I got a little angry at this point and wanted to see what the cost per test was. I also questioned why I had to do these infectious disease test anyway, I was basically told the state mandates it because they don't want any more children being born with HIV or Hepatitis. I both understand this and think its ridiculous, what about all the infected people who get pregnant every day? Can't control that. So the standard HIV test is $40 and then there's a secondary test that tells you what type you have for $400. This is what mad me really angry, I KNOW I have no STDs why on earth would I pay for this extra test??

I basically sat for a hour arguing with the lab on what I would and would not be paying for especially since it had to be up front. I finally got the cost down to $300 and wouldn't you know it my credit card got declined. I totally forgot we used it to buy hubby's flight to Canada.

Totally embarrassed I picked up a form for financial aid and cried the ugly cry in the parking lot.

The PA called and we worked out how to stagger the tests then I pulled myself together in time to walk into my office.

Now I'm back at the lab on Monday morning. I had my first draw done and drank the limeaid sugar water. Toward the end I wanted to gag. I have 2 more draws today, 4 tubes each. Can't. Wait.

Hi Ho Paleo

I decided to dive into the world of paleo eating.

 

A week or so ago I got on the topic of diet with a co worker and ending up telling her that my Dr had recommended going paleo. Excitedly she told me she'd been doing the diet for a few months and loved it. After talking about all our ailments, struggles and benefits of eating paleo she sent me a email full of blogs to follow and let me borrow her book.

Last night I cooked the last bag of pasta in my house. I've slowly been riding my house of carbs and grains as I'm reading the paleo diet book. Principles seem simple enough, no processed foods, dairy, carbs and sugars. If it comes from the earth/doesn't have a label it's A OK to eat baring a few things like legumes and starchy potatoes.

I have to do a little more research on sweet potatoes, starchy and yet a super food. I'm also not ready to give up my hummus! My absolute favorite snack with veggies. Ms. co worker said she had a paleo friendly hummus recipe; I'm leery but I'll give it a try before I knock it.

There's also the little matter of doing a 21 day sugar detox. While I totally see the benefit in this, I think I may just go bonkers giving up carbs, dairy and sugar in one shot. So hubby and I decided to cut the carbs first then move on to dairy and sugar. Also being in the middle of moving this is the best I can do.

After long debate on what to do about getting my blood tests done I decided to bite the bullet and go through with it, I scheduled a apt to be drained on Friday.  Quest Diagnostics will allow us to make payments...because by my count the lab request looks like 12 x $70.   When the results are in I'll be able to start a new prescription of metformin along with the paleo diet and see how my body likes it.  Apparently on this new dose if I even smell a carb I'll get really ill, hoping that will work as a nice deterrent.

From there, when we're ready we'll start booking the ultra sounds/xrays (somewhere around April/May) are really get this pony show on the road!

Counting down the days till we move, starting to pack this weekend and meeting with the painters tomorrow.

What's up Doc?

Here's the big update

The office was nice, intimate and private.
The first thing we were handed was our "hope" workbook and Dr. Potter's book "what to do when you can't get pregnant" I'm not sure if the title was some sick twist on what to expect when your expecting?  But I took it with stride and chose a seat thinking I cant believe I'm in this place.

We sat in the waiting room about 15 minutes. Long enough for hubby to fiddle with the high tech coffee maker and for me to flip through the book. To be honest I haven't even looked through our work book yet because I'm still in "sticker shock" but I'll get to that later.

Earlier in the day I stumbled on to Yelp reviews of the facility and the Dr I was about to see. I thought Yelp was only for food! There was some good bad and ugly, but for the most part I felt it made be better prepared. I chalk up the reviews to some people need to be coddled and sugar coated while others like myself want the more direct approach.

Dr Potter was the perfect amount of straight forward while still maintaining sensitivity.  He started out by asking for my medical history in my own words.  Of course in my own sarcastic way to defuse awkwardness I answered "I like sunsets and walks on the beach".  I got the desired chuckle and proceeded to run down my issues in 3 minutes or less.  He listened as he flipped through my records and made notes.  To my relief he told me that my old Dr Wood was on the right path by prescribing the metformin, that most Dr's are not comfortable dealing with my problem because they just didn't know enough about it.   I was really bummed out when Dr Wood retired and I got passed on to Dr Garcia.  I felt like Dr Garcia didn't really care to work with me, especially when I asked if my met could be increased and she looked at me like I was crazy.  And now Dr Potter is telling me that not only should it be increased, I need to be taking 3 times the amount.  He also shed some light on insulin resistance and how some cultures are more genetically predisposed to it.  He told me that I need to be on the Paleolithic diet, like a hunter/gatherer eating small animals (his words), green veggies, nuts and berries.  He also brought up that people didn't hoard the food they found all day till 5pm and sit down to a big feast, they ate as the went.  Eating wasn't easy, it was out of necessity.  He said if I worked really hard at this new diet, increased my exercise with my new meds the weight should fall off more easily.   I found this all very interesting.  He was so exuberant about it.

We talked a little more about our concerns.  And here is the bottom line. 
Can he get us pregnant?
Yes, he believes with in 3 IUI treatments we can have success.

Does he recommend IUI over IVF?
We won't be able to tell our direct path until we get all the blood work and tests back.  If its as simple as I just don't ovulate with no added issues IUI is definitely the way to go.  But if we find there's stacked issues we wont waste time and go straight to IVF.  Time will tell.

Do I have to drop 100 lbs before we start?
No, while I do have to lose some its not as drastic as I thought.  We can start as early as the next 2 months.  I need to get off my current meds so he can test my hormone levels and check out my liver before I start the new scrip.

He was very nice, I didn't feel like the brush off and no question was stupid.  It was really nice that he was familiar with everything I asked about and had a logical answer to everything.  So after the run down he wrote out all the details of what he wanted tested and when, then we got to sit with his assistant.  She gave us all the test prices and here is where the sticker shock comes in.

Tests include but are not limited to:
Ultrasound to check if my tubes are open  $243
Sonohysterogram (say that 5 times fast) to check my uterus and egg count $500
Mock Transfer (I don't know what this is) $145
Hormone Tests 5X $63
And now the state of CA is requiring infectious decease screening for $200 X2 for me and Hubs.
And then we have to get the guys counted for $220

Anybody have a calculator?  That's about $1900 out of pocket if I can't get insurance to pay for it. (remember I still have to choose a new insurance too)

And it's all so time sensitive, each thing happens on a specific cycle day.  The nurse was kind of pushing that we start in Feb.  But its just to soon.  It's so much to wrap my brain around, I've waited this long 2 more months are not going to kill me.

In the mean time its fun to go to restaurants and order "large animals with a side of carbs"

Dominos

I've maxed out my brain capacity; there are to many things whirling around upstairs. 
I'm going to write it out in a list because its the only way I can make sense of all the domino's.

1. Credit Issues
My sister's first name and my middle name are similar.  Our socials are also 2 digits apart. Resulting in our identity's via the credit bureaus getting crossed up.  Unfortunately she has a some not so bueno things showing up and it is now tanking my credit score.  We hired a company to get it straightened out and its going to take at minimum 30-45 days.

2. Finance
This whole credit issue is really jacking me up because now I can not get financed to put in carpet in the house. I've been getting denied left and right.  We're going to try it under Hubby's name only and see what it gets us. This is also distressing because we will have to finance the baby stuff. 

3. Work
My job location just shifted.  I knew all along that I was going to be working in a different office but I didnt anticipate things to change with in a few hours.  Its kind of hard to explain the whole scenario because I report to one person but have a dotted line to like 6 other departments.  So I came from our Brea office to our Chino office to train and cover for someone else and my supervisor decided it was a good day for me to just make Chino my perminant home.   So I'm learning new people and new tasks.  Also for the time being my hours will be 7-4 M-F, but once my department gets in full operation I'll work 6-6 W-S with a alternating 3 and 4 day week.  Yes that S stands for working Saturday!!  Yuck.

Hubby also started his new job on Monday.  He's loving it.  I just wish he'd cut ties with his old company but thats a whole nother Oprah.

4. Insurance
Kind of ties in with work...So since Hubby's new job is based in Canada (which has standardized health care) they have not quite figured out how to cover his insurance.  The game plan was go put him on insurance through my work and expense the cost difference.  It was going to work out smashingly because I'm supposed to get benefits starting Feb 1.  Surprise! My work doesnt offer medical insurance...they give us the option for supplemental coverage.  Something like Aflac.  So I am now on the hunt for individual coverage and its looking like about $300 for each of us. Yikes.

5. WW
Last Monday I missed my lunch time meeting because of a work meeting.  This Monday I missed because 1. I was in a new city and didnt feel like navigating and 2. I had another meeting to rush to for work back in Brea.  Monday's are clearly not working out for me.  Once my schedule settles down I'll have to pick a new meeting time near my new office.  In the mean time I've slide down the slippery slope of Cold Stones ice cream to the effect of being up 2 lbs.

6. Dr Apt.
D day is Thursday.  For so long it was so far away and now its right around the corner.  I have a wide range of emotions, I wish I could say excited but anxious is a more appropriate word.  I had this whole rosey colored bubble in my head that we'd meet with the dr and I'd show him my progress with weight loss and he'd say we have great odds.  My bubble hasnt totally burst, but I do feel down about not making my weight loss goal.  With no clue as to what we're going to discuss I feel almost vulnerable and I have a gut feeling like I'm going to be told to come back after I'd lost 50 lbs.

All this stress is jacking me up.  My period is MIA, I have a sty in my left eye and my psoriasis is flared up (I could play a mean game of connect the dots on my stomach)

I just need to get through this week....3 more days.  Hopefully I'll have a more positive post on Friday,  I know you'll want all the gory details from my visit.

Secret Society Language - Abbreviations

Unless your interested in Infertility you could probably skip this post...

I've just been noticing that in all these blogs I've been reading there are alot of abbreviations.  Its like their own secret society language.  I'm constantly googling to find out what they are talking about.  So I actually found a nice little list in yahoo answers.  Some of them were ridiculous or creepy so I edited the list to fit my needs/things I may abbreviate.  Hope you find this helpful.

2WW = 2-Week Wait

AO = Anovulation

BBT = Basal Body Temperature
BCP = Birth Control Pills
BFN = Big Fat Negative
BFP = Big Fat Positive
BW, b/w = Bloodwork

C# = Cycle Number
CCT = Clomiphene Citrate Challenge Test (Clomid Challenge Test)
CD = Cycle Day
COH = Controlled Ovarian Hyperstimulation

DPO = Days Post-Ovulation
DPR = Days Post-Retrieval
DPT = Days Post-Transfer
Dx = Diagnosis

EPT = Early Pregnancy Test
ET = Embryo Transfer

FBG = Fasting Blood Glucose
FI = Fasting Insulin
FHR = Fetal Heart Rate
FP = Follicular Phase
FSH = Follicle Stimulating Hormone

GD = Gestational Diabetes
GnRH = Gonadotropin Releasing Hormone
GP = General Practitioner
GTT = Glucose Tolerance Test

hCG, HCG = Human Chorionic Gonadotropin
HPT = Home Pregnancy Test
HRT = Hormone Replacement TherapyIF = Infertility
IGTT = Insulin and Glucose Tolerance Test
IOR = Immature Oocyte Retrieval
IR = Insulin Resistant
ITI = Intra-tubal Insemination
IUI = Intra-uterine Insemination
IVF = In Vitro Fertilization

LAP = Laparoscopy
LH = Luteinizing Hormone
LMP = Last Menstrual Period (start date)
LP = Luteal Phase
LSP = Low Sperm Count
LUF, LUFS = Luteinized Unruptured Follicle Syndrome

MC, m/c, misc. = Miscarriage

NORIF = Non-stimulated Oocyte Retrieval In (office) Fertilization
NP = Nurse Practitioner
NSA = Non-surgical Sperm Aspiration

O, OV = Ovulation
OB = Obstetrician
OD = Ovulatory Dysfunction
OHSS = Ovarian Hyperstimulation Syndrome
OPK = Ovulation Predictor Kit
OPT = Ovulation Predictor Test
OTC = Over The Counter

P4 = Progesterone
PA = Physician's Assistant
PCOD = Polycystic Ovary Disease
PCOS = Polycystic Ovary Syndrome
PCP = Primary Care Physician
PG = Pregnant
PGD = Pre-implantation Genetic Diagnosis
PIO = Progesterone in Oil
PNM = Perinatal Mortality
POC = Products of Conception
POF = Premature Ovarian Failure
PROM = Premature Rupture of Membranes

RE = Reproductive Endocrinologist
R-FSH, R-hFSH = Recombinant Human Follicle Stimulating Hormone
RPL = Recurrent Pregnancy Loss
Rx = Prescription

SA = Semen Analysis
SCORIF = Stimulated Cycle Oocyte Retrieval In (office) Fertilization

TTC = Trying to Conceive
Tx = Treatment

US, u/s = Ultrasound

WNL = Within Normal Limits