Tuesday, December 6, 2016

Update on polyp problem...

I had a friend text me today that my uterus is mean and I just had to laugh cause it totally is dang these polyps!

So I had an emotional break down today and I'm a little embarrassed to even write what happened but I'm going to be totally candid.

I got a call from Dr. Conway's surgery scheduler and she told me the cost estimate that they bill to insurance ($1799 for doctor and facility fee and $600-$1000 anesthesia fee) and gave me the CPT and ICD-10 codes so I could call my insurance and see if it'd be cheaper to do it in Utah or at the hospital here. Called the insurance and they told me it's almost always cheaper to do in office than hospital because of facility fees at hospitals is like double charging you. So Dr. Conway's office it is!

Also after talking with Neal we decided financially it just makes more sense to wait to do the procedure until January since our deductible starts over again then. It's only 3 week wait or so. So I called Dr. Conway's surgery scheduler back and left a message telling her that we would like to wait until January with our deductible starting over and to do it in Utah. I also asked if this would push back the transfer. Which I assumed it would.

I then called the PA at Dr. Conway's office and told her that we would like to do the procedure in January since our deductible starts over then and asked if it would push the transfer back. She said we would need to push back the transfer and that this is the last time they'd let us move the transfer since the scheduling is so tricky and stuff. I got upset and told her it's just due to needing this procedure done and it's not like we are going to flake out. (I was teary and emotional) She told me not to take it that way and that they just have some patients that try and move things around a lot. I told her we can travel to Utah for the transfer, she said we'd have to unless we wanted to wait until April. I told her that's fine and she told me to call back once I have the procedure scheduled so she can start working on a new transfer schedule.

I feel embarrassed and emotional at how I handled things but also upset that she didn't realize how hard this is on me. It's not like I want to have polyps or want to put off my transfer. We also didn't ever move the transfer before hand and we're only doing it this time because of the polyps and financials. I mean to pay $1200 this month for a procedure and then have to pay that all over again next year towards a deductible seems silly.

I realize she probably has not been in the infertility field long ( I believe she was just trained this year to do the scheduling and in April when they did my first saline ultrasound she was being trained to do that then too.) So she is probably stressed with what's on her plate and doesn't really realize how hard it is emotionally on patients. And honestly I've only seen them a handful of times so they don't really know my personality and that I'm organized and on top of things and would never just move a transfer to be more convenient for me and thus inconveniencing them.  Nor does she probably realize the infertility struggles I've had.... (although it's in my HUGE file). I get it it's hard to remember every single patient you see and their whole history but come on you chose to work in a highly emotional field just tread with care and try to be a little more compassionate and understanding. Plus as Neal said "we are paying them a lot of money, and want the best results, so who cares if it's tricky to schedule, we need to push it back."  Love my sweet supportive, knows what to say to make me feel better, better half.

So yes I'm embarrassed and actually put of calling her back today so I wouldn't break down again and had a more level head and wasn't so sassy. I will apologize tomorrow for overreacting when I call her back telling her I have the procedure scheduled.

When the surgery scheduler called back she was super understanding and nice and had spoke with Dr. Conway who said that would be fine to do procedure in January and do the transfer down in Utah in February. I scheduled the procedure for Friday January 6 @ 11 AM. The scheduler told me she would let the PA know and that I should be receiving a new schedule for my transfer soon.

I'm ok with waiting to do the transfer in February. It will probably work out better then anyways. We will be moved into our new house and settled down and no shots for the holidays to worry about.

God is good, and I have to remember His timing and plans are better than anything I could ever plan for myself.

IVF #2 --Egg Retrieval

So we knew we would be moving the summer of 2015 back to Idaho Falls and so we decided to do another egg retrieval in hopes of getting enough embryos to freeze so we wouldn't have to drive back to Spokane to do a retrieval. (there is way more monitoring in retrievals sometimes you're going in daily to check follicle size, etc.) We had paid for 3 tries meaning up to 3 retrievals and 3 transfers or until a live birth was achieved within an 18 month period. So we were ready to move forward to stimulating my ovaries and getting those eggs out. Hoping for more than 3 like the previous cycle. Which we were down to only 2 frozen embryos since the one we transferred ended in miscarriage. 

Here are the meds we used in this cycle (the same as the first egg retrieval cycle with an addition of a couple):

Follistim: this medication contains follicle-stimulating hormone (FSH) and is used to help stimulate healthy ovaries to produce eggs. This medication is usually used in combination with another hormone (hCG) to bring about the growth and release of a mature egg (ovulation)
Microdose HCG:   or low dose HCG is used for ovarian stimulation during IVF it helps,the smaller follies to grow...sort of tricks them into thinking it is trigger time.
Ganirelix: Sex hormone suppressor: It can prevent premature ovulation in women undergoing infertility treatment.
Lupron: new twist on the antagonist ovarian stimulation protocol for IVF called the "Lupron trigger protocol" or GnRH agonist trigger protocol has recently been used by some fertility specialists to completely eliminate the development of ovarian hyperstimulation syndrome. (OHSS):
Doxycycline; Antibiotics It can treat and prevent infections
Cabergoline: It can lower high levels of the hormone prolactin in the blood. 
Heparin: blood thinner to prevent clots

5/17  Last day of birth control
5/18  Labs indicate ovaries are suppressed
5/20-5/24 Period
5/21  Labs and u/s
5/22-5/24 Follistim 150 iu, Low HCG 10 units (both are shots in abdomen)
5/22 Neal to take doxycycline
5/25 Labs and u/s
5/25-5/27 Follistim 100 iu, Low HCG 10 units
5/27 Labs and u/s
5/27-5/28 Follistim 100 iu, Low HCG 10 units, Ganirelix (all 3 shots in abdomen)
5/29 Labs and u/s
5/29-5/30  Follistim 100iu, Low HCG 20 units, Ganirelix
5/31 Labs and u/s No Follistim, NO Low HCG, Ganirelix,  Lupron Trigger shot 80 units @ 11:30PM, Have intercourse with condom
6/1 Labs   Lupron Trigger shot 80 units at 11:30 AM

6/2 RETRIEVAL DAY -- Neal dropped off semen sample in morning -- 22 Eggs retrieved 21 eggs mature and placed in petri dish with Neal's sperm (which looks similar to image below)
6/3 Day 1- 16 of the 21 Eggs fertilized
6/5 Day 3- 14 eggs still growing
6/7 Day 5- 10 Frozen embryos 4 others still growing
6/8 Day 6 - 2 more embryos frozen

My estrogen was too high and I overstimulated (OHSS) so again we did a freeze all to transfer later. 

Now that's just a little run down but now some extra details. As you can see it's busy and every single day you have to remember your meds or are travelling to the doctor for labs and u/s. It's a bit stressful and you're hoping your body responds like it should.

The stimulation drugs are all shots given in your tummy and My Hubster really is the greatest, he squeezes that pooch of mine and sticks it right in like a pro. So on some days I was doing 3 shots a day in my abdomen. It was sore, it was bruised, and I felt like a pin cushion. As I started getting more follicles and they were getting bigger I felt bloated, and looked like I was pregnant and was a quite a bit miserable.

This is an image of what an ovary looks like when it's ready for retrieval x 2 ovaries

On Retrieval Day you don't wear anything with a scent, so deodorant, etc. is out. They took me back and I put on my gown and hair net and socks and they hooked up my IV. They had me walk into the sterilized room, get up on the bed and then they push the anesthesia juice into the IV and I was out.

6/2 Day of transfer Dr. Robins gave me some type of IV after the transfer I think it was creatine (don't remember the name specifically I had just come out of anesthesia) in addition to lots of fluids to help with the hyperstimulation. He said one of my ovaries was hiding so he wasn't able to drain it all and that would cause even more hyperstimulation. I was so miserable and bloated and hurt. I threw up after my transfer and a couple times at home. My sweet parents came up to help us with Grayson and they were a saving grace. Don't know what I would've done without them. Heart bursts with gratitude for them. 
6/3 Hard time breathing again sharp shooting pains up my shoulders and my whole back, laid in bed all day trying not to throw up, nauseated, bloated, had heating packs on my abdomen and back to help the pain. Tylenol wouldn't even touch the pain. 
6/4 Still super sick, hurting every where, so bloated my stomach won't even indent when pushed on, pretty sure I was gaining weight extremely fast which they told me to watch for with overstimulation. Called nurse, she said to come in next day to do a paracentisis to drain the fluid to help relieve pressure. Also started me on Heparin shots to prevent blood clots and cabergoline to help reduce hormone levels. 
6/5 Neal and I went to the clinic early that morning and I had 1200 units of fluid drained by paracentisis. I remember them pumping it out of me and it hurt worse than I expected but probably in part because I had just had needles all over my ovaries and uterus.  It took longer than expected and Neal had to go to work so my dad came to their office and picked me up and sat with me. I felt a tiny and I mean tiny bit better after being drained of fluid. I had gained 30 pounds in less than a week from this over stimulation.
6/8 Was told to continue cabergoline for one more week and heparin for additional 4 weeks and that once I started my period I would begin to feel much better.
6/13-6/17 Period

I looked 5 months pregnant and still felt bloated for at least a month. Looked bloated even longer Wore PJS and big shirts to feel more comfortable and not put pressure on abdomen. It was awful and hellish and I hate thinking about it. I PROMISED MYSELF I WILL NEVER DO ANOTHER RETRIEVAL AGAIN! (I can say that now since we have 11 embryos still frozen) Thank goodness for those little embabies.

Next up FET (Frozen Embryo Transfer) #2 

Monday, December 5, 2016

H2O (Saline) ultrasound...

Had my water ultrasound today to see if there are any polyps or other abnormalities in my endometrium for our upcoming transfer in January. They do this to make sure there isn't anything that could prevent implanting of the embryo.

They found at least 3 new polyps (they told me they are like little skin tags). Which is just crazy to me. The first polyp I ever had was before the last transfer and they scrapped it out. So I'm glad they had me do this ultrasound and I'm glad we did it earlier in the month so there is still time to get them scrapped out before transfer in January.

I asked if I could do anything to prevent polyps or what causes them, they told me they just grow-- sometimes it's hormones (which I've been loaded with) but there is really no way to prevent them. 

I'm not going to lie I was a little shocked, I had this blog post draft written last night that all was well and we were a go to move forward....but tis not so. 

So now we have to schedule this surgery in the next 2 weeks to remove the polyps and we may possibly have to drive to Utah to have it done in Dr. Conway's main office. Otherwise we will be doing it in the hospital with Dr. Denson. Either way more money then we were expecting to spend. 

So I'm waiting for the surgery scheduler to call me and let me know what is our cheaper option and if Utah is cheaper Neal is in Butte, MT until Thursday working so I'm hoping they could squeeze us in Friday. 

Also got a call from the specialty pharmacy Stroehecker's for our medications for the cycle. Just for the Progesterone and estradiol shots is $417...but money is just that if I get a baby out of this I don't care what it costs!

I can't believe it's already time to prep for this transfer. I'm kind of in denial and feeling a mixture of emotions. Anxiety, dread of another possible loss and dread the sore bum from shots, guilt of the financial cost, hope this is the one that sticks for good, faith that this is all in God's perfect and capable hands. Loved this quote I read on Instagram today.

Praying for peace of mind and strength to move forward with faith and hope.

And our house is almost done being built! We will probably be moving in right around the same time as the transfer (if transfer doesn't get delayed... or our house). So lots of exciting things coming up.

If you're looking for a good Christmas present or white elephant gift we'd love you too purchase one of our coloring books to help us pay for costs of IVF. The Fiddlesticks one is kind of my favorite haha!
I'm working on the story of our egg retrieval #2 and transfer #2 blog posts so stay tuned. Much love to all who are reading along and following our journey. We appreciate all your love and support more than you even know.