Holy Bikram Batman!

As an alternative to running, I was encouraged to consider yoga. There are all kinds and if you google "yoga for conception" or "yoga for ovulation", you will come up with some interesting stuff. Now, I will begin by stating that I was a yoga skeptic. I went to 2 yoga classes in my life and found myself going to the gym before or after. I didn't have the head for it. I thought the little meditation oms were corny, and I thought it was a celebrity fad. Also Jennifer Aniston does it and I can't stand her so I want to have as little in common with her as possible.
During my two classes,  I remember looking at my watch, pumped for the class to end so I could go on with my life - so when it was suggested for my current situation, I was kind of bummed.

Then Groupon had an offer for 30 bikram yoga classes for $49 (usually a $450 value). It may have been fate that the timing was so on point, but I got the Groupon and figured if I went to 4 or 5 classes, I would make my money back anyway.

So I show up on Wednesday night and I know the room is going to be warm so when I walked in, I thought "this isn't so bad" and sat on my new yoga mat waiting for the class to start. Fast forward fifty minutes into class, the temperature jacked up to 102*, I'm sweating from places I didn't even know could sweat, and I am coming in and out of tunnel vision doing some kind of camel pose or another. I started the class thinking, I'm a hard-ass. I run half marathons, bike, and tae-bo. I'm an athlete.A little sweat and bending's got nothing on me.
I was wrong.
This is hard and exhausting and draining. Your mind is clear because you are focused on your breathing, keeping sweat from your eyes, and not falling over into the person next to you.
The class is 90 minutes and I don't know if I have ever been so beat in my life. There was definitely no post-yoga gym trip after this class.
This morning was my second class and I think I hydrated a little better before and after class, but there were still a few poses I needed to rest through before joining back with the group. 2 down, 28 to go!

Also I had more blood work yesterday to finalize a few things before I start my drug regiment. As with any major procedure, I am going for a second opinion with a different fertility group on Wednesday, the 28th but I really like the ladies at IRMS so I'm still planning on continuing with them no matter what.

The latest tests will check for Polycystic Ovary Syndrom (PCOS).  From the Mayo Clinic's website,

PCOS is a disorder involving infrequent or prolonged menstrual periods. The ovaries develop numerous small cysts and may fail to release eggs. PCOS is the most common hormonal disorder among women of reproductive age. Women with polycystic ovary syndrome may have trouble becoming pregnant due to infrequent or lack of ovulation.

IF you have PCOS, the drug Clomid - mentioned in a previous post - will work; however if I have hypothalamic amenorrhea (which Dr. K suspects) the clomid may not work because part of my brain, that gets my hormones going, has temporality shut off because of intense exercise and lean body mass (which would normally be a very flattering compliment from a physician). Clomid is there to "revv" up the brain to get the hormones working, but if the signals are suppressed, the drug doesn't have a basis for working.

I will report back after the follow up and then I am off for vacation for 5 days in Dublin and maybe the "luck of the Irish" will do some good.

Until then - Happy Holidays  and Merry Christmas to all and to all a good night!

Quickie

Ok so I have this blog posted in two places - here and Sparkpeople.com. For those who aren't familiar with SparkPeople, you track your food and exercise to help you get skinny (I did it for my wedding and thought it was super great) but also connects you with people from all different backgrounds, all different hobbies, and all different  issues - infertility being one of them.

I have a "follower", if you will, on my blog there and, to date, her attempts to get pregnant have been unsuccessful. In her personal research she has met other women who were encouraged to undergo IVF but before starting the cycle found success with a drug called Clomid. It is designed for people who aren't ovulating but everything else with regard to plumbing is in ship shape. This includes fallopian tubes, availability of eggs, weight, health, etc. So more or less - me.

Since learning this, I have decided to conduct some of my own research to see if I fit the profile.

Clomid is the most well-known fertility drug, probably because it is the most commonly used. About 25% of female factor infertility involves a problem with ovulation, and clomiphene citrate, as a fertility drug, is easy to use (taken as a pill, not an injection (YAY!)), with not too many side effects, is pretty inexpensive compared to other fertility drugs, and is effective in stimulating ovulation 80% of the time.

Clomid is used when there are problems with ovulation, but NO problems with blocked fallopian tubes. It may also be used in cases of unexplained infertility, or when a couple prefers not to use the more expensive and invasive fertility treatments, like IVF. (That's us)
The most common dosage of Clomid is 50 mg, taken for five days, on days 3 through 7 of your cycle, or days 5 through 9 of your cycle. (With day one of your cycle being the first day of real menstrual bleeding, and not just spotting.)  (I'm really not sure what this means but thought I would add it for educational value)
The side effect you’re probably most familiar with is the risk of multiples (Gina - that ones for you!) . You have a 10% chance of having twins when taking Clomid, but triplets or multiples of more are rare, happening less than 1% of the time.

Clomid will jump start ovulation in 80% of patients, and about 40% to 45% of women using Clomid will get pregnant within six cycles of use or about 6 months.
Using Clomid for more than six cycles is not generally recommended. If six cycles go by, and pregnancy is not achieved, alternatives may be considered (and we would/could go to IVF).

I have a second opinion visit scheduled for December 28th (I thought I would make it to the New Year with out any new people poking around in my chachki, but at this point - whats one more onlooker?) and although this new research may not change our plan - it could be a new, exciting, and less expensive and invasive option. At this point, this research is all Google based so I will report back with the official findings.

*UPDATE* This "follower" turned out to be a freakin' whack job. Later I posted how I was not a candidate for Clomid and my husband and I were going to move forward with IVF. Well, someone must have peed in her Cheerios that morning because she ended up going ballistic on my Sparkpeople wall, making crazy claims about how the doctors only wanted my money, were ill-intended, and wanted to "invade my body with foreign chemicals". Long story short, I ended up blocking her immediately from my blog and from my life. IVF blogs are no place for nay-sayers!

Build Ford Tough

Yesterday was a bad day.
Doctor appointment days are usually bad because they bring back to life the reality of what is happening.

We met with Dr. K in the morning and she assured me that everything was as she expected and the communication between my brain and ovaries is "sleeping" and we just have to go in and wake it up. Its really the statistics that are difficult to swallow, especially when you are shelling out so much money to make it all work.

Couples, in general, have a 25% chance of getting pregnant. This includes all of you out there with normal reproductive systems. There are also a large number of women that are "pregnant" but never know because the fertilized cells don't reproduce effectively enough for it to be noticed.
I have about a 55-60% chance of getting pregnant since I am getting the fertilized egg directly placed inside the uterus. This, more or less, takes out the timing and guess work other couples have.
From this number, depending on where you look - 30% to 70% of fertilized eggs do not make it to the third trimester. Now, that's a pretty huge gap so take that one with a grain of salt. I couldn't find a very accurate statistic online.
All of this said, these numbers are not as high as any of us would like them to be. When taking a gamble or placing a bet, you want 70, 80, and 90% in your favor but c'est la vie.

December 29th we are going to Ireland so when I return on January 5th, I will go on birth control (oh the irony) to figure out what my cycle is and regulate my period. It seems as though i will be on the pill from 2 to 4 weeks.
From there, DJ and I are taking a class so he can learn how to give me shots in my butt. The class is with 7 other couples so I hope everyone in the room has a sense of humor because if not, this could be awkward. I just got off the phone with my doctor and it looks like it will be 12 days of shots, but I  have to go back in for blood work every other day or so to be monitored.
Once the shots begin, my ovaries (which are normally the sized of apricots) will swell to the size of oranges as they are stimulated to produce eggs for transfer.

Without getting too ahead of myself, I will end this here until I have more information.

But the bad day came after my appointment when you have to update those in your life and they give you this look. They mean it to be supportive and considerate, but it really just makes me feel like I'm broken. Its the look someone give you when you tell them you put your dog down - not as sympathetic and devastated as the loss of a grandparent, but enough to where it says "aww gee, that's too bad".

The truth is -this all sucks!It sucks to be unable to do something that's supposed to come so naturally.  It sucks to be told you can't do the one thing that relieves your stress and run, but all you are is stressed. It sucks to travel for work and have to figure out what to do with syringes when you travel. It sucks to think you are doing everything right in life and then you get blinded sided with this.

BUT what doesn't suck is my family who let me have a break down (more like has a psychotic episode) in the kitchen yesterday and then came in and pick me back up or my friend, who, despite my sad and pathetic text to cancel, convinced me to get my shit together and meet her for dinner. Thank you, Gina!
Like those smoking commercials, they help make this all suck less :)

I also got a groupon for yoga so I went ahead and got it. I figured if I paid for it, I have the incentive to go. Its Bikram yoga so I will probably just sweat out my chi and feel better about life.

Boo. Hiss.

So we make too much money to be approved for free medication from Fertility Lifelines which is pretty lame. There is still one more option - a "GoCard" that saves a certain dollar a mount on medications from participating pharmacies. The savings isn't as glamorous but savings is savings.

My annual gynie visit went as per usual and there were no new surprises to report. Thank goodness. I feel like I have a whole practice of women rooting for me through this process. As I mentioned, I'm not entirely "out" yet, but those who are in the know have just been great. Once things get underway, there will be a lot of thank you notes to be sent.

One place where I have decided good news will NOT be posted is Facebook. As of December, I have gotten rid of my account because its bad for my mental health. I always thought it was a bit much for people to post their ultrasound  pictures on Facebook. You can't even see anything. Its a darkened splotch against other darkened splotches and everyone just "likes" it because its the polite thing to do. I am going to venture a guess and say that 50% of those "Likers" could really care less.
I also have a beef with the sideways shots. "Here I am sideways against a wall" and "Here I am sideways on my front steps". If people really want to see how fat I am, come look at me. If you are close enough a friend or family member, you will probably have direct access to my horizontal growth and can see it with your own eyes. Also - its not really something I want to brag about.
The following article is from Redbook Magazine (I think) about women who have baby envy and how social media causes a divide between them and others: http://www.dailymail.co.uk/femail/article-2102376/Baby-envy-The-new-social-divide.html

All of these seemed commonplace and more or less non issues until I had an issue getting pregnant - isn't that the way? Its like getting an alarm system after you've been robbed. You weren't scared of your neighborhood before, but now you are. In my case, pregnancy announcements didn't piss me off until I couldn't get pregnant. But like any great (or not so great) experience I have learned my lesson and here is a short list:
1. Do not ask married couples when they are going to get pregnant. Not only is it annoying in general, but if you are like me - its salt in an open wound
2. No one really needs to see my pregnancy progress. I will happily send you pictures or even do a world tour to visit you- but Facebook isn't the place for it
3. Although we started off with this in place and then we lost it and now we are kind of back on it, the rules of Baby Making should be like Fight Club (http://vimeo.com/7929772) . The first rule of baby making is don't talk about baby making. This way no one can pressure you, assume a time line, or be all up in your Baby Making business.
4. Do not take your period for granted. When you are 14 years old and you are trying to play soccer with a yacht sized maxi pad between your legs, you may find it hard to believe - but you will miss your period one day.
5. Pay attention in Health Class. Hindsight is 20/20 but I would have spent a lot less time Googling things if I had paid more attention to Ms. Gibney (or Gibson?) in 5th grade and Mr. White in 10th.
6. Marry a good person. Although your parents, friends, cousins, aunts, uncles, and doctors will provide the utmost support for you and be nothing but wonderful - your husband has to live with you. He has to be prepared for your out-of-the-blue breakdowns, your rants, and your constant "look what I found on WebMD" claims
6. Keep a sense of humor. You will need it!

"The best thing in life is free...But you can give it to the birds an' bees"

As I mentioned in a previous post, Compassionate Care is an organization that helps people like me pay for the drug portion of IVF. I finally found their site and its fertilitylifelines.com.

Once the process gets underway, I am going to be one of those people that have the MTWTFSS pill boxes so I know what to take on which date. Here is a short list:

GnRH Agonists - Lupron, taken as an injection just below the skin. It allow the body to produce a greater number of high quality eggs during the treatment cycle. (I am super excited about this one because who doesn't want to give themselves injections. Holler!)

Antagonists - used to prevent premature ovulation. These medications are given by injection and the duration of treatment is usually three or four days. (OMG! Another injection! Couldn't be more pumped!)

Gonadotropins - provide stimulation to the follicles that contain the eggs during the stimulation phase.

hCG -  are taken as an intramuscular injection and are used to induce the final maturational changes in the eggs and prepare them for retrieval.

Medrol - a steroid hormone given daily, typically for a period of four days during the cycle, to assist pre-embryo implantation.

Doxycycline - Doxycycline, an antibiotic administered in pill form (Thank goodness), is given to the male partner (oh wait - that's for DJ - not fair!) during the wife's stimulation cycle to reduce the low levels of bacteria that may be found in the semen and which may compromise the performance of the sperm during an IVF cycle. It is also given to the female partner to reduce the risk of infection following aspiration of the follicles at the time of egg retrieval.

Progesterone - taken as a daily intramuscular injection beginning two days after egg retrieval and continuing until the placenta is making adequate amounts of Progesterone. Progesterone can also be given in the form of a vaginal gel or vaginal suppositories or pills (Hot!)

Now I haven't been given prescriptions for all of these bad boys yet and I am guessing the injected ones might be power packed into one shot - which would be nice. If not, I could look like a junkie at the end of this with all my puncture wounds. As I do more research and get a more finite list of medication, I will be sure to inform you.

Here is an education video if you are interested: http://www.fertilitylifelines.com/fertilitytreatments/ovulationinduction.jsp
(I think Treatment Day 13 is my favorite, it makes me think of Ovarian Space Travel)

Tuesday I have an appointment with my regular OB/GYN so I may have a more educated post after that appointment. I also have a dentist appointment that day. All of my orifices are getting checked out.

DJ at the Bat

For this post, since its not so much about me, I took a little artistic license. This is not exactly how today occured, but you can pretty much get the idea

DJ at the Bat
(to be read like Casey at the Bat and if you dont know what Casey at the Bat is, read this first: http://www.poets.org/viewmedia.php/prmMID/15500)

The temperature was chilly on that December day
Our checklist near complete, just two more rounds to play
Elizabeth had been inked and poked inside the ring
Now it was DJ’s turn to do his manly thing

Abstinence was the game, days one through four
to ensure his little soldiers would be beating at the door
The appointment made was early, he better bring his game
He’d seen his wife step up, now he’d have to do the same

He walked into the lobby, checked in, gave ID
He felt a little awkward, hoped do one else would see
him twiddling his thumbs, smiling as he sat
This was DJ’s moment – DJ at the bat.

Led in to a room, heard the door knob click and turn
but knew this was no match for Mutant Ninja Sperm
For the sake of privacy, we won’t detail what occurred,
but it wasn’t too long after from the room he stirred

He felt eyes were on him but he exited with grace,
and felt himself applauded as he strode across the place.
He held his sample closely, hidden against his hip 
But defiance gleamed in DJ's eye, a grin curled DJ's lip.

There was ease in DJs manner as he stepped into his place;
There was pride in DJ's bearing and a smile on DJ's face.
And when, responding to the nurse that looked at him quite shady
He shrugged and said “It’s been a week and I haven’t touched my lady”

Ten million little DJ’s were passed in a jar across her desk
and she thanked him kindly and explained their office would do the rest
And as he left, he heard people laughing, cars drove by and children shout,
he had done his work and done it well and now DJ was peacin’ out.

I love you, I hate you Medical Insurance

First I would like to start with a disclaimer: I'm not really editting this, so there is a very good chance you will find typos and misspellings. If I ever decide to write a memoir, I can assure you those will be taken care of but for now, we are in "stream of consciousness" mode

This morning was spent on the phone discussing financing IVF. It started with a call to IRMS to discuss the cost of various items from the medications I will have to take, the cost of treatment itself, and the transfer costs (the big day when fertilized egg meets awaiting uterus). Needless to say, none of this is cheap.

After speaking with Susan in Finance, I called Compassionate Care. Apparently they have a website that I haven't looked at yet, but they help those of us who do not have insurance coverage for IVF. In my case, they can provide me with one cycle of medication for free. Medication costs can be up to $5000!! I submitted my contact and initial information and from there I will be reviewed for eligibility. I am uncertain if this program is like undergraduate college financial aid where you have to live in a cardboard box with 20 siblings in order to qualify OR if they are more open minded to assist people like me. More details to follow with that. The nurse, Jen, at IRMS also mentioned they receive samples from pharmaceutical companies for patients. Now that she knows we are "IVF ready", she will keep an eye out. In these cases, every little bit helps.

Then I called my financial advisor - and by my, I mean my dad's - to see if I could borrow some money from investments to cover costs. The short answer is yes but the annoying answers is taxes. He recommended putting money into my Flex Spending Account. I would be able to put money in here directly and pull it out to cover medical costs as needed. Good plan IF Open Enrollment for DeVry didn't end November 18th.

Now to call DeVry Human Resources and ADP and see if I can get that added. Their answer was yes or no depending on my appeal. DJ and I had to write an appeal letter stating who we were and why we needed to add Flex Spending to our coverage. If our appeal is granted, life will be good. If not - life will still be good, just a little taxed. We faxed that letter in today and should know more by the end of the month.
(*UPDATE*  we found out we were approved to add the Flex Spending in January which was obviously too late for us. Thanks a lot HR!)

Not that any of this is glamorous, but I would say this is the least glamorous. At least getting ink in your chatchki is unique and makes for a good story, but no one is ever pumped when talking about money (unless you are on the receiving end). From start to finish, this was about 2 hours on phone calls and about 30 times of shouting "representative" into the automated answering service.

After all these calls, I had to rush myself together and get ready for work. When walking down the hall, I felt "uneven" and upon looking at my feet I realized I was wearing a black boot and a brown boot to work. Fortunately I was in good company at the time and my friend and I had a great laugh over it. After the morning I had, it was almost what a needed. Oh life.