Friday, July 31, 2009

The Ivory Tower of Fertility

We had our consult at Cornell last week. It is the ferrari to my clinic's toyota. Their was no comparison. For one, we saw the dr. at the scheduled time! (It is my belief that dr.'s offices are run by air traffic controllers and airline personnel.) I was shocked and nearly sold just on that. The waiting room also had the air of a well-appointed hotel lobby with a delightfully inviting bathroom. We found the dr to be both competent and personable. He was also very thorough. Thorough is reoccurring theme with Cornell - during the exam, he even listened to my breathing and gave me a breast exam. That marks the first time my breasts have been felt during this entire process. I wasn't quite prepared for that- buy a girl dinner first. The minute he walked into the room, I started sliding down the table and assuming the position. This has become a sort of Pavlovian response for me. Whenever someone in a white coat walks in, my legs go up. I am little nervous for my upcoming dentist appt!

Back to the consult: the dr. seemed confident that a low dose protocol would be right for me. I am reluctantly willing to do what ever it takes, but would only like to do the minimum of that. With that in mind, he also said he would be willing to put only two embryos in and possibly even one which I wholeheartedly and maybe somewhat naively support.

So far, so good. After the consult, we met with the IVF coordinator who gave us an overview of Cornell's process. She also scheduled us for a IVF class. (they offer a class - talk about thorough.)We then met with the billing dept who went over the costs and gave us info on how to work with our insurance. It was like a well-oiled, baby-making assembly line. Impressive.

So the moment of truth was upon us. I had an appt on Monday morning to start the IVF process at my current clinic, and until Friday afternoon, I had every intention of keeping it. But there I was, making an appt to have b/w and to take Cornell's ivf class on Tuesday. Did it make sense to pass up the opportunity to go to one of the best clinics in the country? Did I need a ferrari when a toyota could get me where I needed to go and would be less of a financial burden? We are fortunate enough to have the resources to cycle at Cornell so I didn't want to get too caught up with the cost comparisons. I labored over the decision the entire weekend. I knew we would end-up with Cornell but I still left a sense of loyalty to my dr. and was starting to feel like an infertile sell-out. I was trading my mom and pop for the brand name. Sure it was a big decision, but my talent for over thinking was at its zenith.

Monday morning I slept in. Tuesday morning I sold out.

Saturday, July 25, 2009

Cirque de so Weird

For the last 6 months or so, my co-worker and I have been trying to find a good time to take trapeze lessons. Because of my surgery and the monthly 2 week wait, we haven't been able to fit it in. With pending IVF, I had a now or never feeling. So after a little back and forth with a circus douche manager(long story), we finally made it happen. I have taken a class a long time ago and had a vague fuzzy memory of the rush from flying through the air. What I clearly remember is the terror of standing at the edge of the platform and hopping off while white-knuckling the trapeze bar. It's the fuzzy rush that brought me back and the clear terror that almost made me turn around.

Rush prevailed! Not only did I stick the catch/transfer, I also learned a split trick. It was two hours of endorphin rush that resulted in a 10 hour post-rush high! I actually woke-up smiling the next day. Did I mention that I was caught by a circus hunk? Now you my say, I didn't know there was any such thing as a circus hunk. Neither did I, until his shirt went while flying revealing a Beckham slab of abs.

It's a little pathetic that it took a mildly dangerous thrill to distract myself from the on-going infertility process, but it did. The only time it crossed my mind was when one of the instructors was putting on my safety belt and said that it needed to be so tight that my ovaries would be in my throat, to which I nearly replied, "they are in my throat? I might be ovulating! Hurry get my husband so he can get a blow job out of this!" Pathetic, but on the train ride home, I realized I had spent the entire class focused and in the moment. Probably the first time in months.

Wednesday, July 22, 2009

Now is it time to panic?

After waiting nearly two hours, we finally had our consultation with K. Matt and I had spent a great deal of time discussing our thoughts on IVF and concerns and questions we had for the dr. Matt wanted to make sure he sold us on the practice because he is leaning towards Cornell (I was too until we got there and then started to feel unreasonably loyal - I mean he has seen my vagina more than any other man besides my husband not to mention, he was great during the entire surgery process). Anyway, we discussed the process and Matt asks him why we should do IVF there. I knew it was going to be awkward but I had no idea that it would be so awkward. K hesitantly launched into their statistics and reputation for taking hard cases. Then he said we should stay because he liked us. He likes us. While that may have made me feel warm and fuzzy, I am not interested in hanging out with him. I want a baby, and you liking me is not going to get me one. This is a man who has Yale, Harvard and NYU degrees on his wall, and all he could come up with is he like us? In his defense, he said he is not a salesman and not good at giving the sales pitch, and Matt didn't exactly do a great job with framing the question.

So we are moving on to IVF. I feel like we are toying too much with nature. I know I can do the injections (and there are much more this time) and I can do a few weeks of early morning monitoring and put up with the headaches and bloating. I just don't know if I can take another negative.

I am reminded of that time my sister and I missed our train to Munich which caused us to be hours late in meeting our mom at the airport. The entire trip we knew we were going to be late, but we kept telling ourselves, "don't panic; don't cry; we will work it out." When we finally got to Munich, mom had already left the airport. Tobie and I looked at each other and said. "Ok, now it's time to panic."

My panic has been escalating these last 6 months as my hope has been diminishing. I was hoping I would be pg, so I wouldn't have to keep my RE appt, then hoping I would be pg, so I wouldn't have to do IUI, then hoping I wouldn't have to do the surgery and then hoping to avoid IVF. But I have had to do each one. I don't want to know what it is like to go through a miscarriage, but I am afraid that is going to be part of this process too.

Monday, July 20, 2009

Funbelievable

I got the Sunday I needed this weekend. We spent the day on Governor's Island and as if the perfect weather, warm breezes and lovely views, a boat trip and picnics weren't enough....we were introduced to Tragedy while waiting to board the boat back to Manha'an. Tragedy is the number one heavy metal Bee Gees tribute band in the tri-state area. Imagine "How Deep is Your Love" being sung by the lovechild of Axl Rose and some guy who is a little too glam at karaoke night, but even better.

It has been nice having a break from cycling and early morning blood work, but this is consulting week, and we have appt with Dr. K tomorrow and another with Cornell later in the week. I am feeling distraught over switching, but Cornell has such an outstanding reputation. I go on these message boards and almost feel this weird peer pressure to go to Cornell. All of the cool infertile kids are doing it. I am nervous that I won't be able to start with my next menstrual cycle if I switch, and I really don't want to lose another month.

Monday, July 13, 2009

Candy-cane Stirrups

I finally worked up the courage to get my medical file. I have made an appointment to consult with a dr from Cornell, and I can't shake the feeling that I am two-timing my dr. I have this strange sense of loyalty to him. I think part of it is that seeing another dr makes me feel like I might have been wasting my time with K. Cornell is regarded as one of the top clinics in the country so I do feel a little daft for not going there first. My ob/gyn recommended K, and it was geographically far more desirable then Cornell and they take my insurance. But if we are going to be doing IVF, I don't want to play around.

So back to the medical records. I made the call trying not to feel too traitor joe and the receptionists were sooo nice to me. They are not the friendliest bunch, not rude, but the type that got by in charm school with a solid C+. Since it was large, I opted to go pick it up rather than having it mailed. I stopped in and again with kindness all around.

On the train I start reading through it, and it was pretty fascinating. The report on my surgery was the best. It is written in narrative form and mentions that I was "placed in the dorsal lithotomy position using candy-cane stirrups." Candy-cane stirrups? What happened next? In the gingerbread OR, they ran a licorice IV and a sterile gumdrop speculum was inserted into my vagina? Was there a lollipop scope? That laparoscopy sounds delicious.

Sunday, July 12, 2009

A Woman on the Verge....

...Of tears. It's day one again. When I woke-up this morning, I had a terrible headache and felt queasy. We had friends over last night for cake and such. All I had was a sip of beer, so I was hoping that I had a lemonade hangover. I didn't really want to go to the bathroom, so that I could hold on to the possibility for a little while longer.

I allowed myself to cry a little when the I saw the blood, and told myself that it is good that this was such a short cycle, so that I can start trying again. No more tears, now. I dried my eyes and walked out and started to cry again, and again, and again. I bawled while cleaning a fan. Sitting down to enjoy a refreshing mint lemon slushy in a restaurant, I started up again. To be fair, it was Coldplay's fault with their heart wrenching lyrics: "no one ever said it would be this hard. I am going back to the start." Really I am crying in public over a silly Coldplay song.

Another month is lost. I will not have a baby before I turn 35. Here are the tears again. Other thoughts.....I made pesto today, and it was delicious.

Sunday, Bloody Sunday

It Failed. Damn it.

Thursday, July 9, 2009

Bird in my Soul

Emily Dickinson was right about hope: it never stops at all, but I would add to her poem (which I diligently memorized in grade school) that it is also a Mother Fucker. I came at this cycle with a steely determination not to fall victim to hope's seductive charms. But that bitch got me again. At the first slightest twinge of nausea, I was hers. I once again started reading into anything that could be taken a sign of pregnancy. Constipation? No, I don't need more fiber, I am pregnant. Tired? Not lazy, it's my first trimester. I am sure that I will even try to convince myself that my period is really just implantation bleeding. I even have a new way to announce to my closest friends that I am pregnant. It's cheeky and makes fun of all of the drama, and I might never get to use it.

I supposed if I didn't have hope, then I would give up, and I am not ready to give up yet. So little bird with your prickly feathers and scratchy claws, you have a stay of execution.

Wednesday, July 1, 2009

Stick It

This process has started with me getting stuck in the arm, then in the vagina and most recently in my stomach (belly button included). Now my insurance company is trying to stick it to me. I came home to $9,000 bill for my surgery and have been a little sick in the stomach ever since. So before I launch off on my insurance-companies-are-evil soapbox, let me say that we have very good insurance. Not only do we have good insurance, we also have this magical supplemental insurance which pays for things like gym memberships, out of network psychotherapy, and other things the main insurance won't cover. We are very fortunate. Some people go broke from fertility treatments, but while the $30 co-pays add up, it is a much better option than paying out of pocket. They even cover part of IVF!

That said insurance companies are evil. I learned this the hard way but thankfully with very minor claims such as contact lenses. But my clinic is not Lenscrafters and there isn't a get pregnant while you wait option. I almost didn't have the surgery because the insurance repercussions scared the whatever out of me. So I did my due diligence and Jenny kindly assured me that I didn't need precertification as it was considered outpatient surgery and that there wasn't a co-pay for the surgery, but probably for the lab work. What happy fortune.

When I went in for my pre-op check-up (two days before my surgery) the intake lady told me that she needs my hospital info, not my regular insurance because they aren't the hospital insurer. I wasn't as diligent as I had thought. I have never used the hospital insurance before and really had forgotten that I even had that insurance. So it is too late now. I convinced myself that regular insurer was the provider for this because it was outpatient surgery. Now a month later, I have serious buyers remorse. This surgery did nothing to advance my chances of conceiving and now it is going to cost me $9000? That's my IVF and/or adoption money.

Matt is handling this one. He is convinced that our insurance will pony-up something and whatever it doesn't, our magical insurance will. (You think I am lying about it being magical, but the insurance card has a picture of Santa Claus riding a unicorn on it.) I suspect he is right, but I am planning on remaining mildly nauseous until this is resolved.