Need Help w/ Insurance

ICLW couldn't have come at a better time. I need help!

Yesterday, J and I got a copy of the letter the insurance company sent to RE's office. It basically said that if the HSG would be covered if it was for fertility diagnosis, but not for fertility treatment. My RE's office took this to mean that it most likely will not be covered and that we will have to pay all $1,300 out of pocket. Why?! It is for diagnostic purposes! Sure, I've been treated for IF in the past, but the HSG is used to diagnose a kind of infertility that I've never been treated for (blocked fallopian tubes).

So, if we find that the HSG was not covered, how to we go about successfully appealing it? We spent almost 5 months dealing with our insurance company to find out whether or not it would be covered, so I can't imagine the kinds of hoops they would make us jump through to try and get them to actually pay for something.

HSG: Ouch! Ouch! Ouch!

I had my HSG this afternoon. J came with me for moral support, but wasn't allowed in the room. I'm not sure why, as the exam room was the size of a small restaurant. I was told that the procedure would be "a little uncomfortable" and that I might have "a bit of cramping afterwards." Okay, a few things about that. It was VERY painful. Kind of like cramps that are 10x worse than any I've ever experienced mixed with a knife slicing up my insides. I cried through the entire procedure. Not big, snotty tears, but a solid stream of tears and concentrated deep breathing. I'm not usually a wimp, either. My level of pain tolerance is usually average if not above. So, either I was misinformed about the level of discomfort that comes along with this procedure or my doctor was less than gentle. To her credit, she seemed to get it over with as quickly as possible. I told J afterwards that after that lovely experience, we had better get pregnant eventually!

That's enough of that. $1,300 and 5-10 minutes of sharp-as-knives pain later, the doctor told me that everything looks completely normal! I'm sure my RE will want to look over the results in more detail, but that's great news to hear. So, I assume that if timing works out in our favor, we will go ahead with another Follistim cycle next month. This will be our 4th cycle with Follistim (injections), but only our 2nd Follistim-only cycle (no Femara).

Question for all of you IF'ers out there -- how does the pain/discomfort of a HSG compare to that of IVF?

Pat on the Back

You know, sometimes you just need a little pat on the back. I realize that I'm not perfect. I should cut out fast food completely. I should eat more vegetables. Etc etc. I could go on and on. Trust me, I spend at least 30% of my day dwelling on things that I should and shouldn't do and essentially blaming myself for all of my IF struggles.

J is amazing. Incredible. The best person I know. The person I look up to. The person who calms my fears. And, the person who assures me that I'm insane when I start with the self-blame. In his opinion, PCOS is to blame, not me. Whether or not he is entirely correct, it makes me feel better to know that he is in my corner. He never criticizes me, never advises me to skip dessert. Never. He knows that I punish myself enough as it is. That's not to say that he isn't supportive if I ask him to help me to eat better and exercise more -- he's just found the balance. I can't say enough about this man.

Anyway, I've gotten off track. I am a list-maker by nature and I think it's time for a list of accomplishments from the past year. Sometimes I need to be reminded of the progress I've made, rather than dwelling only on the fact that I'm not pregnant. So, here goes.

1. After reading up on supplements, I've started a daily regimen of Metformin (2,000 mg daily as prescribed by RE), Vitamin D3, Flax Seed, Chromium, and a prenatal vitamin. Anything I'm missing? Fellow IF/PCOS'ers, what do you take?

2. I've lost 10 pounds! Yippee!

3. I've fallen in love with yoga. And I am not someone who normally enjoys exercise. I try and go once a week.

4. I signed up to walk in a 5k (Race for the Cure) in April. J runs 1/2 and full marathons, so my measly walking of 3 miles is a bit sad in comparison, but still. Along the same line, now that it's warm outside, we're back to walking/biking almost every day.

5. I've had FOUR unprovoked periods in a row! They've all been 22-32 days apart. For a normal 28 year old, this wouldn't be anything remarkable. But for someone with PCOS, this is a huge milestone!

6. Because of my work schedule, I am forced to eat fast food more than I would like. Okay, not more than I would like, but more than I should. However, I've stopped ordering fries, started taking the top bun off of sandwiches, and started ordering water rather than Diet Coke (sometimes). Sure, I'm not eating a grilled chicken breast and broccoli for lunch, but it's a step, people.

7. After starting my blog last summer, I've "met" so many inspiring women! In addition to finding others who I can relate to, I have found a network of women that I can go to with questions. I've really learned a lot just by reading others' stories! For example, I read about the HSG in another woman's blog and asked my doctor about it. He had never mentioned it before, so I'm sure glad I asked! I'm having one tomorrow. Hopefully they won't find any problems, but either way, I'll be better off with the information.

So, there you have it. Not a wasted year!

Me, stressed?

Throughout this process, I've gone through a myriad of emotions -- sadness, frustration, anger, hope, fear. And that's not to say that stress has never entered the equation, but it isn't usually on the short list. My friends who know me well are probably shaking their heads in confusion, as I certainly wouldn't consider myself to be an ultra laid-back, carefree individual. But as far as IF goes, or has gone in the past, my stress has been somewhat muted by the other above feelings. However, for whatever reason, I've been especially stressed this week. Some theories:

• the HSG on Friday
• money
• our hectic April/May/June schedules and timing for the next cycle(s)
• We're getting back on the horse after a couple of months off and I'm fully aware of the rollercoaster that is looming in the near future.
• We're getting closer to the end of the rope, which is terrifying. We've done several cycles of Clomid, several cycles of Follistim and TI, and likely only have one or two more Follistim cycles left before RE recommends moving on to IVF. (He said that because J's fertility is fine, IUI wouldn't really benefit us.)

I have knots in my stomach, which has been a strong indicator of stress and anxiety since I was a child. Now would be the time to say encouraging, calming things. Talk me down, people.

To round out the day, some amazing news!

An update on The Subfertile Frugalista: Today, they found a HEARTBEAT! How incredible. To be honest, I don't know how I would have survived the weekend waiting to hear either way. Perhaps a self-induced coma until Monday morning? But seriously, amazing news. I've never met her, but I couldn't be happier for her and her husband! What a miracle.

HSG, here we come!

Finally, after almost five months of navigating through the maze that is our insurance company, we are scheduling a hysterosalpingogram! Granted, the likelihood that it will be covered by insurance is low, but J and I are both happy to be moving forward and taking another step. The insurance company basically told our RE's office that it will not be covered if it is for infertility. But wait, not so fast -- the HSG's diagnosis code (or whatever it's called) will not be infertility, so there is a chance that it will be covered. However, if the insurance company asks RE's office for any further documentation, it is unlikely that it will be covered. We certainly aren't holding our breath, but fingers are crossed. $1,300 would be much better spent on April's medicated cycle!

Speaking of which, RE does not like to do an HSG and a medicated cycle (Follistim, etc.) during the same month, so March will be a purely diagnostic month for us. That being said, they recommend timed intercourse (I will never get over how insanely clinical that sounds...) soon after the HSG. Even if they find that my tubes are not blocked, supposedly the test itself tends to open up and clear out the fallopian tubes and some women end up pregnant as a result! Now, that would require many things from my body that it doesn't usually provide me with without medication: mature follicles, ovulation, etc. But, I suppose you never know.

I'm a tiny bit stressed about the timing of our next medicated cycle. J and I are both going to be out of town sporadically, which isn't usually the case, so things are going to have to land just right in order for us to continue with a medicated cycle in April. May is worse and June isn't much better. And we really need to do a medicated cycle in April -- it seems to be an ideal time (directly after the HSG). Also, I might very well lose my mind if we aren't able to try again soon. I might just pull my hair out stand by strand.

So, let's all hope that things go our way! Months and months ago, J and I planned a weekend trip with eight of our nearest-and-dearest that is supposed to take place towards the end of April. I will be a very, very, very sullen girl if our plans are thwarted. This trip is something I've been looking forward to for quite a while. I've been talking about it so much that, quite frankly, I'm surprised that my friends are still game for going! It would be a relaxing, cathartic weekend away. And let's be honest, when you've been knee deep in fertility treatments for the last handful of years, the occasional weekend away with dear friends is necessary.

Should Insurance Companies Fund Fertility Treatments?

Very interesting blog from Stirrup Queens on this topic. Here is the gist:

According to Resolve, the National Infertility Association, “[Photo][Photo]Some insurance companies and employers incorrectly believe that adding infertility coverage to a health benefit package leads to increased premiums. In fact, states that have passed laws requiring coverage of infertility treatment actually have reduced overall health care costs.”The reason being that those with insurance coverage tend to treat their infertility based on the best course of treatment rather than first trying procedures, surgeries, and medications covered by insurance. It saves money to bypass expensive attempts that have a lower success rate based on the reason for the person’s infertility. Coverage of expensive procedures such as IVF, means that those utilizing the procedure can make sensible decisions such as transferring fewer embryos and therefore lowering costs on the back-end including the financial burden associated with premature birth (which is often the case with multiples). According to Resolve, “In states with full coverage for infertility treatment, multiple birth rates (twins, triplets, etc.) are lower than in states with no infertility coverage. (New England Journal of Medicine, August 2002).”Think about it this way: would you rather have your insurance dollars going towards a $10,000 IVF cycle or a $150,000 hospital bill for a three week NICU stay for premature triplets?

My heart hurts

I just caught The Subfertile Frugalista's most recent blog:

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6wk u/s=no heartbeat

I'm not sure what to think right now. On one hand, it could still be okay. I've been researching and seem to find instances here and there where people got a 6 week u/s and didn't see a h/b.

But.

We saw a heartbeat at 6 weeks with Mya.

The baby's heart should have started beating at least a day or two ago.

But.

I got my +opk on 2/11. That means I could have o'd anytime between the 11th and the 13th. Dr. J seemed to think that if I conceived on or after the 14th, we might be okay. If I o'd on the 12th or 13th, it is possible that implantation took another day or two, in which case we might be okay.

But.

What is the likelihood of that? Not high.

I go in for bloodwork tomorrow to see if my levels are where they should be for this stage in pregnancy. If so, we will go in for another u/s on Monday. If not, well...you know the deal.

I'll keep you updated. Please pray.
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I'm hoping and praying and crossing all of the fingers I have. Why does this happen? She and her husband suffered a miscarriage just over a year ago and now, after the excitement of finally becoming pregnant again, this. It just doesn't seem fair, does it? She is certainly due for something good coming her way. Let's hope (and pray) that everything will turn out okay.

Congratulations to a fellow blogger!

I just read some fantastic news -- Christina over at The Subfertile Frugalista is pregnant! Her story is really inspiring. Long story short, she has PCOS and after several unsuccessful Clomid (etc) cycles, decided to switch doctors. He advised her to hold off on IVF and, instead, adjust her diet and lifestyle. And now she's PREGNANT! I'm absolutely elated for her...and now even more hopeful for myself :) And on that note, I'm going to put down the Sun Chips and go on a walk.

Yoga Mat

My lovely, thoughtful in-laws got me a new yoga mat for my 28th birthday. It arrived in the mail this week -- such a nice surprise! So, naturally, I had to go to class tonight to try it out! (How's that for motivation?)

As I was peering down at my mat this evening, I realized that it reminded me of sperm and egg! I'm sure most people would find that to be odd, but after facing infertility for two years, I found comfort and hope. Almost like someone telling me, "Keep going! Keep trying! You'll get there!" I don't think yoga is a miracle cure for PCOS, but I know that it is good for my body and will make me stronger. And the healthier my body is, the better chance I have of conceiving. Bring on the yoga!