Say whaaaa?

One of the lovely nurses from RE's office called this morning. She confirmed that our HSG was completely normal, which is great news! She then proceeded to fill me in on our next plan of action. It went a little something like this:

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Nurse: Dr. G wants to try another round of Follistim and Femara, but this time increase your Follistim dose to 125.

Me: Uh, last time he took me off Femara because in past cycles it was keeping my estrogen levels too low. Also, my last Follistim dose was 150.

Nurse: OH! Uh, yeah, you're right. (kind of stutters nervously about how RE gets caught up moving so quickly in his method of madness, she'll talk to him again and call me back)
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WHAT?! First of all, we have been seeing this RE for over a year but have only seen him twice. Is this normal? He has four offices scattered around Indi.ana and, therefore, doesn't seem to be in town very often. And secondly, this isn't the first time I have had to correct his mistake or recommend a course of action. For instance, a few months ago, J and I requested to have an actual visit with him and came armed with a list of questions. One of my questions was why my estrogen levels seemed to be so low. He nonchalantly looked at my chart, agreed that they were a bit low, and decided we should drop Femara. After that cycle, my estrogen went through the roof (in a good way). Great, right? Sure, except for the fact that we felt like the only reason he thought to make that change is because we asked about it. I understand the need to be proactive, but is it too much to ask that our RE gets to know us a bit better and takes the time to really consider the best course of treatment for us? And that he doesn't make silly mistakes like this morning? I mean, had I not been paying attention, we would have repeated the kind of cycle that proved not to work twice before because of his clerical error.

So, we're going to wait to hear back from the nurse and go from there. I would hate to leave this office -- not because of the RE himself, but because of the two fabulous nurses that we actually deal with on the phone and in person.

Daydreams

I don't allow myself to daydream. Anytime a vision of J and I tickling a laughing, smiling baby appears in my head, I stomp it out immediately. Before we started TTC and I was blissfully unaware of my (insert harsh expletives) PCOS, I spent hours dreaming of babies. Everything short of stuffing a pillow under my shirt, really. And now? I don't even let myself get to the part of the daydream when we announce the news to our families. Is this normal? Is it self-preservation or punishment? Infertility is hard enough as it is. I think that allowing myself to slip deep into these daydreams would only make the thing I'm (we're) missing more palpable. On the other hand, if J and I are ever lucky enough to get pregnant, I suppose we will appreciate that miracle more than we ever would have if we didn't have to fight as hard as we have to get there.

Yoga: Safe during ovulation?

My RE's office recommends that I abstain from practicing yoga once I've triggered ovulation (Novarel). They want me to take it easy, which I understand, but yoga? Is that really considered to be strenuous exercise? Curious to hear your thoughts!

India.nap.olis Doctors

Anyone from Indi.nap.olis out there? What doctor do you see? Are you happy with him/her? Just curious!

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.