January 28, 2014

Deus ex machina--NOT

I'd be lying if I didn't admit to a serious fantasy where-during this last month of "not trying" and waiting to line up insurance for IVF-an unexpected and completely shocking pregnancy occurred, saving me from the reality of going forward with our last resort.  I had a terrible cold last week, so I took a pregnancy test in order to be allowed some Dayquil and Nyquil treatments, and it was negative.  It was the first time I tested without my husband there, and I came down to his office to report, "Nope, no miracle baby to save us from IVF."  As ridiculous as it sounds even to my own ears, I was still a little saddened.

There's lots of good news to report, though, so I am buckling on my big girl IVF panties and gearing up to begin the next phase of our odyssey.  The odds seem to be around 1/3 for IVF for us, generally speaking.  We have three chances to do this.  Right now there is no legitimate reason to feel pessimistic.  (Umm, so why do I a little?  Probably because I've given myself this pep talk a few times already along the way, but whatever.)

POSITIVES:

1) Insurance authorization came through.  We have coverage for three cycles, with assisted hatching (will be doing) and ISCI (don't think we will need).

2) The cost for all the visits and procedures for our part is "only" $558!!!

3) I have started on my birth control pills, and I have a "schedule."  Will be taking pills until 2/13, and go in on 2/14 for a check.  Stim meds to begin 2/17.

4) I have a mock embryo transfer scheduled for Monday.  (A practice for when they later do the real embryo transfer.)

5) All my hormone levels remain in the normal ranges, albeit some are closer to ideal than others.

STRESSORS:

1) The insurance company has excluded medications from being covered even though the procedure and doctors are covered.  Not sure how this is legal, actually.  I am planning to send a complaint to the state of Maryland regarding this issue, but I won't be holding my breath on anything coming of that.  It is for my own sense of justice and possibly for future generations that come along.

2) Paying fertility meds out of pocket means pricing them all through several sources, which I began to work on today.  Overwhelming!!  Some time ago, the clinic gave us an estimate of $3,000-$5,000 for a cycle, so we will see where this shakes out.  I still have about 18 vials of Bravelle from my last IUI, which appears to be like $850-$900 worth of medicines--nice to have those and wish I had gotten a dang refill back when I had coverage on my old insurance.

3) Been trying to lose a last 5-10 lbs for what seems to be ages.  Lose 2 gain 1.  Lose 1 gain 1.5.  Get sick.  Go on a trip.  Rededicate myself.  You get the picture.  I need to crack down on exercising full force and eating well every day for the next weeks so that I am in the best possible position for this stuff to work.

4) Not sure what to make of the extra hints and tips I see out in the web world.  Eat avocado?  Eat pineapple?  Eat pineapple core?  Mediterranean diet?  Meditation?  Acupuncture?  I am just so cynical at this point, and I find I still have this fatalistic view that tells me it will happen if the egg and sperm are of good quality.  All the other stuff seems so random.  Maybe I am just plain burned out.


Generally speaking, I feel excited, positive, and a little jittery.  So far, I am doing a good job of "not borrowing worry" regarding the future possible issues and problems.  I am trying to stay in the moment as much as possible.  I have a bit of a fog/numbness around me, possibly a self-protective shield sent by my psyche, and it is helping me stay calm for now.  I had this thought about how we seem to manage to get pregnant every two years.  We got pregnant in February 2010 and February 2012.  Well, here it is February 2014 for our first IVF cycle.  Significant?  I vacillate, but it's a nice thought.

January 18, 2014

Addictions

The meeting to go over the IVF cycle, risks, procedures, medicines, etc. went well on Thursday.  I felt so much more like a real human being interacting with medical professionals who were interested in me as a patient and a person--incredibly rare over at the clinic.  Maybe I will feel more like a cog in their machine again once the IVF check in appointments begin, but for now I am basking. 

Ending my infertility vacation to get "back to work" on being a competent patient has been time consuming already.  Emails, phone calls, internet research, insurance stuff, and chats with my husband have shot way up from minimal to front burner again.  Yet, I feel so hopeful and optimistic right now.  Infertility treatments are like that, at least for me.  Each "level" of treatment gives you a renewed feeling of hope:  Moving from trying with nothing special to trying with a thermometer and a chart, moving from trying on your own to meeting with the fertility folks and getting tested, moving from trying solo to trying with medical assistance (Clomid), moving from timed intercourse to IUI with pills.  Moving from IUI with pills to injectibles and IUI.  Now moving from IUI injectibles to IVF.  Of course, a ginormous piece of cynicism, bitterness, self-protection, and doubt has formed all along the journey, too, but despite all the many versions of dashed hopes I've encountered for the past four years, here I am, shockingly, feeling optimistic.  I keep vacillating on whether this is good or bad.  Then I chastise myself for judging my feelings good or bad :)

Seriously, am I addicted to fertility treatments?  Am I just addicted to hope?  Are we as humans disposed to keep hoping?  Am I a hope junkie?  A quick google search of characteristics of addiction led me over to Indiana University's site (http://www.indiana.edu/~engs/hints/addictiveb.html) to diagnose myself:

"The person becomes obsessed (constantly thinks of) the object, activity, or substance."

CHECK.  I can personally only liken the constant obsession of thoughts to the first obsession one has when falling in love and is hyped up on the good hormones in the brain.  Infertility (whichever aspect) races through my mind all day from wake up to sleep.  Getting away from the constant thoughts the past eight weeks only confirms how obsessed I am normally.  It's started back up again in full force.

 "They will seek it out, or engage in the behavior even though it is causing harm (physical problems, poor work or study performance, problems with friends, family, fellow workers)."
 
"The person will compulsively engage in the activity, that is, do the activity over and over even if he/she does not want to and find it difficult to stop."
 
CHECK and CHECK.  While it is a little different than drugs or alcohol, these statements hold true.  A certain degree of planning and thought is required to actually be thorough and successful.  The addictive behavior is not so much the actual treatments, exactly, but thinking about the treatments, the past, the future, and everything in between.  I try very diligently to ignore my infertility thoughts and treatments sometimes, but it often proves impossible for me.  I compulsively revisit past conversations.  I sit and read infertility blogs for hours at a time, even when I didn't want or mean to.  While there are benefits to my behaviors, there are certainly drawbacks.  I reinforce my obsession and negate opportunities for a fuller, non infertility life.  I know I annoy the hell out of my husband with constantly talking and mentioning things nonstop. 
 
"Upon cessation of the activity, withdrawal symptoms often occur.  These can include irritability, craving, restlessness or depression."
 
CHECK.   Just after the last failed month when we had decided to take a break, I felt this itchy craving overcome me to keep going anyway.  Fighting that off with some semblance of reason and logic, the restlessness increased.  What to do without my infertility treatments?  I hate them but I missed having a chance.  I feel so brainwashed with stats on maternal age as well as the reality of four failed years, that just living a treatment free life for short period was an adjustment.  I will say that the feelings got better rather speedily, and I was able to shake the withdrawal feelings altogether as I had more distance from my addiction.  Is this what they call "detox"?

"The person does not appear to have control as to when, how long, or how much he or she will continue the behavior (loss of control)."

HALF CHECK.  This statement has been somewhat true, but it is one of the things I most fear with infertility treatment.  Your desire for a baby feeds your addiction to the treatments.  Then you have this "I must be due for a positive" psychology that kicks in as well--I call it the "lotto effect."  Just one more.  Just one more.  Would the next one be "the" one? It's so hard to set limits when the reaching and upholding of a certain limit amounts to living childless.  We've now got three tries of IVF.  We feel that will give us a logical, fair chance to try within the bounds of reason.  But what happens if none work?  I fear a loss of control. 

"Depression is common in individuals with addictive behaviors."

CHECK with caveat.  I wasn't sure if they meant depression causes the addiction or results from it.  Plus I have always struggled with down periods in the past.  I would say, though, that infertility doesn't help depression.

So for six of the ten behaviors listed, I could see varying degrees of applicability.  I think it is important to remain aware of the psychological dynamics at play during this long battle.  I have often felt like just quitting cold turkey just to be free of this whole thing.  Enough is enough, as they say.  Since I don't seem to do a great job controlling my reactions as I go through all of this, I crave control to just pull the plug.  It's kind of a "quitter's" attitude, but it makes me feel better to fantasize about telling infertility to suck it.  

Here I am on the verge of the "next great hope" in IVF.  Will I emerge triumphant, baby in arms, so happy that I clung to hope and persevered?  I don't delude myself on the odds, despite feeling hopeful these days.  The next two months will give us a lot more information as far as how viable IVF might be for us--a fact that both excites and terrifies.  Logically, I know we are not grasping at improbable straws.  I am not in full desperate junkie mode by any stretch.  But I sure as hell never thought I'd be where I am right now.  Even after all these months and years, I feel shock and disbelief to be on the verge of IVF.  It's really real.





January 15, 2014

Back in the Saddle

Being "on vacation" from infertility treatments the past weeks has given me some much needed distance and freedom.  The frenzy of this process in general, and specifically for those of us in the "advanced maternal age" category, limits guilt free breaks and time off, most definitely to my psychological detriment.  It feels so so wrong to not DO something and to let time simply elapse.  As the treatments fail over and over again, my need to control things, to act, to try becomes more intense and less receptive to reason.  If I am doing everything I can, then I am not causing things to fail (other than by being old) at least.  It makes you illogical, insane, and warped.  I admit it.  I even know it as it happens.  Unfortunately, knowing is, as they say, is (only) half the battle.

Honestly, I have felt really positive about this break.  I feel like I did everything I could do for as long as I could.  Nothing seemed to be working anymore.  The stuff that worked couldn't be replicated or explained.  The problem isn't clear.  The insurance wasn't there to move on.  It gave me a guilt free get out of jail free card, and I am thankful for the break.  This morning when I sent the emails, I didn't even know what day of my cycle it was!!!  I'm 80% living my life and not thinking about whether I am pregnant as I get closer to my period showing.  It feels like I can breath a little deeper.

The insurance stuff has been a major nightmare (ongoing), but I feel confident enough of having IVF coverage in some form (it seems the treatment is covered, as are the doctors, but not any medicines they prescribe for the treatment..WTF??).  I made the "IVF TALK" appointment I have been ambivalent about and emailed the nurse and the financial counselor to get things rolling.  So, tomorrow for the first time in like eight whole weeks I will head to the Infertility Juggernaut's nearby branch to get back on the hamster wheel.  

Staying positive already:

1) Appointment is luxuriously late--9:15 instead of 8:30.
2) I like the PAC who does the talk.
3) No vaginal ultrasounds or bloodwork :)
4) I will probably get an IVF calendar or checklist.  I LOVE THOSE!!!
5) Literally just this minute got an email from Starbucks announcing a special latte event and discount starting tomorrow when I will be out and about to partake--right across from the RE's office.  SCORE!

I feel a renewed strength in dealing with their BS, which started today already.  I was able to smile it off with more ease than usual because I haven't had to deal with it lately.  I have a slight hope that this all can align and I can go straight into IVF protocol when I get my next period.  At the same time, I think I am doing okay with the possibility that I might have one more month "off" from treatments to get all the paperwork lined up.  I think I can accept it and even embrace it as an extension of my vacation.  I will call it bonus snow days or something if necessary.  

As always, it is nice to feel some positivity.  Even nicer than feeling it is knowing that I can still feel it.  
 
Oh yeah, and also, someone actually signed up to follow my blog.  A stranger read my diary ramblings and found something interesting in them!  That actually means a lot to me, even though it is not the goal of my writing here.  I have read so many blog posts that have struck a cord in me and made me feel less alone and freakish about my infertility struggles.  It makes me happy to know that anyone connected to me in a similar way.  Thank you, follower :)

January 1, 2014

New Year-New You?

January 1, 2014.  Fresh slate time.  Sign me up on the dotted line.  I am grateful that I still feel hope on the fertility front as this new year begins.  We are bringing out the big IVF guns as soon as this insurance stuff gets sorted all the way out.  I know that IVF is not a magical cure, but we should get more information than we've ever had as we undergo the treatment.  We will have the best chance humanly possible, however big or small that chance will ultimately be.

Whether or not I let my hopes soar or force myself to be skeptical and cynical, I know my heart will feel the exact same devastation if this fails.  And so, I have decided to let myself feel hopeful.  Not unrealistically, in denial of the facts hopeful, but it's okay to believe in this chance hopeful.  So for today I will say to myself, with only a faint echo of doubt echoing in the distant background, "2014 could be our year."

Maybe in the future I'll scornfully laugh at this naive bubbling of the old me recorded forever in cyberspace, but right now I am just relieved I can still feel optimism.