1.31.2010

Going up the first hill of the rollercoaster :)

There has been waiting.  Lots.  And anticipation.  And now...it's here.  This is the fourth cycle since I have had my son (I am on CD 4), and we have been given the green light to ttc.  My son will be 16 months very soon.  He is a wonderful gift, and our time not ttc has been a gift as well.  But dh and I were open to trying very soon after he was born and it just wasn't in the plan.  As a result, in some ways there has been this growing anticipation.  I feel like, since about November, I have been on the sidelines watching and I have just been picked to participate too! 

On one hand, conceiving  this first cycle trying may seem unlikely.  I mean, an infertile like myself after all it took the first time?  (and I am not talking time, because that isn't an adequate description of the heartache and uncertainty, etc)  On the other hand, I am very hopeful because the cycle before I was medicated looked okay and the past cycle was medicated and looked great.  I mean, dare I think that maybe the secret combination from before still applies?!  No new diagnosis to uncover, etc?!  Isn't that every IFers dream?  And with Napro I figure I have the same 3 cycle window they refer to in the intro sessions.  If it doesn't happen for us in that time, we better start doing our detective work again!  (in addition to the monthly draws and cycle reviews).

I have been counting the days, as one does when they are waiting and don't have anything better to do, and for a few months now I have been thinking that our ttc green light might occur...around Valentine's day.  That still looks entirely possibly.  This is incredibly exciting to me for 3 reasons.  First, the obvious-Valentine's day is about love, and conceiving a child is first and foremost about a married couple expressing their love for each other.  Second, my husband proposed to me when we were celebrating Valentine's day.  Please see here for that very fun story!  Third, a successful pregnancy would mean another fall birth and wouldn't it be nice to have a boy and put all these clothes to use again?!  And it would work out nice for maternity clothes too.  Okay, that is clearly the least important.

1.30.2010

All Lab Results Are Not Alike

I have removed my recent post due to its "inflammatory" nature (not your comments, basically my title which was not correct in hindsight).  That wasn't my intent and I assure you, I am working on it.  I seem to be having a lot of "foot in mouth moments."  Sigh.  I hope you all know that I really do mean well.

However, the information I gained from it was very useful and new to me, so I am including it here.  In the words of the lovely Mrs. Blondies, "Dr. Hilgers uses a different scale (ng/dL) than what you often see in other labs (pg/mL) so the number from Dr. Hilgers are going to look like 1/10 of the numbers of what other labs will say. So estrogen that is 259 pg/mL from another lab is actually 25.9 ng/dL on the scale used by Dr. Hilgers.  The progesterone scales seems to be the same across labs (ng/mL)"

1.27.2010

All Napro Doctors are NOT Alike-slightly Updated

I struggled thinking about this post.  I want a happy ending.  Then I decided that maybe this post would launch discussion and that your comments would help complete the picture.  I am genuinely interested in your thoughts.

I often recommend that folks chart using the CrMS and take advantage of Naprotechnology.  I believe in the methods with all my heart-for those who are Catholic and those who aren't.  For those who struggle with IF and those that don't.  I put my stamp of approval on it.  Some people have asked my opinion and respected it enough to learn to chart and seek out a medical consultant.  On some level I am so happy about this.  But at some extent, I cringe because for those that really could benefit most from it, my advice often leads them to the same place.  Omaha.  And sometimes Omaha, though the best possible option, isn't an option at all.  It can be expensive, obviously, if the insurance coverage isn't there.  It can be time consuming if you have to be there for 2 weeks like I was (usually worst case scenario, just waiting and waiting for you to ovulate).  Some people simply can't take off work or don't have the money.  I know this.  And it makes my heart ache.

Now, I firmly believe with all my heart that even if one was to pay cash to see Dr. Hilgers, it would be worth it.  He saves time.  Lots of it.  And by being so quick, he often saves money (a big chunk spent now or a little here and there for a very long time).  But that is easy for me to say-afterall, my insurance covered him (miraculously)-both the one before I was married and the one I have now.  Some very good and discerning Catholic friends have drawn lines about how far they will go to treat their IF.  They will not basically mortgage their home, etc.  I respect that.  We all have to have boundaries or IF would lead us all off the deep end, financially and emotionally. 

So is it wrong that I suggest Napro and CrMS to these folks?  I have justified it saying it is always best to give them all the information so they can decide for themselves what is best.  It isn't for me to decide, but if I know something that might help, I have the responsibility to share it.  But I have seen, in some cases, my suggestion lead to heartache.  And that hurts me too. 

What I want is for Dr. Hilgers' network of doctors to be just that.  I want for folks to have someone nearer to them, more accessible financially and physically, that they can count on to deliver Dr. Hilgers' tried and true methods.  But I am increasingly discouraged at what is being delivered.  What I can't help but describe as Dr. Hilgers LITE (this is relatively limited experience, granted; I live in an area with 3 Napro docs that are all primary care physicians-none have received hard core training; I have listened to other's experiences as well online, through emails and discussion boards).  When I see folks given large (greater than 50 mg) doses of Clomid right off the bat or otherwise hyperstimulated.  When I see folks given progesterone that isn't progesterone in oil.  When I see folks getting blood drawn and run at local labs instead of shipped to Omaha.  When I see pregnant girls being told their placenta will take over production of the progesterone after 12-14 weeks and thus taken off their supplements without data.    I GET FRUSTRATED!   And I know I have read TCIE get frustrated about the Tamox situation which I don't know enough to comment on . 

I know Dr. Hilgers must get frustrated too.  I say this because I have friends who have had laps and ultrasound series done locally with someone who said trained in Napro.  These show no problems, yet these girls try for years to become pregnant unsuccessfully.  Finally, they send their charts in to Dr. Hilgers and what does he recommend?   An ultrasound series, a hormone series, a lab-with him in Omaha.  Clearly he thinks the way he does things is different.  And that is where you receive the benefit.  He does everything the best and he does it all at once-"one stop shopping" I consistently say.  But what about the folks that don't want to go Omaha?  Can't?  I struggle with this.

Systems change is a big part of my field.  We do trainer of trainers and try to spread "our methods" to others.  I must tell you, it often fails.  It is watered down.  Folks don't have the resources to devote to receive the training we have and to implement it with the same fidelity.  It seems so many things have to be aligned just so.  And so it fails.  It is a hard field to be in, certainly not for the faint of heart.  More like the eternal optimist.

I know that Dr. Hilgers doesn't desire to have the monopoly on IF treatment.  He is not at all that type of man.  He wants others to learn from him, to carry it out.  His actions have shown that.  After all he isn't going to live forever.  It seems the only person he can truly vouch for is Dr. Keefe in his office.  I imagine the amount of time and money that would go into the oversight to ensure that this network of professionals are truly carrying out his methods in the purest fashion would be too great.  He is only one man, after all.  But there is some responsibility.  They are respresenting his brainchild when they use the name Napro medical consultant.

I have an email out to Fertility Care regarding their medical consultants list on the website.  It has questions such as, why don't Dr. Stegman and others of that calebar share a special distinction that is noted on the site.  And what does it take to get the current distinction?  And to keep it?  I noticed one of the doctors locally that I have criticized in the past has been removed from the site.  I want to know why.  And why my current doctor (primary care) is not on there.  If they are not current, Fertility Care practioners should at least receive an email updating them to who has been removed and why in their area.  That seems like a simple step that may help?

I am not writing this post to attack any Napro medical consultant in particular and my experience is a mix of local and national.  I am not trying to make anyone feel bad or put anyone on the defensive.  My goal is to use our experience to educate each other.  I want everyone to be able to discern for themselves if they are getting care in a manner that Dr. Hilgers would give, if that is what they want.  If they are getting different, they should know about it.  I mean, even "local" medical consultants can be a good distance away.  And like me, maybe you are globally recommending something where all Napro medical consultants are not alike.  And then we are putting our name behind something.  I think I can answer some questions pretty well about "would Dr. Hilgers do this?" related to the experiences I have had, but there are also a lot of new things going on that are outside of my experience.  Certainly with all our experiences combined we can answer this with some certainty though?   And help each other discern?

Thank you for reading a post that is very close to my heart. It is only one person's perspective and therefore incomplete until you respond.  I want to hear from you.  I want to know your thoughts and reactions.  I want to know if you know if you are getting Dr. Hilgers lite or not.  Or would you know if you are?  I want to know about your bad experiences and with who so other's don't experience the same.  I want to know who are the big names in Napro and where they are located.  How did you learn of them?  They don't seem to be listed on the site any differently.  Does anyone know what criteria it takes to get on the list?  Is there monitoring to stay on the list (I have an email out to find this out from the source).  Do you agree with my list of criticisms?  Or do you think it is okay if doctor's who are Napro do these things?  Maybe they don't matter?  Maybe you don't want your blood sent out?  Do you want to add anything that isn't Napro or is Napro lite?

Part of my goal with this blog is to share my experience-how I was able to VERY quickly and inexpensively find out the problem and treat it successfully by going directly to Dr. Hilgers.  (And my case was not easy, not at all open and shut).  I want to document my effective experience so if you are not getting similarly quick and effective care, then you question why and figure out how it can happen differently for you; you can discern if your doctor is the best doctor for you.  (And I know the answer for everyone can't be-go directly to Omaha).

Update: I am so frustrated I didn't update this earlier to include the response I received. It did explains levels of training, recognize that there is a problem, and that it is being worked on. Unfortunately, I no longer have access to that email. I apologize. If anyone asks Omaha and gets a response, please let me know and I will post it here.

1.26.2010

Poland and IVF

My AMAZING friend and FertilityCare Practitioner sent me this today.  My great grandma was from Poland-we are a smart people!  LOL  Why must the US be so slow to adopt these truths?!

100 Polish Scientists Condemn In Vitro Fertilization

By Thaddeus M. Baklinski

WARSAW, January 11, 2010 (LifeSiteNews.com) - A group of Polish scientists have issued a document demanding that the government legislate a statutory ban on artificial (in vitro) fertilization procedures. The 100 signatories also call for full government funding of NaProTechnology, an ethically acceptable and highly successful method of evaluating and treating infertility.

The demand from the scientists follows on the heels of an open letter delivered to the Polish parliament last September from hundreds of doctors and medical professionals, urging them to vote against legalizing in vitro fertilization (IVF) and opt instead for the more successful, safer, and natural treatment for fertility problems.

Several proposals had been brought forward in the fall session of parliament to deal with the widely available, though officially illegal practice of IVF. Proposals range from taxpayer funding for all IVF treatments without restriction, including for lesbians, to an outright ban of the creation of human embryos outside the mother's body.

"September last year saw the commencement of the work on the legal regulations concerning the in vitro procedure. As scientists and academics, we would like to stand up to speak on such an important social issue," the scientists begin their appeal to the government. They then state categorically that IVF is "deeply unethical" and is a "a gross contradiction with the ecology of procreation – by replacing the natural environment of conception and of initial human development, i.e. the mother’s womb, with ‘glass’.”

The scientists confirm that "human life begins at the moment of conception – this is a biological fact, confirmed scientifically," and then declare that their moral and professional objection to artificial procreation is based on the fact that countless human embryos are created and destroyed in the process of IVF treatment.

"The in vitro procedure aiming to transmit human life is inseparably linked with destruction of a human life in its prenatal phase. Data published by various medical centers performing in vitro fertilization show that during this procedure 60-95% of conceived human beings die."

High praise is given to NaProTechnology by the scientists, who view this form of infertility treatment technology as a much more effective, safe and ethical alternative to artificial reproduction.

"NaProTechnology does not involve the destruction of conceived human beings, nor the violation of the dignity of a husband, wife nor their conceived child, and it observes the ecological principles of procreation. It is also worth mentioning that compared to the in vitro procedure, NaProTechnology is more effective and several times less expensive."

NaProTechnology has shown a success rate of 76% in assisting couples to achieve pregnancy, compared to the 10-15% success rate of in vitro fertilization, and without the enormous financial cost and adverse emotional and other psychological effects of in vitro fertilization.

The Bishops of Poland have issued statements condemning IVF and appealed to the government for a complete ban on artificial procreation.

Last June the Polish Bishops' Conference issued a statement in support of a proposal submitted to the Polish parliament by the chairman of the Parliamentary Committee on Health, Boleslaw Piecha, which provides for a complete ban on in vitro fertilization procedures.

"This draft is in line with the Catholic Church's position expressed in the Vatican's official instruction, the position of the Church in Poland, and that of Polish Catholics," stated Bishop Stanislaw Budzik.

"The point of departure for the Piecha draft is an unconditional respect for, and protection of, the human genome and embryo. A draft that bans extracorporeal fertilisation is closer to Church teaching and generally in conformity with it," added Warsaw's Archbishop Henryk Hoser.

A grassroots initiative by the group 'Contra in Vitro' has also presented the parliament with a petition signed by 160,000 citizens which calls for not only a ban on IVF but also for prison sentences for doctors performing it.

Contra in Vitro chairman, Jacek Kotula, said the group's proposal asks for changes to the civil code that would establish legislation providing a three year prison term for anyone convicted of engaging in the fertilization of an egg cell outside of a mother's body. The group also called for between 5 and 25 years in prison for anyone engaging in embryonic stem cell research.

"We are appealing for the introduction of a statutory ban on the drastic and inhumane procedure of in vitro fertilization," the scientists conclude their appeal to the government, "and for a widespread popularization of NaProTechnology and its full funding by the National Health Fund."

See related LSN articles:

Poland's Bishops Support Draft Law Banning In Vitro Fertilization

http://www.lifesitenews.com/ldn/2009/jun/09062306.html

As IVF Debate Rages in Poland, Doctors Propose Ethical, Natural, More Effective Alternative

http://www.lifesitenews.com/ldn/2009/sep/09092902.html

Fertility Treatment is Hugely Successful but Largely Ignored by Medicine

http://www.lifesitenews.com/ldn/2008/mar/08031707.html

Study Finds Common Infertility Treatments Are Unlikely To Improve Fertility

http://www.lifesitenews.com/ldn/2008/aug/08080801.html

1.24.2010

Update and Tips for Anyone Doing Blood Draws to send to PPVI

I am pretty much 100% now, and Charlie seems to be better but definitely NOT 100%-he isn't eating or sleeping great and it is hard to tell what is the cause.  I normally feel so confident about him, but there is so much going on at the same time-I know his throat is sore, the junk is running down his throat and he is swallowing it which could make his belly sore.  He is congested, etc, and he is also teething.  I am not sure which is blame, but he is eating less and less variety; thank goodness for signing or I would NOT have known he was hungry in the middle of the night-thank goodness he told me!  Hoping he will feel better soon.

I have been wanting to write a post about my experiences with lab draws.  As we ttc #2, and there is more and more new territory (new things Hilgers does/tests for, new ways to give my hcg, blood draws with a 15 month old on my lap! etc), I have to remind myself there are plenty of things that have become old hat.  I am hoping the things I am familiar with can help others.  So here is a post about getting your blood draw to mail to Dr. Hilgers. I hope what I have learned can benefit those new to the process, and maybe even make it more efficient for those who have been doing it awhile.

There tends to be a few reasons why you would have your blood draw to mail to the Nation.al Hormon.e Laboratory at Pop.e Paul the VI Insti.tute: a hormone series, a peak plus 7 draw, a pregnancy test, or progesterone draws during pregnancy.  I have done all of these, except the series, at least 3 times.

First of all, you can always get your requisitions from PPVI ahead of time.  That is nice so you don't have to wait after you think you already might be pregnant.  Secondly, always make a copy of your requisition to keep at home.  I actually scan all of mine (front and back-back is important for the lab), so I can print them out as needed.  Anyone need a requisition?  lol 

As far as where to do the draw, I have found the best place to be the local hospital.  The reason is that Qu.est, LabCo.rp, La.bOn.e , etc have all turned me down.   They don't like to draw a sample and then not get to run it themselves.  Plus, most hospitals have longer hours and you don't need an appointment.  We live in a large metropolitian area, so our hospital labs are open 24/7.  That is the most convenient since you are working around your cycle and you may want to do a pregnancy test on a Sunday, etc and not wait another day.  Some hospitals do have problems with giving you the blood to take with you.  To avoid problems, I always call ahead of time and speak to the manager at a new hospital (I have done this at at least 10 hospitals due to traveling, etc)  In many cases, their fears are eased if you explain the situation and tell them you will bring the packaging in with you to show them how you will be shipping it.  This has happened to me several times.  Unfortunately, locally I am now down to only 1 hospital option in our area from 3 because 2 stopped letting blood go home with you because a new "risk management" policy...

If you are doing monthly peak plus 7 draws, Dr. Hilgers' staff must write "series" are "repeat draw monthly" on the requisition. Then when you register (required in every hospital I've been in), you can simply register as a series and not have to register again each time you come in for a draw.  Now, if you change hospitals or go somewhere else for travel, of course you have to register again.  It depends on the hospital how long registering is good for-some places it only has to be renewed every year.  Anything that saves time, right?!

When you are done registering and go to the lab, I have learned that if possible get to know the staff and even come around the same time to get the same people.  There is definitely a learning curve when it comes to this.  It is not at all what they are used to and these people are not phlebotomist because it is their life's passion.  It is a job, it pays the bills (and not well, mind you).  I highly suggest you become very familiar with the requisition.  When you check in, explain to the secretary that they will be drawing it, not running it.  But that they do need to let it clot and spin it (this is true for all but some of the hormone series).  Tell them you need to take a filled out requisition with you, but that you will be back monthly (if that is the case), so please make several copies.  Often they will show you where they are filed so you can show the person when you come next time, if it is a different person.  I always bring a copy just in case they can't find it too.

When the person goes to draw you up, remind him/her that it is 1 red top tube (for peak plus 7, pregnancy test, or progesterone levels; for a series it depends).  Sometimes they want to draw 2 (one for progesterone and one for estrogen-but there is only a very little serum required so many tests can be run off one tube).  Sometimes they want to draw a lilac tube because they see that is part of the specimen key at the bottom.  Grr.  Just one red top tube please.  And I ALWAYS have to remind them to fill out the line on the requisition.  Before the phlebotomist leaves, I remind him/her they aren't running it, just letting it clot, spinning it, and pouring it off.  I show them the back of the requisition.  I have the items circled that apply.  When I leave, I tell the secretary: I will be back in one hour because it needs to clot for 30 min and spun for 15.  I also show them on the back where it says "room temp is fine if it will get there in 5 days."  I tell them it will, so please please please do not put it in the refrigerator, even if I don't come back until tomorrow for some reason.

Even with all of that, I sometimes come back to find that they hand me blood.  They should be giving you clearish serum.  That is what they pour off after spinning.  Ideally they give it to you in a clear plastic transport vial with a biohazard bag.  The bag has a pocket for the requisition, filled out, to accompany the product.  In the beginning I used to pay to overnight the serum.  I also used to use dry ice.  Over time I have found that is not at all necessary.  Most people live where it will get to Omaha in the 5 days.  Overnighting it is a huge unnecessary charge.  In KS, I simply buy padded envelopes (very small) and put plastic bag with tube and req in.  If you are doing this monthly, I highly recommend you buy a ton of the same kind of envelopes.  That way, you only have to weigh it once at the post office.  I have a PDA and I put in the "notes" section of the Outlook contact for Dr. Hilgers the amount of stamps (in my case only 3) and dollar amount.  This way, I can just remind myself and it should still work even if the price of stamps goes up.  Especially with a 15 month old, I spend as little time in the post office line as possible!  You can usually weigh in the lobby, but for $40 I have invested in my own scale (10# or under) that I purchased from the post office.  You can buy postage online and print it off too.

I know this all probably sounds like a pain.  It really isn't that bad; I definitely find it worth it.  I do as much "preventative" as possible and I have never had to repeat a draw (they have taken too much blood and they have had to respin it...)  I know it sounds like I must be a complete pain to these people, but I never talk degrading to them and they seem to find it helpful to navigate the unfamiliar.  They often come to me for questions, or bring the person running it out to talk to me.  I must say, after all this bloodwork (series and the peak plus 7 draws) it was pure joy to get to go in with the peak plus 16 pregnancy test requisition.  I have had many lovely lab ladies celebrate with me, feeling they knew me after all our time together! :)  See here for our story about our first positive pregnancy test and how the lab lady screamed (in the back) when she read the results (we could hear her from the lobby) she was so happy for us!  And see here for how the one who ran the test for Charlie had no idea she was delivering the news to me that I was pregnant, lol!

I hope this is helpful to anyone who is new at this (and maybe even if it isn't?). If you have anything I mentioned that is not correct in your state, or doesn't apply to your situation, I would be happy to hear that feedback.  I would also be happy to know of any other tricks or tips you have developed over the years, if you too are "old hat" at this process.  I plan on doing a post soon about IVs (hopefully none of you have to experience these to have a healthy pregnancy, but just in case!)  Please share this post with anyone you know that might be helped by it.

1.19.2010

Our First Trip to the ER and Reassurance-*Updated with pictures


The only thing worse than being that being that sick is my child being that sick! :(  I tried so hard to be proactive, to no avail.  Thursday he coughed and sneezed and I immediately called the doctor and told them what we were exposed to and how bad I felt.  They said if he got raspy, bring him in.  He was a little raspy all weekend, but the junky cough was extra bad Monday and so I took him in.  They said no fever so no secondary infection.  Call us if he gets a fever.  He took a nap and woke up all pink cheeked and sad, so I called.  They said, just call us if he can't breathe.  Seriously?!  Argh!  So last night he went down a little late, at 8pm because he had two long naps instead of one.  Thirty minutes later he wakes up crying, then coughing, then choking, then gasping!  On his own phlegm!  He sounded like he was swimming in it!  I flew into the room and brought him into the light and put him upright and smacking his back and he threw up buckets of mucus!  Poor guy!  He did a few more gaspy noises that confirmed that I was getting no sleep until he got checked out, so off to the hospital we went.  I didn't think twice since we are talking breathing here-not to mention he was hot and lethargic!  He started to perk up on the drive over, so that made me feel better.  His chest x-ray was clear, but he had a fever despite motr.in, he'd developed an ear infection since that afternoon, and they gave him a breathing treatment.  I was so glad they could do something to help him breathe better.  Of course, I slept with the monitor on the highest setting!  He is still miserable today, crying sadly, etc.  I would gladly be sick all over again instead of him!

On a completely unrelated note, a friend sent to me a nice reflection I wanted to share. 
1 Peter 3:17 For it is better to suffer for doing good, if that be the will of God, than for doing evil.
She saw this as a powerful testimony for NFP and not doing the culturally accepted IUI/IVF.  I hadn't thought of it in this light.  She wrote to me, "It is amazing to me how God gives us reassurance along the way. I know that we're seeking to do good and God's will, and that is enough."  May you also find reassurance in those words?  I hope so!

1.17.2010

First shot sub-q, cycle update, and "sicker than a dog"

Where does the phrase "sicker than a dog" come from anyway?  Oh, well.  Here it is entirely appropriate.  I don't think I have ever been this sick in my life and the timing sucks.  But, in all fairness, there is never a good time to be sick (and always a worse time to be sick-like when you are pregnant and can't take crap and have to make awful decisions like "is this illness hurting the baby or would my taking the meds hurt the baby?  which is worse?")  I digress...I have a virus that turned into a secondary infection.  I am: coughing (though occasional, always disgusting junk that is hard to move, tastes horrid, and makes my throat feel like fire, and my chest seize up), more physically exhausted then I have ever been (heart pounding, tired going up stairs, etc), with fever/aches/chills/headache to top it all off.  I pray it doesn't move into my sinuses.

It is bad timing primarily because my husband is working crazy hours and can't help much with me or the baby, my mom is taking care of my sister's 3 kids while she is out of town so she can't help, and I am fearful that my hubby will get this because I know he won't be able to stop working.  I dread when I feel better and have to go back to the piles of laundry, dishes, school, and work that have been piling up.  Not to mention the disinfecting that will need to occur.  Additionally I worry about my son getting it, of course; he already has a junky cough and a few sneezes but seems otherwise unaffected.  My husband is helping the most he can, letting me be upstairs in our room while he is with our son, taking care of the meals he is home for (i.e. takeout), last night he did the bed/bath routine (bathing is exhausting on a good day!) and today he took my son with him to church while I slept.  Being sick sucks!  Oh yes, it also bad timing due to the meds.  I will explain later.

Anyway, on to the "good" stuff!  I love love love being back on the meds for the most part because things are predictable and the signs are clear.  Of course, I am completely tied to the clock, and the number of meds is insane, but I am hoping and praying it is temporary (we are only trying 3 cycles before we know this regime won't work and will look for additional problems, etc).

Reminder: this cycle is the first one medicated since I got my period back and the 3rd one I have had since nursing.  We are NOT trying this cycle, just getting on the meds and then doing a peak plus 7 draw and then we will know based on the cycle review and levels if they are good enough to support a pregnancy.  Then, and only then, would we be given the green light (I am hoping for it to be around Valentine's Day-totally possible and dh proposed the Sat before, but would be ecstatic for any BFP as anyone who knows me knows). 

This cycle looked good on paper.  I had 6 days of bleeding with no brown blood.  I had a little peak type on CD10 and CD13, but I knew not to be "faked out" because I took clomid 4,5,6 so I was figuring CD 15 peak type and that is when the real run actually began (of course we had to avoid those days anyway, just in case, poor dh, seriously).  Unmedicated I would have maybe had 1 day of peak type and it would have been 1".  But not on these meds, baby!  Six, yes six, day of peaktype that ended with 5" (sorry TMI) that I didn't think possible until I did the meds last time.  It was a pity not to take advantage!  lol

Peak day was CD 20.  Here is where the little problem came in.  I filled the amox and started it on CD10.  I was told to take it when I saw peak type and continue through peak day (weird, you don't know peak day until the day after...).  So that is what I did, but recall there was 2 false alarms so I actually had to fill the script twice and take it 10 1/2 days total-oops, I missed a dose somewhere in there.  Technically I should have filled it a 3rd time!  Additionally I am on clarythramyacin (biaxin) (and dh) on CD1-10.  But we didn't get told this (like the clomid) until my cycle review.  By time I got the call back with order, due to the holiday, it was CD 4.  So I was told to take it CD 4-14.  So lots of antibiotics.  (and probiotics) And yet, I got sick.  With a virus.  But they called me in a z pac.k.  I wasn't going to take it.  I got sick Thursday morning, Jan. 14th, my peak day, but by Saturday I was dying.  I called the doctor and they said it had become infection (a secondary one had developed) based on my symptoms and to take the meds.  Which are similar to Biaxin.  Gosh, I really hope we don't get resistant to this stuff.  Typically I don't worry about that since it is here to be used when we need it and it is important to take the right amount so it actually works and not dilute it or why bother...anyway, we only take it a few cycles and then have a break for one reason or another.   But this time I am little worried.  Such large amounts!

Sorry for the long post.  Just one more thing-I gave my first peak plus 3 hcg injection sub cutaneously today and it was so not a big deal.  Really!  I took a minute to get over the body's natural desire to not want to harm itself!  But I just did it in the stomach where I definitely had some extra, and no problem!  It is so much better than that progesterone in oil during pregnancy where you give anywhere from 2-4 cc's since my place doesn't compound it strong enough...and you give that veeeerrrryyyy slowly.

1.11.2010

Dissertation Blues with a Happy Ending

Today was a rollercoaster day, not even related to ttc, lol!  I came in, excited at my progress and newfound passion only to be told by my advisor that I needed to "be more conservative."  Me. More Conservative.  Being told this by the most radical guy in education.  The irony!  Yet another example of me being so happy and then having that much further to fall.  I balanced out eventually and thought of the positives.  My work wasn't wasted, it will make a great article to submit to a journal.  My dissertation can still sort of be about this, just not the exact line of thinking.  I am glad I knew this before meeting the methodology professor so he could help me (and he did).  This process is really infuriating though, all the ups and downs, etc.
My methodology guy was great.  I was upset going in.  I felt I was prepared and now my idea was shot and I wouldn't look like I did my job coming into the meeting. He doesn't know me well, but he is a very nice guy.  I worried that I was giving him the wrong impression of me, that I could see what he saw through his eyes, and it wasn't me!  I grew more nervous, on the verge of tears.  I called a friend on the phone.  I really need to rely more on God during these times. I got really good at giving my ttc worries and pregnancy fears over, but for other things I tend to go to the phone.  Anyway, talking to a friend helped.  I went in there and he helped me problem solve the issue, thankfully, so I could do something I am interested in but something that I can feasibly get done.  I was honest with him (my policy on everthing is to share your concerns and why, be open, honest, vulnerable, it works most of the time) about how I felt I looked disorganized, and I worried he thougth I was relying on him too much, just thinking I was trying to scrape through to get the program over with, etc.  He said all the right things, and was incredibly kind.  And I didn't even cry in his office like last time (man this dissertation can really get to me!  I do not typically cry for these sorts of reasons!).  It was a good meeting, and even though everything can be shot down tomorrow by someone else, I am just going to enjoy today and leave it at that.

1.10.2010

Just a quick update...

Been crazy busy since dh has his busy time at work this month and I am doing lots with dissertation deadlines and doing more on my own with Charlie and around the house...(I can feel the dissertation prayers, really, I am getting more excited and passionate so thank you!!!!)
Today I was so happy to see peak type CM that was really peak type and not just some of that false alarm stuff leading up to the real deal.  It makes me more confident that I am picking the days right (I need to meet with my practitioner since I am rusty, but she is booked out and just had surgery so soon, but not in time for identifying peak day-good thing we are good friends and I can text her with questions!
I actually had to refill my amox a 2nd time this month!  It says CD 11-15 so they only gave me 15 pills worth, but they told me to take it through peak day and...I am still taking it.  Lol. Oh well!  I am just glad that things are making sense, I have my meds, and I won't be totally unorganized for my meetings tomorrow.  Btw, so far dh has had no side effects except for the stomach ache with the first pill.  It may have just been coincidence.  And I just had the taste in my mouth-I found from last time that water and gum help, esp my favorite (orange trident-so yummy!).  We are trying to be diligent about probiotics, so we will see.
I am feeling good, busy but good.  :)  Dh and I got a date night this weekend that actually involved leaving the house.  My niece gave us free babysitting for Christmas, dh's birthday was friday.  We went to a Japanese Steak House and then played trivia, pop a shot, and driving games at a video game place.  Fun!
Hope everyone had a nice weekend!
P.S. Charlie had his 15 month appt and it was so fun to get him weighed, etc.  He is 20th and 25th percentile on weight and height, hard to believe b/c he is so solid and eats and ton; also dh and I are not short at all.  Oh well, he is healthy and I find the info interesting, but don't put too much stock in it.  He is doing great, just a little cranky from teeth and shots so we have had to do a lot of motrin.  He is such a happy go lucky, playful guy.  He is so fun to watch explore and learn new things.  His latest is eating with utensils!

1.07.2010

Seriously? Seriously?!

I called today to make sure that Cigna TelDr.ug had received the script. They had, but said it would be awhile.  Since I am showing peak type today, I don't necessarily have "awhile" so they were kind enough to put it on priority so it would go out today.  Then I get a call back, usually it is to set up delivery.  But this was to say that, fyi this isn't covered under your insurance.  I told them it was covered under medical if the dx isn't infertility and it is not.  It has to do with my cycle and hormones I am low on, PMS, etc.  She said the dx they were given was infertility.  That is absolutely BS b/c Dr. Hilgers never uses that term b/c he is smart enough to know that IF is a result (or symptom of the problem is maybe better way to describe), and not the cause.  He calls everything what it is. So I just left a message for the insurance nurse again, who is fabulous.  I am grateful for her to argue this on my behalf.  Grrr.

1.06.2010

Happy Epiphany!

A friend posted this on FB (btw, she is not IF, though an insane proportion of the folks I know IRL are); it applies to all of us, but of course I look at it through IF eyes...-

Today we celebrate the Epiphany! The three kings find Jesus!  Here is an excerpt from today's meditation in "In Conversation with God":


"They obeyed the king and went on their journey; and all at once the star which they had seen in the East was there going before them, till at last it stood still over the place where the Child was. They, when they saw the star were glad beyond measure. They were not surprised because they were led to a village, nor because the star stopped over a simple little house. They rejoiced. They rejoiced with an uncontainable joy. How great is the joy of these wise men who have come from so far away to see a King and are led to a little house in a village! How much is there for us to learn here! In the first place we will learn that every rediscovery of the way that leads us to Jesus is filled with joy.


We are perhaps in danger of not realizing fully how close Our Lord is to our lives because God presents himself to us under the insignificant appearance of a piece of bread, because he does not reveal himself in his glory, because he does not impose himself irresistibly, because he slips into our life like a shadow, instead of making his power resound at the summit of all things ... How many souls are troubled by doubt because God does not show himself in the way they expected?"

Or things don't go as expected?  I have been reminded constantly, but especially this week through AYWH's experience, that the stories He writes are amazing, but when we are only able to view a little piece it doesn't always look so great.  And then we doubt.  But He is always there, like the footprints story, even carrying us!  In AYWH's (and other's) case, we are able to step back and see the bigger picture of God's plan for her suffering.  But if you can't see yours yet, it is because God is still writing!  Have hope, my friends. 2010 has started off with a bang!

1.05.2010

How Much is My Time Worth?

I think insurance companies are put here to drive us all mad.  Seriously!  With their double speak and other confusing language it is no wonder that we all spend hours and days of our precious time WASTED!  Today I had to ask myself, how much is my time worth? I spent a good 2 hrs on the phone just today with the insurance company and mail order pharmacy (which, I realize, is really nothing as these things CAN go) and much more when you consider how long I have dealt with this particular issue.
I mentioned before that I was told hcg wasn't covered 2 year ago or so.  Somehow I got the impression it was just b/c of IF, can't recall why, and so a letter was sent by Dr. Hilgers that it wasn't IF.  I was told, it wasn't about it being IF, it just wasn't covered.  Thankfully I had some leftover from when it was covered so I used that.
Then when I called again, last week or so, they said it wasn't covered under pharmacy, but maybe medical if it wasn't for fertility.  I said it was not for fertility and so she said my doctor would have to fill out medical necessity paperwork and it would probably be covered.  That would have been helpful a year ago. I guess what the women should have told me back then was that the letter merely was processed by pharmacy and should have been processed by medical.
So today I call to check on it since Dr. Hilger's office had sent in the paperwork and I need to take it in about a week.  The first person I talked to said, yes it was approved and she sent me to Tel Dr.ug (their mail order pharmacy) because to get it anywhere else would be costly.  Here is why.  Now that it is covered under medical, Target etc are only contracted through Ci.gna pharmacy, not medical, so they would be considered out of network.  It is hard to find a medical provider that will give this kind of medication as if they were a pharmacy.  She suggested another option may be something like Apr.ia.  (I asked for this 2nd option because sometimes Tel Dr.ug is not the cheapest option).  Then they connect me with Tel Dr.ug who proceeds to tell me this medication is not covered-under pharmacy or medical.  This time, armed with the right information, I tell them it has been proven medically necessary and is covered by medical since it is not related to fertility.  Okay, she says, since it isn't fertility it can be covered.  (Man they train them well to be so anti IF!)  What if I didn't know and just said okay?!  Like I basically did last time!!!!  I ask how much it will be next.  Full price for this Novarel (hcg) is $102.38 per vial without insurance.  Of course, she had to transfer me back to Cig.na Medical to determine the coverage.  I want to know because now I have been informed that Fertility Friend is $59.  And I also learned that Kubats, who compounds it themselves, (mail order that Dr. Hilgers uses in Omaha) is $51!  So I wanted to make sure it wasn't higher than that with insurance.  At first I am told it is covered 90% and subject to my copay.  But then I push more-why then was my progesterone (similar situation) while I was pregnant covered 100% with no copay or deductible?  He puts me on hold again and low and behold-it will be covered 100%  Yippee!
Today I asked the question, how much is my time worth?  And now I know, it is worth free hcg while ttc.  That's actually pretty good for once!
I hope this post will help you know the right questions to ask to get something covered that perhaps wouldn't have been covered had you not had the exact same words. Ridiculous!  Please share this post with everyone you know on hcg!
P.S.This was the simplified version-there was even more confusion and transfers and I had to talk to Dr. Hilgers office twice (not their fault) and I am waiting for a 3rd call back.