The End of the Road?

Dramatic title, much? Yes, I know, but I do want to ponder this topic out loud.

But first, quick updates and background. We will wrap up our oral antibiotics on Sept. 26th. It's been good, for the most part. I do have bright orange urine once or twice a day, but thankfully my tears and sweat didn't change color. There have been a lot of sweaty 100+ days around here. That could have been...awkward.

I am taking a pretty benign probiotic, Syntol, and a second one called Yeast Management. These are mostly aimed at yeast and probably not as comprehensive as some. Dh takes align, nothing special, and hardly takes it daily. He does eat yogurt regularly, which I think can help but isn't the end all. We are, again, in general, doing great. I did have one day with very loose stools that could have been very embarrassing had I been working from my office. And that's all I am going to say about that! My dh has survived in that area. He did, we believe, have symptoms of yeast he got from me prior to all this. Those continued. My symptoms of yeast went away after treatment until about day 12 on orals. And then I died the slow death  known as the yeas.t infection. Lord knows I am not exaggerating and if I could have physically removed my lady parts in anyway, I would have, and been quite happy about it. But this from someone who also didn't show enough restraint around the halloween candy.

I decided to be so smart and go to the drug store for an OTC treatment. I always forget about those. One day treatment does not in one day heal, fyi. More like 3-7. Ugh. The cream had another bad effect-making me unsure of my observations. On a month that correct charting is essential. Not good.

Dh was also treating OTC for yeast and he felt he wasn't improving. I called Dr. Toth's office as they suggested if not better and they were about to script Difl.ucan for both of us (despite me not mentioning my problem) when...oops. It decreases the effectiveness of Rifampin. So don't take together. So you should probably stop taking Rifampin and finish up after Difl.ucan. My question-will that put taking Rifampin during my fertile time or even post ovulation? Is that safe? I didn't really like the idea of disrupting our protocol. Dawn put Dr. Toth on the line who promptly said he didn't like the idea of me taking Rifampin on it's own. Our choices were to: a) ride it out. Difl.ucan (one pill, twice a week for two weeks totally four pills each) after Rifampin is done on the 26th or b) take Difl.ucan now if we must, but quit Rifampin permanently. Guess whose riding it out? Yup. These suckers.

So I continue to heal and dh continues to tread water. I can tell you he doesn't seem to be near as uncomfortable as I was or even am now 5 days post 1 day treatment so I don't feel too bad.

Some other updates, Dr. Hilger's office has been amazing in that they came back with a SHSG date of 9/27/13. Yup, the day after I finish abx. The catch, I need to be CD 4-8. Not like a reg HSG where I could be any old day. A very tight window of cycle combined with a very tight window of when Dr. Toth wanted it. They seemed to align. I got a call a few days later from Cheryl, the surgery scheduler with more info. Did it look like I would ovulate on time? I told her I might be late. Work was crazy stressful. Like I have responsibility for $25 million work of human subject protection work to take care of in a short timeline when new info keeps coming out of the woodwork. I was kind of freaking out I wouldn't meet my deadline, meaning we could not get approved to collected the data in time, when folks were scheduled with plane tickets already. That kind of pressure. Then Cheryl is on the phone saying here is your pre-op appt (wait, I have to go down a day early-I was thinking this was a one day deal?) and you'll also need an u/s the day before and a hospital pre-op. Yikes-I am thinking if my mom goes with me so the hospital will release me, then who will watch the kids...and you are telling me, don't stress, we need you to ovulate so you will be on CD 4-8?! Aaaaaahhhhh!

But my head didn't explode. instead I had peak type mucus that day, because I am weird like that. My prayer was for things to line up if we should go and they were. I have childcare. I have someone to go with me. I have a date that works with cycle (so far) and Dr. Toth's requests. So what's the problem. It's a teensy thing Cheryl said in all that "don't stress" talk. I said, just a little concerned that my insurance won't cover the HSG in a hospital. Clearly that bill could be huge. Her response? Oh, those are rarely covered. Okay.....I trust you, God. Really. But really?!

I called Rene to pre cert. The thought was, if it isn't covered then we won't go. Period. My tubes could be freaking open, people. I don't want to pay a surgery on my own dime to find this out!!!! On the flip side, they could be closed. And a little catheter through and they could be open. A little procedure. With a big price tag. A $20,000 hospital only self pay price tag, not including any of the doc bills (Hilgers, radiology, and anesthesiology) per Rene. Insert more bad news. First of all, BCBS will say they never pay SHSG. But the good news, they always do in the context of a lap. But the bad news, I am not having a lap. More bad news, there is no one that she knows that has done it this way so nothing to go on. And while precert isn't necessary, she would do it. But it's no guarantee. And they will say no, because they always say no to SHSG. Despite the fact they say they will cover dx of but not tx of infertility. To check the tubes, in my book, is to dx. To unblock is to treat. Heck, I would pay the $900 to unblock them if they were blocked if the $20k hospital bill was tied to the dx and not the tx.   She guessed it was a 50/50 chance. She will talk to her supervisor, but that's what she is thinking. That, my friends, is not a risk I am willing to take. On tubes that may be already blocked. Oh, Erin, I hope you are right!

So, I have heard a lot of discussion on the yahoo health board about when to say when with ttc. And while I am sure it is different for everyone, I can tell you my journey, I have had enormous peace come over me in the last 18 months and time to absorb the fact that I may not have another child. There are moments of sadness, but it didn't have to come all at once. It was an adjustment over time. I am extremely grateful for my boys. I would love another child. But I have peace. I do not feel desperate. I do not ever want to make ttc my life or my God. Despite all we've done, it hasn't bothered me. Everyone is different on how much is too much. For me, what has bothered me is the losses. The four babies I can not hold. That will never snuggle into me and let me sniff them or squeeze me tight when they are scared. The hair I can't brush out of their eyes. Their cries I can't comfort. In a therapy session, I drew a line I didn't know I had until it came out. One more loss and I am done. Dh agreed. Dr. Toth confirmed, said completely independently. In that office we came up with another line we'd draw. If the tubes were blocked, as in tubal reconstruction blocked, we were done. Here we are. Facing potentially $20k in surgery. We are done. Unless God swings the door wide open, we will try with what we have. Tubes blocked or unblocked, we don't know. But we will not pursue further expensive treatments. We will take these next three cycles to try. The tubes may very well be open after inflammation goes down, but they may be shut in a minor way or a big way. And we are going to let it go. We will not have turned over every possible leaf. That's okay. I know in my heart it is not for us to spend this money. It won't be good on my marriage. I don't feel responsible spending it. God has a plan for us. It may be our two boys. It may be future adopted children. I have no idea. But I trust in His plan. It really wasn't a hard decision to make. It made sense to both of us and we are at peace. It wasn't even a hard decision. We just stepped outside of the situation and thought spending that money is nuts. For us, its nuts. Sometimes when you are too close to the situation, you come up with all sorts of what ifs and how our circumstances make this special. For us, stepping outside made it clearer. We have not drawn a line yet, but in the future we may have to decide again when to stop actively ttc with clomid. We know 3 cyles was enough for each of our other pregnancies, but perhaps we will need 6 to let go. I don't know. And it will be hard if we don't conceive. But despite hard times, there can still be peace in our decision. I sure know that from experience that day in the airport. I am excited about what lies ahead. If God writes our story, it will continue to be incredible.