Is It Really That Surprising?

I had to sign an authorization form so that the REI Clinic on post would release my records to the civilian clinic for our IVF consult next week. When I called the IVF coordinator on post, she sounded genuinely shocked that we were looking into other options, which totally blows my mind.  For those who have been reading my blog for the last several months, you are familiar with the endless cycle of problems I have had with the clinic. For my new readers, I will do my best to explain:

Last summer, after 20 months of TTC, I finally got my referral to the infertility clinic but they had no availability until September.  At my first appointment the 2LT looked confused when I handed him my 19 months worth of charts and looked at me like I had three heads. I was given the dx of unexplained infertility and they refused to do further blood work on me since I'm "young."  There was no availability for my HSG until the end of October and when I expressed my frustration to one of the nurses she asked, "What is your rush?"  Seriously? My followup after my HSG wasn't until 6 December due to lack of availability. The technicians who did my HSG told me that everything appeared to be normal and I never received a phone call telling me otherwise, but when I went to my followup, an idiot resident told me that I had an unknown mass in my uterus--something she'd never seen before. Because of my "abnormal" HSG I had to have a hysteroscopy and had to wait until January due to lack of availability.  At this point we went to the Tricare office to seek a referral off post--we were sick of the waiting game and constantly being told that they couldn't see us. We were denied.  In January, I had my hysteroscopy and there was absolutely nothing abnormal in my uterus and we were FINALLY given the all clear to start Clomid.The doctor said the goal would be to produce multiple follicles so that we would have an increased chance of conceiving.

On CD 1 in February, I called the clinic so that I could get my first prescription of Clomid. I was so excited to finally get some treatment started! I called the clinic several times but no one answered and I became increasingly concerned that I wouldn't get my Rx before the three day weekend (For those unfamiliar with Clomid, you have to start it on a specific day in your cycle.)  After no one returned my calls, Mike called patient advocacy and explained that this wasn't the first time we've had issues with the clinic--the IF clinic called me back right away and was highly annoyed that we had called PA.  We did Clomid Cycle #1 and I only produced one follicle. I requested more blood work and was once again told that I was "young" and didn't need it.  When I questioned their Clomid dosage and only producing one follicle, I was assured that it was "quality over quantity."  Clomid cycle #2 produced one follicle on my left hand side--that was in March and I have not produced any follicles on that side since. After four failed Clomid Cycles and two IUIs, we were "allowed" to move on to Femara. I saw a different doctor at this point and questioned (again) why I never had any other lab work done--he was more than happy to order CD3 labs for me as well as thyroid check as well as add us to the waiting list for IVF in July of 2012.  My thyroid came back normal but my AMH came back at .87, suggesting DOR, but I was still brushed off when voicing my concerns.  In July, I was going to start my first Femara cycle and when I went to the lab to do my urinalysis, there was no record of it in the system--the nurses never put in the order. My prescription wasn't in the pharmacy either so I had to make the 40 minute trek to post two days in a row because of their "forgetfulness." When I tried to schedule my monitoring ultrasound, they told me there weren't any appointments available and to just do OPKs to detect my surge. I insisted that I be monitored (I knew better thanks to all my boards!) and begged them to double book me--I would have rather waited than not be seen at all. Seriously, what kind of IF clinic prescribes fertility meds and doesn't do proper monitoring?! When I went in for my follicle scan, they had no record of my appointment. When we went back to the room the nurse had the entirely wrong information for me. ::head desk::

Femara cycle #1 + IUI #3 turned up a BFN and at this point the doctor finally sat us down and talked to our diagnose of unexplained infertility. He still gave my AMH and LH levels no credence but did give present us the opportunity to do a diagnostic laparoscopy. At this point I sought another referral to see a civilian clinic, to get a second opinion before proceeding with a surgery and more expensive treatments. Once again, I was denied.  I was told to expect a call from Patient Advocacy but I never heard anything from them.  We did decide to proceed with the laparoscopy in search of answers and we did get them--but not without complications. I received the diagnosis of Stage I Endometriosis and found out that my left fallopian tube is partially blocked due to left ovary adhesions, which is likely the cause that I never produce any follicles on my left side. The complication was the piece of plastic that the effing resident left behind in my vagina during surgery. Are you still wondering why we want to look into other options?

This month was our second round of Femara and now that most of the endo had been removed, we were given an increased chance of conception. We decided to try IUI one more time, post endo removal.  When I called to schedule my monitoring appointment, I was once again told that they had no availability but this time I was able to say, "My left fallopian tube is partially blocked so we really want to make sure that I have follicles on my right side before paying for IUI." I went to my appointment and they had no record of it ever being scheduled. Sound familiar? I did end up having two follicles on my right side and we decided to go for IUI #4.  It was a BFN. We are now at the point where we know that IUI is most likely not going to work for us and that we need to consider IVF. Yes, we're on the list on post (We've been moved up to the May cycle)and although the IVF would be done at a somewhat discounted rate, I would be just one woman in a large group of women cycling all at the same time.

As if all this wasn't enough, yesterday I was waiting on a fax with the paperwork I needed to sign to release my records. It never came.  No one answered when I called the office so I couldn't get the fax number I needed.  I ended up sending a fax to the OB/GYN department and had to request that they deliver the fax to the nurse in the REI Clinic.  When I finally spoke with the REI nurse, she asked me if I'd like to be moved up to the May cycle and sounded annoyed and sincerely astonished that we would be looking into care elsewhere.  I wanted to say to her, "Are you seriously surprised?"

There are plenty of women who have absolutely loved and raved about their experience with the REI Clinic. It's been my observation that the majority of these women were able to get pregnant within a few cycles of Clomid and I have yet to personally meet anyone who has made it "this far" with the clinic. Throughout my entire journey with the REI Clinic on post, I have felt like a part on an assembly line and have never received individualized care. We have had problem after problem and do not feel like we can fully trust the clinic or the doctors. I do not want to be part of a large group during an IVF cycle.  I want focus and dedication and I don't want to have to fight to be seen.  I want to be able to talk to someone the first time I call and not have to wait all day for someone to call me back.  Am I expecting too much? Are my standards too high? I have been told repeatedly that I need to go in and talk to Patient Advocacy about all of this but I honestly feel like it wouldn't do any good. At this point, we are desperate to find a doctor that is truly invested in helping us become parents, to make our dreams come true, and I do not think that we are going to find that at an Army hospital.

IUI #4

Well, cycle #34 is in full swing and I finished the last of my Femara a few days ago.  I didn't notice the label on the bottle last time I took it.  Notice anything odd? Yeah.....I'm taking the medicine to help get me pregnant but I shouldn't take the medicine if I plan to become pregnant. Did you get that?

I had my follicle scan yesterday morning. I arrived at the clinic promptly at 0745 and they had no record of my appointment. Again. Luckily, they saw me right away and thankfully my right side is still a rock star!  Before my laparoscopy last month, we were always wondering why my left side never or rarely produced any follicles and now we know why. Thankfully I still have one good ovary and totally clear tube and "rightie" produced two follicles this month--a 15.5 and 16.5.  By the time we do our IUI they should be fully mature at 19.5 and 20.5.

The IUI...oh the IUI! It was originally scheduled for Friday at 0900 but Mike came home from work last night incredibly stressed and pissed off because Uncle Sam decided to move up his training by a week and send him away at 0dark30 on Friday morning.  Right away I called the clinic to see if we could move our appointment up a date but of course it was after hours and I had to talk to an answering service.  I left a message and thankfully the clinic called back as soon as they opened this morning---they DO have a spot for us tomorrow and we will be doing our IUI at 0900 tomorrow morning.

Because our IUI was pushed up, I had to administer the trigger shot myself and I was a nervous wreck, which is pretty funny considering the needle is teeny tiny, but I survived! I'm feeling very hopeful this cycle too. Of course there comes a point where every cycle feels like "the one" but I'm really optimistic this time around. Maybe it's because we finally have answers and most of the endo is gone. Combine that with the recent HSG and two follicles and I'd say our chances are pretty good this month! While the idea of twins would scare most people, I can honestly say that it I would be extremely excited and thrilled! If this cycle works, I would be due in June. See how optimistic I'm being? I never let myself think this way! What lucky socks should I wear???

I'm flying out to Ohio in one week to help care for my nieces while my sister and brother in law are in the hospital for the arrival of baby girl #3. I'm super excited and can't wait to see how the girls have changed since I saw them in England and I can't tell you how much I'm looking forward to holding my newest niece in my arms! I've never held a brand new baby. I know it's going to be a struggle emotionally but I just know it will be wonderful.

I'm glad I will be in Ohio during my 2WW and hopefully it will help it go quickly. I'll try to post while I'm away but I'm sure those little girls will be keeping me extremely busy!

Lucky #34?

AF finally arrived late last night, with very little spotting beforehand--a good sign of things to come?   I was hoping my severe menstrual pain would have disappeared with my endo removal but it hasn't. I still slept with a heating pad shoved between my legs.  =( Since we're still on the waiting list (and will be for quite awhile) for IVF on post, we're going to continue to do ovulation induction + IUI for now. We'll probably do another three cycles of IUI before calling it quits, which would make three IUIs pre-surgery/diagnosis and three post-surgery/endo removal.  My RE feels confident that I'll be able to get pregnant and we won't have to move to IVF, but I'm being cautiously optimistic. I'll start Femara tomorrow and hopefuly we'll be doing IUI by late next week! Here's to lucky #34

Post-op Follow Up

I had my post-surgery follow up appointment this morning. My shiny new Windows Phone makes waiting in the horrible waiting room so much less awkward. You see, the geniuses who planned the clinic set it up so the ob/gyn clinic is right next door, with the reception for both clinics in the middle of the two. So when I'm waiting for my appointments, I get to hear people on the other side of the desk booking ultrasound appointments and scheduling their prenatal care. The grass is always greener, right?

While I was waiting, a female soldier sat across from me in the waiting room. A few minutes later her husband came from the back holding a biohazard bag and exclaimed rather loudly, "Wow. That was awkward." Hahaha! I don't think he expected me to be in the waiting room. His wife handed something to him and he said, "Should I go back in the bathroom and do that?" It was all I could do to keep myself from laughing. Poor guy. I wanted to tell him that it was okay, that we'd all been there. Oh, the joys of infertility....

My follow up appointment went well. I wasn't expecting to find out anything I didn't already know since I had already seen my RE for the alien plastic two weeks ago. What I wasn't expecting was to be seen by the idiot resident who left the plastic inside me! At first I thought Dr. C. sent her in so that she could apologize to me but I was wrong. She didn't even bring it up! She checked out my incisions and made a remark about my bruising--  if only she'd seen me last week! Ouch.  When she was done checking me out she brought in Dr. C. and we discussed what our new plan of action is going to be.

If you remember my first post that I made after surgery, you will remember that the laparoscopy revealed a substantial amount of endometriosis on my left side. I was informed that my left ovary  is covered with endometriosis and is adhered to my pelvic wall at such an angle that my left fallopian tube is partially blocked. It was too risky to remove the adhesions because of their location and removing the endo from my ovary is not an option at this point, as they would likely have to take part of an otherwise healthy ovary along with the affected tissue.  As if that wasn't enough, today I found out that my left side is basically worthless and that my left tube is also partially adhered to my bowels. As much as this totally sucks, it is so incredibly refreshing to finally have some answers. EVERYTHING from our infertility, my spotting before periods, my intense menstrual cramps, my painful intercourse and the incredibly painful bowel movements during my period finally makes sense!

So, where do we go from here? Dr. C. put my mind at ease and said that my pain is normal since I'm still healing and that we won't worry about it unless I'm still in pain after six weeks. Although the majority of my endometriosis has been removed, my left side is basically unhealthy and unreliable. While I may in fact produce follicles on my left side, there's no guarantee that the eggs will go where the need to go since my tube is partially blocked. The good news is that my right side is perfectly healthy and always produces rock star follicles. Dr. C. is confident that now that our chances of conception are higher now that most of the endo is gone. Mike and I are going to continue to do ovulation induction but stick with timed intercourse for now and see where that leads us. Who knows, we may end up doing a few more IUI cycles too.

I really have a gut feeling that we're going to end up needing to do IVF to finally get our baby. I'm praying, of course, that this is not the case but I can just feel it. We're still on the waiting list for the IVF program through our military hospital and as of right now we won't be able to cycle until July of next year. They've told us that there is a good chance we could cycle in as soon as 6 to 8 months though, which would be fantastic providing we have the money saved by then. For now, we've decided to stick with the infertility clinic on post and see how the next few months go. Let's hope that we won't even have to decide between infertility clinics but instead choose between an OB or midwife!

Back to "Normal?"

I have the house to myself this morning for the first time since my in-laws invaded on 17 August for Mike's 30th birthday. It's been a whirl wind these past two weeks and I think life will finally get back to "normal" for us.

I'm going back to work today and I spent the morning answering e-mails and sending invoices. I now have over 90 people on my waiting list and I'm still working on order submissions from June--yikes!  Mike's taking some classes this week to be his unit's Equal Opportunity rep.  His WOCS packet is due on the 15th of September and he still has a few things to do. I'm stressing for him but you know how men are--if I even bring it up he accuses me of micromanaging and gets all pissy so I just have to keep my mouth shut.

For now, I'm enjoying having the house to myself. Luckily, I don't have too much to do since my mom kept my house pretty clean while she was here. It is supposed to be really hot here this week. Well, hot for the pacific northwest. I know all of you southerners/mid-westerners are going to hate me for talking about an 80+ degree heat wave but that is scorching hot for here, especially since most people out here don't have air conditioning. It will easily be 85 degrees in our room when we go to bed tonight.
 
I'm feeling better, but definitely not 100%. I was in a lot of pain on Sunday night after I stupidly went out in a kayak with Mike and then later played ping pong. Oxy was my friend that night.  My right side is fine, my incision is a little tender, but I'm not having any pain. My left side is a different story. I feel better each day but I still have a LOT of residual bruising coming out and it still hurts to bend or walk too fast. Perhaps this is why:

None of this burising showed up until about a week after surgery and now it seems like more and more appears each day. My left side is where he found a substantial amount of endometriosis and was able to remove most of it.  I have always bruised really easily but the amount of residual bruising after surgery has really surprised me. I can't wait until I feel myself again.  Dr. C. told Mike and I that we could start trying again as soon as I feel up to it but sex is still the last thing on my mind. Hell, I'd love to have a normal and pain-free trip to the bathroom right now! Thankfully, no other alien parts have been found anywhere. Whew.

I hope all my readers had a wonderful long weekend. For the second year in a row, Mike and I made the two hour trek north to Lake Cavanaugh to my SIL's mom's house. It's basically a camp ground with an indoor pool and theater room. Poor Mike--I married such a great guy. I still can't really carry anything (just carrying my cup of tea with my left arm still hurts) and he pitched our tent all by himself. The tent I didn't even sleep in. I had every intention of sleeping outside, snuggled in the covers with Mike and our dogs, but it didn't happen. The first hurdle was the sound of snoring coming from my brother's tent next to ours. The second hurdle was my pain and the fact that it was freezing, which made me tense up and hurt even more. All his hard work for nothing! 

We had a great weekend though. We won't talk about the way the Irish played in their first game but it was nice to sit in first class air line seats for the second year in a row and watch the game in the theater room! 

 Zero and Bailey had a lot of fun chasing the chipmunks all weekend. There was tons of good food and lot of relaxing. It was great to spend a few more days with my mom too and it's always fun to hang out with my brother and sister-in-law. This is pretty much what I did all weekend. It's beautiful there, isn't it? The lake is just on the other side of the trees. On Saturday evening a very intense water fight broke out between the little kids and the big kids, but it was mostly the big kids. The pictures I caught are hilarious!

How I Spent My Weekend

"Oh please, oh pleeease be my prisoner!"

He's just a little intense.

Boys will be boys.

Mike and I enjoying the lake

I spent a lot of time in the hammock too.

 

Me, my mom and my brother

On our drive home last night Mike asked me, "If we don't have to do IVF what would you want to....." and I responded with, "Go on another vacation!" He smiled and said, "Get out of my head, woman!" So Mike and I talked about where we'd like to go next. Whether we'd go somewhere in Europe or keep it simple and do something a little closer to home.  He and I decided that if I am able to get pregnant without IVF (fingers crossed!) that we will take a "Baby Moon" to Hawaii for a week OR a week at Walt Disney World, as long as my sister's family can go with us too. Because Disney World just wouldn't be the same without these two little princesses (and another on the way!)

I, being the crazy infertile woman that I am, have already planned Walt Disney World vacations that included my phantom baby. Character dining, parent swap, how we'd work around nap times and even what we'd have to pack in the back pack. I've always ventured on my delusions dreams by myself so it was really sweet to hear Mike talk about the future this way.  We talked about Baby Mooning to Disney World with my sister's family and how I could sit with Charlotte (ETA October 7) since I wouldn't be able to ride any big rides anyway.  Here's to hoping that these next few months will bring us luck, fertility and that we will get our family the old fashioned way. A dream is a wish your heart makes when you're fast asleep. <3

Little Post-Op Complication

So I've been having some bathroom issues since my lap, which is to be expected. Last night I was having a lot of pressure down there so I thought I'd check things out. I inserted my finger into my vagina and felt something hard and with rough edges, almost like a water bottle cap. It was after hours so I couldn't call my clinic and I didn't feel like going to the ER on post. I had horrible nightmares last night about not really having surgery and being taken to the mother ship instead!

I called as soon as the clinic opened and THANKFULLY they called me back right away and said the doctor definitely wanted to see me. So they had a tool that basically cupped on my cervix to keep it in place. That tool snapped to a catheter that they put through my cervix to inject contrast dye to make sure my tubes are open. When my doctor went to tell MH that the surgery was over, the resident assisting him was supposed to be closing and cleaning me up. She removed the tool but the cap stayed inside me. He said that when he does it he always makes sure that the two pieces that snap together come out together. Apparently she didn't do this. My doctor was very apologetic and took responsibility for it even though he wasn't in the OR at the time. He removed it pretty easily with a speculum and forceps. I hope the resident gets her ass chewed out. I was FREAKING out when I felt it last night. I was scared to pull it out though for fear of damaging something.  I just don't understand how something like this could have happened. He said "you're a really good patient! Most wouldn't think to check it out. It could have been in there for weeks!" :/
I'm doing a lot better, but definitely still sore. Mostly on my left side where he removed all the endo. I've got some fresh bruises that I'm guessing are internal bruises finally making their way to the surface.  I am kind of glad I got to see him today since my follow up isn't until the 12th. Thankfully, everything looks healthy and he said we can start cycling as soon as I'm up to it!

Houston, We Have a Diagnosis

Houston, we have a diagnosis! I am a little out of it so bear with me. My doctor found endometriosis on my left side, partially blocking my left fallopian tube. My left ovary is kind of attached to the wall by my endo so it is not at the best angle.  Not sure what stage of endo since I was asleep when he was telling my husband and mom everything. He removed as much as he could without damaging my ovary. He cauterized the endo but also scraped below to kind of "uproot" it, which is why I am having so much pain. He said our chances of conception are greater now that the endo has been removed.  We are basically starting "fresh" now that the endo is removed and will try a few more cycles of ovulation induction and/or IUI before moving on to IVF. It would be amazing if I didnt' have to put my body through that.
The overall experience wasn't too horrible and all the doctors and nurses at Madigan were actually really nice. One part that sucked was the hospital's playing of lullabies every time a new baby was born--super annoying when you're there having surgery for infertility.

I am having some pain, getting up to use the loo is a PITA but they gave me oxy so I'm not doing too bad, just moving really slowly. The oxy made me sick last night and I threw up all over my couch. Thank goodness my mom is here to help out right now since moms clean up much better than husbands.

All my random pain, pain during intercourse, bleeding before AF and painful BMs during period....it all makes sense now. I'm just happy to finally have some answers. I'll obviously know more once I have a follow up. I thought for sure they'd make my follow up a priority at the clinic on post but she told Mike that they can't get me in before the 12th. Good Lord. Mike's been really wonderful and he even shaved my legs for me today.

So, we finally have answers. The endo didn't look too severe from the pictures I saw but apparently the doctor told Mike that there was quite a lot. The diagnosis of endo definitely sucks but I am thankful that we finally have answers. Time for another oxy. Night night! :)