Can't I Just Go Back To Bed and Try Again Tomorrow?

I had my first monitoring visit for our FET last week. My lining wasn't great, but it wasn't horrible either.  She thought I'd be fine by this week.

Not so much.

My day started when I literally tripped into the clinic.  Yes, literally in the real sense of the word,  not the way people butcher it now.  I somehow walked right on out of my shoes and landed flat on the concrete, cutting my knee and scraping my chin.  That should've been my first clue that today was destined to suck.

My lining has actually shrunk.  What was a 6.5 is now a 4.7 and I still have a bunch of mucus in my uterus.  They pushed back my transfer to the 23rd and I'm adding Vivelle dots.  Two of them twice a week.

I cried the whole way to my office.  As much as I've tried to remain cool, I don't think I really tuned into how emotionally ramped up I was about this cycle.  I can't stop crying.  I can't get it together.  I'm all E2ed up and I can't. stop. crying.  I guess all of this estrogen is just going to my emotions and my ass.  Both seem out of control lately.  I hate FETs.  I think I've mentioned that before.  I also think my lining did this before.  Swell.

I went to fill my prescription.  Insurance apparently only pays for one box a month, not two.  So I filled the one box, cried again, and will hope that the angel nurses at the clinic can fix this shit sometime in the next 15 days so I don't run out of patches and can get them filled before I have a new deductible to tackle.

I hate this.  I hate the drama.  I hate watching my body fail again.  I hate worrying about insurance and money.  I hate over analyzing everything I do.  I hate being sad when I should just be enjoying the holidays with my healthy, happy two year old.  I hate it all.  This SUCKS.  It all just sucks.

And my chin hurts.

Crap Day Recap and Some Photos

You know when you have one of those crap days?  We had one of those crap days today.  I found out that there was a mix up at the clinic and my FSH labs didn't get "posted" correctly so they didn't get done.  Awesome.  I didn't really want to know what they were - my insurance did.  So now I have to get off BCPs at some point and have another period, which my RE wanted to avoid, so I can get it drawn again.  I will raise holy hell if I have to pay another copay for it.  I'm still bitter about paying one in the first place.

It might be a moot point anyway.  J found out that his company is switching insurance providers.  We've been very lucky with insurance coverage thus far.  We had a crap time with drugs in the beginning, but things have gotten much better with the new clinic.  If it weren't for insurance coverage, we would not be able to try to have a child - no way we could afford it.  My husband works for an MA based company, so we really lucked out.  I know this, and I'm not posting this to rub it in.  We have no idea what the new plan will cover or what their "rules" are for coverage.  I managed to find their infertility bulletin online and I THINK we'll be okay, but I really have no idea.  I would really rather not try to cram in our last cycle before the end of the year.  We won't even know what our coverage will look like until the middle of November.  I REALLY wanted to make this last fresh cycle the best it could be.  Try not to be as relaxed as I can, not be traveling to my mom's, not be hosting my in-laws... all of these things do not mix with the holidays!  I wanted a little break!

My clinic says that 90% of the time they have no problems with out upcoming insurance company, but that they are sometimes denied for surprising reasons.  We're leaning towards sticking with our original plan and if we do a final fresh cycle, we'll hope for the best or take out a loan.  I don't know.  I'm tired of being stressed ALL THE TIME.  Anyone out there with BCBS of MA have any tips to share?

In an attempt to relax, I'm going to post photos from our trip to the mountains.  I forgot to post them earlier!

Hunger Games!

Calendar! Preparation For The Return Of The Jedi

Shiny and new!  Here we go!

We met with the nurse today to get our calendar for our FET and pay up.  Everyone we met with knew about the nuances of our cycle, had everything together and ready to go for us, it was so nice.   Other differences I'm excited about?
Estrace and no patches!  Yay!

• Baby Asprin.  I see the rest of you taking it, now I'm in the club.
• Medrol.  What's that you say?  You have a condition that some believe causes an auto-immune implantation problem and you've never added a steroid to the mix?  What a novel idea!
• HCG added to the transfer medium.  New clinic is really excited about this.  Apparently it's showing some pretty great results.

Only bad thing is that insurance requires day 3 bloodwork and I'm already on BCPs.  They have told me in the past that as long as it was completed in the last year, it's all good (until my 35th birthday).  Since they are dumb and don't actually hold on to records, this has to be sent in every freakin time.  So to avoid coming off BCPs and getting a new draw, I have to get the last day 3 lab results from the old clinic (they didn't come over with the last bunch of records).  Thankfully, I knew the exact date they were drawn on, so I called and said I'd be picking them up tomorrow morning.  No relying on them to fax that crap in.  I'll do it myself, thankyouverymuch.

So, hopefully something will survive the thaw and a couple days of extra culturing for a blastocyst transfer on October 4th.  Beta is scheduled for the 15th.

Go ute, go!

All Clear!

My baseline ultrasound was cyst free and meds start on Saturday!  My insurance decided to ovary-block two of my Ganirelex (Get it?  Ovary-block?  I'm so funny.), so we'll see how that all pans out.

When I was in the waiting room at the clinic this morning, there was a child there.  It always irks me a bit when there's a kid there, but I get over it.  Today was a little different, though.  This was a boy of about 10 or 11.  Seriously.  A fertility clinic is no place for a boy that age.  Ew.

Maybe If I Run A Marathon...

If you're here from ICLW, welcome!  You can visit the our journey page to catch up.  All caught up?  Good.

I had my baseline ultrasound for IUI #3 yesterday and we're good to go.  There are two fellows who do the IUIs and ultrasounds and I tend to get the same guy for ultrasounds and the other guy (Dr. Texas) for IUIs.  So Dr. Ultrasound was shocked to see me - apparently he really did think I'd be getting pregnant with triplets last month.  Ha ha!  Fooled him!  Anyway, I think he's afraid I'm going to cry on him since I cried after my first baseline ultrasound.  Poor guy.  I only cried because he benched me for a cyst.  I finally got to come to the playground to play and he told me I had to take my ball and go home.  I'm tougher now, dude!  He kept saying, "Don't think about the month to month odds.  You'll just get depressed.  Think cumulatively.  You've been responding well.  This could still work."  God love 'im and his optimism.  I had a resident doing the actual ultrasound this time.  She needs to way be speedier.  Someone should give her a date with Wanda and maybe she'll learn that lesson.

Now we're on to the insurance fight for drugs.  It's not starting well, but if I type about that right now I will launch my keyboard through my monitor.  Menopur needs to be here by Friday.  Who thinks it will even be approved by then.  Show of hands.  Anybody?

J was talking about how he thinks he's going to start saving for a BMW.  Then, as soon as he's close to having a down payment, I'll end up pregnant it he will have to spend that money on baby stuff.  I thought it was good logic.  Murphy's law and all, right?  If you plan for something, it will get all messed up.  I planned for a baby and that's all messed up.  My coworkers and I were talking about running today and some races that are coming up.  I think I'll register for a marathon.  Okay, maybe a half-marathon.  Then, right in the middle of training, I'll get pregnant. 'Cuz.... I really want to run a marathon... (insert as much sarcasm as you can muster here)

Have I totally lost my marbles yet?

Nothing Important, Really

I've been sitting here staring at the screen, not knowing what to write.  This week has just seemed so hard.  I guess I had gotten my hopes up too much on the IUI.  The BFN was much harder than I had anticipated.  Having the period from hell hasn't helped my mood.

I've spent the tail end of this week dealing with my effing insurance company.  In the words of Nurse J "I hate insurance.  Just my personal opinion.  I know, it's a blessing when you have some coverage, but they are messing with your life!  How can they do that?"  My thoughts exactly Nurse J.  Anyway, my drugs have not been approved or denied... the approval is just sitting there in the hands of some random insurance company nurse.  Here's what's going down.  My RE's office calls insurance company to get approval for this cycle.  Nurse orders drugs through insurance company (yeah - not allowed to order from where I would like to order anymore).  Insurance company specialty pharmacy sends request to pre-cert department, pre-cert department notes that I already have approval and sends request to the infertility nurses who have final approval.  So even though I already have approval, a nurse employed by the insurance company gets to decide if what my PHYSICIAN has prescribed is really medically necessary.  But we don't need insurance reform in this country.

We pay so much for this insurance that at this point, it's the principle of the thing.  Between the out of pocket costs on the meds and the premium we pay we aren't coming out ahead, so it's not like I'm whining when I should just suck it up and be glad we have coverage.  I just want them to do what's right!  They keep telling me "It takes 24-48 hours to process an order."  WHY!?!?!?  This is a specialty pharmacy.  People need these meds NOW!  And, I start meds on CD3.  I don't know that I need them until CD1.  So how on God's earth am I supposed to be able to get meds in 48 hours if it takes that long to process the damned order?!?  No one seems to be able to answer that question.  The good news is that my RE's office had enough samples on hand to lend me enough to get me through the weekend.  If my order is approved, I'll reimburse them through that.  If it isn't, I'll pay out of pocket.  This is just so FRUSTRATING!!!!!

I have two concerts to sing this weekend and they involve a solo.  Here's to hoping I don't muck it all up since my head is in la la land right now.

Crap We Have To Deal With Just In Case IF Isn't Hard Enough

It's been a long Fing day.  Here's why.  My period started the second I didn't take my Prometrium, so today is CD1.  If I want to be "in the game" for the next cycle, I had to get my drugs ordered.  Now, I've dropped my primary insurance since I last got drugs so I needed to get prior approval for this round for what was my secondary insurance and is now my new primary.  Yesterday, the nurse told me I could just call the pharmacy and get refills (we don't have a local pharmacy for this crap).  She also told me about how my insurance wants 3 day blood work every month.  No biggie, right?  They told me that last month and the doctor drew my labs so I wouldn't have a hassle this month.  I gave my doc's office a heads up on the insurance and meds issue yesterday, so the nice insurance lady (NIL) was already on it.  I called there first this morning and she already had an auth number for me.  She told me she verified with them that I won't have any hang-ups when I order my meds.  Cool.  I called the pharmacy.  She took my info, found out what refills I needed, and told me she'd call me back.  I asked if she needed the auth number and she told me no.  I figured she would know what she was doing, right?  WRONG!  Pharmacy tech (PT) calls me back.

PT: Hey, Ummm, I like, talked to Aetna, and like, nothing is going through because they said you don't have any coverage.
Me:  Excuse me?  I know I have coverage.  They just covered a procedure two weeks ago and they covered some of my last prescription.
PT: Well, this is a new plan year, and like, they said you have, like, a different pharmacy plan and you probably just don't know about it.
Me: (After a period of stunned silence).  Look, there's an Rx Bin number on my card and my RE's office already got an auth number, so I'm sure I have coverage.
PT: Well, does your card say, like, Caremark or something on it?
Me: No, just Aetna... and an Rx Bin number.
PT: Well, give me that. (Takes number) Okay, I'll call them again and call you back.
Me: Do you need the auth number?
PT: No

In the meantime, I called Aetna again.  The woman was completely incredulous and said "Of course you have coverage.  There's even a prior auth number here.  That girl is doing it wrong."

I call her back.

PT: Oh, hey, I was just going to call you back.  They say you have coverage, but it's still not going through.
Me: I just talked to Aetna.  She even saw the auth number in her system.
PT: Oh.  What is it?
(I give it to her and try not to reach through the phone and choke her.  She types some things on a computer).
PT: That auth number was for procedures but you should have a different one for meds.
Me: No, that's not how the fertility program works.  They give you one auth number in the beginning of your cycle to cover medications and procedures so you don't have to keep track of 85 auth numbers.  My RE's office verified that that would cover meds.
PT: Well, it's not going through.  I'll call your RE's office and call you back in 30 minutes.

I'm not sure what "it" is or what "going through" means, but this chick is not helping me.

She calls back.

PT: So, the Letrozole and Prometrium went through, but like, you have to order the injectables through Aetna's Specialty Pharmacy.
Me: (silently relieved that I don't have to deal with this moron anymore, but also panicing because I'm afraid I won't get my meds on time now that I have to start all over again... and pissed that I didn't know this).  Okay, fine.  Just send me the Letrozole and Prometrium so I can at least have that to get started on Friday and I'll figure the rest out.

I called the NIL at the RE's office.

Me: Hi, this is Lisa, the most annoying woman you've had to deal with all day.
NIL: (Laughs - I'm sure she wants to choke me)
Me:  So the pharmacy says the injectables have to be ordered through Aetna's Specialty Pharmacy.
NIL:  Absolutely.  That's how it works.
Me:  Okay, I didn't know that since they didn't pay for them last time and nurse told me I could just get a refill.
NIL: The girl from the pharmacy just called me not 10 minutes ago and asked if I'd ordered them.  I had to remind her I wasn't a nurse and I sent her over to the nurses line.  Let me send you over there and you can get them to place the order.

So I leave a message letting them know that I just need Menopur and Ovidrel ordered through the Aetna Specialty Pharmacy and that I'm nervous about it since I don't think they do Saturday shipping and I'll have to start the Menopur on Sunday.  I get a call back right after I get in the car to go home, but my phone had fallen out of my pocket and dropped under the seat and I couldn't find it.  When I get to it and listen to the message it says:

"Hi, this is nurse J.  I got your message, but I don't think Aetna is going to pay for it since they want day 3 blood work and we won't be able to do that until tomorrow or Friday.  So call back tomorrow and talk to nurse M about that."

I yell, "WHAT THE F^@*!!!!"  Since hubby and I carpool and I work a block from my RE's office, he pretty much just pulled into the parking lot right there.  I got all stalker and just went into my doc's office and asked to talk to nurse J.  I felt like such a bitch.

Nurse J: Yeah, there's a note in your chart that says that Aetna needs day 3 blood work every month before they can pay for anything, so since the lab is closed and we can't get that until tomorrow, I don't think we can get your meds in time.

Now, it is just me, or is this woman a COMPLETE moron?  HOW ON EARTH are you supposed to be able to get medications THAT ARE SENT IN THE MAIL approved, ordered, and sent to me to take on day 3 if you are drawing blood for approval on the same day I am supposed to be TAKING THE DAMNED MEDS!  They want the numbers from the month before!  That's why my doc drew them and said "We'll just get them today so you won't have any hassle next month in case you don't get pregnant."  Instead of pointing this out and being a complete bitch, I just said, "NIL already got an auth number."  She said, "Really?  How'd she do that?"

AHHHHH!!!!!!!

I hope she never touches any living tissue related to my cause.

So she's putting in the order, but I'm still not sure the Menopur will be here in time.  I'm almost hoping I have a cyst so I don't have to worry about it and I'll just have the drugs for next month.  Of course then my E2 will be super high tomorrow and I'll run into issues because of that.

STUPID Fing RED TAPE and STUPIDITY!!!!!!!!!!!!!!

I know I should be happy I'm not paying 100% out of pocket, but it would be really swell if I could just order what I needed from wherever and get reimbursed.  This is just one more layer of stress that I DO NOT need.

Thanks for reading all of that slop.  I still feel like I was a complete bitch to people all day. I felt like I was doing something wrong and all these people were exasperated with me, but I was just doing the best I could to get my damned meds on time!

I Get To Shoot Up In My Mom's Bathroom!

HAPPY DANCE!  THE CYST IS GONE!  Let's get this show on the road!  I start Letrozole tomorrow. My first injection will be on Christmas day, at my mother's house, probably in her bathroom.  Awkward.

On a less exciting note, my insurance said they won't pay for anything else until I have updated blood draws (even though I just had one a couple of months ago and haven't had any actual treatment since - buttheads).  So I had a fresh FSH, LH, and E2 drawn today.  Since I posted just the other day about how anxious I was about the FSH, I'm now sitting here anxious to hear from the office.  She said they'd call with it today, but I haven't heard anything yet.  Not that I can do anything about it - it is what it is - I just don't know how to function if I'm not freaking out about something.  Besides insurance cuts me off from ART if it gets over 19.  If it's over 19 we need to regroup anyway.