For those of you who didn't know, a week and a half ago I had one fabulous Friday! In the morning I got a call from the new doctor's office (Wash U) and found out they could move my appointment up to March 18! That would save us a whole month in IVF timing - LOVE THAT! To top the day off my regular OB gave me a call out of the blue that afternoon to see how I was doing. He had heard I got passed back to Wash U from the doctor he recommended and he wanted to check in on me - feel so incredibly lucky to have him as my doctor! Fast forward to today...it's time for the REAL consultation!
To start things off, I did much better this time around in staying calm cool and collected prior to my appointment. The strategy? Focusing way more on my mental health leading up to this appointment. I invested in some meditation tracks from Circle & Bloom. Now, if you would have told me 3-4 years ago I'd be using meditation to stay grounded I'd have told you thats bat shit crazy. A bunch of voodoo hippie non-sense (that would be my mid-western roots talking). The one I listened to last night was awesome - they have a special version that has a meditation track for each day you are on IVF plus some pre-cycle tracks. It worked great for the anxiety and I woke up ready to tackle this appointment head on! I found out about Circle and Bloom from the IVF support group I found on Facebook. After my first blog so many wonderful people reached out to me via personal message - one of them hooked me into the group and it has been the most wonderful support network ever. I can ask them anything anytime and there is always someone there to answer my questions and support me when I am down. It's been so wonderful having a network of ladies who have been there and so many of them are pregnant!
Back to the appointment. Our appointment was at 9 so Bryce and I decided to head down to the doctors office and grab breakfast down the street. It was a great decision - we were in the area way early and got to have a relaxed breakfast and not be rushing through traffic to get there in time. I also had control of Bryce's arrival time :) The office building, even though its in a busy area, has an easy parking lot right outside the entrance - so far so good! We were about 20 min early but got in after about 15 min in the waiting room. I quickly had my height weight and blood pressure taken and then we sat down in the consult room. The only bad part of our day was the lame medical student who came for our first round of questioning. Seriously the questions he asked were like trying to concieve 101 and he started the meeting with "So, what's up? How's it going?" he ended the meeting with "Welp....I'm no IVF expert but Dr. Ratts is great!". Seriously?? OK...so we still hadn't met our doctor yet so I was willing to give this experience a pass until the entire appointment was over. So we waited....and waited....and waited...
FINALLY our RE was there and she was GREAT. Very knowledgeable, direct, to the point and a very good match for my personality. She walked us through a lot of great information and what to expect for the first round, timing, my medical history, etc. Remember though that we are here for a reason and we know what our fertility troubles are centered around....so here it is.
I have what is known as Hydrosalpinx. I'll post some links below so you can read about it but here is my "idiots version". Hydrosalpinx is when your tubes are closed off due to a previous infection (remember the appendectomy). To start, this will cause you issues with fertility as you need those tubes open to allow sperm and egg to meet - anyone with blocked tubes has to go with IVF...its your only option. Secondly, because I have this condition, during IVF the tubes will fill up with fluid during my cycle - because they are blocked there is nowhere for this fluid to go therefore it is believed that the fluid can move back into the uterus and be very problematic for the embryo unless they are open enough to allow the fluid to get out. The medical community is fairly aligned that this condition causes a decrease in your chances for IVF to work. What there isn't broad agreement on is why it occurs. So what are our options? Well..it depends. Dr. Ratts is going to have my scans (showing the extent of the blockage) to a radiologist in a couple weeks. From there she will recommend either proceeding with IVF or recommend having my tubes removed. Now this problem has come up here and there for the last 6 months and here are the three things I have heard.
1. (Dr .Herrmann) - After my surgery in September he was very happy about his success in opening up my left tube and my right tube partially (HSG, I thought, confirmed this)
2. (Dr. Pineda) - After reviewing my films would have recommended using "aspiration" to remove the fluid build up in my tubes during the IVF procedure and therefore avoiding the removal of my tubes.
3. (Dr. Ratts) - Tubes don't look good, need someone else to look at them but if they aren't open recommends to remove tubes - doesn't agree with the aspiration technique.
So we wait. I Google, Google some more, waste time at work while Googling all the while totally freaking myself out. Here is where we are at.....
Mandy: Emotionally really DON'T want them to take out my tubes. This is based on two things...not wanting them to take my tubes which really shuts down the idea we will ever concieve on our own (I am still holding out for that chance we will get pregnant when our first born is 2 months old and we can say "look what we went through and then it just happened so easily!") and not wanting to delay IVF by 1-2 months. I'd really like to try one round of IVF first (even though I have been reading my chances could be as low as 20% :( This really isn't a rational opinion so luckily we have Bryce :)
Bryce: Need to hear from Radiologist. If there is NO chance we will ever concieve on our own we should have tubes removed first. If there is a SLIGHT chance one little eggy could eventually work its way through my ugly tubes we should go for IVF first. See? Very rational. I'll blog some other time about my opinion that God gives you a partner that will even you out!
These are some of the hardest decisions I've had to make in my life. There isn't one right answer - its about listening to your doctor, your heart and your spouse. Everyone keeps telling me that I am being so strong and they are so proud of me for being open and tackling this head on. Truth is I am scared to death. Petrified this won't work. Terrified I still won't be pregnant at Christmas. On some days, not hopeful at all. I literally can't say those words without getting upset...every time. What I can say is that I have met some of the greatest people through this experience and it has taught me a lot about myself and made me appreciate what I have.
So here is what to expect in the next two months:
~Today: Consultation and blood work for Mandy
~April 1: Cycle Day 1- call doctor for appointment to happen within 8-10 days. We will run some tests (basic blook work and sonograms to measure my uterus). Bryce also has to re-do his lab work sometime in the next few weeks.
~Month of April: First two weeks will be birth control pills and second two weeks will be Lupron injections which essentially put your cycle totally under your doctor's control
~April 18th: 1/2 day IVF Orientation - Bryce gets to learn how to give me shots!! Now.....Bryce has a big problem with needles. He isn't scared but he has a stupid physical reaction to anything blood/needles/IV/etc so hard telling how this will go! I may need my neighbors to give me shots every day :)
~1st week of May - Stimulations (warning: crazy person ahead!) to make me produce a crazy number of eggs
~Mid May - Egg Retrieval, fertilization and Transfer day!
~Early June - Find out if Baby Burke is on the way!
If we get tubes removed - scratch all of that, schedule the surgery in April and we will see those meds in a couple months!
I keep telling myself I am going to remain positive and hopeful throughout this experience from now on. Until now I try to manage my dissapointment by assuming it won't happen. I am being coached that positivity is the way to go so am trying hard to give that a chance. It's not easy...dissapointment has always been easier for me to handle when expecting the worst.
So here's to the next chapter and all the ups and downs - thank you for being there for me...it has helped in so many ways! Here are a few links to look at if you'd like to know more about Hydrosalpinx.
http://en.wikipedia.org/wiki/Hydrosalpinx
http://www.ivf1.com/hydrosalpinx-infertility-IVF/
http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Committee_Opinions/Salpingectomy_for_hydrosalpinx(1).pdf
Monday, March 18, 2013
Wednesday, March 6, 2013
The First of Many Setbacks
Don't worry...it's not too bad, though if you would have asked me the night of our Dr. appointment with Dr. Pineda I would have told you it was as bad as as it was going to get.....after over three weeks now I feel like I can share :)
So there we were, at our first IVF consultation. We had been waiting a month and a half for the appointment - thats how long it took us to get in. This particular clinic is known around the world - pretty incredible it is here in St. Louis! To say I was a nervous anxious mess is the understatement of the century. I couldn't sit still all day at work let alone think about anything but that appointment at 3! We were meeting at the Dr's office and both hadn't been there before so I gave Bryce VERY specific directions in how to get there, where the office was, etc along with specific direction to be there 15 min early. I had been pouring over the details of the information I had to bring and be prepared with for a month and wasn't going to be late after all that! Well they actually took me a few minutes early and Bryce was a couple minutes late - NO COMMENT! :)
He finally made it and we had a few questions with the nurse. Now...I know my cycles better than anything at this point but I was so nervous I even had trouble answering some of the most simple questions! I was a wreck! From there we got right in with Dr. Pineda - who was a very sweet guy. I could tell he honestly wanted to answer my qeustions and listen to what we had to say. The only problem was he didn't tell me what I wanted to hear...."If you have insurance that covers fertility treatments you shouldn't come to our clinic - you need to go to Wash U"
Excuse me? I'm sorry...I just waited a month and a half for you to tell me that after 15 min of my consultation? It was very hard for me to focus on anything else that was said - I was trying too hard not to burst into tears. You see..I am about as Type A as it gets. Everything is planned, I's are dotted and T's are crossed 25 different times and I am ALWAYS prepared with everything in situations like this but somehow I didn't ask that question? I felt heartbroken and angry with myself. Dr. Pineda did shed some light on some additional things about my condition I hadn't heard before - that there may need to be a special procedure along with my IVF to ensure fluid wasn't building up in my tubes during the procedure - it will be good to know when I meet with my NEW doctor to ensure they can perform the same procedure. Overall he was a very sweet guy and I am sad I don't get to work with him. Essentially their clinic has made a decision to require up front payment from all patients regardless of insurance coverage (I am in the minority that have fertility treatments covered) - he was very clear that he did not want us "playing the insurance game" and hoping to be reimbursed in full. Wash U accepts insurace up front. So that was it...off we went home (after a co-pay of course). I was a mess and Bryce was going to do anything he could to make me comfortable (which that night happened to be Popeyes Chicken and a few glasses of wine...yes I am an emotional eater).
So we start over. I called Wash U the next day and OF COURSE the earliest I could get in was APRIL 8. Good lord a month and a half never felt so long - it might as well have been a year away. One question I asked this time was when I could actually start my IVF cycle - finally some good news. They would start with my next cycle after my appointment which will be late April. At the previous clinic I would have had to wait 2-3 months to work into their schedule. All in all I don't think we lost any time in the grand scheme of things but holy cow was that alot of emotions to get through! I will now be seeing Dr. Valerie Ratts who is part of the Wash U Infertility clinic - they work as a team so there will be 5 doctors reviewing my case and my protocol.
We are back playing the waiting game with lots going on outside of the IVF world. I just got back from a great trip to New York with my neighbor friends, my best friend Tessa is getting married at the end of the month, St. Pattys Day festivities are coming up and this weekend our favorite UNI basketball fans are coming into St. Louis. All things to celebrate and enjoy in the moment. I saw a quote a couple weeks back - "Life is not a destination, it's a journey" It was exactly what I needed to see at the time. This whole process feels like one milestone after another - Beginning of cycle, Middle of Cycle, End of Cycle, next appointment date, etc, etc. I need to keep in mind that while we are going through this there is this thing called life passing us by - and there is alot of great stuff going on there that we don't want to miss!!
So thats the update - sorry for taking so long but it took a while to gain perspective (one that wasn't negative and depressing that is) :) So here's to another month/month and half of injection free freedom!
So there we were, at our first IVF consultation. We had been waiting a month and a half for the appointment - thats how long it took us to get in. This particular clinic is known around the world - pretty incredible it is here in St. Louis! To say I was a nervous anxious mess is the understatement of the century. I couldn't sit still all day at work let alone think about anything but that appointment at 3! We were meeting at the Dr's office and both hadn't been there before so I gave Bryce VERY specific directions in how to get there, where the office was, etc along with specific direction to be there 15 min early. I had been pouring over the details of the information I had to bring and be prepared with for a month and wasn't going to be late after all that! Well they actually took me a few minutes early and Bryce was a couple minutes late - NO COMMENT! :)
He finally made it and we had a few questions with the nurse. Now...I know my cycles better than anything at this point but I was so nervous I even had trouble answering some of the most simple questions! I was a wreck! From there we got right in with Dr. Pineda - who was a very sweet guy. I could tell he honestly wanted to answer my qeustions and listen to what we had to say. The only problem was he didn't tell me what I wanted to hear...."If you have insurance that covers fertility treatments you shouldn't come to our clinic - you need to go to Wash U"
Excuse me? I'm sorry...I just waited a month and a half for you to tell me that after 15 min of my consultation? It was very hard for me to focus on anything else that was said - I was trying too hard not to burst into tears. You see..I am about as Type A as it gets. Everything is planned, I's are dotted and T's are crossed 25 different times and I am ALWAYS prepared with everything in situations like this but somehow I didn't ask that question? I felt heartbroken and angry with myself. Dr. Pineda did shed some light on some additional things about my condition I hadn't heard before - that there may need to be a special procedure along with my IVF to ensure fluid wasn't building up in my tubes during the procedure - it will be good to know when I meet with my NEW doctor to ensure they can perform the same procedure. Overall he was a very sweet guy and I am sad I don't get to work with him. Essentially their clinic has made a decision to require up front payment from all patients regardless of insurance coverage (I am in the minority that have fertility treatments covered) - he was very clear that he did not want us "playing the insurance game" and hoping to be reimbursed in full. Wash U accepts insurace up front. So that was it...off we went home (after a co-pay of course). I was a mess and Bryce was going to do anything he could to make me comfortable (which that night happened to be Popeyes Chicken and a few glasses of wine...yes I am an emotional eater).
So we start over. I called Wash U the next day and OF COURSE the earliest I could get in was APRIL 8. Good lord a month and a half never felt so long - it might as well have been a year away. One question I asked this time was when I could actually start my IVF cycle - finally some good news. They would start with my next cycle after my appointment which will be late April. At the previous clinic I would have had to wait 2-3 months to work into their schedule. All in all I don't think we lost any time in the grand scheme of things but holy cow was that alot of emotions to get through! I will now be seeing Dr. Valerie Ratts who is part of the Wash U Infertility clinic - they work as a team so there will be 5 doctors reviewing my case and my protocol.
We are back playing the waiting game with lots going on outside of the IVF world. I just got back from a great trip to New York with my neighbor friends, my best friend Tessa is getting married at the end of the month, St. Pattys Day festivities are coming up and this weekend our favorite UNI basketball fans are coming into St. Louis. All things to celebrate and enjoy in the moment. I saw a quote a couple weeks back - "Life is not a destination, it's a journey" It was exactly what I needed to see at the time. This whole process feels like one milestone after another - Beginning of cycle, Middle of Cycle, End of Cycle, next appointment date, etc, etc. I need to keep in mind that while we are going through this there is this thing called life passing us by - and there is alot of great stuff going on there that we don't want to miss!!
So thats the update - sorry for taking so long but it took a while to gain perspective (one that wasn't negative and depressing that is) :) So here's to another month/month and half of injection free freedom!
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