Carolina Conceptions is a new clinic in our area that I mentioned in an earlier post. Before I even left my apppointment, I'd pretty much made up my mind that Dr. Meyer was my new doctor and that I was not going back to see Dr. Toma! It is in Raleigh so it's a slightly longer drive but well worth it. The facility is brand new (still have all sorts of construction in the building and the parking lots not even finished) but the drs have plenty of experience.
After just a short wait, the nurse ushered me back into Dr. Meyers office (brownie points for him already being in the room instead of sending me to a empty room to wait more). Dr. Meyer is a very pleasant person and is happy to work with you on a treatment plan. Since I didn't have my medical records from NCCRM (see previous post for that rant), I had typed up all my IUI & IVF results (thankfully I had all that info here on my blog). That info plus the treatment chart (that was my 'treatment bible' through IVF) was enough information for him to determine what steps to take next.
I was thrilled when he said that he thought I could get pregnant without doing IVF. There's about a zillion reasons why that made me happy, but primarily money, time & pain in that order. So he wanted to try something he called sequential therapy IUI. Basically it's just a combo of the type of IUI that I did before, plus the same injectable fertility drug I took during IVF.
He also said I do not have to take metformin (glucophage) anymore! This was the best news I could have gotten. I had been complaining since Sept. about the awful side effects of this drug but my old RE basically said 'get used to it'. Dr. Meyer said we could try Avandia instead and that it had little side effects.
So the waiting game begins... wait for a period to start. He actually said I could take prometrium (that I have left over from IVF.. thats one really great thing about this doc, he's trying to maximize the leftover drugs that I've already paid for!). The prometrium will start my cycle but I'm waiting until I get back from an upcoming business trip (to Minnesota) to make sure that we have no conflicts with the travel.
Friday, March 30, 2007
Saturday, March 24, 2007
fun & sun.. sort of
I'm off to Miami!! It's a business trip, but I don't mind this one. We have to be at the first session at 4PM on Sunday, so I'm flying in early to spend some time at the beach before my classes start. I've got all day Saturday & Sunday to enjoy myself and take a break! Then a few days of classes and then back on home. Even the classes will be a bit of a break from the usual work routine. I've not been to Miami before so if you have suggestions of places to go, things to see.. send me a comment.
Friday, March 23, 2007
it shouldnt be so hard
Get a copy of your medical records before your appointment.
Sounds easy right? Wrong! Now I'm not a novice at medical run-around, but this is just ridiculous.
After our less than thrilling appointment with our RE on Monday, DH & I debated various options. Since I'm the one enduring the daily hardships during treatment, DH is pretty much leaving the final say to me. So, I decided that we needed a second opinion. I already had an RE in mind since I've done plenty of research on the topic since our initial IVF education back in December. Dr. Meyer is in Raleigh at a new clinic that just opened last year (yea I know, it's new.. are they good enough, can we trust them... I'm not going into all that right now, maybe another post, you can read all about their clinic & make that call for yourselves. I will say the co-founders used to be directors of both the Duke & UNC IVF programs). I was thrilled to find that Carolina Conceptions could get me in to see Dr. Meyer in less than a week!
Okay so that all seems good so far. Here's where it got frustrating. I need to take my medical records to CC in order for the RE to give a second opinion. So I call NCCRM yesterday trying to get the process started (only 3 days after the appt that led to our decision to try another clinic). Finally today I get instructions on how to get my records. First I need to fill out a release form. Done. Then, NCCRM contracts out their copy service to a company that comes only once a week (Wednesdays of course, so the day before I called). So I have to wait until next Wed. Oh and by the way, then you call the contracted company on Friday to find out when you can get the copies. So that would put us at 7 business days later & still no copies. Then, you finally get the copies the next week around Wednesday. So I called the contract company hoping I could get some sort of expedited service (and expecting an extra fee, thats okay). Nope, they don't have anything like that and they wouldn't even commit to the Wed date that the dr office gave me. So I made the initial request on 3/22, and by sometime around maybe possibly 4/4, I might have my records for a doctor appt that is on 3/30.
And what really gets me - my file is sitting in a filing cabinet right now. No one is using it. And they have a copier.. I've seen it. I'd even make the copies myself & still pay the copy fee.. I just want the information they are holding hostage.
Sounds easy right? Wrong! Now I'm not a novice at medical run-around, but this is just ridiculous.
After our less than thrilling appointment with our RE on Monday, DH & I debated various options. Since I'm the one enduring the daily hardships during treatment, DH is pretty much leaving the final say to me. So, I decided that we needed a second opinion. I already had an RE in mind since I've done plenty of research on the topic since our initial IVF education back in December. Dr. Meyer is in Raleigh at a new clinic that just opened last year (yea I know, it's new.. are they good enough, can we trust them... I'm not going into all that right now, maybe another post, you can read all about their clinic & make that call for yourselves. I will say the co-founders used to be directors of both the Duke & UNC IVF programs). I was thrilled to find that Carolina Conceptions could get me in to see Dr. Meyer in less than a week!
Okay so that all seems good so far. Here's where it got frustrating. I need to take my medical records to CC in order for the RE to give a second opinion. So I call NCCRM yesterday trying to get the process started (only 3 days after the appt that led to our decision to try another clinic). Finally today I get instructions on how to get my records. First I need to fill out a release form. Done. Then, NCCRM contracts out their copy service to a company that comes only once a week (Wednesdays of course, so the day before I called). So I have to wait until next Wed. Oh and by the way, then you call the contracted company on Friday to find out when you can get the copies. So that would put us at 7 business days later & still no copies. Then, you finally get the copies the next week around Wednesday. So I called the contract company hoping I could get some sort of expedited service (and expecting an extra fee, thats okay). Nope, they don't have anything like that and they wouldn't even commit to the Wed date that the dr office gave me. So I made the initial request on 3/22, and by sometime around maybe possibly 4/4, I might have my records for a doctor appt that is on 3/30.
And what really gets me - my file is sitting in a filing cabinet right now. No one is using it. And they have a copier.. I've seen it. I'd even make the copies myself & still pay the copy fee.. I just want the information they are holding hostage.
Monday, March 19, 2007
IVF consult
DH & I showed up at the dr for our 4PM appt. 45 mins later we finally got to see the RE. Then he rushed me with all my questions. He kept checking his cell phone & once said 'you about done with all those questions?'. UGH... what a jerk. We were only in there maybe 10-15 minutes tops.
Most of my questions were shrugged off, indicating that there is nothing we could have done different & there are no other tests we should do to look for any other problems. Just try again. He said that I stimulated like their 21-yr old egg donors (I guess that was supposed to make me feel better?). Of course stimming that way did us no good since my levels went too high (as you know already if you've been following along on this blog). The only explanation he would give as to the failure of this cycle was the possibility that 'coasting' (no ovulation induction meds) for so long prior to retrieval and/or that I had not been taking my full dose of glucophage could have reduced the quality of the eggs. I have several issues with this statement. First, we had no idea until today that there had been anything wrong with the eggs. All he could tell us was that we had 'slow embryonic development' (though even that confuses me since 2 got to blastocyst stage on day 5 which is typical.. did they start slow & then catch up?). Second & third, I had informed the nurses of my difficulty in taking the glucophage as it made me sick & he never tested me for insulin resistance (not all PCOS patients are insulin resistant & only need glucophage if insulin resistant).
For the next try, he had only a few changes to make. Take birth control longer (20-25 days instead of the 15 or so I did last time). He is also going to start me off with FSH of 100 (started at 150 last time) and Lupron of 5 (10 b4) and just try again. He also said to make sure to take the full dose, at least during the stim phase if I can't manage it the rest of the time. (Glucophage gives me GI issues at full dose, or even at smaller doses sometimes).
So, just try again. Now that he's seen how my body reacts, he says he knows what doses to use next time. What if these doses are not enough? Plus, the problem with that mentality is that we only have one more try that our insurance will cover. And we don't have $10-15k to pay for another try ourselves. So I'm very interested in doing all we can to increase our chance of success at this try. I'm not in a hurry to do it right away.. if time is what we need to be better prepared then fine by us.
Most of my questions were shrugged off, indicating that there is nothing we could have done different & there are no other tests we should do to look for any other problems. Just try again. He said that I stimulated like their 21-yr old egg donors (I guess that was supposed to make me feel better?). Of course stimming that way did us no good since my levels went too high (as you know already if you've been following along on this blog). The only explanation he would give as to the failure of this cycle was the possibility that 'coasting' (no ovulation induction meds) for so long prior to retrieval and/or that I had not been taking my full dose of glucophage could have reduced the quality of the eggs. I have several issues with this statement. First, we had no idea until today that there had been anything wrong with the eggs. All he could tell us was that we had 'slow embryonic development' (though even that confuses me since 2 got to blastocyst stage on day 5 which is typical.. did they start slow & then catch up?). Second & third, I had informed the nurses of my difficulty in taking the glucophage as it made me sick & he never tested me for insulin resistance (not all PCOS patients are insulin resistant & only need glucophage if insulin resistant).
For the next try, he had only a few changes to make. Take birth control longer (20-25 days instead of the 15 or so I did last time). He is also going to start me off with FSH of 100 (started at 150 last time) and Lupron of 5 (10 b4) and just try again. He also said to make sure to take the full dose, at least during the stim phase if I can't manage it the rest of the time. (Glucophage gives me GI issues at full dose, or even at smaller doses sometimes).
So, just try again. Now that he's seen how my body reacts, he says he knows what doses to use next time. What if these doses are not enough? Plus, the problem with that mentality is that we only have one more try that our insurance will cover. And we don't have $10-15k to pay for another try ourselves. So I'm very interested in doing all we can to increase our chance of success at this try. I'm not in a hurry to do it right away.. if time is what we need to be better prepared then fine by us.
Go ahead and take your best shot,
Let 'er rip, give it all you've got,
I'm laid out on the floor,
but I've been here before,
I may stumble, yeah I might fall,
Only human aren't we all?
I might lose my way, but hear me when i say,
I will stand back up,
You'll know just the moment when ive have enough,
Sometimes im afraid, and i dont feel that tough,
But I'll stand back up,
-Sugarland
Let 'er rip, give it all you've got,
I'm laid out on the floor,
but I've been here before,
I may stumble, yeah I might fall,
Only human aren't we all?
I might lose my way, but hear me when i say,
I will stand back up,
You'll know just the moment when ive have enough,
Sometimes im afraid, and i dont feel that tough,
But I'll stand back up,
-Sugarland
Thursday, March 15, 2007
lots of questions
Man is my RE in for a surprise on Monday! Usually when I see him, I listen to everything that he has to say but I don't really have many (if any) questions. Now that I've had some time to think about the previous IVF cycle, plus read all these books lately... I've got a nice list of questions. I'm up to about 25 questions so far on my list!
Wednesday, March 14, 2007
Life ain't always Beautiful
Life ain't always beautiful
Sometimes it's just plain hard
Life can knock you down, it can break your heart
Life ain't always beautiful
You think you're on your way
And it's just a dead end road at the end of the day
But the struggle makes you stronger
And the changes make you wise
And happiness has it's own way of takin' it sweet time
No,life aint always beautiful
Tears will fall sometimes
Life aint always beautiful
But it's a beautiful ride
Life aint always beautiful
Some days I miss your smile
I get tired of walkin' all these lonely miles
And I wish for just one minute
I could see your pretty face
Guess I can dream, but life dont work that way
But the struggles makes me stronger
And the changes make me wise
And happiness has it's own way of takin' its sweet time
No, life aint always beautiful
But I know I'll be fine
Hey, life aint always beautiful
But its a beautiful ride
What a beautiful ride
Artist/Band: Gary Allan
Lyrics for Song: Life Ain't Always Beautiful
Lyrics for Album: Tough All Over
Sometimes it's just plain hard
Life can knock you down, it can break your heart
Life ain't always beautiful
You think you're on your way
And it's just a dead end road at the end of the day
But the struggle makes you stronger
And the changes make you wise
And happiness has it's own way of takin' it sweet time
No,life aint always beautiful
Tears will fall sometimes
Life aint always beautiful
But it's a beautiful ride
Life aint always beautiful
Some days I miss your smile
I get tired of walkin' all these lonely miles
And I wish for just one minute
I could see your pretty face
Guess I can dream, but life dont work that way
But the struggles makes me stronger
And the changes make me wise
And happiness has it's own way of takin' its sweet time
No, life aint always beautiful
But I know I'll be fine
Hey, life aint always beautiful
But its a beautiful ride
What a beautiful ride
Artist/Band: Gary Allan
Lyrics for Song: Life Ain't Always Beautiful
Lyrics for Album: Tough All Over
Tuesday, March 13, 2007
Is Your Body Baby-Friendly?
This week I received my Amazon order with several IVF books. I'll review them here as I read them. But I wanted to make a note on this book now.
Is Your Body Baby-Friendly? By Alan Beer
I was surprised at the size of this book. It is nearly 500 pages! Skimming through it, I found that nearly 1/2 of the book consists of notes. The notes provide supporting documentation for the many statements through the first half of the book. Most of us non-medical types will have no interest in referring back to that section. From the few other parts I've skimmed so far, I see that this is not going to be an easy read. Though many of the medical terms are explained as simply as possible, it is still rather in-depth and highly technical.
For any of my friends concerned about miscarriage or IVF failure, you can borrow this book. If I had skimmed the book at a bookstore/library, I would not have purchased one for myself.
Is Your Body Baby-Friendly? By Alan Beer
I was surprised at the size of this book. It is nearly 500 pages! Skimming through it, I found that nearly 1/2 of the book consists of notes. The notes provide supporting documentation for the many statements through the first half of the book. Most of us non-medical types will have no interest in referring back to that section. From the few other parts I've skimmed so far, I see that this is not going to be an easy read. Though many of the medical terms are explained as simply as possible, it is still rather in-depth and highly technical.
For any of my friends concerned about miscarriage or IVF failure, you can borrow this book. If I had skimmed the book at a bookstore/library, I would not have purchased one for myself.
Monday, March 12, 2007
I'm Alright
So maybe I'm a little ragged around the edges
And I've been keeping a little more to myself these days but
I'm alright
Shot down but I'm still standing
I'm alright
A little banged up from the fall
But I'm alright
Still shaky from the landing
I'm alright, after all
You know it's really not that bad
No matter how bad it might feel
Cause there ain't nothing time won't fix
This ain't nothing that some time won't heal
So maybe I've been walking a little wounded
I move a little bit slower not but that's okay 'cause...
I'm alright
Shot down but I'm still standing
I'm alright
A little banged up from the fall
But I'm alright
Still shaky from the landing
I'm alright, after all
I'm Alright lyrics by TERRI CLARK(Angelo/Larry Gottlies/Kim Richey)
And I've been keeping a little more to myself these days but
I'm alright
Shot down but I'm still standing
I'm alright
A little banged up from the fall
But I'm alright
Still shaky from the landing
I'm alright, after all
You know it's really not that bad
No matter how bad it might feel
Cause there ain't nothing time won't fix
This ain't nothing that some time won't heal
So maybe I've been walking a little wounded
I move a little bit slower not but that's okay 'cause...
I'm alright
Shot down but I'm still standing
I'm alright
A little banged up from the fall
But I'm alright
Still shaky from the landing
I'm alright, after all
I'm Alright lyrics by TERRI CLARK(Angelo/Larry Gottlies/Kim Richey)
Saturday, March 10, 2007
more books
Below are a couple other books I've ordered but know very little about. These were not recommended to me, I found them on Amazon while searching. I purchased these based on the summary & reviews on Amazon. Hopefully these will prove as helpful as the others have been.
1 of: The Couple's Guide to In Vitro Fertilization: Everything You Need to Know to Maximize Your Chances of Success [Paperback] By: Liza Charlesworth (Author)
1 of: Infertility Survival Handbook [Paperback] By: Elizabeth Swire-Falker (Author)
1 of: The Couple's Guide to In Vitro Fertilization: Everything You Need to Know to Maximize Your Chances of Success [Paperback] By: Liza Charlesworth (Author)
1 of: Infertility Survival Handbook [Paperback] By: Elizabeth Swire-Falker (Author)
infertility books
warning - long post
----
I've started reading a lot on infertility though recently I've been focusing on the emotional/mental side. Intially most of my personal research was online (faster, easier, free!) though I've read a few books too. I'm pretty much through all the basics of fertility treatments, so I've skipped to the more in-depth IVF books. For anyone going through fertility issues or close to someone going through it.. I recommend the following books. I have also ordered a few others. I'll update later once I've read those. (These link to Amazon just b/c I copied the titles from there to speed up writing).
1 - Conquering Infertility: Dr. Alice Domar's Mind/Body Guide to Enhancing... By: Alice D. Domar, Alice Lesch Kelly
This one was recommended to me by my therapist. I started seeing her b/c infertility is one of her specialties and around last fall I started having a harder time dealing with my feelings about this process. She recommended this book in one of our first sessions. I skipped around a lot as I read this.. depending on where we were in our cycles. There are a lot of coping skills that are mind/body techniques (google mind body medicine if you want to learn more) plus it shares a lot of stories from other women. I suggest reading sections as they apply to you (I think it would be very stressful and upsetting to read the chapter "When Miracles Don't Happen:Coping when Treatment Fails" in the midst of treatment. But I flipped straight to that chapter the day after finding out our IVF cycle did not work). I also have found this book to be the kind of book that you want to reread, specifically if you are having trouble in certain areas. The chapter titles are very helpful in directing you to sections you need most. The day I got the book, I skipped ahead to 2 chapters.. first "Coping When Everyone But You Has a Baby" and then "Infertility and your Career". At that time, those were the two areas I was struggling with most. I definitely recommend this one regardless of where you are in your fertility struggles. It is not IVF specific.
2 - Nurturing Yourself Through IVF: Improve Your Experience, Maximize Your Odds of Success [Paperback] By: Lynn Daley (Author)
I found this one on Amazon as I searched for books that were more focused on IVF. Many of the other books I had found were too basic. IVF is one of the more advanced infertility treatments and as such, it can be more difficult to deal with both the physical & emotional aspects. I wasn't sure what to expect from this one but was pleased with it. Don't be disappointed when you see it, as I was initially, it is very short but worthwhile. Daley expands on (and references frequently) Domar's concepts from Conquering Infertility. Though this one does focus on IVF, I would say most of the advice can be used at any stage of infertility. I wish I'd found this one just before starting IVF instead of after one full cycle. In this case, the author is neither a doctor or psychologist, but just a regular person who went through IVF several times. She talks a lot about both her own experiences and those of other women she met along the way. Not everything in the book will apply to all people (I found I did not relate one iota to the section on superstition, but apparently some women do become superstitious during this process) but you should find that the majority of it is very helpful. She focuses on putting yourself first, 'editing your world' (such as avoiding baby showers if they make you uncomfortable), and the mind-body connection. This is again one that is good to read once, but more useful to reread & reference as needed. She also references lots of other resources along the way.
----
I've started reading a lot on infertility though recently I've been focusing on the emotional/mental side. Intially most of my personal research was online (faster, easier, free!) though I've read a few books too. I'm pretty much through all the basics of fertility treatments, so I've skipped to the more in-depth IVF books. For anyone going through fertility issues or close to someone going through it.. I recommend the following books. I have also ordered a few others. I'll update later once I've read those. (These link to Amazon just b/c I copied the titles from there to speed up writing).
1 - Conquering Infertility: Dr. Alice Domar's Mind/Body Guide to Enhancing... By: Alice D. Domar, Alice Lesch Kelly
This one was recommended to me by my therapist. I started seeing her b/c infertility is one of her specialties and around last fall I started having a harder time dealing with my feelings about this process. She recommended this book in one of our first sessions. I skipped around a lot as I read this.. depending on where we were in our cycles. There are a lot of coping skills that are mind/body techniques (google mind body medicine if you want to learn more) plus it shares a lot of stories from other women. I suggest reading sections as they apply to you (I think it would be very stressful and upsetting to read the chapter "When Miracles Don't Happen:Coping when Treatment Fails" in the midst of treatment. But I flipped straight to that chapter the day after finding out our IVF cycle did not work). I also have found this book to be the kind of book that you want to reread, specifically if you are having trouble in certain areas. The chapter titles are very helpful in directing you to sections you need most. The day I got the book, I skipped ahead to 2 chapters.. first "Coping When Everyone But You Has a Baby" and then "Infertility and your Career". At that time, those were the two areas I was struggling with most. I definitely recommend this one regardless of where you are in your fertility struggles. It is not IVF specific.
2 - Nurturing Yourself Through IVF: Improve Your Experience, Maximize Your Odds of Success [Paperback] By: Lynn Daley (Author)
I found this one on Amazon as I searched for books that were more focused on IVF. Many of the other books I had found were too basic. IVF is one of the more advanced infertility treatments and as such, it can be more difficult to deal with both the physical & emotional aspects. I wasn't sure what to expect from this one but was pleased with it. Don't be disappointed when you see it, as I was initially, it is very short but worthwhile. Daley expands on (and references frequently) Domar's concepts from Conquering Infertility. Though this one does focus on IVF, I would say most of the advice can be used at any stage of infertility. I wish I'd found this one just before starting IVF instead of after one full cycle. In this case, the author is neither a doctor or psychologist, but just a regular person who went through IVF several times. She talks a lot about both her own experiences and those of other women she met along the way. Not everything in the book will apply to all people (I found I did not relate one iota to the section on superstition, but apparently some women do become superstitious during this process) but you should find that the majority of it is very helpful. She focuses on putting yourself first, 'editing your world' (such as avoiding baby showers if they make you uncomfortable), and the mind-body connection. This is again one that is good to read once, but more useful to reread & reference as needed. She also references lots of other resources along the way.
3 - Is Your Body Baby-Friendly?: Unexplained Infertility, Miscarriage & IVF Failure - Explained and Treated [Paperback] By: Alan E. Beer (Author)
I found out about this book from my online friends, specifically from the leader of a bulletin board that I frequent. [Sidebar: I've read lots of other message boards in the past but found they became an obsession, not only for me, but for the other women. When I was going through the last 3 or 4 rounds of Clomid, I joined a board focusing on Clomid. Though I thought having other women in the same boat to talk to would be helpful (and it usually is), this was not! These women posted to the board at least daily, but often more than that. During a Clomid cycle, you must take medicine for several days (for me it was days 3-7) and then you 'try' at home during a certain timeframe. Then you wait. And wait. If you are reading and posting daily, you will go crazy during a Clomid cycle. Though you can never truly forget about trying to conceive, I found during Clomid I had to distract myself. Reading & responding to those posts so frequently actually made me feel worse instead of better. Point of the story is that online message/bulletin boards are useful, but find one that is helpful for you, if you feel worse after visiting your board, then maybe you should move on.] Anyway, the leader of this board has had several (about 5 I think) failed IVF cycles and is a few years younger than me (this is not the norm with the women I meet.. usually they are older than me). She has reached a point where they cannot figure out why IVF will not work. She's going to a specialist in IVF failures now and one of his colleagues, Alan Beer, wrote this book and was founder of Alan E Beer Center of Reproductive Immunology and Genetics. She caught my attention when she mentioned a family history of Rheumatoid Arthritis as my DF was diagnosed with RA in his early forties. I've not received this one yet (should be here any day now) and I'm anxiously awaiting it. Beer focuses on the 5 types of immune system responses that can cause reproductive failure (including IVF failure & miscarriage). This link was also mentioned in "Nurturing Yourself Through IVF" (previous review). I'm hoping to get through this one before our next consult with the RE. At the very least, I will be asking him about this type of testing. I don't want to go another IVF cycle without at least testing for this immune problem in case it could help us with treatment.
moving on..
We've made an appt. with the RE to see what our next steps will be. When we had our first consult with Dr Toma, we came up with a treatment plan that included 2 IUI cycles, 2 'fresh' IVF cycles and then 2 'frozen' IVF cycles (sometimes called FET). Since we've done 2 IUIs, and 1 IVF, we expect to give IVF another try. Unless there is some medical reason why he changes his recommendation. So, we meet with him on 3/19.
Saturday, March 03, 2007
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