Monday, August 29, 2016

Official ERA Results

It was a really busy day at work and I almost didn't realize another day has gone by without results until my drive home. It really helped to no longer be angry; what a relief. Anyway, I figured it's been long enough and it was time to email the doc directly. 

So at about 5:15 PM I emailed a simple message: Hi Dr. X, We were advised on Thursday that you will review the ERA results and give us a call. Since it's been a few days I wanted to follow up.  Please let me know when we can expect your call to go over to the ERA results and discuss next steps. 

See? Not bitchy or demanding at all. I honestly just wanted an estimate.  

He responded a few minutes later:  Will call now. Send best number to reach you. 

Cool!  

A few minutes later he called. Turns out he took off the weekend and he apologized for not getting back to us sooner. Awesome. That's all I needed. It didn't even bother me anymore that it took a while to get back to us. I was happy he responded and that we got our results. 

So now... on to the results. The uterine lining came back as not ideal, in other words pre-receptive. As suspected, there are two options: option one is to repeat the test delaying the biopsy by one day to confirm "receptive lining." Option two is to do the transfer one day later without repeating the test. I asked what his recommendation is and he said it's totally up to me. I asked what do other patients who do this test do generally. He said there is no "generally" since they do this test so rarely. After I pressed a little more, he said if you're going to to do the test you should do it until you get a receptive lining. It's an optional test and an added expense, but if you're going to do it you may as well do it until you get receptive. I agree with that. 

My husband and I decided to do the second biopsy to confirm the exact day. We're not interested in wasting money, and I'm not thrilled about delaying another six weeks, and I'm certainly not excited about another biopsy. But. But I'd rather do all those things rather than risk wasting an embryo. 

I want to go into the next FET knowing that we did everything possible to succeed. If this is what it takes, it is what it is. 

I'm really ok with this plan. I hope I don't get worked up halfway through the cycle and freak out about wasting time/money/meds but know I probably will. 

The upside of this delay in results is that baseline is at the end of this week. Onward.

Education

While reading other blogs I come across a lot of information. Some of it is fertility related, some baby stuff, some social issues that come with fertility stuff. Since there is such a plethora of information, I try to absorb what I can and file away "Google later" things that can wait.

I know there is a lot I don't know about pregnancy and babies. I figure when the time comes and it's relevant, I'll take the time to research it. So when I noticed a hot topic issue going around the preggo IVFers, I filed it away in my Google Later pile in the back of my mind. It's so much information and it's not even relevant to me; I'll look it up when I get pregnant.

Over the weekend I got a rash on the back of my ankle. It wasn't terrible, but it was itchy and annoying. At first I thought it was a mosquito bit (ahhh zika?!) but then it started spreading a bit. My initial thought was to ignore it, but it happened to be that my husband wasn't feeling well and needed to see the urgent care doctor so I went along and had my rash looked at. The doctor couldn't pinpoint what it was. He did, however, recommend that I get a tetanus shot on the off chance it was a bug bite of sorts. Since it's been so many years that I can't even remember when my last one was (certainly not in the last 5 years, probably not even last 10), I said sure.

As I walk out, I get a sheet explaining the shot I just got: Tdap. Hey, I recognize that! It's the thing going around all the blogs now! I didn't realize they give a combination tetanus, diphtheria, and pertussis vaccine. Turns out it's a recommendation for women to get it late in their pregnancy so that the baby gets immunized from it as well. Rather, that's the controversy - whether to get it during pregnancy or after, and whether to get all the family members in contact vaccinated also.

So I guess it was relevant after all. Not sure what this means for future pregnancies. I know that I wasn't supposed to TTC for a month after getting the MMR shot but I think that was because it was a live vaccine, as opposed to this one which is safe for pregnant ladies.

Does this mean they baby would be immune since I just got it? Would I have to get it again after 30 weeks? I know exactly when my husband got his Tdap shot because it involved a situation we won't get into, so I know he's covered. I'll ask all these questions when it's relevant, but it's interesting how things come around full circle.

This time it worked out fine, but I realize if you wait to get educated on things then by the time it's relevant it may be too late.

Sunday, August 28, 2016

Quickie update WL

Not much to report on weight loss. I've only lost half a lb since the last official weigh in. I lost my motivation when I realized the FET will likely be delayed because I may need a second ERA. I did pick up a bad habit: morning coffee.

I discovered it's a great breakfast to get out the door. It's quick. It has the caffeine for energy, a little bit of milk for protein, and it's warm and filling. It usually keeps me until 10:30 AM or later when I have my morning snack of sugar snap peas and baby carrots in hummus.

I never used to drink coffee and I don't think it's a great habit to get into so I know I need an alternative. I should go back to smoothies. Maybe I'll try that this week.

Weekend

This weekend had a lot of what I needed: sleep, unhooking from all screens, spending time with people I love, walking, and lots of delicious food.

We had a potluck lunch at my sister's for a family birthday and among other things, I was in charge of dessert. I brought fresh fruit, two mousse pies (one chocolate and one vanilla) which were divine, and the winner was the mini cinnamon buns with cream cheese frosting. I am a huge fan of baked goods already but these came out really out of this world.




Mini cinnamon buns.... with cream cheese frosting


They were perfect. Even though everyone was full from lunch and the relatively heavy mousse pies, we still finished nearly 2/3 of that 9x13" pan of cinnamon buns. If you like baking, or eating delicious baked goods, I highly recommend this dessert.

I also did a lot of thinking over the weekend. As much as I feel aggravated by the doctor and his lack of phone skills, I notice I still defend him when someone trash-talks his indifferent behavior. I know I technically CAN move to a different doctor if need be but I'm not ready. The trapped feeling I have is due to needing fertility treatment in general, not necessarily this particular doctor.

I worry that changing doctors may delay the next steps somehow, as though they'll insist on repeating all the prelim testing for which we already have answers, instead of moving forward and picking up where we left off with this doc. If I was unhappy with the medical care I was receiving, that would be an acceptable delay. But the part I'm unhappy with is the manner in which he communicates. He relies too heavily on the nurse to do the majority of the communication and when he's needed to step in, he doesn't do it on my timetable. I could change to a different doctor with a more hand-holding bedside manner, but will that get me to my goal any faster?

In full disclosure, I realize that this is a common theme with this clinic. Before January I was assigned to a different nurse. I felt like she was distant and had a robotic, detached demeanor. There were several mistakes that she made that I felt warranted a complaint letter. This happened before I started the blog so I have nothing to link to, but suffice it to say that I was ready to request a new nurse then. It happened to be that I held off with the complaints wanting to think it over and in January she was assigned to a new office and I got the nurse I have now, which I love. Fast forward to a few weeks ago, I was ready to request a new financial counselor because of all the things she did. The issues are real issues and my complaints are valid, but I'm noticing a pattern here. Either everyone is incompetent or I just have extraordinary expectations.

So I need to be prepared to keep going to this place and know that I have to keep a vigilant eye on things because they tend to screw up, or I need to cut my losses and start looking for another place.

I'm inclined to give this doc one more chance simply because I don't want to lose sight of the big picture, which is trying to get pregnant with a healthy baby. We finally have a thread to pull: we were told my uterine lining is pre-receptive. We just found out we have a variable we know was wrong in the protocol. Changing it may be the key to finally getting somewhere on the road to having a baby. Do I want to put the brakes on that while I yell at him for not calling soon enough? No, that's not helpful and will not get me what I want.

Is his manner frustrating? Yes. Could he be a better doctor? Probably. But I am willing to look past this so we can move on to the next steps. I don't want to hold a grudge, I'm not interested in being mad at him, and I don't need the added stress of thinking about switching right now. I know this is probably not the last time he'll disappoint me, but my wanting a successful pregnancy supersedes all the disappointed feelings.

Putting things in perspective has really helped calm me down. It's hard not to lose the forest for the trees, especially when everything is so emotionally charged.

I am a big believer in stepping in and advocating for yourself, which has proven helpful time and again along this journey. But I also believe in balance and picking your battles. There is a time to fight and there's a time to be patient, and right now is the time to put away the boxing gloves and sit tight.

Friday, August 26, 2016

Still no call

I haven't heard from the doctor yet. I read all these fertility blogs and they all talk about how their doctors go out of their way to make them feel comfortable and supported. I get none of that from my doctor. He's a world-renowned clinician but when it comes time for anything related to the phone, he's the worst. The most recent time I felt like he didn't give me the time of day was after the chem pregnancy beta results came back and I was a complete mess. I attributed that situation to my hormones, misplaced sadness, and extraordinary circumstances that were beyond his control.  After the wtf appointment I felt better.

Until now.

Now I'm angry.

Our results from the ERA were delayed to begin with. There was anxiety already. Finally on Thursday morning (five days after we were expecting the results to begin with), my nurse emails with the results and that "I put those results on Dr. X's desk for review and he will contact you to discuss." That was at 7:44 AM on Thursday. That evening, I emailed her back and said that I didn't get a call. Maybe I misunderstood?  Was I supposed to call him? Should I have scheduled a phone appointment? Her response came back at 7:53 AM this morning, "No need to make a phone appointment. He will call you." Yet, it's now Friday evening and still no call.

It bothers me that I've been on pins and needles for nearly 48 hours waiting for these results. It bothers me that I haven't allowed my phone to leave my sight for more than a few seconds for fear that I might miss the call when it finally comes. It bothers me that the earliest I'll hear from him is probably Monday, and even then there's no guarantee.

What kind of service is this? You'd think they were doing me a favor, as though I wasn't paying thousands and thousands of dollars for their services.

It bothers me that I feel trapped because it's the best clinic, and he's considered the best RE. It bothers me that I'm stuck with them because they have my embryos. It bothers me that I'm stuck with them because I still need them.

I'm so annoyed and frustrated. It's so unfair to keep people waiting like this. No matter what benefit of the doubt I try to give him, it still doesn't excuse this kind of treatment. If he's on vacation, or has a family emergency, or is swamped with patients... whatever the excuse is.... he could've told the nurse to pass on the message that he is unable to talk immediately and he may not call for a few days. What is this madness keeping someone waiting for results???

This whole ERA process was a cluster from start to finish. Everything along the way was awful - from the financial, to the scheduling, to the appointment itself, to the checking out of the appointment, to payment, to results.

It pains me to think that we have to go through this again. Or do we? I assume I know what are options are but I don't really know because the trained medical professional has yet to call me.

I know I need to calm down. I'm so frustrated and infuriated at this trapped/dependent feeling that we're stuck with him that I have hot angry tears simmering just below the surface. Should I switch doctors? Should I complain to the office manager? Should I just suck it up and wait to get pregnant? Are my expectations just unrealistic?

Let's say I write him an angry email. Then what? What am I expecting in return? He'll say sorry? He'll write back, "Oh I don't have your file, talk to you Monday." Anything he writes will make it worse.  But a thought came across my mind that what if he doesn't even know he needs to call me? Then I thought that of course he needs to call. We have a baseline appointment next week and we don't even know if it's for another ERA or an FET. Plus the nurse would have made sure that he knew. He knows. Maybe he's ashamed for being so wrong about nothing being amiss that that we should "just keep transferring." Yeah right.

It seems like he doesn't care at all. He's won awards for his work, he has 20+ years of success. He has a pristine reputation and has nothing to prove. What's in it for him to be a good doctor? He's got no incentive to see us succeed. He gets paid regardless. In fact, the more we fail the more he gets paid. He's basically got no motivation to keep me happy or help us get pregnant.

He'll apologize, come up with some dumb reason why he didn't call sooner, and then we all have to move on because we still want to have babies.

I'm so sick of this. I'm sick of this clinic and all their bs. I'm ready to move on from them but there's nowhere to go. I'm done dealing with the uncertainty of the unknown and the dread of the news of the next phone call. I'm done with fertility treatment and I just want to move on.

Shabbat shalom.

Thursday, August 25, 2016

ERA Results

After multiple calls to the lab and being on hold for a combined nineteen hours (only slightly exaggerated) with the most awful tingy music of the 90s, we finally got the results of the ERA: pre-receptive.

I'm feeling a combination of relief and disbelief. I'm relieved because we finally have an answer as to why none of the embryos stuck. They were being transferred too early! It's like hosting a dinner party: planning a menu and shopping for ingredients and cooking for days and setting the table just so and then having the guests show up three hours early when you're in your bathrobe in a mud mask brushing your teeth. Not yet, it's too early! All that planning and prep for nothing.

We got the results first thing this morning from my nurse who knew we were anxious to hear them but they still need to be reviewed by the doctor. Once he does he will call to discuss next steps.

I believe our choices are to repeat the test until we get a "receptive" result OR to guess the new transfer date based on their recommendation and hope for the best. While the thought of waiting any longer makes me want to jump out of my skin in frustration, it makes the most sense to give our embryos the best possible chance to repeat the test until we get a "receptive" result.

This means that we're probably going to do the second ERA in the end of September and not transfer anything before November. I don't like it. I don't want to wait. But I also don't want to spend October crying about another failed transfer if we don't do everything in our power to help it succeed.

The doctor was so sure that nothing needed to be changed. He was so calm that it made me feel like an alarmist who was just trying to waste money for fun. I honestly thought that the results were going to come back normal/receptive and that I was looking for issues. This just goes to show that you should always trust your gut. It is so important to do your own research so that you can make informed decisions and know what questions to ask.

I'm trying not to regret the three transfers that failed due to this error. They were a kapara. It happened. At least we didn't take his advice to "just keep transferring" and wasting the last two as well. Some people don't get this information until after 8 or more transfers. I consider myself lucky to live in a time when it's even a possibility to test for this.

Hold on, tiny embryos. Maybe we'll be together again for Thanksgiving.

Monday, August 22, 2016

On the Road Again

Our doctor is convinced that we have great quality embryos, good lining, and just need a bit of luck to get one to stick. According to him it's a numbers thing and the more times we try the more likely one will work. Sure, he has 20+ years of experience and multiple accolades in his profession, and maybe he's right. But I feel like I have to DO something.

We had three FET transfers. Three. Each one had a perfect uterine lining and a top quality PGS-tested day 6 blast transferred. Each one was perfectly timed and medicated per protocol. Only one stuck and even that ended in a chemical pregnancy.

In my mind, that is unacceptable. Some may say that if we were a "regular couple" that's the equivalent of trying 3 months in a row and doesn't it usually take at least a year of trying? To those people I say SHUT UP. Not really. I actually say: people trying naturally aren't timing it to the minute. People trying naturally don't know what their uterine lining looks like or its exact measurement. Trying naturally also doesn't filter out the embryos that are by nature incompatible with life or otherwise not in top shape.

It can't be anything to do with diet or health because women across the globe get pregnant all the time. Women who smoke, eat fried food, allergic to pineapple, addicted to crack, have 100 extra lbs on their body, with cold feet, or high blood pressure all get pregnant. So it's clearly something else.

I get conflicting thoughts when I hear of someone else announcing their pregnancy, especially another person in the IVF trenches. On one hand it's enormous joy and a secret glee: "If it can happen to her with all her issues, it can happen for me!" On the other hand I'm thinking that's one less miracle baby available for me. As if there's a quota of babies upstairs and dolling them out means less for everyone else to pick from. Both thoughts are insanely ridiculous, I'm fully aware of the absurdity. It's not only narcissistic to think that my future is directly linked to other people, but that also the world revolves around me and every act affects my life. It may be insane, but then so are superstitions and we still can't help ourselves, but I digress....

At our last wtf appointment, the doctor listed our options but not before starting with saying that he thinks the protocol is accurate and nothing needs to be changed. He offered doing an RPL workup, the ERA biopsy, or an endo scratch. He strongly advised against transferring more than one embryo because of the risk of multiples. He gently suggested that getting to a healthy weight is always helpful. I get that. I agree that it's true and I believe he said it because there literally was nothing else medically preventing a pregnancy.

So do we continue "just trying" forever? No. We will try something different every time! My way or bust!!!! Not really, but it makes me feel better to think I'm in some control.

First, we did the RPL workup. It's a simple blood test and there's no reason it's not part of the prelim testing done before you even start. Done. No issues found.

Second, we agreed that spending the time and money on an ERA biopsy was worth it. There's no point in wasting precious embryos on a transfer if we have the day wrong. Even if we hear back that the timeline is correct, at least it we have peace of mind and not wonder the what ifs in case the next one fails.

Third, if the ERA comes back that the timeline is accurate as is, we will try the endo scratch. We have nothing to lose.

If the ERA comes back that the timeline needs to be adjusted, we will adjust based on the recommendation and not do an endo scratch in that cycle - you can change only one variable each time. Like a science experiment! With my uterus! How fun!

That's the road map. If we still don't get pregnant after that, we're back to square one and have to think about IVF #5.

Sunday, August 21, 2016

Updates

ERA results got held up because the lab was missing paperwork. My nurse is out of town and apparently the one filling in let something slip through the cracks until I called on Thursday and she followed up on Friday, so now they have everything and we'll get the results by early next week.

The mail situation is resolved, for now. The adrenaline rush and stress relief from taking out my pent up anxiety was more cathartic than any cry I've had in the past few months.

One of the resumes I sent stuck: I have a phone interview scheduled for tomorrow.

I've come up with an excellent compromise for my gym dilemma. I realized I was willing to spend the $99 to avoid being locked in for a whole year, but I still had the travel time issue. So I decided to buy a step to work out at home. I used points to buy it so it didn't really cost anything. It was one of the packages being held up in the mail so I only got it on Friday when I picked everything up.

The medication billing error was escalated to the director and they came back with a reduction of 50%. It makes me believe that they recognize the mistake is on their end. I appreciate the reduction. I'm undecided if to let it be and pay it or continue to fight.

I'm happy to report that my plan to lose weight is on track. I'm down 2 lbs from my 20 lb goal. That's 10% and I'm pleased. I'm counting calories using myfitnesspal.com and every day is hard but worth it. I weigh myself daily but only count the Sunday readings for official measurements because of expected daily fluctuations. Overall I'm two lbs down and happy with it. Next week I hope to report another two lbs down.

Saturday, August 20, 2016

Badass

We haven't been getting our mail for a few days and even after calling the post office a few times I was told nothing was being held.

On Friday I happened to bump into the mail carrier and saw it wasn't our regular guy, so I'm thinking, "Ohh, ok. It's a noob who doesn't know what's going on." I asked her if she's been delivering all week, thinking it's a simple mistake. She said no that today is her first on this route but that our house has a hold on it. I'm like huh?? She's says, "Yeah and you have a few packages waiting. There's been a hold placed on 8/11 with no end date - just until it's picked up." I'm like, I know there are packages, I've been expecting those!!! More than that I was waiting for important paperwork from the clinic to start our next cycle. Us not getting our mail was potentially delaying a cycle. So instead of taking out my wrath on her, I thanked her and said I'll contact the post office.

So I called the post office and the lady who picked up was like oh yeah Mr. Blank put a hold on this address. I tried not to lose my shit on this lady.... I said he hasn't lived here in over 6 years (two owners ago), why are you holding my mail at his request?? So I told her I'll come by to pick up MY mail today and that she should take the hold off.

Fast forward to two hours later. When I'm able to take off work, I get to the post office and as I'm walking in a man is telling the manager that "Congress is going to hear about this" and he left. In a split second, I knew. I look at her, make eye contact, and ask her, "Was that Mr. Blank?" She said yes and I went after him.

In the parking lot I yelled out his name and he turned around, saw me coming and kept walking to his car. So I walked after him and yelled that he better stop using my address or I will call the police. He tried to take a picture of me because he was saying he'll call the police on me but his hands were fumbling with the his flip phone and it didn't work. I was so worked up I didn't even care, but I still had the presence of mind to take a picture of his car for the license plates but he didn't even have any!!! So I went back in the post office and filed an official compliant and picked up a weeks worth of mail.

Turns out he was holding my mail because he is waiting for paperwork to renew his license. Apparently he's been committing mail fraud with his prior address, my current address, until now. I don't know why the post office allowed this to happen but I put a stop to it and will continue to follow up to make sure it doesn't happen again. I filed a claim at the post office and also contacted the Maryland Vehicle Administration to file a complaint there.  For good measure we also put a lock on our mailbox, just in case. 

I felt like such a badass yelling at him in the parking lot. All the stress and anxiety I've been feeling all week that I was planning to take out on the poor post office employee who tried to explain this travesty was taken out on this guy. Clearly he is not 100% and it's one thing to commit fraud, but when it directly affects me and my life, the gloves were off.  He was directly responsible for me not getting my mail from the clinic. Getting between me and my babies?? Oh hell no. I came out swinging and he had a target on his shitty face.

Thursday, August 18, 2016

No news

The crown won. My permanent crown was put in this morning while we're still waiting for results of the ERA.

I don't understand what takes so long. My assigned nurse is on vacation this week but I called anyway to find out if results have come back yet. The nurse filling in left me a voicemail and said she talked to the doctor and no results have come back yet. She also said that she'll call the lab tomorrow to follow up.

I'm trying not to think too far ahead. The problem with fertility treatment is that the highs are so high which makes the lows so low. It's scary to hope.  Even at the lowest low, it's hard not to think about the future and continue to keep the hope alive. It's almost an addiction. After every negative failed beta, one of the first thoughts is, "So when can we try again?" and mentally calculate the options. It's a survival tactic. It's a way to deal with the devastating losses.

But how many times will we have to do this? How many more lows? How many more 2WWs will we have to survive through? Will we ever make it to the other side?

There was an accident and a set of glass shot glasses we got as a gift from my husband's grandmother had a tragic meeting with the floor. My husband's reaction? "It's just stuff..." as he sadly swept it up. "The thing about going through treatment is that it gives you perspective. You start to value the things that really matter." He is wise.

We had three healthy embryos the last cycle. We've already transferred one and it's gone forever as a failed chemical pregnancy. I know what I hope for next. Hoping is dangerous and scary but hope is also the fuel feeding the fire. As long as there's a chance, there's hope. 

Tuesday, August 16, 2016

Total eclipse of my life

Simmering just below the surface is an underlying annoyance. Easily provoked by the slightest inconvenience, I'm on edge and everything is ticking me off.

Annoying things:

- I got into a tiff with my husband about something stupid. I find something to pick at and lash out. Getting caught off guard, he lashes back and it's on. Not being hormonal and moody, he gets over it long before I do and I'm left stewing.

- I applied for two jobs on Thursday and haven't heard back. I felt like the shizzle applying and not hearing back makes me question whether I should have bothered.

- We haven't gotten our mail since Friday. UGGGHH. If it doesn't come today I'll have to call the post office and the thought of dealing with USPS employees is too much.

- Not sure why I'm so anxious for my mail, since last time it came they brought me a bill for $3600 in a "medication billing error" that I'm trying to sort out. I spoke to the contact person, I followed up on Friday, I emailed, I followed up again on Monday, and now I'm waiting for a director to get back to me. I don't have an extra $3600 lying around, and we're so careful about spending, so this feels like a noose around my neck.

- My coworker is grating on my nerves. She likes to think out loud and make sound effects and ask me for feedback on her thoughts.

- The High Holidays are coming up and I don't have a plan for shul yet. Our shul situation is complicated and stressing me out. If going to my in-laws was an option, I'd choose that just to avoid having to deal with this.

- My butt hurts from the latest round of PIO shots. I'm also back on the BC and it's making me nauseous and is partially responsible for my mood swings.

- We need to buy another car and we're procrastinating because it's a big deal and we're overwhelmed with the options. We're also terrible at haggling and don't want to overpay.

- Waiting for results sucks. It's been 6 business days. They said 10-14 business days for ERA results.

- The facebook highlight reels are getting to me. People on adventures, taking advantage of the last summer weeks. Families enjoying each other's company. Beach, fruity drinks, sunglasses, beautiful sunsets, happy tanned faces. I want a family vacation. I want to have my own family to take on vacation. I want to have money to spend on vacation instead of "wasting" it on fertility treatment. It wouldn't feel like a waste if we had anything to show for it, but we don't. Not yet, and holding on to hope feels like a heavier burden every day.

- My new diet is making me hangry.


As I was thinking about all the things that were pissing me off last night, I was in my bathroom when I heard the rain pounding on the pavement outside. I took a moment to step out of my bubble of misery to recognize that I'm being partially ridiculous. I have a house and a roof over my head. We didn't lose electricity in the storm and I have air conditioning. I have food in the fridge and clean clothes. There are people for me to love and people who love me.

I complain that we don't have money to renovate the bathroom, but we can renovate tomorrow if I felt like going into debt for it. I grumble about not being able to afford vacation but we choose to spend that money in ways that are more important to us, like finding out if our FET transfer window is right. I'm intentionally making choices from the options we have available based on the priorities I've set. I can't be upset that it's taking time to reap the rewards.

Sure, things aren't where I want them to be, but that's why you set goals and work toward them. Just because I don't have everything I want doesn't negate all the gifts I've received until now. I'm working on accepting things beyond my control and working through the challenges as they come. I feel justified in my sadness about not being successful in having babies, but I can't let that be the only thing that defines me. While it's overwhelming and always on my mind, it shouldn't eclipse everything else in my life.

Monday, August 15, 2016

Gym

As much as I want to avoid joining the gym, I haven't been motivated enough to work out at home and it's been too hot to walk/jog outside. I've researched several gyms and the best fit for me I've found is the one I used to belong to several years ago. The cost is $18.99 every other week and it's a full service gym with machines, classes, and clean locker room/showers. While the price is reasonable, the problem is the location: it's 15 min away without traffic, and rarely is there no traffic. It's closer to 25 min with traffic and I just can't wrap my mind around getting there/back and still to work on time.

It's a $10 joining fee if I sign up for a year. It's a $99 joining fee if I sign up for month-to-month. If I join for a year and want to quit, I have to pay the remainder of my year to get out.

Beside for the traffic issue, here are a few other drawbacks:

- It's a women's only gym, which is great for me but that means I can't get my husband to join in ever. Even if I join one of their other co-ed locations which are all further away I can only bring the same guest once every 30 days.

- If I get a new job and it comes with a gym membership, this will be wasted. Big IF, but still a consideration.

- If I get a new job, my schedule will be tighter in the morning and I can't commit to going in the AM anymore. Not going in the morning means the chances of going at all are slim to none.

- I had a gym membership before and it was an effort to get my butt down there because it was a commitment of at least 90 min (drive there and back and then the workout itself). What makes me think this is different?

- There is a new LA Fitness location "opening soon" in a nearby area. If I hold out maybe I can join there with my husband. I know that if we're in it together both of us will benefit. But what does "soon" mean? They don't have a timeline posted anywhere online.

Every time I consider the pros and cons I always come to the conclusion that it's probably not worth it. On the other hand, if I'm willing to burn the $99 joining fee, I can try it out and quit without commitment if it's not working out.

There are also other locations closer to me, like $89/month at a place 10 min away and another one for $94/month even closer without any traffic lights even. There is another place for $29/month for first six months and goes up to $44/month after that but its biggest draw is the tennis classes. I'd love to start tennis but I also want the machines and fitness classes, and this place doesn't really have it. Their machines and weights are outdated and gross. I went for a tour and didn't even want to use my free 2 week trial.

I don't like working out where other people have been. It grosses me out to think someone else sweated or farted right there. This isn't going to stop me if I feel like joining a gym is the right move, but it's a consideration I'm trying to stuff to the back of my mind so that it's not stopping me from making this decision.

No matter what I need to get motivated to work out so that I can stay fit and lose weight. Either I have to suck it up and go to the gym or get off the couch and brave the heat outside. I'll take it one day at a time and see how this week goes. If I get get myself to work out at least 3x this week, I'll hold off on joining the gym.

Sunday, August 14, 2016

Tisha B'Av

Spotting started on Thursday evening with AF on Friday. I emailed my nurse to get an updated protocol for September. It's the same whether we do an FET or a second ERA but it's better to get on the schedule sooner rather than later because the lab calendar fills up and there's more flexibility the sooner you schedule. My nurse is on vacation this week but the nurse covering for her sent me the info and said we'll just tweak it if necessary, depending on ERA results. I didn't understand if that meant we're doing an FET regardless or if we'll tweak it based on the ERA results for when we repeat it. I didn't press the issue because that will be answered when we get ERA results.

Today is Tisha B'Av. I'm usually a pretty good faster but it's more difficult during my period. I feel drained and thirsty. It's also 100 degrees outside so I've been home avoiding unnecessary movement.

I placed the laziest grocery order ever. I went online on Amazon Prime Now and saw what they had available in my zip code. I was able to get almost my entire regular shopping: fruits, vegetables, milk, yogurt, some fun salad toppings, OJ, and bottled water. I was craving orange juice for after the fast but didn't want to go out which is what inspired the order, and then I had to fulfill the $20 minimum to get free delivery. So easy. It was at my door in ice packs within two hours.

Amazon also came out with Amazon Fresh but that costs more money where as Prime Now is included in regular Prime membership.  I think Fresh has more options but this was perfect for what I needed today. The groceries I bought were more expensive item-for-item (i.e., $4.19 for a 24-pack of water instead of $3.49 I usually spend) but overall I saved money from not getting extra things not on my list like I normally do at the store.

Last week I started applying for jobs. I've debated for a while about my job (see Leaning In and Weepy) and I think it's time to face reality. As much as I hope a pregnancy is just around the corner, it may not be happening that quickly. While there are a lot of perks to my current job, I just can't deny the fact that I'm ready for a change and I don't see room for growth.

If I were to get pregnant, it makes sense to stay put and have the flexibility in a job I already know. I still don't regret giving fertility treatment the priority over my career. I still have 30+ years of career ahead of me and I can afford to cruise for a year or two while I build up my resume.

A few opportunities presented themselves and I decided that it doesn't hurt to apply. I have a number in my mind that I'd be willing to give up my current job for and if the new job offers it, I see that as a win-win. I have no interest in wasting their time or mine with an interview so I am seriously considering a switch if it makes sense overall.  I know that they are interested in someone with my background and skill set and thought it might be a good fit. The job is a lot less customer-service oriented and more about numbers and spreadsheets -- definitely my cup of tea. I'm the nerd who took an extra statistics class as an elective in college. Just for fun.

So we'll see. There are a lot of pros to my current job and it would have to be a great opportunity to leave it, but I'd be dumb not to even consider something new just because of my current job's perks. I have my annual review coming up at the end of August. If I have a new offer at that point I can use is as leverage for a higher salary, but is that what I want?  I have time to think about it.

In other news, my palm started twitching weirdly at the base of the thumb. I googled it and of course the answer was hand cancer, epilepsy, or the start of Parkinson's. OMG relax Google. I decided to see if I'm doing anything specific to trigger it and realized I was using the mousepad on my laptop with my thumb as the anchor which keeps the muscle tight for long period of time. Stopped doing it and the twitching stopped. Thanks Google.

Thursday, August 11, 2016

Participant

I've been derelict in my housewife duties in that the house needed a good scrubbing so I hired a cleaning crew. They came yesterday and everything was amazing, except one thing: they took my vacuum cleaner. I'm still awaiting its return. Let's be honest, I'm not in any rush to use it - haven't in a an embarrassingly long time. But it's still mine and I want it back.  I'll still use this company again. They are reasonably priced and do an excellent job. I felt some of the Ramona Raincloud attitude lift when I came home and everything was sparkly clean. 

No update yet on the ERA. It's been 3 days and they said 7-10 business days. Waiting for AF now and will get a new timeline for a transfer or second ERA as soon as it comes. 

No news on the crown. Other than my jaw being slightly sore from the numbing shot, no issues. Even that is getting better as the week wears on. 

I was determined to do my best to have a good day yesterday and it started with telling my needy coworker that I need an uninterrupted hour without questions from her while I work on a report. If I had an office door I'd just shut it but I work in an open area and that's not an option so it was the next best thing. It worked and I was able to meet my deadline, but I could tell she was hurt. I would usually care a lot about that but these days I'm in survival mode trying to get through one day at a time and I have to prioritize my needs. 

I'm debating about how to ask for a new financial counselor at the clinic. I definitely don't want to deal with the person we've had since January since we've been screwed twice now. But I know how the office is structured and I don't think we can get a new counselor unless this one gets fired. While I want to put my best interests first, I don't want to be the cause of someone losing their job.  I'm waiting to see how things progress and take it from there. I have enough on my plate now that I can afford to put this on a back burner until I can figure something out. 

In regard to the medication billing error, I started the conversation with the pharmacy and it's already been escalated up to the director. I shouldn't be penalized for someone else's mistake and I'm making sure they know I'm displeased about it. 

Yesterday was my grandmother's yaratzeit. She was a very important part of our family and is incredibly missed. The family whatsapp group was full of stories and memories. :'(

I feel like staying home in bed and watching TV. I don't know if that's because I don't want to go to work, because I want to watch the Olympics, something else, or a combination of all of those. Avoiding people definitely won't help me get out of my funk, so I got dressed and went out into the world. I'm not quite aiming for the gold yet. I doubt I'll even medal, but I'm sure gonna earn my participant sticker. #participatinginlife

Tuesday, August 9, 2016

Challenged

I'm feeling challenged today. I had to go in to work because I have deadlines coming up but I think I could have benefited from another day off.

Physically I'm feeling fine, just a little sore. My jaw is sore from keeping it open for an hour and the numbing shot. I'm having some minor cramping but I think those are pre-period from stopping the meds rather than the ERA.

It's more of a mentally challenging feeling. I just wanted to zone out and quietly get my work done but people kept annoying me with needs and questions and thoughts to share. Someone came over to ask whether she should get a new stroller she found a deal for on a sketchy website. Not only was it not even work related, but I'm also really not in the mood to discuss strollers right now.

I'm stalled on a project because a coworker is delayed on their part of the project and I can't start mine until I have theirs. I also got an email asking me where critical documents due today were and I responded that I sent them on Friday but the coworker that was supposed to pass them on after review dropped the ball. None of these are actual issues on their own, but when I'm already agitated and annoyed, each one has been an explosive situation in my mind. So much so that I started looking at job listings late this afternoon.

It didn't end there. When I got home I checked the mail and got a letter saying we owe $3,600 for a medication billing error. I don't know what happened, and I plan to look into it and raise some hell, but it was too much to deal with and just tipped me over the edge into a sobbing mess.

It's a bad day and I'm on edge waiting for results. I know that logically. It's just all very overwhelming and challenging right now.

Monday, August 8, 2016

Big Day: Part II

Crown appointment done! It actually wasn't so bad. The whole thing took 55 minutes from start to finish, including getting numb and digital impressions and temp crown. It wasn't painful, only a little uncomfortable. In short, it was better than expected. I was told the permanent crown will be in in 10 days, so it's now a race between the crown and the biopsy results.

Speaking of the biopsy, I have an update. Turns out the financial advisor was wrong AGAIN only this time it was in our favor! Turns out the clinic part of the fee is covered by our insurance and I should never have been charged last week because that fee goes to the lab doing the biopsy. So it is actually the original fee quoted of $875 and all the drama was completely unnecessary.  Whatever. Yay!

My lip is still numb and I hate it but I know it will hurt as soon as it wakes up.  I'm exhausted. I feel like I took a beating today. It was a long day and I'm ready for a nap.

Big Day: Part I

Today is the big day! ERA is happening at 10:45 AM. I'm excited and happy: for the first time in weeks I feel like I'm doing something to progress toward our goal. I'll continue updating as the day goes on.

I left a little early this morning because I was jittery. I knew that I would find something to do or some errand to run and preferred to be early rather than late. It's a good thing I did leave early because there was heavy traffic and a trip that should have taken 10 minutes took 20. Beside that, the elevators at the clinic were being cleaned so only one elevator was working which also took a few extra minutes. I got there at 10:40 AM for my 10:45 AM appointment. Score one for me.

I can tell that the clinic doesn't do these very often because there were a few hiccups.

First, when I checked in the receptionist asked if I'm there for bloodwork and ultrasound. No, I'm here for a biopsy. She had to go check and see what paperwork I need. She found something and had me sign it.

Second, she asked me to report to the lab to give a urine sample so they can run a pregnancy test. I wasn't told to prepare for that and I had emptied my bladder right before. I chugged some water and squeezed something out.

Then they took me back to the room and there were three nurses helping because there were questions: about the paperwork, about which instruments are needed, about payment. Why are any of these things a question - shouldn't you guys know all this by now?

I had to fill out paperwork that goes with the sample itself and as I was filling it out, a nurse comes back and says that the doc is ready so I should get undressed and we'll figure out the paperwork after. This was 11:00 AM and I get that they wanted to keep him on schedule. Everything seemed very rushed. The doc seemed to know what he's doing so that was reassuring.

The ERA itself took less than 3 minutes. I chatted with the doc for a minute about his choice of a pink shirt for the day and then he requested a specific instrument from a nurse. Once settled he put in a speculum, which was uncomfortable but nothing I've not had before. Then cleaned out the cervix; again uncomfortable but familiar. A few seconds later I felt the scratching on the inside of my uterus and even though I was expecting it, it caught me off guard and made me tear up. It was only a few seconds worth of scratching, if that, but the cramps continued for another minute afterward even after I sat up. Hours later I'm still feeling period-like cramps. I was still tearing up when the doc was leaving the room and he said, "Oh I made you cry, I'm so sorry." I responded with, "It's not the first time..." trying to be funny but failing miserably because it sounded more like I was trying to get back at him for hurting me.

The nurses gave me a few tissues and the rest of the paperwork to fill out and said I can take all the time I need to clear the room. When they left and closed the door I took a minute to sob -- not because I was in pain but because I was sad that I had to go through this, and I was embarrassed that I cried in front of everyone, and because I knew that if I didn't then I'd be on the verge of tears the rest of the day -- and then filled out the rest of the paperwork and got dressed. I asked for a copy of the paperwork and went to check out.

Further evidence that they don't do this often was that at checkout I was asked if I know how much I owe. I said that I was told the procedure cost was $875 and I had paid it in full when I came in for the lining check last week. She was telling me that the cost to the lab was ALSO $875 and that I had to give my credit card info to submit with the paperwork in order for the sample to get processed. I already had a foot out the door and wanted to get out of there, so I gave her a credit card number and said I'll contact the financial advisor directly, who told me the exact fee (and which we based our decision off of). There's no way that the advisor quoted me $875 when the fee is actually $1,750.... right???

Turns out the financial advisor has screwed up once again. Here's the first time she messed up. It actually does look like the $875 is only on one side of the biopsy. The lab charges the same amount as well on their end. So we are being charged twice what we expected and only find out about it after the biopsy is already done which is too late to do anything about it. I'm so upset and I can't stop crying. I know "it's just money" but I'm so annoyed that this keeps happening! How can they be so callous about information to patients?! It's not only hundreds of dollars that I wasn't expecting to pay, but now that we've decided to go down this route if we need to repeat the test based on the results it's going to cost another $1,750!!! What are they thinking not giving patients the full information?

So, being pissed as all hell and hormonal to boot, I sent a scathing email to the financial counselor, her supervisor, and her supervisor's supervisor. I don't care - I'll escalate it to the President if I have to. This is an outrageous injustice and I won't have it. Her email basically insinuated that we should have known to call the lab to find out that there was an additional fee on their end. I don't even have words to describe the nerve of that statement.  We should have known? That's your freaking job!!!! YOU should have known to verify that before quoting us a price!!

No matter what the outcome of this is, I am requesting a different financial counselor moving forward. I gave her a second chance and she blew it. This process is hard enough without having these preventable issues come up due to incompetence.

So anyway... light cramping, minimal spotting, super hormonal, very upset. That was my morning. 

Crown appointment is up next in T minus 50 minutes. 

Sunday, August 7, 2016

ERA and crown

Tomorrow is a big day. The last PIO shot is tonight and tomorrow morning is the biopsy. We should get results back within 10 days. I also have a big dental appointment tomorrow.

We've already discussed the ERA so I'll tell you about my tooth.  In the past few weeks I've had a tooth bothering me. When I was young I had lots of problems with my teeth because I didn't brush. Once I got braces they taught me how to floss and told me that if I don't brush the braces will ruin my teeth (or some such) and ever since then I didn't have any new problems.  So I haven't had a cavity or dental issue in nearly 10 years... until last summer. I go for my cleaning every six months and the dentist is like, ok see you in another 6!

Maybe it's related to the hormones, or maybe not, but the issues started last summer, right around when we started treatment. I've also noticed that ever since we started treatment my nails have been less strong than usual and I have to take special care not to crack or chip them. So could it be a coincidence? Maybe.

In September I went to the dentist with discomfort in my upper jaw. He said there is a start of a cavity in my wisdom tooth. All four of my wisdom teeth erupted at around age 15ish and were perfectly aligned. I had no issues with them until that point. Because of the location of the decay, he said that it's not possible to fix it and recommended getting the tooth pulled. Since I was getting the top pulled I had to get the bottom one pulled as well. And if I'm already getting those two out, he basically recommended getting all four wisdom teeth pulled at once. What?? Get 4 teeth pulled for a tiny not-yet-cavity? Are you serious?? So I went for a second opinion and also asked one of my good friends who happens to be a dentist specializing in TMJ issues for their opinions.

Consensus was that the best thing to do was to get rid of all four at once before they become a problem later on because, and I quote, "They will eventually become an issue." The one that had the start of a cavity couldn't be fixed and it would just continue to decay until it hurt. Not one to procrastinate, I got on it and made an appointment.

In October, at age 31, I got all 4 wisdom teeth pulled out. Because they were all erupted it was actually a simple procedure and took all of 5 minutes once the local anesthesia kicked in. I didn't get the laughing gas or whatever it is that makes you loopy. I had the procedure done on Thursday morning and by Monday I was back at work. Minimal swelling, some discomfort over the weekend, but nothing too traumatic.

Fast forward to June and I start getting some pain in my lower right jaw. It's not a shooting pain but I noticed I was favoring my left side to chew and got headaches more often. I knew it wasn't going to go away on its own but it came and went so I kind of forgot about it when it wasn't actively bothering me. More recently it started coming up more often, especially when I had hot or cold food. As inconvenient as it is to get it checked, there's no reason to push it off: if there was an issue it should be dealt with sooner rather than later.

On Thursday I went to the dentist to check it out. Prognosis is that, due to grinding, a tooth with an old filling in it cracked. The crack can be fixed by putting a crown on the tooth. Crown runs about $1,375. In addition, the dentist suggested a nightguard to prevent grinding and future damage, an additional $450. Insurance will cover about 2/3 of the cost.



It's a sucky thing to deal with right now, but avoiding it won't help anything. If I don't take care of it now, the tooth will continue cracking and eventually also need a root canal in addition to the crown, or worse, needing an extraction. At least now the tooth itself is healthy and doesn't need a root canal.

I took the day off tomorrow for the biopsy because I have extra vacation days that are use-or-lose expiring at the end of the month. I was planning to go to the biopsy in the morning and then veg out the rest of the day. If I'm off anyway, and will be uncomfortable anyway, I may as well deal with this crown and get it over with, so that's happening in the afternoon. The permanent crown takes about 10 business days to come in so I may have to deal with a temp crown and mikvah but I'm not thinking about that unless it becomes relevant.

I hate it when my mouth and lip are numb so I'm expecting to be miserable and complain-y most of the afternoon. My husband has already been warned.

As for the ERA, I was told it shouldn't be too painful but who knows. I took the day off because I didn't know what to expect. I'm working on keeping my mind off the what-ifs of the results. I know that logically we decided to do this for multiple reasons so I just have to keep reminding myself those reasons. If anyone ever asks me in the future about ERA, I'll refer them to these posts and tell them they better be sure because the mental aspect is a big challenge. It's helpful to have a list of reasons to refer back to when the second thoughts start creeping up.

I'd be lying if I said I wasn't nervous. I'm hoping everything goes well tomorrow with no complications. Right now I'm watching Survivor on the laptop with the Olympics on the TV in the background while I write up this post. I love the Olympics and see no reason to have to choose between the two.

Wednesday, August 3, 2016

Down day

I've been feeling a little bummed the past few days. I can generally tell what's bothering me but I can't quite pinpoint what it is this time. There are a few things that are possible contributors.

Tonight is the first night of the PIO shots. It's harder and more emotionally draining than I expected to do a fake cycle with all the shots and appointments but none of the hope of a transfer.

I've been busy at work, but it's busywork. It's not challenging and I'm not feeling accomplished or motivated. I have my yearly review coming up. More on that in a future post.

My friends are busy with other things. Most of them are either dealing with their kids, or going on vacations, or just generally unavailable to hang out. It's a little lonely.

I've been exercising more and pulled a muscle in my back that's taking a while to loosen up.

I'm seeing newly preg people complain about nausea, heartburn, fatigue, and how nothing fits. I understand they're suffering and uncomfortable, I really get it. These are all real problems for them and I can't help but wonder if I'll ever have to deal with these issues. I think of how exciting it is for them that in just a few short weeks they'll be done with the first trimester and get to tell everyone their special news.

I started watching Cheers. I was curious about the show dubbed the most popular series of all time and since I was looking for a new show to binge watch it helped that it has 11 seasons. Y'know what? Some times it IS nice to go where everyone knows your name! I wish I had a place to go to relax and socialize with people I know and like. I'm up to S1:E4 and so far I don't hate it.

I've got too much time to think. Most people my age have so much going on. I feel like I could be doing better with my time. I think the hormones are also not helping. I dunno. Tomorrow is another day.

Tuesday, August 2, 2016

FedLoan sucks

We interrupt your regularly scheduled programming to complain about the worst student loan servicer. The WORST.

I have been calling FedLoan nearly every week since April to resolve an issue. Not only have I had to wait on hold for at least 20 min every time, I've also gotten conflicting advice from every rep I've spoken to.  If I try to resolve the issue by contacting customer service via email, I don't even get a response. When I complained that the last rep I spoke to said they did something and they didn't, the response I got was that I could easily go online and take care of it myself. I said (in a very loud and frustrated voice) that I would have had I known the rep messed up and didn't take care of it on the phone. Since the rep said it was taken care of, I had no reason to believe it was LIE.

Actually, it wasn't a lie; it was an oversight, a mistake, which is even worse. They don't even know what they're talking about!  I finally got to the bottom of the issue and will hopefully see it reflected in my account in 24 hours.  I still requested to be escalated to a manager and vented my frustration at her for about 5 minutes, ending with, "If you're not going to fix this issue t.o.n.i.g.h.t, please advise me on how to transfer my loan to another service provider." I was very calm and professional in how I yelled at her about her incompetent staff.  I know they're probably recording me "for training and quality purposes." Such BS.

Worst service ever.


Monday, August 1, 2016

ERA: lining check

Lining check appointment today went well. There was very little traffic and even though the waiting room was crowded, I was seen pretty quickly.

I made sure to drink a lot yesterday and this morning and bloodwork went smoothly with only one stick. Results are back and E2 is at 409 with low progesterone. Ultrasound was also good: lining is at 11.7 mm.

So PIO starts Wednesday and then biopsy is on Monday. Moving along.

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