If I had $5,000...

Every so often I like to think about what I would do with an extra $5,000. It's not millions of dollars winning the lottery which is so unlikely to happen. Five thousand dollars is technically an attainable amount of money, like a new job sign-on bonus or a crazy tax refund. It could happen.

Obviously I could only do one of these things, but in no particular order:

• Replace kitchen appliances
• Fancy yard landscaping
• Car down payment
• New furniture
• Living room
• Dining room
• Bedroom
• Home repairs
• Update fence
• Kitchen floor
• Kitchen granite 
• Bathrooms
• New roof
• New air conditioning
• Add bedrooms basement
• Redo floorplan upstairs
• Lasik eye surgery
• Invisalign 
• Vacation
• Throw it at the mortgage
• Put it in savings or lock it in something that earns interest

I think of all the money we spent on treatment and wonder if we'll ever have extra for any of these things. They're not needs, they're wants. We can absolutely go without most of them but it's fun to dream. I like having a wishlist and adding to it every so often. It may be boring but it's mine.

We've been living intentionally frugally so that we can do what we need to do to build a family while still trying to be financially responsible. It's kind of ridiculous to think about trying to stay out of debt when I still have an insane amount of student debt, but it's the principle of the matter. It's easy to let spending get out of control so we do our best to curb it as much as possible. The holiday season kind of put a monkey wrench in the budget so we're going on a temporary spending diet. It's a pretty trim budget to begin with but I know we could be more careful about grocery shopping and food waste so that will be our goal for November.

Thursday Thoughts

I'm feeling UGHGHGHGHGHGH. I don't know what I want.

We went straight from the holiday season into two events at work. Even though I work at a Jewish institution, nearly 90% of the employees are not religious. So while they know all about the holidays and everything they entail, they don't necessarily celebrate. For them, the past few weeks were vacation. Which means that they're ok with planning events on the day we come back.

For me, I'm exhausted. I'm getting over the holiday stress. I'm trying to catch up on work stuff I didn't do at home during the holiday season. I'm trying to catch up on laundry and dishes and getting the house back in order. I have a brain fog I can't shake and it's frustrating me.

We had the event last night and while I didn't mind working the event, I knew I had a million other things to take care of. I'm kind of over busy work. I don't want to deal with dumb minutia of someone else's ideas. I want to implement my own ideas and be excited about the tasks I'm doing because I came up with the path to do them.

It's times like this that I revisit the idea of getting a new job. I've talked about it before, here and again here. I want a new challenge, but I don't know what the challenge is. I want to have an interesting job that I find interesting and I can be proud of telling other people about it. If I think about it honestly, I don't really believe in the methods or agree with a lot of the organizations choices.

I like my direct supervisor who I work with on a regular basis. It's partially because of her that I've stayed as long as I have. My supervisor's boss, who is also technically my boss, is not someone I respect. I don't think I have any more to learn from that person. In fact, there are things I actually don't like that I want to make sure I don't learn, such as not respecting people's time.

I'm back to the age-old conundrum: do I leave and give up a lot of non-salary perks, like having a flexible work environment, many days off, short commute, etc. or do I try to find something more satisfying that has clearer potential for growth? It would help if I knew what it is that I wanted to do, or at least what my passion is. Ten years ago when I was in an entry level job I didn't think I'd be in an entry level job still trying to climb my way up a rung.

It could be I have a complex. I believe I am such a good employee that I should not only be getting promoted regularly, but that people should also be knocking down my door trying to recruit me to their company. I definitely think very highly of myself, rightly or otherwise. At the same time I am reminded of how grateful I am to be employed. On one hand, I have it so good that people are envious of my job and its perks. I am lucky and I recognize it. On the other hand, why should I settle? I could have it even better with a job I like, great perks, and an amazing salary!!! Right? Maybe?

I truly believe that I am able to accomplish anything I set my mind to. The challenge is getting started and figuring out what it is that I want to accomplish. What do I want? Do I want to stay in the same field? What are my priorities? Do I want to make lots of money? Do I want to work from home? Do I want to manage people? Do I want an anonymous cubicle job where everyone just leaves me alone?

I don't want power, but I want autonomy. I want repetitive work I can do while I zone out, but I also want exciting challenges where I get to be creative. I want to have responsibilities but only ones I like. I want a high paying salary. I want excellent health and medical benefits. I want an easy commute or the ability to work remotely. I want the opportunity for growth. I want to work as part of a team with a strong leader I can learn from. I want to manage competent, dedicated people. Am I asking for too much? Does this even exist?

When I was in college I knew exactly what I wanted.  I loved school and knew my exact path moving forward. I finished my degrees with honors.I finished my MBA with so many student loans but I didn't care because I knew I'd get a high-powered job and pay them off in no time. Somewhere along the way I detoured into the non-profit sector and kind of lost my ambition and confidence when we started treatment. 

The water-cooler rumors have it that there will be a major shift in my organization in the next 5 years. The details are vague but what I believe that means is that a lot of the higher ups will be retiring, opening a lot of positions in management. Is that enough to get me to stay? Am I patient enough to wait that long for a change? Will I be happy with whatever the change will be, assuming there's a lot more information that doesn't get trickled down via rumors?

Then there's the whole baby thing. Is it happening? Is it something to plan around? It's the proverbial elephant in the room. I started treatment thinking it will work eventually and so I should be patient because WHEN I get pregnant I'll want the work flexibility. But it's been a year. I've put my career on the back burner for a while now because of something that may happen. At this point I'm not sure it will happen so soon, if at all. I'm not sure I want to put things on hold for it anymore. If it happens, then I'll work it into my schedule, whatever that may be. I don't know that I want to pause life while I wait for my babies. In reality, I think I'm scared that I'll put 100% into having kids and if it doesn't work out, I'll not only end up childless but also in a career going nowhere because I waited too long to make a move.

I'm a believer in living life without regrets. I don't want to look back and say "should've" for anything. I know I will not regret putting everything I have into trying to have a family. I know I won't regret that. I want to make sure I'm making strategic moves for my career as well. I would definitely pursue an opportunity if it landed on my lap. The question is at what point do I go out and start pursuing a new challenge?

I think this transfer could answer a lot of these questions. The outcome may determine a few factors leading down a specific path. If I get pregnant, then the decision is made to stay put and keep the flexible schedule throughout pregnancy and until daycare starts. If it doesn't work, then I'll likely need to do more IVF rounds in the future, which means that I may as well start looking for another job with better health benefits that could cover future cycles. We'll see. Maybe there's secret option #3 I'm not thinking of that will reveal itself later on.

Open enrollment

In 2015 we nearly exhausted the benefits on my husband's insurance, so toward the end of the year we did our research about plans and decided I will go on my own employer's insurance for the year.

The start of 2016 was incredible stressful because we discovered that our financial adviser gave us wrong information. In short, she told us we would be covered for the reduced rate under my husband's insurance as long as he was still on it but I didn't have to be a patient on it to qualify. Turns out that was not true, and we were stuck the entire 2016 with very slim coverage for fertility treatment.

For 2017 I want to avoid a similar problem. It's worth it for me to switch back to my husband's insurance because not only are the monthly premiums more affordable but the coverage is better. In addition, there's a very slim chance we may have some fertility benefit left over. There is a lifetime maximum on fertility benefits which we were nearing at the end of 2015. When I sign up for benefits in 2017, I don't know if that counts as a new policy. If it does that means my benefits refresh then we'll get a new lifetime maximum. If not, then I'll pick up where we left off and just use up whatever is left over. Something is better than nothing.

I will try to confirm just so we know what to expect, but in either case I'm still planning to make the switch. Even after maximizing my lifetime benefits, there is still a reduced rate negotiated with my husband's insurance company and the clinic. So even if we are paying out of pocket it's usually 50% of the rate we would pay otherwise.

How do other people do it? Are there better insurance plans? Do most plans cover all fertility treatment?

I'm fighting for these benefits but in the back of my mind I'm hoping it will all be irrelevant. The maternity benefits are amazing -- covered at nearly 100% -- and I'm hoping that my focus will be on that in the coming year instead.

FET 4: Baseline

It's happening!!! FET 4 is officially moving forward. 

The official weigh in this morning was 5.9 lbs less than last Thursday's weigh in. The unofficial weigh in on my own scale showed I weighed 6.2 lbs less than last Thursday (in the same clothes) so at least now I know to expect approx a half lb different between the two scales.

 

I was nervous about the weight so I skipped breakfast or drinking water and of course there were issues getting blood. Lots of poking, smoothing, feeling, and two sticks later they had what they needed. They told me that they have to wait for the bloodwork results to come back to make sure I didn't ovulate during the last week which made me anxious all day waiting for results. 

My nurse called around 3 pm and left a voicemail. She sounded kinda bummed so at first I thought it was bad news but she said everything looked good. First shot was tonight and off we go.

I took a break from the strict diet for a celebration dinner with my husband. I think I'll get back to it tomorrow and stick to it a while longer though. It's been really exciting to see such fast results, and while I was drinking tons of water I never really felt hungry. We'll see - taking it day by day.  In the meantime I'm glad I was able to get accomplished what needed to get done to start this. I hope it continues with less anxiety.

Nervous

Tomorrow is my second baseline appointment and I've been worried and anxious all day. I've kept a really trim diet over the past week which was difficult over the holiday but I stuck with it.

This morning I weighed myself and there was no change from Sunday's weight, which was lower than the clinic's recorded weight by 4.2 lbs. I'm worried that it's not enough. I'm worried that there is too much of a difference in the two scales, both digital, but still. I'm worried that we'll have to wait an entire month for my next cycle to get started.

All day I tried to think of ways to get an 'edge' in case it comes down to a minuscule amount. Like, I was trying to contemplate what to wear that won't add extra weight. Since I couldn't stop thinking about it, I actually weighed the clothes I wore last week (weighed myself, then weighed myself again holding the clothing) to see that they actually weigh 1.4 lbs. Getting weighed unclothed is not an option.

I drank so much water today that I'm hungry and stuffed at the same time. I trimmed my nails because it was time, but when I thought of it I was like, "Oh, there go another few ounces!" I'll find some normal, light clothing and I'll shower tonight instead of the morning so my hair isn't wet. Once I started thinking that maybe I should trim my hair I realized I've taken it too far. It is what it is. If we need to wait another cycle, so be it. I hope it's not the case.

Chag Sameach

Sukkot is here! It's one of my favorite holidays. Miraculously, everything somehow got done in time. I give most of the credit to my lists.

Menu includes...
First dinner: lemon salmon and salads, mushroom beef barley stew, sesame cake
First lunch: Eggplant parm, carrot muffins, zucchini kugel, salads, pumpkin cheesecake
Second dinner: chicken soup, sweet and sour meatballs, rice, broccoli kugel, apple cake
Second lunch: Salmon and salads, lasagna, onion kugel, pumpkin pie

I made so much more than listed, but this is a skeleton menu I'm using for reference. Two meat meals, two dairy meals, lots of salads and variety. My husband's family is here for the first days.

In weight news, I've been on a low-carb/counting calories diet. I weighed myself this morning (after a day and a half of this diet) and the number on my digital scale was 4.2 lbs lower than the number on the clinic scale. Obviously they were full of shit (apparently so was I?) and it was just post-fast bloat. Whatever. I understand there are oscillations between scales. I also know it was just a day and a half so to make sure it doesn't oscillate back suddenly I have to keep up this salad parade for another few days. I've been eating mainly vegetables, some protein like eggs and chicken, and staying away from sugar and white flour. Really easy in theory; harder to execute in reality, especially during the holidays and when the house smells so good from all the challah. No matter: I will persevere. This transfer is happening even if I have to eat iceberg lettuce for a week.

I'm in a great mood. The sukkah is beautiful and the weather is gorgeous. I'm excited for the holiday and can't wait to get this transfer started.

Chag Sameach!

False alarm

I left the baseline appointment this morning upset and frustrated.

The financial counselor didn't tell me that we have a balance due from the biopsies, in addition to the fee for the FET. So I was surprised with an extra balance due of several hundred dollars that I wasn't expecting when I checked in for my appointment this morning. I tried to speak to the financial counselor but she was so unhelpful. She didn't email me in advance telling me it was due; she had no idea that insurance is supposed to be covering it; and she has a loud voice and was talking in the front hall near reception and the waiting room, so she was talking about my business in front of other people. The most frustrating part was that even though I know I'm right, if they don't financially clear me then I can't start the cycle. I paid the fee feeling my blood simmer, wishing this is the last time I ever have to deal with this person.

I later emailed to follow up about it and she said there was an insurance submission error, so they will be resubmitting it to insurance. I asked if I will get a refund once it's all straightened out and she tried to tell me that I would not since I didn't pay it. What is wrong with you, lady?? Luckily I had the receipt and I forwarded it. Now I have to keep an eye out on my account. Ugh.

After the financial thing, I got weighed and things continued to go downhill. My clinic has strict BMI rules. I am 0.1 points over their requirements as a max. I could say it was because of the fast yesterday and that I'm retaining fluid from eating the entire day's worth of calories after 8 pm. I could say it's all the water I drank in order to make sure they're able to do bloodwork. I could also say that it's partially because I've been on back-to-back cycles and my body is so bloated from meds. I could excuse it away but I know they're just excuses. I feel frustrated for knowing this might be an issue and not being more proactive to prevent it. I feel disappointed at myself for not taking care of something that is technically within my control.

To add to today's drama, my cell phone is not accepting voicemails and I don't want to miss important info from the clinic. In 2011 I signed up for Google Voice. I have never used my phone's voicemail app since then and have never had a problem. A few weeks ago my phone automatically switched to my carrier's voicemail app. Feeling like a dinosaur, I couldn't figure out how to get it back to the Google Voice app. I keep meaning to look into it but haven't had the time. Today I realize I'm not getting any voicemails at all and realize it's because my voicemail box is full.  UGGGGHHH.  I figured out how to delete voicemails in order to get new ones, but I'm still trying to figure out why I'm not linked to Google Voice. One more thing to deal with.

There is only one weeknight before sukkot which starts Sunday night. We're hosting my husband's family for first days. I'm so not in the mood, especially since I'm apparently on a strict lettuce diet now. We still have so much to do, and since the basement flooded last week, we still have to organize and rearrange everything.

On top of everything, today is the 1 year mark since our first negative beta. It was the first major blow and disappointment of our treatment ordeal. The first time our dreams came crashing down. The first time we dealt with failure. It was the first of several disappointing days in the past year, but it was the very first one that lifted the rose-colored glasses I was wearing and made me realize that this might not be as clear cut as I originally thought. It was truly a devastating day. Today is proving to be only slightly better

Now we're so close. So close. We're three weeks away from a transfer, and yet so far. I spoke to my nurse about the BMI. It needs to come down before the do a transfer, there is no question. At first I thought there may be a chance they'll let me start and then reweigh me before the actual transfer date. But my doctor won't even start the protocol until I'm 0.1 points below what I am now.  It's 0.1! That's basically a large BM.  I'm so overwhelmed with disappointment and at the same time slightly relieved that it's something technically within my control.

My husband, in his infinite sweetness, is going to diet with me. He also said if we have to wait a cycle then it's not the end of the world. In my mind, it is!!!  How could I let this happen?! It's very sweet that he made sure I knew he doesn't blame me. Even though I blame myself.

In the meantime, we're delaying everything by a week. I will go back next Thursday for a new weight check and baseline.

Fall theme

Now I'm ready for Fall. 

#newbloglayout

#pumpkinspiceeverything

Meds

There is a national shortage of Delestrogen and I've been having a tough time trying to fill my prescriptions. I need to have the meds in hand in order to start the cycle with the baseline on Thursday.

The only pharmacy that has any left is in South Miami. Remember Hurricane Matthew? Everyone in Florida is busy trying to survive the storm and they're all closed.

My nurse and I have been researching pharmacies to see who still has an alternative to substitute. There's on in New Jersey who might. I've also been contacting my regular pharmacy, Freedom, and their hold music is literally the worst. The Worst. I don't know why there have been such long wait times but it's a minimum of 10 min on hold each time I called. I called several times throughout the day yesterday and stayed on hold as long as I could before needing to go back to work.

I finally got hold of someone in the evening. They offered an alternative where the dosage and concentration of the medication is different but essentially it's the same drug. They need to confirm with the doctor that it's an acceptable swap before shipping the order.

ERA II Results

Receptive!

Official report came in from the lab last night and I got the email from my nurse this morning. I'm so happy we did this. I'm glad we insisted on doing this now. I'm glad we insisted on doing it twice, to confirm receptivity. I'm glad the results came in and are what we want to hear.

I'm trying to not be angry or regretful about losing those three beautiful, healthy embryos because they were transferred too early. So much pain to get them, so much hope once they were transferred, so much devastation every time it failed.

They make one go through so many tests and procedures before they even start IVF. The ERA should absolutely be one of them. They may not change their protocol, but I've become an advocate. It's uncomfortable and expensive, but so worth it in the end.

So... pushing all those bitter feelings to the back of my mind, we're celebrating! Receptive!

Rosh Hashana 5777

Rosh Hashana starts on Sunday night. I've planned menus and did most of the cooking. The things in the freezer include: roast with vegetables; stuffed chicken with mushrooms, onion, and spinach; sesame cake; various vegetable kugels; challah; two types of meatballs; and meat/bean roll ups. On Sunday I plan to make salmon, honey cake, rugelach, simanim, and salads. I've prepared more than needed for just this holiday in prep for the rest of the season, when we will be hosting my in-laws in a few weeks.

With the new year starting, I feel like we have a new shot. New beginning. New start. Now that I have the schedule for our new FET I can't help but mentally calculate everything as bFET and aFET: before and after. We got tickets to see a Sebastian Maniscalo (one of our fav comics) the weekend after the transfer and I can't help but worry that trying to get to the venue close to after Shabbat might be too stressful. It's probably fine.

My cousin is getting married in Israel in December and we joked about hypothetically making the trip because we both really want to visit. Then it wasn't so much a joke as an actual conversation about whether we're able to swing that. It comes down to not really being able to make a decision until we find out if the transfer took. At best, I'll be pregnant. At worst... well, not quite ready to think the worst yet.

That's not entirely true. We've had multiple conversations about what comes next. Extensive, thoughtful, intentional conversations. If FET #4 doesn't result in a pregnancy, we'll have one final healthy embryo to transfer. Our beta would be the week before Thanksgiving, so we'll know by then whether it took or not. It means that we'll have about 5-6 weeks before the new year which leaves us with a few options.

• Option 1 would be to do FET #5 with our last and final embryo, which would probably be right around Christmas, but I think that the clinic is closed for that week for retrievals, surgeries, and transfers, so it would likely be scheduled for the week after. 
• Option 2 would be to hold off until after Jan 1, once I'm back on the new insurance, and do another IVF cycle before another transfer. It would likely not be until February, once they can verify the new insurance which takes 4-6 weeks.

It's a solid plan, with a lot of hope of continuing to try and try until it works. But thinking about it now and putting it in writing makes it depressing to think that the ERA didn't help at all and the change in protocol it initiated wasn't helpful. I know that if the November transfer doesn't result in a pregnancy then the next time we do a transfer, whenever it will be, will include an endo scratch. That was the last and final option that the doctor suggested at our June wtf appointment, and the only thing we haven't tried yet. It has a 50/50 shot of working and there's not enough science to back it up, but it's an option I'm willing to try if everything else fails.

I'm going into the Jewish new year hopeful and scared. Optimistic and guarded. This time last year we had just finished our first IVF cycle and were getting ready for our first FET. We were so, so hopeful. So naive. So sure that by this Rosh Hashana we would be parents to a 2 month old baby. We were talking not about IF but WHEN at that point. I don't think that I could have gone through what we did over this past year if I had known then what I know now. I don't know that we would have done all those cycles, all those shots, spent all that money, if we knew that in one year from that day we would be no closer to being parents. Sometimes it's a blessing to be forced to take things one day at a time. The enormity of what we went through would have been too much to bear all once.

Even with all that, I can't help but feel lucky. Hopeful. Excited. Confident. I don't know what it is that makes me believe that this will happen for us. I know that I might be setting myself up for failure, but if I have no hope then I have nothing. Over the past year, with every devastating call about FET results, the first thing I would do is mentally calculate when we can try again. It was automatic. I knew it would take time to heal and time to wait for my period and time to start again, but at least starting again was an option. Until we're ready to really call it quits, there will always be a 'starting again' option.

I hope the new year brings with it lots of happiness, health, peace, and babies.

L'shana Tova U'metukah -- here's to a sweet new year!