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.

Results

Bloodwork results came back some time in the afternoon and the voicemail said that HCG is now at negative levels, which I assume means back to zero. This officially closes the chapter on FET #3.

AF started yesterday. It feels like my uterus is mad at me. Period from hell has arrived. Tylenol was helping but cramps have gotten painfully intense and I'm debating upgrading to something stronger.

In prep for the in-person appointment with the doc I requested a copy of my file. I don't care if they think I'm leaving the clinic (I have no plans for that now). I want to see what he sees so we're on the same page.

I want a change of scenery and I really miss the beach. Eff Zika. We don't have friends or family to stay with near the beach so accommodations will be the biggest expense. I have points for flights and I have points for hotels, but for some reason I can't seem to make the two line up in the same city. I don't have the talent of getting great deals at amazing prices. If I try to save money the place is always gross. If we want to go somewhere specific it's going to cost at least $1,000 for just a few nights. I'll keep looking.

Embryo Watch: Day 5 update

The nurse tried to keep me posted all day but she wasn't getting much info from the lab. Toward the end of the day we got the news that one embryo was biopsied, two-ish stopped growing, and the rest are at various stages of growth so they will give them a chance to grow one more night. She said her best estimate is that 4 +/- total may be biopsied but she didn't want to lock in a number because there's no way to know which ones will survive til tomorrow.

It's not bad news; it's just not final news so the wait continues. Always waiting.

In other news, I was very productive today while waiting for this update. I made chicken soup, matzah balls, fish, stuffed chicken, roasted chicken, meatballs, two each of zucchini, carrot, and potato kugel, chocolate cake, blondies, mandel bread, potato salad, and cheese souffle. Tomorrow I'll make cheesecake and salads. I'm feeling productive and full from the tastings menu ;)

Embryo Watch: Day 5

We haven't gotten updates yesterday or the day before. They say that they like to give the slow ones a chance before counting them out, and by letting them just be and do their thing even if they don't grow one night, there's a chance they might still develop. Today we find out how many survived to Day 5. If we were doing a fresh transfer, today would be transfer day. Since we're doing PGD, there's a chance they'll give the strong ones an extra day to grow before biopsying them.

If it was even an option, there are pros and cons to having a transfer today: the pros are that it's the first day of spring break and I'd have a week to rest. The drawback is that Pesach is in a day and a half and I'm still preparing - lots of cooking, organizing, last minute errands. Plus, not to mention the four cups of wine on Seder nights, which obviously could be exchanged for grape juice but still.

The bloating and exhaustion have slowly been getting better every day. I'm feeling better, but now I have a cold (or allergies?) and my head feels like a balloon. I feel like I'm doing things in slow motion, which is frustrating since I have a lot t get done and I like working fast and efficiently.

Since we're not doing a fresh transfer, there's time before we do an FET. By my calculations, assuming there's a healthy embryo to transfer at all, I still have to wait at least a week for my period and then three weeks after that on BC pills, per protocol. That's before we even start with the two weeks of pre-FET injections. That gives me about six weeks of waiting. Patience is not one of my strongest points and it frustrates me to no end that it takes so long between procedures. Still, the time will pass and I have a choice as to how to spend it. I decided I will take the six weeks to work on really getting healthy. Work out regularly, cut out unnecessary calories, be careful about the vitamins, etc. That way when an FET does come along, I'll know that I did everything in my power to help it succeed. The time will pass anyway; I may as well make it meaningful.

Right now I'm taking it one day at a time, and today we'll find out if any of the embryos won day 5.

Embryos: Day 2

Eleven embryos made it to today. The loss was expected but still stings. Still, 11 is great and hopefully most of them make it to blast.

Recovery took a different turn today. The smooth coasting I've had until now was no more. I was so bloated. Even though I think I slept well, I was exhausted and distracted. This morning as I was getting ready for work I was feeling ugly and gross. I had to pull myself together to keep from falling apart crying, for no particular reason. I had trouble walking and spent most of the day at my desk.

I was thinking of going home at lunch but ended up powering through. Wednesday is our last day before Pesach break and I have a lot of work to do. At home I cleared out a few cabinets and the freezer and called it a day - that's enough Pesach cleaning for today.

Tomorrow I'm planning to get the dairy and produce, then flipping the kitchen after work. I'm picking up the meat order on Wednesday. The goal is to have everything done by Wed eve so that by Thursday morning I can just start cooking. We'll see how that works out.

No embryo updates until Day 5 so all that's left to do is just to pray they continue growing.

Embryo update

Out of the 27 eggs from yesterday's retrieval, 15 were mature and of those 13 fertilized. So there are now 13 on Embryo Watch 2016. I couldn't help feeling disappointed with that number. I know it's a great number. I know that we are so, so lucky to have gotten this number this far. I'm just worried about having enough make it to blast stage so they can be sent for PGD testing.

In the end I know it doesn't matter because in cycle 2 we had 6 make it to blast and none were healthy to transfer, so logically numbers don't actually mean anything. Still, I was unrealistically expecting something like 18 embryos to make it to this point. That's insane and I recognize that. I also realize that my hormones are completely swinging again and that's contributing to the exaggerated expectations.

Recovery is going really well, considering. Either my body is just used to it by now or I had a super gentle doctor, but I'm feeling so good compared to previous egg retrievals. At one point I told my husband that I'm concerned they lied to me or that I misheard about the number of eggs because it doesn't feel like I was poked that many times. I'm bloated, as expected, but I don't feel the same pain as before. It's possible I'm also a pro at recovery by now: keep hydrated to flush everything out, stay upright for the hours after, keep the heat pack on.

I've been conservative with the pain meds. I just don't feel like I need them, even the Tylenol. It's been such smooth sailing so far that I've literally had to hold myself back from doing things like carrying heavy laundry. I was ready to drive last night and my husband outright refused to "allow" it (tee hee, like he can stop me. I didn't drive because I would have felt guilty if I'd killed someone else, but I felt confident that I could). I'm forcing myself to take it easy today so that I can be more efficient in Pesach preps this week.

Next embryo update tomorrow. I know it's unrealistic to expect all of them to make it, but I still hope they do.

Uphill

Last year I was on my husband's insurance. We used up the majority of the fertility treatment benefits and were nearing the lifetime maximum so we decided that I would switch over to the insurance offered by my employer. Before switching, we were debating whether it was necessary to keep me on his insurance as a secondary insurance. I verified with the clinic that, should there be no coverage by insurance (I like planning for worst case scenario), we would still receive the self-pay rate offered by my husband's insurance. Per the supervisor, we were approved as long as one of us was on that insurance, and since he was staying on his own, we decided I would switch without keeping his as secondary since there was no point.  I submitted the insurance information as soon as I got it (mid-December) even though I knew they couldn't do anything until it became active on 1/1 but so that they can verify it as soon as possible and to avoid any last minute scramble.

January 1 comes around and the wait begins.  We were told it takes 4-6 weeks to verify insurance. Once insurance is verified, it's an additional 2-3 weeks for preauthorization. We could have technically started a cycle the second week of January but we waited for insurance to kick in. We were verified January 20 and submitted for authorization. Response came back on February 3 that authorization was denied. The reason? We don't have "documented infertility for a minimum of 2 years." We requested a peer-to-peer review and the doctor had the appointment on Friday, however insurance is not changing their mind. As frustrating as it is, I feel responsible for not checking the fine print more carefully before switching. Even though we didn't really have another option since we had reached nearly the lifetime maximum on the previous insurance.


Meanwhile... I saw that it was taking a while to get the answer back from insurance and didn't want to miss another cycle start date so I confirmed with the clinic that the previous self-pay rate was still active.  I received the worst email in response:

"So I spoke with my supervisor again this morning just to confirm the rate. She did not realize that you were not on the actual plan, that it is just your husband's plan. If this is the case, we cannot extend the rate to you. You, as the patient, actually have to be on the plan, even if it is only as secondary insurance, to receive the rate."

I was just completely floored.  I had ASKED. I VERIFIED! We purposely had multiple conversations about this!  Then I took the information YOU gave me and made decisions based on it!  These decisions affect me until January 2017!  You're going back on it because someone didn't realize something??  I was livid. I couldn't see straight. I couldn't type a response without tearing up. It took me several deep breaths to collect myself and start the week-long discussion with the clinic about how we shouldn't be penalized for their lack of communication skills.  I kept the emails professional and to the point, knowing they file everything. They kept calling it a "miscommunication" to which I replied that while for them it's being referred to as a misunderstanding, for me it means that I made a decision based on information I received from their office that will make a difference of thousands of dollars, possibly multiple times. They promised me an answer by Thursday. I got no answer by Thursday and nothing on Friday. I escalated the issue twice until I got to the management team, who told me to expect "worst case scenario" and that they hope to get me an answer by Monday. 


Good business sense and customer service dictate that if your office makes an error then you should rule in favor of the customer in order to keep the customer happy. Even if it means making a few less bucks now, you'll keep the customer coming back and make more money in the long run. I don't think that happens in the IVF world because they know you need them and will pay whatever they require. I'm curious how they will respond to this. 


As it stands right now we have no insurance coverage and no cushion in terms of self-pay. We also don't qualify for any of the financial programs they offer because we're just shy of the eligibility requirements. I definitely plan to fight for the insurance benefits but it's not going to get resolved overnight and in the meantime, I have a baseline appointment scheduled for Tuesday which I plan to keep regardless of the answer we get tomorrow.

Updates

It's only been ten days since the last post but I'm happy to report that there are a few new things that have happened since (progress!): 

• Timeline - I started my CD1 and reported it to my nurse who was able to  give me a timeline for our treatment.  It looks like my baseline is scheduled for 2/9 with an estimated ER on 2/26. It would have worked out a lot better schedule-wise if the ER was during President's Day weekend, but I'm happy to get a date and get started. 
• Insurance - My new benefits have been verified at the clinic - yay!  Finally. It took 3 weeks for that info to come in. Now that it's in, they can submit for authorization for an IVF cycle which may take another two weeks. Still... progress!  
• Medication - Since my benefits were verified I was able to go ahead and schedule a delivery for the fertility medication. We had to work around the epic Blizzard 2016 and the delivery came today.
• Halachic all-clear - We were able to schedule an appointment with the Rabbi which I will elaborate more on in another post. We had specific questions which we needed answered before a cycle started and today we got our answers. This was an ongoing conversation my husband and I have discussed almost daily and finally having a resolution puts the issue to rest and gives peace of mind. 

Even though the current schedule puts a transfer later than I wanted, I'm still glad we're moving forward. I'm praying for a successful cycle with embryos to transfer and not a repeat of disastrous IVF #2 where none of the embryos were viable. Late is still better than nothing, so I'll take it, and if it works the extra 6 weeks won't matter in the long run.