Show and Tell: Pink

November 30, 2008

Yesterday while tidying up I found the Vogue magazine that I had been reading in the hospital before my hysteroscopy. When I picked the magazine up, I found some photos tucked inside that I’d never seen before.

Can you guess what they are?

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Did you guess?

No? I’ll give you a second to think about it…

Ready?

They are photos of my uterus — from the inside! Something I never ever expected to accidentally find lying around the house. Never ever ever.

I knew that Dr. Full Steam Ahead showed the photos to DH, but I didn’t know (since I was unconscious at the time, and DH never mentioned it) that he gave us a copy to take home. And therefore I also didn’t know that DH tucked the pictures into Vogue. Surprise! No, that’s not a Dolce & Gabbana maxi dress, it’s your empty womb!

DH was 100% right when he described the photos simply as pink.

Randomly discovering photos of your uterus… one of those moments that only infertility can deliver.

If you’d like to see what else people have brought for Show and Tell this week, head over to Miss Lollipop’s circle time. It’s a pretty safe bet that no one else brought a uterus. If someone else also has internal photos of their reproductive organs, I would be so embarrassed! Embarassed at the duplication, not at showing the world pictures of my hoo-hah. That is no problem, obviously.

Post-Op Quotables

November 15, 2008

For a surgery in which I had nothing to report, the last post about my hysteroscopy was ludicrously long. Here is a relatively short post — within the limits of my verbose nature.

  1. Overheard through the curtain between another patient and a nurse — I was actually trying not to listen and just read my Vogue, but when other people are having a conversation at full volume and the only barrier is a piece of fabric, eavesdropping is inevitable.
  2. Nurse: You’ll need to take (dosage) of aspirin.
    Patient: How about Excedrin? I have Excedrin at home.
    Nurse: I think that is aspirin, but I’d have to look it up. Why don’t you just go to the pharmacy and buy regular aspirin on your way home.

    (Really? First of all, I was shocked that a nurse wouldn’t know the ingredients of one of the most basic over-the-counter medicines. Though, to be fair, there are now more than half a dozen versions of Excedrin. But still — I’ve never taken Excedrin and I know that regular Excedrin contains acetominophin and caffeine, but that some other formulations also contain aspirin. Excedrin is “The Headache Medicine,” thanks to the caffeine — since a huge number of people have headaches due to caffeine withdrawal. Yes, yes, I realize I know far too much about over the counter medications, especially for someone who almost always refuses to take painkillers and has never experienced caffeine withdrawal in her life, but still. I find it bothersome when I know more than people whose job it is to know something, and I start to wonder about the implications for how they might treat or mistreat me.

    Second of all, really? She couldn’t take a minute to look it up or ask someone? If it had been just plain aspirin, such as Bayer, it would be pretty dumb to make a patient stop at the pharmacy on the way home from surgery to either spend needless money or find out that the trip was wasted.)

  3. After I’d regained consciousness.
    Me: Did Dr. Full Steam Ahead explain everything to you?
    DH: Yes. He also showed me some pictures of the inside of your uterus.
    Me: Ooh! Were they fascinating?
    DH: Um… no. They were pink.

Post-Op

November 15, 2008

Hysteroscopy went well! Nothing to report really — no abnormal findings, no endometriosis, no fibroids, no structural problems. No news is good news, right? I kind of hoped that he would find something because maybe that would have been the true reason for the years of infertility and the two miscarriages and then we could have fixed it, but I guess it’s better not to have anything actually wrong, even if the term “unexplained infertility” is so infuriating sometimes.

At yesterday’s support group meeting, I heard many horror stories about hysteroscopies, and went from no-longer-too-concerned to rather freaked out. Of course, most of the members with horror stories had also had laproscopies, which probably explains much of the difference. Based on having the same RE as some of the members but a different RE than others, it also seems like Dr. Full Steam Ahead, as aggressive as he may be in many ways, is also judicious. He doesn’t order extra medications that happen to sometimes have terrible side effects, just to cover his own ass in case something goes wrong. Score one for Dr. Full Steam Ahead.

Of the three times I’ve had general anesthesia, this was the quickest wake-up and least groggy aftermath. The anesthesiologist told me beforehand that he’d be administering agents that would specifically allow for quick wake-up. Score one for nickname-less anesthesiologist.

Even so, I wasn’t fully awake most of the day — not coherent enough to blog, anyway. Lori can attest that she received an email from me with no punctuation, no capitals, and plenty of words and parts of words missing. Most of that resulted from typing with one hand, supine, rather than incoherence, but I was certainly not at 100% mental capacity.

Dr. Full Steam Ahead talks very quickly and proceeds with treatments quickly, so it should have been no surprise that he performed surgery quickly. Apparently I was in the OR for less than 10 minutes. The whole experience took more than 3 hours, though.

I was sensible enough not to bring work with me to the hospital. I did spend most of the morning before the surgery working — in part after a phone call home from one of my bosses who urgently needed me to check over his changes to a project that’s been hanging over my head all week and which I had finally finished in the wee hours on Thursday night/Friday morning. But I turned around a quick response to him (“All of your changes look wonderful, thanks, all set, let’s proceed [and now you can stop bothering me]”) and moved on to less brain-intensive work. I haven’t checked any of my work email accounts all day — I figure that by now, nothing is so urgent that it can’t wait until Saturday or Sunday; plus, can’t a girl get a day off to have surgery? Not that anyone from either job knows about the surgery (or anything about IF at all — except for the lady from HR).

Instead of bringing work, I brought an issue of Vogue to occupy the pre-op waiting hours. Because of my work schedule I’m an issue behind, so I got to read all about Valerie Jarrett on the campaign trail with Obama, coincidentally on the same day that she was named White House Senior Advisor (though I didn’t know it yet in the hospital). I also read all about fashion trends that have already passed.

(Side note: I bet you didn’t think I was the kind of woman who read Vogue cover to cover every month, did you? Yeah, well neither did I. I received a subscription as a gift, but have been enjoying the feature stories and even-handed, fairly feminist journalism very much. The fashion I can take or leave, though I guess I do like increasing my familiarity with the top designers for the sake of being even more well-rounded and capable of talking to almost anyone at a cocktail party. That is the same reason I watch a single episode of many reality shows, just so that I don’t have to stand there mute while everyone else goes on and on about that sassy Santino or Cloris Leachman’s joie de vivre or Gary Busey’s latest Buseyism. I already don’t want to talk about child-bearing or -rearing topics, so I need to keep my other conversation options open.).

The other event of note was an answer in terms of whether I’d be able to start the month of BCPs for IVF #2 (whenever my period arrives — once I figure out how to distinguish post-op bleeding from my period, that is), complicated by the need to wait for insurance authorization. I’d delegated this task to DH since I assumed that Dr. Full Steam Ahead couldn’t make a determination until after the surgery, at which point I might be entirely loopy and incapable of medical decision making or full sentences. Several days ago, after my long phone call with the RE’s office about health insurance, I explained and reexplained the issue to DH carefully. DH wrote down the questions he was supposed to ask verbatim — including things that weren’t part of the actual questions, such as “because you will be unconscious and can’t ask the questions yourself.” (“Enter Laughing,” anyone?). When we got to the hospital, DH recalled his assignment but realized that he had forgotten his notes. In hushed tones in the waiting room, we went back over the questions until DH had all the details memorized.

Then, it turned out that DH didn’t need the notes nor the cramming session at all. I got to ask Dr. FSA the questions myself, when he came to check on me before surgery. He said that as long as I didn’t have any endometriosis there would be no problem in starting the BCPs immediately. This is probably a different stance than some doctors, and also as I understand it quite different for laproscopies or any surgeries where, for example, structural problems are addressed. Anyway, Dr. FSA said it was fine to start the cycle immediately, and I had to grab him (verbally — I am not in the habit of grabbing anyone physically, plus I was hooked to an IV rendering one arm immobile) to ask more questions about the chain of events that had to do with insurance. Excessively long story short, he agreed to give me the prescription on my way home so that I could start the BCPs whenever my period arrives, even if insurance isn’t sorted out yet. Score two for Dr. Full Steam Ahead! There is no way I would ever have gotten the prescription out of the nurse before the insurance authorization was finalized. It’s actually pretty sensible bureaucracy in this case, but Dr. Full Steam Ahead knows that the IVF cycle will get paid for one way or another. And he’s the boss, so he wins.

I was a pretty good bedrest patient after IVF #1, but since I haven’t been in much pain, I have been up and about more than last time. DH drew the line when he discovered me in the process of installing a curtain rod — I managed to mark up the future holes on the wall, but he insisted that I stop as I was on my way to get the power drill. There are a lot of things I can and do “delgate” to DH, but handyman tasks are not among them.

I had originally planned to go to the pottery studio tomorrow, but since I’m not supposed to drive (nor do strenuous physical activity, which pottery can certainly be depending on the task), maybe I’ll do some light work from home on Saturday (even though I’ve been trying to keep Saturdays work-free for the past few weeks) and instead satisfy my Pottery Jones on Sunday.

Finally, lest I paint DH in an unfair light, I will point out that he was fantastic all day long. He told me repeatedly how brave I was. He was affectionate and sweet. He waited patiently (armed with laptop and wifi, plus a spare book in case the wifi hadn’t worked out) the whole time at the hospital, and on the way home he even called my favorite soup restaurant to see if they were serving the flavor I was craving — despite being almost-late for a work phone call that he had to make as soon as he’d gotten me settled at home (I was out of luck, so instead I had a different soup flavor at home). He made my meals, and he went to the supermarket when I felt like eating something that we didn’t have at home. He watched the TV shows I wanted to watch.

Most IF bloggers seem either silent or fairly positive about their partners (perhaps because most of the partners are reading the blogs?) but the support group yesterday was full of griping about how husbands don’t understand what we go through and aren’t helpful and don’t take enough time off work for RE appointments and don’t know any of the abbreviations or terms and did we mention that they don’t understand what we go through? There was audible surprise when I mentioned DH making a phone call (a relatively minor task, he and I both agreed, but one that was stressing me out and neither stressed him out nor took more than 10 minutes of his time) that one of the ladies was describing always making entirely on her own, over and over, despite the stress. I got the impression that no one else in the room could depend on their husbands to do the simplest of tasks (unless the women who didn’t mention much about their husbands were just too sheepish to flaunt their supportive husbands — personally, I would rather set the bar high and have someone go home and demand what she needs from her husband with me as an example).

DH and I share the perspective that if I’m going to give myself shots multiple times a day, go under the knife repeatedly, be rendered out of commission for days at a time, and wake up several hours earlier than usual on dozens of occasions for dates with a dildocam, it is entirely reasonable to expect him to make a few phone calls, go downstairs to put something in the microwave, drop by the pharmacy, and yes, produce a “sample” a few times. I knew that I have the Best Husband in the World long before we experienced infertility, but the nomination is definitely clinched now. Thank you, Designated Husband!!! He prefers to think of DH in a sports context rather than as the usual Dear or Darling — not that he minds being called dear nor darling. My dear, darling, dapper, droll, determined, dependable, dynamic, dedicated, delightful, Designated Husband.

Thanks also to the commenters for all of your reassurances and well wishes, and to silent lurkers who may have mentally sent positive thoughts in my direction. As your reward, tomorrow you can look forward to a Show and Tell that has nothing to do with my uterus.

Insured

November 12, 2008

With my hysteroscopy scheduled for Friday, I decided to avoid surprises by calling the RE’s office to confirm that my insurance coverage for the surgery was all set. After half an hour on the phone talking to multiple members of their staff, here is what happened:

“Insurance approved for hysteroscopy, at 100% coverage.” Hooray! Finally a tangible benefit from my new insurance and therefore from my new job. Almost makes the 14-hour days and 6-day weeks worth it. Almost.

“You owe us hundreds of dollars.” What? How come the last bill that I just paid didn’t say anything? “(after 10 minutes on hold) Nevermind, we just forgot to take some old charges off your account.” Phew.

Can I get partial insurance coverage for the next IVF? “We can’t contact your insurance for authorization until after the hysteroscopy.” What if I get my period between the hysteroscopy and whenever authorization finally comes through? Would I have to miss that cycle? “We can’t get insurance authorization or set the cycle in motion or do anything else until after the hysteroscopy.” But then I might have to wait a month for the cycle. Is there any way we can… “We can’t get insurance authorization or set the cycle in motion or do anything else until after the hysteroscopy.”

Uh, ok. I guess I will wait. “(surprisingly sweetly, after a very brusque 30 minutes, punctuated by large blocks of time spent on hold) My name is S. Call me anytime, honey. Bye!”

Appointment

November 6, 2008

My hysteroscopy is booked for next Friday.

Getting a date set really shouldn’t have been this difficult.

As I’ve mentioned before, the health insurance from the new job kicked in on September 1. Then I had to wait a few weeks while Human Resources and the insurance company figured out some logistics which would determine my choice of primary care doc. When I finally got the go-ahead, I found a doc who was actually taking new patients (apparently he has openings in his practice for a reason), and within two weeks I had seen him and obtained referrals. Once the referral went through, I called the RE, Dr. Full Steam Ahead, to set up an appointment for the hysteroscopy that is a necessary step between M/C #2 and IVF #2.

I was informed that surgeries were only booked twice a month, but that one of the November dates and one of the December dates were cancelled because of holidays. The only November date is a day when I absolutely can’t miss work, and the only December date is a day when I will be giving a talk to several hundred people. I really would have tried to accommodate most dates, but they picked two that were impossible. This meant I would have to wait until January.

Really? January? I have to wait until January before I can have the hysteroscopy, which means I can’t start the pre-cycle of IVF #2 until then? Really?

The scheduler said that sometimes, rarely, they open up an extra surgery day, and that she’d keep me on The List.

Periodically over the past four months since M/C #2, DH has asked, “Uh, what’s going on with the RE? When is the next IVF cycle?” and my response is always, “I have no idea.”

Surprisingly, after a couple of weeks, the RE’s scheduler left me a voicemail that they’d opened up a new surgery day in November — on a day when I can actually make it — and I should call back to set it up. I called back as soon as I got the message, but she’d left for the day. The next day, I called only to discover that the RE’s office was moving to a different building and that they couldn’t handle any business. Call back tomorrow.

I called back the next day. Still moving. Call back tomorrow.

I was frustrated, but I consoled myself with the thought that nobody else could get scheduled either, so my time slot was probably not going to get snapped up by someone else.

Finally the next day I reached her. “I’ve already got you down for November 14. You’re all set.”

Infertility is a series of fits and starts. Hurry up and wait. Running to stand still. Any other clichés you’d like to suggest?

Post-Procrastination Report

August 29, 2008

Post-procrastination, and also post-RE visit report.

Today’s theme: If you think you know what will come next, you are forgetting the nature of infertility.

As I mentioned in my last post, I was a bit anxious about this RE visit, but still I thought that I knew what would likely happen. He would tell me what we learned with IVF #1, and what we’d be tweaking for IVF #2 to make our odds even better.

That is called hubris.

Do you know what the universe does with people who exhibit hubris? Smacks them in the face.

There were three key things that occurred at the visit, which I did not expect.

  1. He insisted that I try to figure out if I can get any insurance coverage for IVF. Now, I can barely get insurance coverage at all (or at least, insurance that will cover maternity if I can ever get pregnant), which is why I am about to start a new job with good benefits. I have looked exhaustively into every possible plan that is available to individuals in my state, and I know for a fact that not only is there no IF coverage for me, there is barely any coverage at all without getting a job that will include insurance, which I have now done. But Dr. Full Steam Ahead insisted that it’s easy to get fertility coverage. Basically he said that he was happy to take my money if I still wanted to pay out of pocket, but that since it might require a couple more tries at IVF, I should try to get coverage. He detailed the many ways in which coverage is so extensively available, and what a dullard I must be to have missed them for so long. Well, DH and I just spent several hours checking and calling every insurance company, and he is totally wrong and I was totally right. Unfortunately. I would love it if insurance would cover my IVF cycles, but it won’t. I have never been so annoyed to be right.
  2. He wants to add ICSI to the next IVF cycle. We have never had any male factor problems, and it didn’t seem that we had any fertilization problems with IVF #1, so ICSI never entered my mind. We had 50% of the mature eggs fertilize last time, but Dr. Full Steam Ahead wants to get that number higher. Did I mention that his name is Dr. Full Steam Ahead?
  3. He wants to do a hysteroscopy before the next cycle or during the birth control pill phase. In case there is any endometriosis from M/C #2, and just to really “get in there and look” at my uterus.

The insurance part was totally stressful. You’d think that it wouldn’t be stressful to potentially get tens of thousands of dollars covered, but just raising the possibility meant all sorts of phone calls and research when I knew it would turn up nothing. There are few things in life I hate more than figuring out health insurance, in large part because the situation is so bleak.

ICSI was a shock but actually no big deal once I thought about it. It costs more money ($2000), sure, but it requires no extra work/pain for me or DH. If it will increase the number of embryos, so that we have better embryos to transfer and/or some to freeze, it may save money in the long run, and save us one or more additional IVF cycles. I’m on board.

The hysteroscopy really freaks me out though. I am pretty okay with pain, and I have learned to accept all of the different painful aspects of the IVF cycle. But the idea of an additional invasive surgery, an additional couple of days out of commission, and the possibility it raises that he might find something wrong, all scares me shitless. By nature I am pretty calm and very matter-of-fact (even if some of my blog posts don’t give that impression — this blog is my place to be an emotional wreck, so that I can pull it together in real life), but this one is getting to me.

Oh, and remember when I said that it looked like I might have no Procrastination Tax for putting off my RE consultation? Yeah, well now because I need to wait for my new health insurance to kick in (since it should cover the hysteroscopy and maybe some parts of the IVF cycle like meds — fingers crossed) I may need to postpone the cycle a month. I had just updated my About Me page to say that IVF #2 would start in September. By adding that one line of text, I must have jinxed it.

As I have mentioned before: Man plans, G-d laughs.

To reiterate today’s lesson: If you think you know what will come next, you are forgetting the nature of infertility.