Wednesday, September 23, 2015

Omaha

Once again I've managed to go AWOL on you... And once again it's not for lack of anything to say, more for lack of time. I volunteered for the search committee for our parish's new director of music ministry, not quite realizing how many meetings, choir rehearsals, and Masses I was committing myself to. I'm thrilled with the candidate we have chosen, and the experience gave me a new perspective on finding my voice again (which I hope to write about later). 

The biggest source of craziness for me has been Omaha, meaning PPVI. The Friday before Labor Day I got a call from the scheduling nurse about scheduling surgery (which my phone promptly dropped). Not knowing her extension, I couldn't call her back; the voice mail and subsequent e-mail said to send her a copy of my latest chart so she could work on picking potential dates for my surgery. At that point, I wasn't 100% committed to having surgery again; I recover slowly; I didn't really see any positive effects from last year's surgery; I thought everything would be out of network and thus very expensive. Getting that phone call meant that we had to be certain - did we really want to do this? At this point neither of us has high hopes that having surgery will lead to me getting pregnant; more realistically we are hoping for answers, less pain, and closure. And are those worth the time, money, and hassle? Once we scheduled, canceling or changing incurs a $275 fee, so I wanted to be certain. On the long drives to and from my godfather's cabin in Michigan, we discussed and debated whether we really want to do this. Despite all my doubts and griping, the answer was yes. 

Tuesday morning I got the call back from the scheduling nurse. If we wanted to wait for Dr. Pez, who wrote the letter I received, to come back from maternity leave, there was a date at the beginning of November; if we wanted Dr. H to do the surgery, there was a date in early December; Dr. K was an option, especially if we wanted to do this as soon as possible. I could get scheduled with her for early October. Having surgery so soon was an option I hadn't even considered; the possibilities were overwhelming. At the nurse's suggestion, I said I would get back to her on Thursday morning, since she would be off on Wednesday. After going round in circles for a long time and despite rumors of Dr. H's lousy bedside manner (if I could deal with the then team doctor for the Chicago Bulls when I was 15, who had a terrible bedside manner, I could deal with Dr. H now that I'm an adult, right?), we decided on that early December date with Dr. H. Thursday morning I called the scheduling nurse back to book that date, which was fortunately still available.

However, when she called me back, instead of confirming the date, she told me that she had miscalculated my cycles. If the last pattern of the last couple of cycles continued, the December date I would be looking at would be December 18, not early December. We would have to stay in Omaha over Christmas for the ultrasound series. This new information necessitated a new round of frantic phone calls to my mother and Husbandido. Round and round and round we went. Both Husbandido and I were strongly opposed to me having surgery a few short days before his 40th birthday. Neither one of us wanted to be in Omaha for Christmas by ourselves, but the October date was less than a month away. After colossal amounts of waffling and dithering, we chose October. There was one pleasant surprise during the process: either hospital option was in network, so we should end up paying less out of pocket.

Once we got confirmation of the date, it was time for the whirlwind of booking flights and a hotel (which required deciding how long we were going to be out there without knowing for certain how long the ultrasound series would take), arranging for time off work, and starting the hormone series (at the suggestion of the surgery/head nurse, who recommended I start mid-cycle, then pick up the CD5 draw at the start of the next cycle, so it would all be done before surgery). My boss was not happy with me for not giving more notice, which had me upset, given that I let him know the same day I scheduled it. Up until that point, I was expecting to have surgery in late November or December. 

I've been stressed about the scheduling, about work, about being so busy and having no down time, about getting it all done, about whether the committee would agree on a candidate, and about my cycle. I'm sure there's irony somewhere in there: stressing about my cycle being weird could be making it more weird. This my third cycle off fertility drugs, and this month peak day was earlier than the last two. My post-peak phase has been much longer, too; it's P+10, and I haven't started spotting yet. The last two cycles my post-peak phases were closer to 7 or 9 days, with spotting starting much earlier. Now I'm waiting for the spotting and CD1, so that I can do the CD5 draw and get the blood out the ice cream's spot in the freezer. 

Omaha, here we come.

Tuesday, September 1, 2015

A Jealous Rage

I don't think anyone can accuse me of pretty-ing up our experience with IF; if you were to look back through the archives, I think I've been pretty honest about the ways in which IF has affected us. I'm not going to deny that there has been growth and development during the last more than 4 years, but I wouldn't remotely go so far as to say that it has strengthened me or improved my relationship to God. I think it has strengthened our marriage and forced us to improve our ability to communicate and to adapt to changing circumstances. I can honestly say that I don't like how infertility has changed me; pre-IF I was much more open and extroverted; I was less defensive, less angry. My self-confidence, which was never good, has been battered and abused even more than it was when I was an adolescent. 

Yesterday was particularly ugly. I am physically, emotionally, and spiritually drained. Between work, being on the search committee for a new director of music ministry, trying to prepare to work with PPVI, adoption stuff, and general household stuff, I haven't been getting enough sleep or down time. There is always too much to do, too much to think, to worry about. Friday, after an appointment with the counselor I've been working with for the last couple of months (more on that later - really!), I stopped at 3 different labs/outpatient diagnostic centers trying to find one that is willing to do the blood draws, centrifuge and separate the blood, and either ship it to PPVI or give it to me to ship. Each stop took 15 minutes or more as I tried earnestly to explain why I needed to have this done, hoping someone would be willing to do it. Before I got out of the car at the first location, I asked "God, if You want me to do this, please make this easy." If we couldn't find somewhere withing reasonable distance, we were considering dropping the plans to work with PPVI. At the third place I stopped, I found a phlebotomist willing to slightly bend the rules (they aren't supposed to centrifuge samples that they aren't going to test) if I could get a kit with all the tubes needed (and something to hold them for transport). This meant another call to PPVI; after our early experiences calling them, I wasn't looking forward to it. (That first phone call from the receptionist asking who I was did not leave me with a very good impression.)

Yesterday I got the call back; they do have a kit they will send. Between my original call and their return call, I had come up with another question: how do I handle a post-peak phase shorter than 11 days? The slip for blood works requests draws on P+3, 5, 7, 9, and 11; last cycle my post peak phase was only 6 days. This cycle I'm on P+8, though I started spotting by P+5. The phrasing was odd, but the intent was clear: "Just do the best you can." (Because I have so much control over the length of my post-peak phase. [Sorry for the sarcasm.]) You would think that I would have been cheered and encouraged by the existence of a kit, and PPVI's relatively quick response. Instead I was hurt and angry. I don't want to go through all this. I don't want to have surgery again. I can't begin to guess what they will have to offer me - higher doses of Clomid, injectables? Given the blood clot scare that I had on 75 mg of Clomid, neither Husbandido nor I are eager for me to go on anything stronger; we have real concerns about whether it would be safe. But I don't want to have super short cycles where I'm bleeding for half the days or more. I don't want to have niggling doubts about whether I'm facing premature menopause or something worse. (Though I have occasionally thought that it wouldn't be that bad to have uterine cancer; it would be a legitimate reason to have a hysterectomy, and there couldn't be any second-guessing that decision.) 

Depending on quite how the individual/family deductibles and coinsurances work, we could be out over $10,000 just for the diagnostic work that PPVI wants. They're out of network, which complicates and makes everything more expensive. Is it worth it? We won't know the cost until afterwards, and we can't know what they could offer us. We're trying to make a decision when all the information needed to make a good decision is unknowable. To say that I hate that, and it's driving me crazy would be an understatement. I'm feeling pressured to make a final decision; once we get the call from the scheduler and schedule surgery, there is a $275 fee to cancel or reschedule. Compared to the cost of the blood work/ultrasound series/surgery, that's peanuts, but in our general budget, it's significant. 

Yesterday afternoon it just all came to a head; I was bitchy; I was whiny; I was miserable. Husbandido didn't seem to want to listen to me; my mother didn't want to listen to me; I didn't want to listen to me! What thoughts were going round and round in an endless circle? "Why does God hate me so much? How is it that my body is so uniquely screwed up? I can't think of anyone else my age who has had this many surgeries already; this next one will be 6. Six! So-and-so can have a baby. As can so-and-so. And so-and-so has has 2, or is it 3, and is pregnant again and wasn't even thrilled this time. (Names omitted to protect the innocent, but these are real women who have experienced IF.) Why does God hate me so? I'm trying so hard, all this work for the church. Does He just like to torture me?" Mercy? Grace? Love? I could see none of it, lost totally in a jealous rage. Though today has been better, I'm still angry and still jealous. I still don't know why God hates me.