Friday, August 29, 2014

Deposit Down!

Oh man, things are getting official! I finally sent in the contract and the deposit to SCRC. We are official SCRC clients and are cleared to start getting and filling prescriptions. One more thing checked off the list, but there's still so much more!

After taking care of the deposit, I started looking around for the best infertility pharmacies. The meds for my cycles are going to be REALLY pricey and we need to try and save money wherever we can. Right now I'm trying to decide if I should order from overseas, specifically ivfmeds.com. It's a little scary to consider ordering from another country but it could potentially save us a boatload. Right now the pharmacies on my list are:

  • IVFmeds.com
  • Walgreens Specialty 
  • Alexander's Twin 
  • Freedom Fertility
  • Walmart Specialty 
  • Kaiser 
  • Roxbury Pharmacy 
I need to get prices on Menopur, Cetrotide, Omnitrope, Novarel, and Dexamethasone. Looks like I have a lot of phone calls ahead of me.

Thursday, August 28, 2014

The Wheels of Infertility Turn Slowly

It feels like I've been playing phone tag all day long. Making calls, missing calls, no one is ever in the office when I need to speak with them and they only seem to return my calls when I have to pee. Still, I did manage to get a few things done today:
  • Apply for Compassionate Care program and First Steps to get financial help.   
    • We were approved for the minimum amount, 5% and 10%, but I'll take whatever we can get.
  • Follow up with Reprogenetics. The billing manager needs a letter of agreement from Kaiser but the Kaiser lady has been on Jury Duty and then the billing manager went on vacation Friday to Monday. On Tuesday, both should be back in the office and I should get my letter. 
    • Still no confirmation of the letter. I tried calling a couple times today but had no luck. 
  • I need to order a very large amount of sperm. SCRC wants two vials, Reprogenetics wants two vials, and I'm thinking we should have another two on ice to ensure our donor remains available to us. That's 6 vials for roughly $5,000.
  • Meet with the financial adviser at SCRC to officially sign the paperwork and pay the nonrefundable $18,230.00 fee for our two cycles. As the cycles progress, we will pay separately for medication, ICSI (which is required for PGD), PGD biopsy (which includes assisted hatching) and our FET. 
    • I've got the forms mostly filled out, I just need to go over what is and isn't covered once more. They use really specific wording and I'm thinking they're going to make me pay separately for my two ultrasounds before stimms start, the mandatory ultrasounds that check if I'm suppressed and good to go.  
  • Submit the paperwork to Reprogenetics. I've been waiting on the letter of approval so I know what my portion will be. I think we're going to pay for the additional chromosome testing.  
    • I just sent off my paperwork. We decided to make up our minds about the additional chromosome testing once we know how many embryos we have. If we only get a couple, we'll skip it. If we get a bunch, like 10-14, we'll do it on the Fragile X negative embryos.
  • Send DNA samples from myself, my mother and my sister to Reprogenetics for the creation of our probe.
  • Hammer out a protocol with my doctor. Figure out what our plan of action is and decide how we're going to proceed. 
    •  I spoke with the doctor today and we're going with a very unconventional cycle. Since I had such a nice response to my last IUI, we're going to try and repeat that success. We're going with an all Menopur cycle with some growth hormone and cetrotide thrown in for good measure.  
  • Pay to have two vials of sperm shipped to Reprogenetics for the creation of our probe.
  • Pick up and bring two vials to SCRC and pay the $500 storage fee to have them stored there. 
  • Pick up and pay for my first round of medication.  
    • I did some more research on this and it's going to be PRICEY. The Menopur alone will be $5k per cycle, plus the HGH, HGC, Anti-inflammatory and everything else. It's going to be at least $6k per cycle.   
There's still so much to do and a lot is hanging on that Kaiser approval. I can't send in any of my DNA samples or proceed with Reprogenetics until they have their letter. I also need to call my doctor back, get him a copy of a test that was left out of my file and find out what dosage of certain meds they want me to look for so I can get a better price quote.

Monday, August 25, 2014

Decision Made!

After going back and forth a million times, doubting pretty much every aspect of our decision making process, making up our minds and then doubting things again, we've finally made our decision. I'm still not sure this is the right move and I feel a little sick to my stomach over the money we're about to spend, but this is it. Without further ado, we have decided to pursue IVF with....

Southern California Reproductive Center

Ultimately, I think SCRC and HRC would both be excellent centers. A part of our decision ended up being that I can't seem to get the billing department at HRC to call me back to discuss our Kaiser PGD coverage. I really liked Dr. Kolb and I think he would have been a good doctor. However, our PGD coverage will save us about $8,000 and I can't work with a center that won't accommodate that.  They said they'd be willing to work with me, no problem, but then never called me back. That doesn't seem to be a good start to such an important relationship and it played a part in us ultimately choosing SCRC. Dr. Danzer called me after our consult to see if I had questions and has replied to every attempt I've made to talk with him. He's definitely got the personal touch down.

SCRC is also a lot closer to our home than HRC. It will only take us 10 minutes to get to appointments and the staff has been much better about getting back to me. They have an excellent success rate with PGD and are considered a top center here in LA. We're proceeding with the same plan we would have gone with at either center and I officially started the suppression phase this morning. 

Going forward, we're proceeding with:

- The first freeze all IVF cycle with biopsy samples sent to Reprogenetics
- A second freeze all IVF cycle with biopsy samples sent to Reprogenetics
- PGD at Reprogenetics on all embryos 
- A FET with either one or two embryos

I'm hoping against hope that we get lots of wonderful, healthy embryos and that our first FET is successful. In the meantime, there's still a ton of stuff for me to do:

  • Apply for Compassionate Care program and First Steps to get financial help.  We were approved for the minimum amount, 5% and 10%, but I'll take whatever we can get.
  • Follow up with Reprogenetics. The billing manager needs a letter of agreement from Kaiser but the Kaiser lady has been on Jury Duty and then the billing manager went on vacation Friday to Monday. On Tuesday, both should be back in the office and I should get my letter. 
  • I need to order a very large amount of sperm. SCRC wants two vials, Reprogenetics wants two vials, and I'm thinking we should have another two on ice to ensure our donor remains available to us. That's 6 vials for roughly $5,000.
  • Meet with the financial adviser at SCRC to officially sign the paperwork and pay the nonrefundable $18,230.00 fee for our two cycles. As the cycles progress, we will pay separately for medication, ICSI (which is required for PGD), PGD biopsy (which includes assisted hatching) and our FET. 
  • Submit the paperwork to Reprogenetics. I've been waiting on the letter of approval so I know what my portion will be. I think we're going to pay for the additional chromosome testing.
  • Send DNA samples from myself, my mother and my sister to Reprogenetics for the creation of our probe.
  • Pay to have two vials of sperm shipped to Reprogenetics for the creation of our probe.
  • Pick up and bring two vials to SCRC and pay the $500 storage fee to have them stored there. 
  • Pick up and pay for my first round of medication. 

This is such a huge decision. After a lot of discussion we've decided to accept some of the offered financial support from our families. It makes me a bit uncomfortable but if it's what is necessary to have children, it's just something we're going to have to get comfortable with. 

Can you tell how nervous/anxious/ahhh I am? It's like a miniature tornado churning in my insides. I'm not actually worried about the process itself, I'm a pro at injecting myself and the retrieval is just another procedure for me, but I'm terrified that this might not work. I'm terrified we're going to spend $40,000 and not have any viable embryos to show for it. I'm terrified that E will get completely discouraged and we will be done. I'm terrified that maybe he's not ready after all, that he's feeling just some of what I'm feeling, even though we're in this together and he says he's okay. I'm terrified of failing and never having children.

The only thing I can do is cross everything I have, rub every lucky rabbit foot and Buddha belly I come across, project every good vibe/thought/energy I can muster out into the world and hope with everything I've got that my body cooperates and we are able to create healthy, viable, life.

Sunday, August 17, 2014

Update: Freeway FAIL

My Sydney is finally home from the mechanic but she is sadly not whole. After googling around a bit, it appears she has fallen prey to what appears to be the curse of the Jettas (and other VW/Audi's). Sydney has been serving me faithfully since I bought her, yes with a few hiccups here and there, she is 12 after all, and it's crushing me that she might have a problem I can't have repaired.

The curse of the Jettas seems to start with, you guessed it, stalling on the freeway. It seems to happen to most people when they have less than a quarter tank of gas, as it did to me. The engine stalls, the power steering and breaking go out, and you have to hope you can coast to a safe place. People are usually able to restart the car, but it can take a couple of attempts. Some people see the battery light come on like mine did before it stalls.

The most successful fixes thus far are:
  • Changing the Crank Position Sensor
  • Changing the Fuel Pump
  • Cleaning the Throttle Body
  • Changing Various Filters 
  • Cleaning the Fuel Tank
  • A million other fixes from faulty ignition switches to bits of junk blocking filters
A fuel pump thing? I might need a new one of these.
Thus far, my mechanic has changed the Crank Position Sensor, changed the Spark Plugs, and cleaned the Throttle Body. The next stop would be changing the Fuel Pump but that is pretty pricey and at this point would be a shot in the dark since the pump appears to be fine. She isn't throwing any codes, there aren't any lights on, there's nothing to indicate what the problem might be. Some people have done all the above things and still have problems.

When I picked her up from the mechanic I was hoping she was fixed. I had asked the mechanic to double check the alternator again so she had a dead battery when we got back from Las Vegas. E and I jumped her and then took her on the freeway at night to try and charge up the battery. She was drinking along just fine, heading for PCH when E made the offhanded comment that he hoped she didn't stall. Not 30 seconds later and BAM, she starts dramatically slowing down despite me accelerating and I can tell she's about to stall. I pumped and pumped the gas and by some miracle the engine picked back up.

I don't want this to be me
I feel like I can't trust her anymore. I wonder when I leave the driveway or get on the freeway if she's going to stall. If I'm going to get stuck somewhere or worse, get in an accident on the freeway because the car behind me doesn't know my car just stalled and is going to stop. Inspired by my Williams and Sonoma trip, I thought about calling up my sister to head to the Pottery Barn Outlet but its an hour and a half away and I'm afraid of stalling out on the highway and getting stuck in the middle of no where.  What if she stalls on the way to my IVF appointments? On the way to my egg retrieval? Once I'm pregnant? There are tons of threads of people with VW/Audis stalling over and over. There's clearly an issue that should be recalled but nothing has been done.
 
I was below a quarter of a tank when I stalled both times so I'm hoping I can prevent the problem if I keep my tank mostly full. If it only happens with a low fuel tank, I think that points again to the fuel pump so I'll replace that next. My concern is that it's a flaw in the pump design itself, and that replacing it a million times won't fix the fundamental flaw.

I need Sydney to keep working. I just hit 70,000 miles on her so she's practically a baby, even if she's 12 years old. Our next big purchase was going to be a family car, but since we need to purchase our family first, the car is going to have to wait.

Saturday, August 16, 2014

A Little Vegas Break

I've been pretty quiet for the past week or so because E and I decided to cut loose and go out of town. It's been so stressful lately trying to make these big decisions that have such a lasting impact on our lives. E had been working multiple 26 day stretches with just a day or two off in between and we all needed a break.

For E, close to home relaxation means Las Vegas. I know not everyone "does" Las Vegas the same way so that might seem crazy, but we tend to stay away from the party/gambling/excessive drinking scene. For us, Vegas means lounging in the pool, sleeping in, eating good food and taking in a show. This time, we took advantage of what turned out to be their "renovation" promotion to stay at The Hotel at Mandalay Bay, which is in the process of becoming the Delano Las Vegas.

Super White Living Room. The photo on the wall is of a couples underwater junk. Klassy.


With this awesome little promotion, E and I were able to get a really swanky, modern suite. It was split into two main rooms, a living room with a couch, desk, TV and small guest bathroom, and a bedroom with a huge king bed, closet suite, TV, and a master bath.

Bedroom with a VERY comfy King bed. Excuse all the clothes, I was unpacking.
One of our favorite things has got to be the black out blinds, E never sleeps as well at home as he does in Las Vegas. Air conditioning cranked up, black out blinds drawn, sprawled out in more space than we need. It always gets the job done.

The delicious master bathroom

The bathrooms at The Hotel aka Delano Las Vegas have all been redone, and provided a nice break from the stark white of the suite. They included these lush, plushy white robes and slippers and we spent a good chunk of time lounging around in them. The shower was wonderful too and the tub, with is super fill waterfall faucet, would have been top of my list if it hadn't been for a small plumbing mishap. The construction crew has been working 24 hours to complete the remodel and it seems they made a few hiccups along the way. On our last night there, we had just drawn a delicious, steaming hot bath when we realized the tub was a little too full. We pulled the plug to draw some water out when bam, the bathroom's main sewage pipe started to back up into the shower. No actual sewage came up but the shower STANK. It was not pleasant and we called maintenance to come repair it as soon as we checked out, they were willing to come sooner but we were already heading to bed and didn't want company. 

Michael Jackson ONE
Every time we visit Vegas we try to take in at least one show. We've seen O, Beatles LOVE, Zumanity, Ka, and a couple of others over the years. This trip it was Michael Jackson's ONE by Cirque du Soleil and it was quite a show. They did a lot of acrobatic floor work and a fantastic number with trampolines that was crazy. Couple that with Michael Jackson's timeless music and you should absolutely see it if you find yourself in Las Vegas. 

Show Selfie
We didn't take nearly as many photos this trip since we were too busy enjoying ourselves, so I apologize for the lack of photographic interest. We hit some fabulous restaurants, stopped in at my favorite store Tatyana at the Forum Shops (I found a gooooorgeous dress but it was a little pricey so I've got my fingers crossed for an upcoming sale!), slept late every day and spent at least a couple hours a day lounging in Mandalay Bays Lazy River and Wave Pool. We meant to check out the Delano's private pool and spa but never made it down there since it's hard to get past that Lazy River. I'm pretty sure I could float in that thing all day and be happy, though it would have been better with less people crowding it.

We capped off the trip with a visit to the Williams and Sonoma Outlet on our way home (thanks E <3 a="" again="" already="" although="" and="" are="" as="" at="" badly="" bit="" break="" brought="" but="" can="" cast="" come="" delicious="" favorite="" forward.="" forward="" he="" hectic="" hold="" home="" honey="" hoping="" i="" inside="" iron="" is="" it="" know="" linen="" little="" looking="" m="" most="" move="" my="" napkins.="" nbsp="" needed="" new="" not="" of="" on="" out="" p="" pans.="" past="" relaxation="" s="" shopping="" skillets="" some="" that="" the="" things="" those="" time="" to="" was="" we="" will="">

Thursday, August 7, 2014

Freeway FAIL

E and I seem to have bad "Carma". We both take fairly good care of our cars, they're serviced regularly and we always fix or replace things as needed, but they consistently seem to break down at the same time. E's car needed a lot of TLC and has been in the shop for a little while now. It got everything from new gaskets to new tires and just when we thought it was ready to come home, it has to go back into the shop for another tweak. You'd think that would be enough bad carma for one family but you'd be wrong. Instead, my car Sydney joins the foray by breaking down in spectacular fashion.

I was supposed to take grumpy man Zena to the vet today. He was scheduled for a check up and I needed to pick up another bottle of antibiotics for Zuzu (aka Fuckie) that I'd already paid for and had waiting for me. I nabbed Zena with an empty promise of food, got him in his box, and set off with him protesting loudly in the front seat. I would have given him a dish of food but he can be a vindictive pottier and I didn't want him peeing and or pooping in my car, both of which he's done at his last two appointments. Fun times. 

The vet we're currently seeing since our old one closed her doors is down in the Westchester area of Los Angeles. I was driving along, making good time for LA and moving from one freeway to the next, trying to quiet the disgruntled Zena so I could hear my Harry Potter audio book (priorities!), when my battery light comes on. This is super weird, the battery light usually comes on when the battery is dead and the car wont start. I'm driving the car at freeway speeds right now so it's obviously started, but I figure I'd better take the next exit so I can check it out. I start moving towards the right lane from the middle when I notice that my car slowing down Fast, without any input from me. Uh oh.

This would be the second time my car has stopped on this freeway since I bought it. The first time it happened, my oil pan had been punctured by a runaway piece of something that fell off the car in front of me. This time, there was no apparently physical explanation but the same thing happened. The car slowed, I'm fairly sure it was because the engine stalled, I could barely steer and I couldn't use the brakes. I stepped on the brakes as hard as I could, steered for the triangle of space between the right lane and a merging on-ramp, put my parking break on and got the car stopped and in park. Total deja vu.

Once stopped, I made the usual phone calls. E to let him know what happened, Roadside Assistance to get me a tow, my mother who was closest to my location to come get Zena, my Mechanic to let him know I was coming, and the vet to cancel Zena's appointment. Roadside Assistance also contacted the CA highway patrol to send out an officer to make sure my little car didn't get smashed where it stood. LA drivers are not known for their observational skills and I was definitely not on the side of the road. In the time it took to make these quick calls, my car got HOT. Zena was quickly over heating but my power windows were only cracked a bit and I couldn't open a door without risking it being smashed off. When the CHP officer pulled up the first thing I did was ask if we could chill in his air conditioning and he was really nice and happy to oblige.

Although my Roadside Assistance tow truck was on the way, the CHP truck showed up first and elected to get me off the freeway instead of waiting for my truck. Like I said, not the best location to be stopped, even if I wasn't directly in a lane. The CHP officer was nice enough to let Zena ride in his air conditioning while I rode with the tow truck driver and they were able to get me off the next exit and onto a quiet residential street. Thank goodness Zena didn't pee in the officer's car, I was worried but he seemed to hold it together despite being clearly uncomfortable.  A few minutes later my mom showed up to get Zena home and my tow truck arrived to take me to my mechanic. They were able to get my car started, though it did not run happily, and my tow truck followed me to the mechanic to make sure it didn't stall again.

Thus far everyone has different theories as to what went wrong. The tow truck driver thinks it's my alternator, which must have died, causing my car to run off the battery for a handful of minutes before exhausting it and stalling.  E agrees with this theory as well since the alternator makes the most sense. My mechanic isn't sold though, he turned the car on and after listening for a few minutes declared that my car is not firing all of it's cylinders. It's also vibrating really hard at a certain RPM but refused to spit out an error code even though something is clearly wrong. None of that seems like a good indicator of a quick fix, I'm seeing dollar signs already and we won't know more until tomorrow.

It never ceases to amaze me how quickly things can pile up. Here we are, trying to make up our minds about a clinic and gearing up to spend ~40k when both our cars break down. We really don't have the budget to cover expensive repairs or a new (used) car right now. I don't even know what we'd get if we did need a new car. We've talked and talked about getting a nice family car as soon as we're successful with IVF, since both of our cars are fairly small and clearly not super reliable, but what if we buy a big car and our attempts to build our family fail? I'd be stuck with a lovely car with three empty rows to remind me.

I've got everything crossed that whatever is wrong with Sydney is a (fairly) quick and easy fix. Come on universe, we could really use a bone here. 

Sunday, August 3, 2014

She's so Fluffy

My Button has a furry little problem. Namely, her long, soft, luxurious, fluffy coat.  She grooms and grooms herself, consuming large quantities of fluff, and then hawks it back up spectacularly all over my floor/bookcase/bed/shoes/the cat tree. Thus far, we've had really good luck managing her hairballs with Vet's Best Hairball Relief Digestive Aids. We can crush the pills into her food, she eats it right up, and her hairball frequency is wonderfully, dramatically reduced.


So why am I even bothering to post? Who cares about hairballs? Well, not too long ago, we ran out. I usually buy the stuff in bulk from Amazon, but we've been out for a month. And in just the few weeks since stopping the pills, she has had several disgustingly spectacular hairball incidents. I had gotten so used to the pills working that I forgot how gross things get without them. Her last "incident" was over a foot of mess. Button's current new theme song is :

I’m so fluffy
You already know
I hawk my hairballs
You never know when I’ll blow
I’m so fluffy
Watch me groom myself
Just made some hairballs
‘Bout to blow 

Sung to the (supposedly?) popular Fancy:


I'm too out of touch with popular culture right now to know what's in, but this chorus has been stuck in my head for weeks and now and all I can hear is hairballs. So if you also have a fancy, fluffy kitty who is prone to hawking partially digested fur all over your floors, give the Vets Best pills a shot. I'm ordering another 8 bottles of the stuff right now.

Saturday, August 2, 2014

SCRC in the Running

Yesterday morning we had our consultation with SCRC, our other strong contender for our IVF clinic.  After we ruled out USC I thought we'd be going with HRC, since they came so highly recommended by my acupuncturist, but SCRC made a really, really strong case.

  • They do tons and tons of PGD cycles, about 35-55 per month, definitely over 500 per year, and their embryologist, who came to meet us personally, was fantastic. 
  • They use Reprogenetics about 95% of the time, and with day 5/6 biopsies, they have a less than 1% rate of inconclusive results - I don't remember if he said it was 0.4% or 0.8% but it was excellent. 
  • They use laser biopsy and biopsy in house
  • They're only 6-9 minutes from my house which means I don't need to spend an hour in traffic. This is a huge plus, I don't have to leave at 6am for my appointments!
  • They don't validate for their structure (negative) but there's a structure just around the corner that will give us 2 hours free.
  • The doctor doesn't do my monitoring ultrasounds himself, his tech does them and delivers him the photos and lab work. This is a negative since HRC promises that you get your doctor at every appointment but the tech was very nice and did an excellent job with my scan.
  • They would also recommend two cycles and batching our embryos, which seems like a good plan.
  • This doctor is of the opinion that when you know something works well, you should attempt to replicate it. Since I responded well to the 10 days of birth control and 8 vial Menopur cycle, he's inclined to follow a very similar protocol 
  • They're big supporters of FET and feel it's better to put the embryo back into as normal an environment as possible. I'd be doing a frozen, medicated transfer. 
  • Money-wise I'm trying to sort out where they are. There's some issue with billing since they usually bill on behalf of Reprogenetics and we'd need Reprogenetics to bill Kaiser directly. This will be a deal breaker if they won't let Kaiser pay for our probe because that would cost us a lot more money. Other than that, I think they're about $36k for two cycles, including meds, and one FET. Fairly standard among the clinics.
While there I had another AFC done and was pleasantly surprised to see at least 7 lovely antral follicles! It looks like the corpus luteum cysts are gone, though the simple cyst is still hanging around, tiny and unobtrusive on my left ovary.

If we're counting this as a new cycle, we have until around August 20th to make up our minds about which clinic we're going with. I have a call in to HRC to find out how many FET attempts are included in their package and the billing department at SCRC is looking into making our PGD coverage work. I'm really torn now, I think either clinic would be a good fit and there are some strong positives for each one. I have no idea how we'll make a decision!