Tuesday, May 07, 2013

And so it begins for a final time

We are at the commencement of our final DE FET cycle.
I was at the clinic yesterday for what they called a follow up appointment, even though it's not really.  They booked me that way rather than as a new patient, even though I probably still had the same blood work done.

So I arrived for my noon appointment, on time.  Went through about 10-15 minutes while they tried to figure out where my chart would be since I was last there June 2010.  Yep, three years almost exactly.  In the end they found it down in their archive department.

So, as usual, I took up my seat in the waiting room because I needed to see him first.  However, nothing has changed in the three years.  Did I really expect it to?  Nope.  Anyway, as before, at that time, he's basically finished seeing his daily monitoring patients, with just a few still lingering. So he is back and forth between the OR and the offices as he performs retrievals and transfers, seeing patients in between.

I had arrived with a full bladder as requested.  About 12:30, I knew it would be a wait so I went to "pee a little".  At 1:30pm I went to ask how much longer because at this point. the bladder is full again.  They were going to call over to the OR to see how long.  I went and "peed a little" again although this time it was a little more than before.  Ah, sweet relief.  Do you know how hard it is to stop peeing when you need to go?    He finally saw me at 1:45pm.  This is why I didn't bring V to this appointment.  It really wasn't necessary.  I knew the drill.  And besides, he works nights, so he was supposed to be sleeping.

Anyway, in sitting down with him, I brought him up to speed as to why it took us so long to get back to do this cycle.  As you all know it's been predominantly funds.  We're finally at the point where we have the money to do the cycle.  There isn't any overage really.    He says the three donor embryos are good.  We shouldn't be concerned that they've been frozen since 2002.  The donor couple had four frozen but in 2006 they thawed one.  So I extrapolated and figure they were successful twice with this batch.  The were probably successful with their initial retrieval, or possibly a FET.  Then they thaw one and don't need the other, I figure two kids from this bunch of embryos.  We should have a decent chance of success.  He didn't say otherwise.  So, he goes through everything, asks where I am in my cycle (CD2) and then says, do you want to start now.  So I said sure, why not.  I supposed one more month wouldn't have killed me considering we're moving  in 3 weeks, and transfer would be around the 23/24th.  He mentioned we're going to do the usual 4mg of estrace three times a day, 5mg progesterone twice a day, and an 81mg baby aspirin once a day.  I've been taking 5mg folic acid, the baby aspirin, 100mg of B6 and 1000mcg of B12 every day for the last three years, so I'm already on the baby aspirin.   He'll also add in the 2500iu of Fragmin starting the day of transfer.  Plus he wants to add in Intralipid 20%.  More on that in a bit.  He wanted me to go for full blood work, full ultrasound, see a nurse, then him again, and also wanted me to get an ECG done.

So, I hit the vampire lounge.  She used a butterfly needle (they don't usually) and I didn't feel a thing. Seriously, not even the pin prick.  She then proceeded to fill about 16 vials.   Then, back to my seat in the waiting room.

On to the ultrasound. At this point I'm feeling comfortable.  I can tell the bladder should be okay even if she were to do it now.   About 10 minutes later I think, she called me back and did the ultrasound.  Mid point I was able to completely empty my bladder.  She even said dry dry. She didn't want anything in it. LOL.  I did my best.    Then it was back to the waiting room.

I've lost track of timing at this point but it's probably close to 2:45 or 3pm.  The DE nurse called me back.  I gave her the sad story of why we had taken three years to get back into the clinic.  She was sympathetic to the delay and understanding about the finances as I explained we now had the funds for the cycle.  She then goes over what the RE had said in regards to the meds.  She also gets me "compassionate" meds - a new bottle of the Estrace which will keep me going for just over 2 weeks and 7 syringes of the Fragmin as well.  I'll just get prescriptions for them later as they're covered on our plans thankfully.

So I am due back in on the 16th for cycle monitoring and will probably transfer all three embryos on May 23rd. When he asked how many we were transferring I said all of them. He said "are you prepared for twins?" I answered with a yes. And when we were out at the reception desk as he got the different requisitions, he mentioned selective reduction. I said we'd face that if we had the opportunity. So, I just want to get to transfer at this stage.

She then gets into explaining this Intralipid 20%.  Apparently there have been studies that how shown that it it makes the uterus more hospitable to the embryo aiding in implantation  The implanting embryo is being fought by the body's immune system, and this reduces that possibility. It is being used for those who have had repeat failures  but my RE mentioned it in terms of my age as well.  Another helpful article is this one.  She explains that it's administered intravenously and can take 2-3 hours.  So I would go in for cycle monitoring then held over to the OR suite where the procedures are done and have them hook me up.  So then she drops the bomb that I didn't even think of when the RE mentioned it.  The cost.  It's $300 per application.  The first one would be next week, May 16th which is the 10th day of the cycle.  And then, if pregnancy is achieved, it's every two weeks until 12 weeks.  So that means 5 additional applications depending on when they start.  That's an additional $1500 which was not budgeted.  So now the cost of this cycle has almost doubled.  And the kicker is that even though this has a DIN number, it's not covered under either of our plans and V has a really good plan.  So that's an out of pocket expense.  And it has to be paid for before they give it to you.

So now I'm back to we don't have the all money we need.  I know it's not something I have to do.  But the studies seem to indicate it's a good thing, and he's recommending it.  I don't think he suggests these things just for the hell of it.  I've also been reading on line on different forums that people have used it and been successful when previous IVF cycles haven't worked.

I know V.  He's looking at the overall cost, and I don't blame him.  We've budgeted for the cost of the cycle and the PIO (sort of) which is reimbursable.  So, what do I do?  I don't have money coming out of my butt nor do I have a money tree growing in the backyard (I wish).  On top of all of this we're moving in 3 weeks and may end up at my Mom's for a month while we fine a place.  We still haven't got anything to move into.  So we've got moving costs, storage expenses.  Do I contact the business office and see if they'll let me work out a payment plan of some sort?  If the expense had been reimbursable, I could have probably made some sort of payment plan knowing that the $300 was coming back to be applied to the next application. 

Sigh.....why does something always happen to us just when things seem to be going our way???


JW Moxie said...

Damn, Pam! That is such a tough predicament to be in. I honestly don't know what I would do in that situation, so I know I'm not going to be of any assistance in helping you weigh the pros and cons of having the intralipid infusion or not. :( This sucks. xoxo

Pam said...

I think doing the infusion would be the right thing to do because I'd hate not to have done it and get a BFN. But if it works with it, then it's a matter of dealing with the charge going forward.

I need a fairy godmother or godfather. Or an anonymous benefactor. LOL.