Third time’s a……

Three Times a Charm

I think I am getting the hang of this IUI thing now.  I understand exactly what is going to happen each day, what drugs to take, what side effect will happen and when, who to speak to on the phone, who NOT to speak to on phone, how to ask for what I want, how to make myself understood, how to refill my various prescriptions, what bills to expect, even what emotions I am probably going to feel on this roller coaster of a cycle.  For example, I am on Cycle Day 4, and having taken two 2.5mg of Letrozole last night at 7pm, I knew at approximately 4pm Today I was going to be mega sleepy.  And I was! Where I work, if you have done something more than twice you are considered an expert, so I’m going to declare myself “IUI Subject Matter Expert” on my “CV of life”.  I’m feeling quite chilled out about it all, that is except for one, teeny, tiny, annoying thing.


The thorn in my side right now.  Needles have nothing compared to this pain in the….

You may recall before we started IUI that my insurance company wrongly stated that I did not need pre-approval for IUI treatment.  It was only after I started my first cycle all became apparent that we needed pre-approval before any fertility treatment.  Since then, we have been trying to get things straight with our insurance company.  I am not entirely blaming the insurance company here.  I am blaming ‘the system’.

It seemed so simple, our insurance company required copies of our medical records to determine pre-approval for our IUI treatment.  Well that’s easy! No? Fertility clinic – please provide our insurance company with our medical records.  “No problem, we will get the nurse right on that” they said.  Well each week we chased them, they claimed no knowledge of this request, but wait, what is this? …oh there is a note in our records to do this.  Hmmmmmm.  At our last appointment 2.5 weeks ago, the nurse promised us the request to send the medical files was with their business team and they were going to action it that day.  Well it turned out that was all bull.  No medical records were ever sent because we had to fill out a release ‘form’.  And after the number of people we spoke to try to make this happen, not one person mentioned a form.  Things also got complicated when the fertility clinic realised that our insurance’s medical office is located in Belgium.  This would be impossible! Sending medical records abroad – there are different laws for this. They were not quite sure how they are going to do it,  come on, surely there is a form for that too!  How about I google it, I bet google knows the answer.

So after we hit this road block, Chris tried a different approach.  He has given the half completed ‘pre-approval’ forms to our insurance company to chase up with our fertility clinic.  When my insurance company emailed me this morning to say could I please provide them with a contact number for my doctor, oh, by the way we would need approval for each round of IVF….I flipped!  As you can imagine we had dutifully and carefully provided a contact number and address, but most importantly, it clearly stated on the form the treatment was IUI.  I even provided them with a breakdown of all the costs for each procedure and medication.  Aghhhhhhhhh!

I have no idea what is going on right now, but it is all now in the hands of the insurance company and our fertility clinic to figure our laws, methods of handling medical records, procedures, money and what not.  Why couldn’t we have got to this stage two months ago?  At this rate we will probably get our “pre-approval” for IUI after we have finished all three rounds of IUI!

Without pre-approval we have paid for our first round of IUI out of our pockets and hoping we will be able to claim some money back.  Soon the bills will be coming in for the second round of treatment.  It would be nice if they figured it out before then.  My worst nightmare is that they deny the claim because there was a small test we had to do or form we had to complete before we started with the IUI.  There is little advice the insurance company can provide us on whether we are covered or not until they have our medical records.  Similarly, they can’t answer if we are covered for IVF until they see our medical records.  This makes financial planning for the future a little challenging.  But we are planning for the worst, just to be safe.

I should point out that we do have a rather strange insurance arrangement – because my organisation is international, Allianz, our insurance company, provides coverage for all staff across the various countries.  Allianz uses United Healthcare as their service provider in the US to purely deal with admin for claims made in the USA and negotiate in network deals with providers.  This makes things complicated for medical providers here in the US when we try to explain that they have to provide medical records to Allianz, not United Healthcare.  I hope I didn’t lose you there!

Third time...

Third time…

So to sum up today’s post – Insurance sucks and starting IUI cycle 3 is going to be a breeze.  As the saying goes….third time lucky!  Or….third time a charm!  Let’s hope it’s not like the other google search term on the list above – third time out :-s

Cycle Day 11 Ultrasound – its’s go go go for IUI #2

Today I went in for my Cycle Day 11 Ultrasound to check my uterine lining and follicle maturation.  The doctor was a little more smiley today than the last time she performed the ultrasound.  I felt a little more at ease this time around.

So here are the results from my ultrasound:

8mm Uterine lining – that’s apparently very good

3 follicles in total: 2 in the left ovary, 23mm & 16mm in size and 1 in the right ovary, 25mm.  All three looked good.  So more of a chance of multiples than last time :-s, but it is a risk we agreed to take.

Chris asked the doctor about the last cycle where two of my follicles were a bit bigger, were we too late and missed our chance?  But the doctor said that with letrozole, follicle size can be up to 28mm.

Tonight we get to do the ovidrel injection and then IUI is scheduled for 0800 Saturday morning. Woohoo!!! (but not woohoo to the injection though, that stuff is just mean).

So Letrozzzzzzzzzzzzzzzzzole sleepy…

Wow, these drugs make me sleepy!  Letrozole (AKA Femara) comes with a warning on the bottle ‘Do not drive or operate machinery until you know how these drugs affect you’. Well I never saw that on the bottle first time around!

Pharmacy Fun Time
Yesterday, I got my ‘refill’ of 10 tablets of Letrozole (2.5mg) from my local pharmacy just in the nick of time.  I am supposed to take x2 Letrozole tablets for five days, starting from CD3.  Yesterday was CD3, so I when I received an email from my local pharmacy saying I could pick them after 5pm I was relieved.  However, there was a note in the email saying that I would have to pay full price because it was so close from ordering to pick up, the insurance had not been calculated yet.  That would be $103 full price v $0.26 copay due.  Fortunately, when I got to the pharmacy, the insurance had done its thing and I only owed $0.30.  An increase from last cycle of $0.04 – weird  (My progesterone has gone up by $2.00 as well – has there been a nationwide increase in drug prices? Do drugs fluctuate like oil prices??)

Rahhhhh - Dodgeball is a great place to let off some steam

Rahhhhh – Dodgeball is a great place to let off some steam

What time of day do you take your Letrozole?
I have decided to take the Letrozole in the early evening because last time when I took them in the morning, the drugs were affecting me on my drive home from work, dangerously so.  They do make me extra sleepy – I guess from using all that energy up to grow those extra follicles.  Let’s see how this works out.  Last night I slept pretty well for the first time in a while, maybe it was the drugs or maybe its about time I had a good nights sleep after two weeks on the progesterone.

Dodge, Duck, Dip, Dive and Dodge
Right – off to dodge some balls at our social club and let of some steam!! More on dodgeball next week when I will be facing the dilemma of whether to play in the play offs or sit on the side lines…. :-S

I need my safe place today

14 days past IUI round 1 and I have one negative pregnancy test in front of me….we were good and didn’t test until day 14.  But I’ve known since Saturday it would be negative because I have been having those well known period pains.  But maybe, just maybe I was confusing them.  But no. I was not.

As it is my first time on all these hormones it has been a very confusing month.  My right breast grew significantly larger after I took the Letrozole (and it’s stayed like that); I’ve had horrible ovary pain around ovulation and a swollen abdomen; then after the IUI, sharp pelvic pains that stop me in my tracks, aching lower back, swollen breasts and nausea.  Damn you drugs.

But now I’ve figured all that out this time, surely, the second time round will be easier and less confusing?

Chris was dying as much as I was to take the test, but I knew already and woke up crying this morning because I just knew.  So Chris made me take the test to resolve it once and for all.  I’m not going to put all my thoughts down about how I feel right now, it would not make for good reading.  Maybe later this week when I’m a little more composed.

My safe place is my ‘anchor point’ I developed on a ‘Presentation Skills’ course.  We were taught to have an anchor point that reminds us of our safe place.  Some people on my course thought it was odd and just didn’t get it.  We were made to sit down on the floor and meditate, thinking of a place that makes us feel warm, safe and happy.  Whilst thinking of this happy place we were asked to hold our thumbs to our middle fingers.  We were guided through this meditation to visualise this happy place, smell it, listen to it and feel the warmth of it.  By associating this happy place with this action of holding our thumbs to our middle fingers, we can easily calm ourselves before giving a presentation.  I learnt this ‘skill’ almost 9 years ago and still use it today when I feel anxious.  Today I’m walking around with my thumbs to my fingers, a lot.

IUI round 1: My Big Fat Negative

IUI round 1: My Big Fat Negative

Wonky Boobs – a side effect?

If I could post a picture of my wonky boob I would, but I don’t think the internet needs anymore pictures of wonky boobs, I’m guessing it’s a pretty saturated market out there.

Yesterday I woke up and looked in the mirror to discover my right boob had grown overnight, it also felt overly soft compared to normal.  Chris thought I was exaggerating.  So I didn’t think much else of it.  But this morning it was still like that, so rather than poo pooing my crazy claim, Chris examined it a bit closer.  Upon closer inspection, he concurred that my right boob had indeed grown in size, whilst also laughing in amazement when he came to this conclusion.  Luckily I shared his humour on this one.  I am guessing this is a side effect of the Letrozole (well I can’t think of any other explanation for it!).  I am due to ovulate from the right side, so is it coincidence that it was my right boob that grew?

Will my boob return to normal size and match the other one??? I hope so!  Or perhaps next cycle the other one will catch up – may be I won’t need a boob job after all!  (Just kidding, I don’t really want a boob job, and never have, luckily I like my boobs as they are).dani

Letrozole all gone – waiting for the Ultrasound CD11

I took my last two Letrozole tablets today.  I haven’t had tiredness today like I had last week, but I do have some abdominal pains so I am sat here with a hot water bottle.  Maybe its a psychological thing, but I think the hot water bottle helps.  I don’t really know if it is my Irritable Bowel Syndrome or a side effect of the Letrozole that is causing it.  Either way, it sucks and wish it would go away.

The abdominal pains started today after lunch, just as I was about to lead a workshop for the afternoon.  I thought about all the possible excuses I could come up with as people arrived.  I looked around the room filled with men all over the age of forty five I decided that I would only end up embarrassing one of them with the truth.  So I stuck it out.  But as soon as I got into the workshop I forgot about the pain.  It was only when I stopped thinking and took a breather for a minute that I realised the pain was still there.

I’ll start my ovulation predictor tests tomorrow, a couple of days sooner than when the nurse suggested.  But I have paranoia that I will have a short cycle this month and miss out on IUI!  I’m not sure the nurse was aware that I sometimes have short cycles of 22 days.  It was only after I got home and read the information pack I thought perhaps I should start the tests a bit sooner.  Yey! Holding my pee in the mornings to pee in a cup time.  Trying to do it in the dark can be fun when I don’t want to wake Chris up too early.

Chris took this photo yesterday - It says so much more about him than a blog post possibly could

Chris took this photo yesterday – It says so much more about him than a blog post possibly could

I asked Chris to guest blog for me this week.  He wants to, he is just not sure what to write.  He is a good writer.  He has a published book already and has been writing a novel in his spare time over the last few years, so he knows how to write well.  Unlike me!  He has some ideas what to write about, but is nervous sharing his thoughts.  I said he should read some of the blogs from other men, perhaps it will help him see from a different perspective how blogging can be a bit of therapy for the mind.  I hope he does write something, but I am not going to pressure him or make him feel bad.  Blogging is not everyone’s cup of tea and I am certainly still learning – so far it tastes pretty good and I can see it fitting into my daily routine.  Let’s see how addictive it can get 🙂

Soooo sleepy but still managed to dodge a few balls

Today I started the letrozole. 2 teeny 2.5mg tablets a day for five days. This small prescription should result in ‘super ovulation’; hopefully this should stimulate development of multiple follicles and eggs being released, therefore increasing the chances of pregnancy. The nurse provided me with an info sheet and described some of the side effects. The only strange feeling I had today was sudden extreme tiredness, when I was driving!! That was very bizarre, so much so I almost skipped dodgeball this evening. I checked the pharmacists long list of side effects, tiredness was on there. But so was almost every other side effect known to man! Has anyone had this with letrozole too?

Although I was glad I got out the house, I wish I had skipped dodgeball. whilst playing I pulled a tendon in my thigh. It kills! Being on letrozole means that I can only really take Tylenol as a pain killer (which I have none of in the house! Doh!). So it’s going to be an uncomfortable nights sleep. Why can’t I be sleepy now???!!!

I wasn’t sure how much my prescription was going to cost, but the nurse showed me a good website that gives you coupons for prescriptions. She told me I should pay no more than $10 for the letrozole. So I printed the coupon and discovered my insurance covers it, and I payed just 0.26c for it. I’m so happy!!!

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15

These ten pills can cost over $150 :-s but if you find a coupon they can be about $15