Sunday, September 30, 2007

73=1 and other things screwing with my mind

CD73=CD1, that is. Yup, that's right-- the beotch showed up this morning, but she had to wait until I was at a friend's house for a kid birthday party. Wanted to embarrass me on top of everything else, I am sure. But crisis was averted, so there. What I don't understand, though, is why almost 10 hrs later I am still not trippled over in pain. I mean, I spend the first day of any old period curled up, popping Aleve, drinking red wine, and putting hot pillow to my midsection. And given that a fun little ride on Dildocam Jr. at Dr.YoungGun's on Friday showed 15 mm of uterine lining, this one was supposed to be the mother of them all. But like I said, so far-- very easy going.

Also, I had no pre-symptoms. Nothing, nada, zip. So I am pretty sure this is unovulatory, possibly brought on by the changes in caloric intake with the end of my craptacular diet this week. Whatever it actually is, the timing couldn't be better. I donated a nice round number of vials of blood to the lab on Friday, and now that I am officially their patient, I am expecting to be hauled in on Tuesday for Day 3 labs as well. Those two sets of bloods will tell us with a reasonable degree of certainty both where this visit came from and whether I can hope to ovulate on this new cycle. And by "round number" I meant 13. I like that number, I do. Admittedly, I like it much more when it represents the number of Jonah Gold apples that are all mine and nobody else's (insert evil laugh here), or, say, when it is the number of days of uninterrupted vacation ahead of me (oh, to dream...), but if one is to have a largish number of vials of blood drawn, 13 seems like an appropriate number, no?

So as alluded to above, Dr.YoungGun has a cute little ultrasound machine with a nice, slender, and probably ergonomically designed am... attachment right in one of his exam rooms. It's not a massive one, but I do think its resolution is better than what you normally find on an L&D floor. Because of what he saw on it, though, I am supposed to go drop my drawers for the big boys in radiology and their big, high-resolution machine sometime soon. Thus, the office machine will henceforth be known as Dildocam Jr, and the radiology one will, predictably, be the Sr. And yes, I know the big one didn't actually spawn the little one, but go with me on this. Interestingly, Dr.YoungGun didn't actually find anything on my left side, the one that was bothering me, and he is thinking that maybe I am working on a small hernia in there. But what is prompting this increased scrutiny of my insides is that he did find a largish (over 3cm) cyst on my right ovary. And it's complex, meaning it has some additional matter in it other than ovarian tissue. Apparently, if it doesn't make like a good cyst and scram, it will have to be surgically evicted. I guess I have to name it now. I am thinking Immanuel, like Kant, since it's so complex and all, but I am open to suggestions.

I am also supposed to get an HSG on CD8-10, so that will probably be next Monday. And JD is supposed to provide a sample at a date to be determined tomorrow. No home deliveries accepted at this clinic, so he will have to go there for the entire err... exercise.

I have to say that even though Dr.YoungGun and I didn't get off to a warm and fuzzy start-- I got a bit peeved when while explaining that my insurance is going to resist covering treatment since I recently had ovulatory periods it seemed to me that he himself was also taking that point of view, and I got even more peeved when he then said that it upsets him as much as it upsets me, to which I couldn't resist replying that I highly doubted THAT-- I do like him. He is thorough and knowledgeable, and seems to practice evidence-based medicine. I think I can trust him, and I can definitely see why Dr.B thought I should see this particular guy.

Speaking of Dr.B. I have to see him again. I told Dr.YoungGun that one thing I need to not happen is a higher-order multiple pregnancy, and that I would prefer not to get pregnant with twins either. I wanted to go straight to IVF, actually, with a single-embryo transfer. As it happens, Dr.YoungGun has a paper in press about singe-embryo transfers, and thinks it's a pretty good deal if the embryo transfered is a good-looking day fiver, but not so much if it's only a day three-er. However, none of this is material yet, because insurance won't cover IVF until we've wasted time on suffered through done three cycles of non-IVF first. This is apparently the downside of living in a mandated coverage state-- there are rules imposed on the doctors by the insurance companies. The upside, of course, is only paying co-pays for the whole thing. So, three cycles of chlomid or injectables. Probably injectables in my case, as we talked about greater control that would give, plus I do not like chlomid and its lining-thinning crazy-inducing ways. Dr.YoungGun is willing to mark my file "do not trigger if more than one follicle" and he says he can make any canceled cycles count as far as insurance is concerned. So this is what I have to go talk to Dr.B about-- whether I should be a strictly one follicle/embryo kind of a girl. My gut says yes. We also ran into Dr.B as we were exiting the hospital after the appointment and told him what I will be coming to speak to him about. He did not look thrilled, and he said something like "twins are not insurmountable" which, if we are honest with ourselves, does not sound like a ringing endorsement. So I am even more inclined to stick with one now.

All of this was a lot, and it took me a few days to process. In fact, I am not sure I am really done processing it yet. AF showing up today is a lucky break, because it speeds up a bunch of tests which otherwise would've had to wait until after a period could be induced with progesterone. Hopefully, though, it won't be used by the money-grabbing assholes insurance to insist on denying coverage.

I was doing a convincing Goldilocks impersonation this weekend. We went to an adults-only party last night, and a few times I had to escape the bustle because everything seemed too trivial. Granted, there were people there whom I don't really know, and I did much better while talking to our friends, but still. Then this morning there was that aforementioned children's birthday party. It was a slightly cooler morning than was hoped for, so we were all mostly stuck inside the house, instead of outside, as was originally planned by the hosts. And while I usually do pretty well with children and babies, even if I still do my best to ignore most pregnant women or their state, whatever seems more appropriate, being stuck in the house with something like five babies and at least three pregnant women, even if not all at the same time, was a bit much. Things got a little easier when the festivities moved to a local farm, what with a much decreased concentration of stressors per unit area, but even so I bailed earlier than I absolutely had to. I was wiped.

At the adult party last night I spoke to the older sister of the birthday boy for a while, and she was telling me how she now has everything she dreamed of and worked so hard to achieve-- family (they have two school-aged boys), a graduate degree, a great job, and that now that she has achieved all that, she is lost for something else. A challenge, it seems. She can't find anything that will hold her mind and heart as much as all the challenges of the previous decade did. I told her (and she didn't take offense-- this is why I like her, and why I like talking to her when I see her, even though it's not often) that while if I concentrate, I can understand her concern, it is so far from my own that I just can't feel it, that it feels very foreign to me.

Today Niobe named the feeling that has been chasing me all weekend-- being a stranger, a flunky, an expelled student in the world of the normal, being stripped of its citizenship. From where I am standing, it seems permanent, the expulsion. It's been eight months since my citizenship has been pulled. Eight months exactly, today. That might explain the flashbacks. Or maybe it's just the normal overload that brought them on. Either way, I need a drink. And an Aleve-- it's finally starting to feel like the bad part is about to hit.


Aurelia said...

Hey sweetie, I know it's frustrating dealing with insurance, but it just may be that you can skip ahead to IVF depending on what happens with your tests, frankly if you guys do medicated cycles you just might not need it, right?

As for only triggering when you have one follie, well, you may have several more smaller ones, and only one big one, but you can still trigger right?

slouching mom said...

Oh, goodness, Julia. On top of all else, Immanuel?

(Immanuel should come hang with Gus. Whaddya say?)

I'm sorry this is all so complicated. It just SUCKS. No two ways about it.

niobe said...

I'm completely wiped and I'm just reading about your life.

If you really don't want to do the IUIs, you might try talking to the insurance people. Because multiples would cost them a lot more.

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