Wednesday, November 26, 2008


Despite living in a state where infertility insurance coverage is mandated... We conveniently fit into a nice little loop hole where that is not the case. Yep - we have no insurance coverage for infertility of any kind due to my husband’s company being headquartered outside the state of Illinois. And we’re covered by a major insurance company so as far as I’m concerned this is all a load of bullshit.

Actually, as far as I’m concerned infertility not being covered at all, anywhere, is a load of bullshit. Over the past few days dealing with this I’ve fumed and fussed over all the things insurance will cover and I could go into a rant now, and perhaps I will later, but as of now I just don’t have it in me.

While I understand inducing ovulation is not covered... I don‘t understand why not. Not ovulating is a symptom of PCOS and why shouldn’t that symptom be treated as all others are? IUI, IVF, okay. But if I was healthy and not suffering from PCOS I would be ovulating... And I just want my body to do as it should. I know its beating a dead horse but it annoys me none the less. The entire health care system is so flawed, its all crap.

The kicker to all of this is that up until very recently - as in within the last month to few months - we DID have coverage. However, something changed in the mandate and now we don’t. HR is looking into it to find out exactly what changed (though I have my suspicions as stated above) but at this point I don’t see a point. Knowing why I don’t have coverage isn’t going to help me. There is an extremely small chance that we are still mandated to have coverage and for some reason its been over looked, but even HR said its doubtful.

I was aware of this when I went in for my ultrasound so I made sure to make mention that this needs to be coded for exactly what it is, PCOS diagnosis, and not infertility. However, my appointment on the 18th WAS coded as infertility (in addition to anovulation and irregular cycles) so when I looked it up online today, the $110 claim for that appointment had been denied. I immediately called my doctors office and they are going to recode and resubmit since I technically did go in for irregular cycles... And from now on I’ll be going in for treatment of polycystic ovaries... Infertility after all is just a symptom.

Right now we should be okay - since I’m being treated for PCOS my OB appointments should be covered. Metformin should be covered as well and if its not at least its cheap and on Wal-Mart’s $4 prescription list. If/when the time comes to be put on Clomid I’m not even going to attempt to push it though on our prescription plan... Since as far as the insurance company is concerned we’re not trying to have a baby, just trying to ovulate. Clomid is also on the $4 list (though it costs $9) so that won’t be an issue to cover out of pocket.

This will all become an issue if the drugs don’t work and we need to move on to injectables and/or IUI/IVF etc. But lets just hope that doesn’t happen. Its not going to happen... The drugs should work. I hope they work... They have to work. They will work, and if they don’t, we’ll just have to cross that bridge when we come to it.

I suppose this is just another hurdle to jump. As DH said, we’ll work though it and hope that this never becomes a major issue. It just sucks to have to deal with at all.

Tuesday, November 25, 2008

Another Point of View

This morning I woke up bright and early to make sure I had plenty of time to shower and get dressed before C woke up as I had my ultrasound at 9:30am. I realize now that I really was holding onto hope that those lab results were just errors... That I was soon to find out nothing was wrong with me.

My name was called and I met up with the sonographer.. She introduced herself to me to which I responded “Do you remember me?” “Of course” she replied “but sometimes people don’t remember me so I didn’t want to put you on the spot”.

It was almost two years ago, but after all the time we spent together it would be hard to forget Linda. She performed all of my ultrasounds (outside if the high risk ones) when I was pregnant with C - and in the last months I required weekly AFIs so there were lots of them. I love her - she is great and so sweet. Quite often my ultrasound was the last of the day so we’d spend a little extra time after the fluid measurements were done and just spy in on my little guy, watch him yawn and move around, and I always left with lots of pictures.

I thought going into that room would be difficult, seeing how these were the exact opposite circumstances that first found me there. But it wasn’t. I thought the ultrasound would be much more uncomfortable, but it wasn’t either. Definitely not on my list of favorite things to do on a Tuesday morning, but not as bad as I imagined it might be.

I was starting to regret setting up the appointment for then, since my doctor wasn’t in this week and I’d have to wait until next Wednesday for the results. Legally Linda couldn’t tell me anything... But I already knew I had PCOS. She showed me my right ovary... And she showed me the line of cysts on it. She said she didn’t count all of them but there were five that she took measurements on. My left ovary decided to be more difficult, but three cysts were measured.
It was when I first saw those black circles on the screen was when I realized that despite knowing that they were most likely there, I was still so hopeful that they weren’t. Even if they were not there the diagnosis would still stand due to my labs... But I guess I was secretly hoping that the labs were flawed, errors made by someone. Seeing them on that screen hurt more than I thought it would.

It was after the ultrasound was over and I sat up that I lost my composure a little bit. I saw the string of ultrasound photos hanging from the printer and my mind flashed back to when those images depicted little toes and a baby’s profile. I cried a little. I had always imagined being back in that room because I was having a baby... Not because I couldn’t.

I’m glad that it was Linda - we talked about holiday plans and family and I think that’s what kept me from being over emotional most of the time. She asked when my next appointment was and she isn’t in that day but I’m sure we’ll see her again.

I just hope the next time the image on that screen is a tiny beating heart.

Sunday, November 23, 2008

Accepting a New Reality

I anticipated the phone call for days.. I had hope, a plan, and the labs would just solidify that plan. A little bit of this, a little bit of that, pregnant soon! When the labs weren’t in by 1pm Friday I was down - now I’d have to wait and wonder all weekend. And then, 2 hours later, the phone rang and door slammed shut on previous notions and ideas. I am now forced to chisel a new path out of this mountain that lay before me. I am now forced to accept the reality of PCOS and hopefully overcome the infertility that has come with it.

To be honest, somehow I always knew that I would face this. Despite having fairly regular cycles the majority of my life... In the dark corners of my mind I always expected to have difficulty conceiving. Well before I was planning to have children I lurked infertility blogs and looked up information on tests and procedures. I paid attention and hoped it wasn’t in store for me, though I felt it was.

So on May 26, 2006 as I stood over my bathroom counter, still nursing my sun burnt shoulders from my honeymoon just weeks before, I was shocked in so many ways as to what appeared before me. A stark white background with two blazing pink lines on an almost expired pregnancy test. I glanced at the test, the instructions, the test, and back to the instructions. I threw on my cloths and brushed my hair and hurried out to the store to buy a fresh test... And 2 cans of cat food.

The original test was correct and the six tests that followed confirmed. Despite intercourse timed to what should have been an infertile period in my cycle... We conceived our honeymoon baby. Nine months later, after a pregnancy complicated by preeclampsia complete with 4 months of bed rest, we welcomed our beautiful little boy into this world by emergency c-section on January 24, 2007.

When I first found out I was pregnant, I remember telling myself that I guess all those infertile worries and thoughts were wrong... But I never believed it. I remember my neighbor, who was going through IVF at the time, telling me now that I had one it would be oh so easy to have more. I smiled and nodded... But never believed a word of it. And after Caden was born I couldn’t get the words “secondary infertility” out of my mind, but held on to hope that I was just being crazy again. After all, look how easy it was to conceive our son.

My cycles returned at 5 months post partum and were fairly normal. Now that I think back on it I do think they were a week late at times, but I believe I was ovulating and nothing raised any flags. That all changed after I needed an emergency appendectomy in February of 2008. Since then AF has taken many long vacations only to pop in for an hour or so at a time here and there, just a little spotting, then jetting off yet again. In the past 9 months I’ve had 2 normal cycles. I won’t even get into the mess of what I was told regarding my fertility just moments before surgery.

I went to my doctor in June 2008 and we both assumed it was just taking my body a little longer to regulate after the stress of surgery. My thyroid checked fine, testosterone came back inconclusive. I cycled normally after that so I never went back to be rechecked.
August 2008 came and AF went on hiatus once more. I knew something was wrong and had started to worry that we had just missed the last egg I’d ever get. And with that DH and I bumped TTC #2 up to then. At first it was exciting... I still thought my cycles would regulate. But they didn’t. I started charting and that confirmed I wasn’t actually ovulating.
I headed back to the doctor on November 18, 2008 sure we’d get this figured out. Maybe it would take a little help to jump start my crabby ovaries, but all would be well. We came up with a plan to start provera and clomid in December if I didn’t ovulate on my own by then - in the mean time my doctor wanted to run a few labs for PCOS just to rule it out. Despite the long history of bad lab results I’ve faced over the last several years.... I had hope and believed that these would just rule things out.

I was actually looking forward to looking like an over eager patient who demanded things were wrong when they weren’t. Thats never been the case so it was a welcome change. Every time I go into the doctor thinking something’s wrong, I’ve been right...
“I think I have meningitis”... huh... Indeed I did!
“I think I have preelcampsia”.... Mrs. G - your 24 hr urine collection came back and indeed you are spilling a significant amount of protein...
“I think I have appendicitis.. Though it doesn’t really hurt“..... “well Mrs. G, it does seem that way but you’re not presenting as a typical appendicitis case so we’ll just run this lab.......... Uh.... You need to go to the hospital.......... Now”.
“I think I’m infertile”.... Well Mrs. G... You are!!!

And now we find ourselves conveniently back to the beginning of this entry. Despite the length, I think I’ve summed things up pretty well.

We are still waiting on a few lab results but those that did come in Friday afternoon said it all. My fasting insulin was borderline high, enough to indicate insulin resistance, and my LH:FSH ratio was way off (levels were 19:4). The rest of the labs and tests aren’t necessary for a diagnosis at this point, but will help to paint an overall picture.

Tuesday I am going in for an ultrasound to check my ovaries - my doctor won’t be in to read it but I wanted to get this done and over with. Then on December 3rd I have an appt with my doctor to go over everything in detail and gather up prescriptions. I’ll be starting Provera at that point to bring on AF in a timely fashion and to “give me a clean slate” and we’ll be starting out with Metformin.

With all being said this is a reality that hasn’t been easy to accept, though I feel like I’m doing quite well as of now.... But its only been a few days. I’ve researched and called and clicked and ordered books. Secondary infertility hurts... A lot... But that is never to be mistaken that I am not forever grateful for the gift of my amazing little boy. I’ve always felt so extremely blessed and lucky to have him in my life... And over the past few days I can’t help but look at him and be so thankful that one day on our honeymoon we decided “Lets just see what happens”. We didn’t think it would, but I am forever grateful and truly blessed that it did. Caden is my world - He is everything to me. And not a day has gone by since 5.26.06 that I haven’t been truly thankful for the gift that I have been given in him.

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