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Archive for November, 2010

I am on the verge of bursting into tears.  My PCP doesn’t provide the Varisella (Chicken Pox) vaccine and so she referred me to the two local hospitals (Jordan in Plymouth and South Shore in Weymouth), specifically their travel clinics.  I called both and neither provide that vaccine. 

I can’t believe that something so basic is causing me so much grief.  I’m not looking for vials of the Bubonic Plague – I just need the fucking CHICKEN POX VACCINE. 
I finally called Boston IVF and left a message with the nurse to see if she can help me.  Maybe I need a new PCP, which is fine, but I can’t keep spinning my wheels and calling places only to find out they don’t provide it.

 
People have suggested pediatricians – but I don’t know if I just pick one out of a book and call?  How could I go to a pediatrician’s office – I’m not a kid!  Do Family Medicine doctors take care of children, too?  My thoughts are that this isn’t a common request for an adult.

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I received an equivocal result for varisella (chicken pox) – which basically means they can’t tell if I have the antibodies for it or not.  Which, I probably don’t even though I’ve had it twice but only had 3-5 pox each time so I don’t think I’ve really had it.  I need to get the chicken pox vaccine before moving forward and you have to wait 30 days to conceive after the vaccine. 

 

So I call my PCP and they don’t have it – would have to write a prescription, have me pick it up and bring it to a pharmacy, get it filled, then bring it back to the doctor’s office, which is located in W. Roxbury…about 55 miles from my house.  I told the receptionist that there HAS to be an easier way so she’s sending a message to my PCP.

 

I called my OB/GYN to see if they carry it and they a) don’t and b) can’t believe my doctor’s office doesn’t have it.

 

Seriously, this is my life.

In other news, I was still able to schedule my follow-up appointment with Dr. Zimon for Thursday, December 9th.

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Appointment #3: HSG

Well, that wasn’t nearly as bad as I expected!

They took me into a room that had a total of three people – the Nurse Practitioner who was doing the HSG, the X-Ray technician, and an Assistant.  Immediately, the NP asked if I was nervous because I “looked horrified”.  I told her that I was and it’s mostly because of a very uncomfortable pelvic ultrasound and I heard that this could be even worse.  She asked what happened with the pelvic ultrasound and I told her and she said that this would be completely different and she will do everything in her power to make it as painless as possible.  I instantly felt 50% better about it. 

I took off my bottom half of clothes and lied on a similar table, but without stirrups.  I placed my feet on the table, knees bent, and there was a circular pod-like thing above my belly, which was the X-Ray machine.  Two flat-screen TVs were to my right.

She said the uncomfortable part was the speculum (sp?) to open up the cervix – it’s the same thing us women have when getting a pap smear so it wasn’t too scary for me.  Although – it’s opened much wider for this procedure but she said I had a “cooperative cervix” so it was a non-issue.  I’ll have to remember to thank my cervix later.

She inserted a skinny wand-like thing and then pushed a little of the iodine dye in and asked how I felt – I told her it was a bit crampy and uncomfortable so she immediately took it out and said she could try it a second way, which just takes a little bit longer but it won’t hurt.  I thought that was so nice of her!

She positioned it a second way and I felt a little pressure when the dye was pushed through but nothing even remotely close to the pelvic ultrasound discomfort.  They had me turn on my side to get better pictures of one of my fallopian tubes and then we were done!  It took less than 15 minutes.

Before I got off the table, the Assistant pointed everything out to me on the monitors.  The Assistant showed me the right side first and pointed out the smoke-like effects (or “feathering” as they call it) and then pointed out the left side and the same thing which means that my system is clear!!!  Yay!

Chris was shocked at how quickly I came out and that I wasn’t completely horrified.  I drove home and started experiencing a little cramping along the way but nothing too bad.  I had taken an 800mg ibroprofen 30 minutes before the procedure so I’m sure that helped.  Now I’m home and the only annoying thing is the slight cramp that comes by and the fact that I have a pad on the thickness of a banana and I never wear these things so it’s just weird to me LOL.  But there is some slight bleeding expected because of the clamp on the speculum. 

Next step is to schedule a follow-up appointment with Dr. Zimon to go over all of the test results.  I’m going to give them a call tomorrow and see when they can get us in.  My thoughts is that it might be a couple of weeks because of Thanksgiving and then my birthday trip to Key West, but that’s okay.

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Since the pelvic ultrasound and bloodwork had to be done on Day 3, I went yesterday at 8:00am to complete these tests.  I had called my friend Julie who is currently going through IVF to ask about the pelvic ultrasound.  She said it was a walk in the park and not to worry.  Since I’m sort of naive about this crap, I had originally thought it was like the jelly on the belly ultrasound, but from what the scheduling nurse was saying – I got the impression this was significantly different.  And that it was. 

The pelvic ultrasound is done to get an antral follicle count of your ovaries – so it takes pictures to see all that is going on inside your uterus and your ovaries.  When I walked into the room, I had to strip from the waist down and sit on a similar table to that of an OB/GYN – feet in the stirrups and scooch to the end of the table.  She basically took out this wand, which looked like a dildo, and stuck it on in.  It wasn’t all that bad until she couldn’t find one of my ovaries.  Just picture a long dildo wiggling around looking for something – NOT FUN.  I had to assist by pushing down on my lower abdomen (right above my pubic line), which made the space smaller and I was now at the point of screaming in discomfort.  The lady was like “okay, push and BREATHE”.  FUCK – it hurt so bad.  She finally found it and got her pictures and I was relieved of the terrible cramping.  She said not to worry – that it’s normal and my bowel was in the way.

Now, I’m not sure if I was asleep during this part of biology but I had no idea your bowel was near your girl parts.  I almost said “lady, if you’re seeing my bowel, you’re in the wrong place!!” but alas, I figured she was a skillfully trained nurse who does this often so who was I to question.  From what she told me, if you’re full (i.e., haven’t pooped) it can block your ovary.  So weird.  And since I had to do fasting bloodwork, I hadn’t ate in over 12 hours – no morning coffee = no morning poop for this girl! 

I do have to say – I think the nurse should have poured me a glass of wine and taken me for a long walk on the beach for the sexual assault she gave me.  LOL, it was like nothing I’ve ever experienced and I was sure to call Chris on my way out and tell him that I will be taking every drug possible when I give birth – I have ZERO pain tolerance.  I also texted Julie after and told her she was full of shit and she laughed and said, “if you think that was bad – wait until the HSG next week”.  Oh, goody.  Let’s just hope that the nurse took all the pictures she needed and we don’t have to go through that again.

Right after I was assaulted by the pelvic ultrasound, I was sent a few buildings down for my blood draw.  For the sake of information and my own tracking, these are the tests they were drawing blood for:

Fertility group – (some of these were done by my OB/GYN but Dr. Zimon wanted to re-run a few)
– CD3
– FSH
– LH
– E2
– TSH
– PRL

Prenatal Labs –
– Blood type & screen (which I think is awesome since I don’t know my own blood type!)
– CBC
– Rubella
– RPR
– Hep BsAg
– Hep C
– HIV
– Cystic Fibrosis

Androgens – (these are your male hormone levels)
– Total testosterone
– Andronstenedione
– DHEAS
– 17-hydroxyprogesterone

Metabolic –
– Fasting glucose
– Fasting Insulin

I literally sat down and they took 13 vials of blood from me.  THIRTEEN VIALS OF BLOOD.  I luckily did okay (sometimes when I have to give blood the stream stops – and I was really concerned that would happen!), but when the Phlebo asked if I was okay to go…I told her I was going to sit for a minute or two.  🙂  The Phlebo did a great job – I only have a small quarter sized bruise, which for being someone who consistently has horrific blood draw experiences, I am very pleased.

So, I have to wait for those results, the results from the HSG which is next Thursday, and we have to get Chris to get his blood tests completed (just an STD panel, which is protocol) and then I can make the follow-up appointment to review everything with Dr. Zimon.  Until then, I am preparing myself for the HSG and the discomfort that will come along with it – this one, however, even the doctor recommends taking 800mg of ibuprofen 30 minutes before the test.  Lovely…

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Yesterday was my first appointment with Dr. Zimon and Chris went along with me.  It was a consultation so we met in her office and went over both of our medical histories, including family histories, etc…  After reviewing everything, she basically said the following:

– She is 99.99% confident I have PCOS.  Since there is no “test” for PCOS and based on my OB/GYN’s assessment as well – that is what we’re going with.  Apparently PCOS affects 10% of the female population.  That statistic shocked me.
– It appears I am a rare PCOS individual because most women with PCOS ovulate at some point – 35 days, 40 days, once every 2 months, etc…  I don’t ovulate (from what we could tell over the last year) ever.
– Based upon that – she candidly stated that it’s a wee bit difficult to get pregnant when you’re missing half of the puzzle pieces! 

So, she was confident in that all I need is some help ovulating.  The tests done previously show that my ovaries are not barren and are in good shape so I should have plenty of eggs.  We discussed my weight and I was the one to bring it up – she said I’m not obese and although it could help, it’s not where she thinks we need to focus our time.  That said, she doesn’t want me to stop doing what I’m doing and that it will be critical to continue to exercise throughout my pregnancy due to my risk of gestational diabetes.  That was a big relief as well – she told me to stop pressuring myself into a specific weight loss plan but to instead look at it as a health improvement plan and that 3-5 times a week at the gym like I’m doing is perfect. 

But, before executing her plan – she wants to do more bloodwork and an HSG, which is essentially a test where they shoot dye into your uterus and then take an x-ray to see if it could travel without issue through the fallopian tubes, etc…

Before leaving, we scheduled the next steps – which are based on cycle time.  The bloodwork had to be done on Day 3, which conveniently was today.  The HSG has to be done between days 5-12 so we scheduled that for next Thursday morning – and I have to go to Waltham for that procedure.  She also wanted to do a pelvic ultrasound to take pictures of my uterus and the follicles on my ovares and that has to be done on Day 3 as well.  Should everything come back clear – the plan is to try Clomid for 6 months (possibly in conjunction with some other meds) and see what happens.

I left the appointment feeling rejuvinated.  I know that sounds weird, but after being let down month after month for the last year – it is the perfect word for how I felt.  She was very kind and spoke in human terms, not doctor terms.  She immediately made both Chris and I very comfortable and that is so important to me.  The fact that she was so optimistic was also a great feeling – I won’t get hung up on it, though, because you do never know but it was another bright light in what’s been a dark year.

I decided to take some time after the gym while I was cooking dinner to have a conversation with Chris.  He was being a jerk about completing the paperwork and not really being supportive the night before, so I wanted to be clear about my expectations on his behavior going forward.  I was very calm and told him that he needs to think before speaking / acting (DUH) and that his actions from the previous night were really upsetting to me.  He apologized immediately and said that he didn’t realize all that was involved and that being in the doctor’s office and hearing about everything I have to go through, including a lot of pain, made him realize how selfish he was acting.  He said he wants to be here for every part and truly feels sorry that I have to go through all of this.  It was a very nice conversation and I feel much better – I know he’s going through a lot of change in his own mind with being in PA for the next 6 months and absorbing this whole infertility thing himself.  But, I don’t doubt that speaking with the doctor helped open his eyes to what lies in store for us.

I’ve very optimistic and hopeful.

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Based on the lack of success, my OB/GYN is referring us to a Reproductive Endocrinologist (RE).  She gaves us three to choose from and I solicited advice from my cousin Maria who has two friends who were successful through Boston IVF.  So, I have scheduled an appointment to meet with Dr. Alison Zimon who specializes in PCOS.

Wish me luck!

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