Benched

We have been benched for the month. I have a 3 cm cyst on my left ovary (similar to what happened in October). I'm sad, but secretly relieved that I don't have to deal with the insurance company (isn't that awful??).  

Since we have all this free time, I thought it was best to get the polyp situation figured out. The doctor today didn't see a polyp and seemed skeptical like the other doctor, so next week, I will have a sonohysterogram where they fill my uterus with saline and then do an ultrasound to determine whether the polyp is real or not. I had this same procedure in August as part of the diagnostic work up ... it was not super fun, but at least this way, the polyp question will be put to rest. If there is one, then I can have a procedure to remove it. If not, they can stop bringing it up every flipping time I'm in there!

Before I left, the doctor did say that we should still try on our own this month. I had to stop my eyes from rolling out of my head. Then I was reading an infertility article this evening ... something from Scary Mommy, I think ... to be honest, it wasn't that great of an article ... but this one quote rang quite true to me: "a part of me will always wonder what it must be like to simply have sex and get pregnant." Yes. Exactly.

Next

Another month down.  I didn't even have to waste any pregnancy tests this time ... although I was tempted.  On infertility forums there is always lots of discussion around implantation bleeding.  I've gotten to the point where I feel that this particular symptom is like grasping for straws ... one last-ditch, tiny ray of hope.  I wish I had never heard of implantation bleeding.

Also, on Friday, which was already my one sad day I allow myself, we got a letter from the insurance about that $1000 out-of-pocket that I spent.  I'll let this picture speak for itself.  Fucking insurance.

(Don't hate on the horse!)

I go back to the doctor tomorrow.  Mike wants to do one more cycle of shots before we move on to IVF.  We'll see if that happens this month or not.  For the past couple cycles, the ultrasound technicians have been measuring some little growth in my uterus, a polyp I think.  One doctor tells me he doesn't think it's a big deal and I shouldn't worry about it.  Another doctor says that I should definitely have it removed because it could cause issues with implantation.  Tomorrow will be a doctor whom I haven't met before, so I guess he can be the tie-breaker.

Spring in MN

Spring has finally arrived in MN!  It's so nice to be able to work in the yard and go for walks around the lake near our house.  Sunshine and warm weather really do help me feel more positive.  Here are a couple pictures from our walks this weekend.

Cedar Lake with the Mpls skyline behind the trees

 Sweet little gnome house along our trail

Spring naps!

Trigger Happy

My ultrasound yesterday showed a 22 mm follicle! Finally! The doctor told me to trigger at around 5 pm that evening. The trigger is a different shot which causes ovulation within 24-36 hours. So we actually get to try this month ... for the first time since November. Yay! I was so glad to get that call from the doctor, obviously because I will successfully ovulate this month, but also because it means I don't have to deal with the insurance company for a while. Double yay!

Of course, there is only a 20% chance of pregnancy even with ovulation, but that is much better than the 0% chance without. And it's awesome that this drug protocol worked because it means we could try this for a couple more months (if this isn't our month) before moving on to IVF.

Hope.  Such a happy thing!

New Insurance Part 2

So the "specialty pharmacy" that I'm supposed to be using now is a mail-order pharmacy.  I called them today because I needed more vials of the med (more on that below).  Apparently, the fastest they can get any drug to anybody is the next day.  I was literally losing it on the phone because this lady was giving me zero options other than a one-time override (keyword: one-time) that would allow me to pick it up at a brick and mortar pharmacy.  "Ok.  That's fine, but this is going to happen every time I get this prescription.  They prescribe it and I need it the same day.  You are telling me that I have to use your mail-order specialty pharmacy and that they can never get me these medicines the same day?!  How is it possible that NONE of your specialty customers has ever needed a prescription same day????"  

This whole call happened in the parking lot of the doctor's office.  Yep.  Another day.  Another round of crying in my car in a parking lot.  Anyway,  I went home to wait for the authorization call for the one-time override.  Mike was home by this time and I was so upset about the complete ridiculousness of this that all I could do was yell about it (probably the yelling that I had wanted to do at the insurance lady).  I decided that I couldn't wait and I called them back because while it's great that the situation is resolved today, I didn't want to have to deal with this every single flipping time I go to the doctor.  So I called the main customer care line and immediately started crying to the lady on the phone about this impossible scenario.  She quickly transfered me back to the specialty pharmacy (who I had just spoken with 30 minutes prior), but I got someone new this time.  I think her name was Lena. My sweet, sweet insurance angel Lena.  

Lena actually took the time to listen to my concerns and offer up some long-term solutions (what?!).  She said a member of the pharmacy team would call me and they could work with the main medical insurance plan to perhaps authorize UNLIMITED OVERRIDES!!!  She didn't make any promises but at least it's not a dead end.  Progress.

Yeah ... so more meds.  The ultrasound showed that my right ovary still has nothing going on and my left ovary now has 3 follicles of 13 mm.  So the follicle from last time didn't grow AT ALL.  Frustrating. But two new ones have popped into the running.  I'm definitely a slow responder.  So the doctor upped the dose to three vials per day for the next two days and I go back again on Wednesday.

New Insurance

The new policy year for my health insurance started April 1. While the medical coverage is the same, the prescription drug benefits are being handled by a new company.  I knew this.  I even went on their website to check if I could go to the same pharmacy for these drugs (which are considered specialty drugs).  The pharmacy was listed as in-network and the co-pay was the same as under the previous plan ($70).  Great!

So today, I bee-bopped into Walgreens to grab the two additional doses the doctor had called in yesterday.  I was looking forward to doing a little shopping after.  

"Your new insurance says that we are not an authorized location." 

"What?!  But I looked on their website ..."  Worry creeping into my voice.

"It's giving me a number for you to call.  We also have a discount program you could use.  These 4 vials would cost you $400 with that program."  She was trying to be helpful, but $400 is way different than $70.

"Uh ... ok ... let me go try to call them." 

I fast walked out to my car and called the number she gave me.  Apparently, it was for the specialty pharmacy for my insurance.  "Our office is now closed."  I was really starting to panic at this point.  I need these drugs.  So I called another number that I found on the back of my insurance card.  After several minutes of electronic prompts, I got a real human!  

"You have to get prior authorization for those drugs and you have to have them filled through our specialty pharmacy."

"Ok.  But I need these today."

She explained that I could get reimbursed this one time and that I should go ahead and pay out of pocket.  Whew!

Back into Walgreens I went (not bee-bopping this time ... I mean, $400 is still $400).  I tell the pharmacy tech the plan.

"Oh, you can't use the discount program with insurance.  It's one or the other."

"Ok.  How much will it be then?"

She literally whispered the number to me.

 "Oh my god ... (deep breath and resigned sigh) ... ok.  I have to get these."

So I swiped my AmEx and it was effing declined (!@#$%^) because the purchase amount was so large.  My phone immediately started buzzing.  Oh ... it's just AmEx asking if it's really me spending a cold hard grand at Walgreens.  So for the next several minutes, I stood at the pharmacy counter and said "yes" into my phone several thousand times until the automated voice was convinced that the purchase was not fraud.

Biggest purchase I will ever make at a drugstore complete, I went back out to the parking lot where I sat in my car and cried and called Mike and cried some more.  I know I will be reimbursed, but they're my hormones and I'll cry if I want to.

To make myself feel better, I bought myself this cat planter from West Elm.  And I totally deserve it.

Cycle Day 10, Shot Day 8

I went to the doctor on Wednesday and there wasn't much follicle activity going on.  Largest guy was 10 mm (a follicle needs to be 20 mm or a bit larger for ovulation).  The doctor decided to double my shot dosage and see me again on Friday (today).

They also took some blood to test my estrogen levels.  Let me tell you, this was the most painful blood draw ever.  The woman who usually does blood draws was busy and this other lady volunteered.  She put the tourniquet on WAY too tight and I definitely felt the needle go in.  I nearly passed out.  So that was fun.  Great start to the morning.

I went back in this morning after two nights of double shots.  Still not much activity, but the largest follicle from last time had grown to 13 mm.  The doctor asked if I just wanted to scrap the cycle or keep going.  What kind of a question is that? Obviously, if there is a chance, I want to keep going.  So we are doing three more days of shots and then I go back in on Monday.  She also wanted another blood draw.  This time I got the "right" nurse and it was much less painful, but since I almost passed out last time, I did the same this time too.  I'm not anything if I'm not consistent!

This will be the third time that I've visited the Walgreen's pharmacy in a week.  Every time I get this drug there is a copay of $70, regardless of the number of doses.  So if they had just prescribed all 10 shots to begin with I would have paid $70. Instead, since they prescribed three separate times, I've had to pay $210.  Annoying.  I will ask the nurse if they can do it differently next time (assuming we do these shots again).

For your entertainment, here is what it's like to be a human pincushion from the pincushion's perspective.

(He definitely made me bleed with that one!)