Surrogate Insurance: Check and Double Check

After trying for WEEKS to get the insurance handbook from the GC's HR department, they finally are resending a new hard copy, but also gave our GC a pdf copy. An attorney cautioned us not to unnecessarily send up any red flags, but also not to lie. I immediately sent the handbook to our lawyer, and being obsessive like I am, started digging in it myself. There wasn't really anything one way or another. Arggghhhh. Towards the end, they listed a URL "for more information" regarding covered benefits. After digging around on there I found a pdf listed under " Infertility Diagnosis and Treatment document" that has the following clause:

Services related to the use of a gestational carrier in pregnancy, whether the member is infertile
or otherwise, are not related to medical treatment of the infertile woman and are therefore NOT
covered. However, if a woman who is an insured member is pregnant, her prenatal, delivery and
postnatal pregnancy care are a covered health service, regardless of whether she is functioning
as a gestational carrier.

I'm fairly certain this makes me allowed to jump up and down in happiness, but just in case, I've forwarded everything to the attorney. Contract is due on Friday. (Gah!)

Cycle Limbo Part 2: Return of the Cycle

UPDATE

Nurse called. As long as my SIL can come in tomorrow and get an ultrasound - then we are proceeding as planned. Whoooooooooooooooooshhhhhhhhhh.

When the nurse initially called, she kind of presented it as my option with the knowledge that if my SIL's lining isn't thick enough upon transfer day, than the transfer won't take. Normally they want 11-14 days of the estrace to insure a thick lining, but they don't want to start the estrace until a untrasound and blood work on her confirms everything is a go (eg, no cysts, hormone levels good, etc..) My last cycle gave me only 12 days before transfer. She asked me if I wanted to go forth.

At first I asked questions about how would we avoid this next time if we waited. She said that normal protocol was to control the GC's cycle with BCP/Lupron overlap. Then I asked the follow up question that surprisingly, I think was a bit unexpected: why did we not do it this time? This was a little harder to answer, but the short of it was - they/she didn't want to start medications (including BCP) until all the initial testing had been completed. Of course my logical reply was: Does BCP effect the testing. Answer: No.

So getting past all that, I realized she expected an answer from me about whether I wanted to start or not. Here is where I lost it. Crying the cry only someone that is mildly dehydrated and still slightly sick can manage. My guess is that over the phone it sounded somewhat like a choking horse.

Normally when I get really upset, my sensibilities leave me, but they did not this time. I put the question back to her: "What you are telling me is that I have to choose between my chances lowering further from waiting a month, or take a chance that the lining won't be thick enough." She said she would speak to the doctor and call me back.

I laid the options out like that for a couple of reasons, but the main one was that I really didn't know which is riskier. One would think that a month wouldn't make a world of difference, but women in my age bracket know differently. My AMH dropped drastically in a very short period this year. Conversely, I don't recall our surrogates getting estrate (or similar) that long in India prior to the transfer, so I'm not sure if it is a booster/fail-safe thing or what.* From a medical perspective, since my GC and I started menses within 24 hours of each other, one would think at 29 years of age, her lining would be reasonably thick for ovulation at the proper time anyway.

After speaking with the doctor and both reviewing my records, the nurse called back. She stated that as long as my GC could come in for ultrasound tomorrow (she can), then we would continue the cycle as planned. We nailed down a few of the other details (like when I would start my big gun meds) and now I feel a crapload better than I was feeling. Earlier I was trying not to let panic surge, but I was having a hard time. I would have waited another month if I had to, but honestly, I am ready for this to be over and done with. The emotional and physical, even things you don't let anyone else see, is astronomically draining.

*Originally I thought the Indian surrogates did take meds from the beginning (from my own research of surrogacy), but I had my husband ask the Indian lady directly and she said that she only been told to start medication a few days prior to the transfer. My husband and I now debate if this was a protocol thing, problem with the surrogate, or other. 

Cycle Limbo

Picture from: http://www.examiner.com/review/limbo-a-post-mortem

Wednesday, when I was sick with a nasty cold (and had to work), I posted that I had questions for our nurse. I updated that post with her answers from her call to me. One thing she told me, was that if our GC's period did not started by Friday, to have our GC call her. I promptly wrote it in my notes (where the questions were), sent a copy of those notes to my husband, and started to put a reminder on my calendar to be sure to call our GC on Friday.

"Started" being the operative word. I was distracted by actual work stuff (people come by my desk all the time) and when I got back to a blank calendar entry - I had no recollection what it was for. Between being sick and mission critical work stuff, I hoped that I would remember. Thursday turned into me only leaving my bed to RUN for bathroom necessities due to an added bonus of stomach flu.

Friday rolled around and I was able to work from home. I also had the outstanding attorney papers (almost 60 pages) that I had to start going through ASAP. By Friday night, something tugged on my memory and I realized I hadn't received the insurance information from our GC yet.

<insert important announcement here> I'll go ahead here and announce that our GC is my sister-in-law. She is my little brother's wife who graciously wondrously volunteered to assist us. <end insert>

In my juggling of balls, I guess I thought that getting the insurance information from my SIL was what I needed to do on Friday that was so important. My period hadn't started, but our nurse had told us that my SIL wouldn't be starting injections for 2 more weeks. I was confused and misunderstood this as her "medications". As in ALL medications.

Friday night my period started and I promptly emailed and called our clinic as instructed. Equally prompt was the automated reply (and answering message) informing me that my nurse was out of the office till Jan 2nd. Great. That meant I was going to have to deal with other people trying to get in for my Day 2/3 ultrasound/blood work. Was able to get a hold of someone at the clinic the next morning and they scheduled me to come in for Sunday morning 8:45 AM to get an ultrasound.

You can probably guess what happened at that appointment. First I got my ultrasound and then I was asked, as almost a side note, if our GC had started her period. When I said I didn't know, the nurse on call asked if we were doing fresh or frozen cycle. As I began to explain that we have to do fresh, it sinks in what I forgot. A wave of panic passes over me, except I'm not even sure why because no one has ever told me what it means if the GC hasn't started her period yet. Then I ask the dreaded question. The very pregnant nurse answers - since she hasn't started her meds to insure her lining will be right, we may not be able to start this cycle.

WHAM.

I guess after seeing my face, she decides to call my nurse who I guess is on vacation. We desperately try to get my SIL and brother on the phone. We finally do. Her period started on Saturday. I have no idea if she was supposed to start some medication then. Preggo nurse (can you tell I'm irritated that I have to deal with a pregnant nurse at a fertility clinic in the midst of all this?) tells me that our personal nurse will call us in a few hours. I go home and listen to an recorded meeting we had with our nurse a month ago. Sounds like my SIL should have come in for an ultrasound and blood work as well today. And it sounded like from the other nurse, some estrogen medication as well. Great - just great.

Now I sit and wait. And try to hold myself together. And try not to beat myself up (which is utterly impossible). And know my husband is upset with my forgetfulness, but trying to hold it together and not say anything.

11 follicles were seen this morning and no cysts. 

Petition For Mandated Fertility Coverage

For those interested:

This petition was created with the hopes of raising infertility awareness and request that each state mandates infertility coverage including diagnostic testing and treatment as well as the cost of medication.

https://petitions.whitehouse.gov/petition/petition-approve-fertility-coverage-every-state/PL3BTLvw

Off-Topic - Women and Rape

Yesterday, the woman in the Dehli rape case that has made world headlines, passed away from organ failure. Her death a direct result of the rape and beatings she received. World news organizations, twitter, and even facebook (normally lacking in world news excepting a small percentage) all have references. All of the information made me pause. And think. On so many levels.

Some of what I write here may be controversial - be forewarned.

One of the [several] reasons we chose to go back to Gujarat in September for our second cycle versus Delhi was a safety issue. Please note I have never seen a safety issue posted on any of the blogs who have undergone IVF in Delhi  Our concern was more from my husband's personal experience as an Indian. You see, even according to the lauded Times of India, Delhi is considered the rape capital of India. I've heard this reference made by many media outlets and people, on both sides of the ocean.

We even have family in Delhi  but my husband just did not have a good feeling about me staying there by myself. Even though I assured him that many, many western women have gone and I've never seen a problem. Plus from the blogs it seems like no one is really ever alone there and everyone looks out for one another. Perhaps he knew too well my proclivity to throw caution to the wind. When we considered it for a brief period - he made me promise that I would NEVER go out after dark. EVER.

In contrast, I never once had a safety concern in Anand. Ah well, at least not with regards to walking around. There were the occasional medical things that I raised an eyebrow on and spoke out about. Something I probably would not have encountered in the more modern town of Delhi. (My husband was surprised with a few things as well - city boy.) Should there been a serious emergency medical problem, the hospital facilities in Delhi would have been far superior. But walking to my favorite restaurant at 9pm? No problem.

But, this really isn't a ding about Dehli at all. And if you are considering it, it is not meant to scare you away from your decision. If I've given you a genuine fear then I suggest you talk to people that have done IVF in Delhi, because remember - I have not. This is my blog and thus I post my thoughts, feelings, and considerations - I am posting this because it is honestly one of the things we thought about when choosing. There were other things too, but the recent news reminded me and made it relevant to post. Plus, let's be real. There are places all over the US (including here in Atlanta) where my husband not want me walking around alone after dark.

But this post isn't really to compare Delhi with Anand or the US, although that's how it initially began in my mind. It's really to point out why comparisons about rape places really suck. Even when you mean well. Earlier I had a friend post the following on facebook:
I am feeling especially blessed tonight as I read reports of the woman who was raped in India and has subsequently died. Sometimes it is easy to forget how truly blessed we are to be born in the United States, and the privileges we are provided simply by being a citizen of this country.

Read that again and take it all in.
..........................................
............................
..............
ARE YOU FREAKING KIDDING ME?!?!?!?!

My husband pointed out that sometimes people write things because they don't know what else to say. Or it makes them feel better. I feel way more visceral towards that post. Not in an "India versus US" type of way - but more a "are you so stupid you don't know that horrible rape happens to women in the US every day???" way?

Somewhere in the back of my mind I realized that the poster didn't mean anything bad by it, so I closed my computer up for the day and sat saddened thinking about it for a long time afterwards. Today I made a public post:

Yesterday I saw some posts on facebook and twitter, commenting on the rape/death in Delhi and how great it is to be an American. 
Let us be clear:

Rape happens in the US all the time. 
With women.
With children.
With horrible beatings that bring death.
Human trafficking still exists here in the US, with Atlanta as the USA's #1 hub.
The number of rapes are reported in the US are staggering.
The number that are not reported are even more staggering.
The number of convictions are pathetic.

If we don't realize that these horrible, horrible things occur HERE, EVERYDAY, almost every minute of EVERYDAY, then THAT is part of the problem.
-------------------------------------------------------------
Yes, the irony of how I have flipped this post is not lost on me. I judged and then I was mad at someone else's judgement. Maybe things are not always so black and white. 

Day 1 - Or Something Like That.

I overthink things.

The other day I wrote a blog post titled Day 1.5. Honestly I didn't really know how to number it. Technically, since it was pre-cycle, it should have been a negative number, but since I didn't know WHAT day my period would start on, I couldn't very well guess on what negative number to give it. Anytime I try to predict what day my period falls on, it makes a liar out of me. If I was wrong, then the numbers wouldn't line up and that would DRIVE ME CRAZY. (No comments from the peanut gallery please.)

This made me wonder on how to properly account for it. Using a positive number, should I add BC (before cycle)? Nah, too religious. What about PC (pre-cycle)? Well then we've gone all political. Not good either. I get enough of both of those on Facebook  Incidentally, one of my NY resolutions is to not post and comment on these (and other) controversial topics. This would be a huge challenge for me, but GREATLY rewarding as I usually end up regretting it. Fortunately  I have a decent record for following through with NY resolutions. (Note: I wrote "decent", not "perfect".)

Where was I? Oh yea. What number notation to use? What number....Hmmmmmmmm. What to do? What to do?

Period started. Crises averted. Or starting. Whatevs.

Let the Cycle begin.

Running and Running

Yesterday was a day that started with me waking up in the middle of the night - running to the bathroom. Several times. I couldn't even see what time it was because the clock was slightly obscured and I was afraid any movement would have me running back to the cold tile.

Course that's the kind of thing that makes you afraid to sleep. So there I was, wide awake, trying my best not to do that little gaggy-thing you do before you throw-up, in fear that the muscle contraction would make me poo in my PJs. I had my Hello Kitty's on after all. Fortunately nothing like that happened and I was able to keep running when needed. By 7:30am, I was exhausted. 

During this time I was wondering to myself (and to my husband, whom had much pity on me), how this could have happened. My son had a violent bout of stomach problems for most of the day 3 days prior (and of course I was with him on Christmas), but my husband didn't seem to think that sort of thing was contagious. I remembered differently, but I wasn't exactly in a state to argue or even think straight. More than likely, he mused, it was the Thai food I brought home the night before. 

A little voice inside me feared it was a reaction to my Ganirelix. I've never had it before and wouldn't that be a disaster if we had to figure out a change of meds at the last minute? While I've never had quite the exploding reaction to any other meds (unless you count the time my mom made me take cough syrup and I instantly barfed), I still have a weird history of medicine reactions. Can't take anything from the Cipro class of antibiotics. Well, I guess I COULD in an emergency, but I would be freaking out and asking my husband repeatedly why he was looking at me funny (paranoia is only one of the lovely reactions it causes.) 

Turns out I just had my son's stomach flu. Spent most of the day in the bed (and bathroom), but by 5pm (and a forced dose of  1-2 mg of Melatonin to make me sleep), I was able to come downstairs and eat. (BTW: Melatonin is supposed to help us infertiles, but golly it sure does pack a wallop with me.) Was weak as all get out, but I feared shot #2 less than I thought I would. Perspective I suppose. Now a day later, EXCEPT FOR MY STUPID PERSISTENT COLD, I'm all better. 

Kinda makes me wish I had these:

Photographer and story behind pic here:
http://www.flickr.com/photos/mararie/2137142469/

P.S. If you are a regular reader of my blog and are wondering about the answers to the questions I asked my nurse the other day, I updated the post to reflect the answers. Here it is: Day 1.5. I thought that would be better than to write an entire response post that are a few short sentences. 

Day 1.5

Yesterday Santa brought me a nasty cold. Wee! I managed to make it through the morning's festivities, but alas, was couch bound for the rest of the day. (On a separate note, the movie Mulholland Drive sucks - don't let anyone tell you differently.)

Nevertheless, I began my pre-cycle meds as described in my RE schedule. Namely I started the Vivelle-dot 0.1mg patch (estrogen), which I take every other day. Tonight I will add on to the patch and start a 3 day course of Ganirelix 250 mcg injections. Double wee!!!

I tried to think of a time in my life when I gave myself a shot and came up empty. Even with my couple year course of allergy shots as a kid. Even with my 2 previous IVF cycles in India. Ugh - I guess I should have checked for extra practice needles in my box, although now that I think about it, who the hell wants to take extra shots, practice or not.

Next step is "Await period Day Of Cycle 1 = First day of continuous menstrual flow (spotting is NOT day 1)". Great. Many times my periods are only spotting (due to my previous cryoablation surgery.) How should I determine that? So in typical "omg" last minute panic and realization that I have new questions, I sent the below email to my nurse. Hopefully they will get me some answers today.

UPDATE: rather than write a separate post on my nurse's answers, which were prompt, I'll just type them in red by each one. Nurse ended up calling me directly when I was at work, so my responses are just a quick summary.

P.S. Clearly I don't know how to count...But at least I caught it before she did. 
---------------------------------------
1.) Started the vivelle-dot today. Do these have to be changed out the same time (every other day) or can I change it out with my nightly shot (I put it on in the afternoon)? -->yes - that's fine

2.) It looks like I am suppose to start the Ganirelix tomorrow, but I am not positive because the date is wrong on your documentation (I think we may have previously discussed this on the phone, but I'm not positive now.) Please verify and send an updated copy. Also, please let me know if there is anything special I need to do/know regarding the shots. For some reason I thought we were going to have training on it, but we never did.-->tonight. around the same time. 

3.) I have been battling a very minor cold the last 2 weeks, but yesterday it took a turn for the worse. Today it is in full fledged mode. Please notify the doctor and let me know if there is anything I should or should not take for it. -->Take lozenges, any Tylenol line, robitusson but no DM, sudifed

4.) Last week I wrote you regarding an approximate drop-dead date for when the surrogate's cycle could start (and thus you would have to have a contract in hand.) Haven't heard back from you on this - please let me know. The lawyer has submitted the rough draft to us. --> earliest Friday. You have 2 1.2 weeks before her injections start. If she hasn't by Friday, call Mikesha on Friday. 

4.) Dr. Carpenter approved my taking supplements for the last few months. I need to know if and when I need to stop taking these. In particular the DHEA (75mg per day) as it is a hormone and I don't want it to interfere with the other hormones I am now taking. -->yes --continue taking all

5.) My 2 previous cycles I had cysts prior to the start of cycle. The first IVF cycle, we had to aspirate the cyst as it was interfering with my hormone levels (and consequently would have ruined the cycle.) I need to know if we need to do an ultrasound or blood tests to make sure this isn't occurring again. Dr. Carpenter is aware of my previous history with this. -->will come in on day 2 or 3 for ultrasound and bloodwork. Check it then. 

6.) My blood tests are complete. The FDA ones should be faxed to you directly from Quest. The remaining ones were done at Emory. Please let me know if I need to sign a release for you to get them. I believe you already have it on file, but since it is a new doctor, I am not positive. -->need to fill out a record release for emory to send over to ACRM. She will email. Email back to her or fax.

7.) The ACRM email system appears to remove emails after a certain period. This is very confusing and I worry that I might miss some documentation. It is also difficult for me to log on to the ACRM email system when I am in the office. If possible, I would prefer to use regular email rather than your website email system. Please copy my husband on return correspondence as well (his email is included in the CC line.) -->yes - that's fine. 

Thank you and I hope you had a great holiday.

Mad Dash to the Finish Line

I don't know who Mr. Pipo is, but this image rocks.
You can get it here: http://commons.wikimedia.org/wiki/File:Mr_pipo_clock.svg

Yea, yea, yea. The ole "I've been a blogger slacker" post. The "I've been too busy" post. The "Too emotional with all that's going on in the world" post. Whatevs. Get to it.

We are on full throttle for surrogacy to start next cycle - which means hopefully the end of this month. (Crap - no drinking on NYE!) I've been a mess trying to get everything done in time, but we really wanted to pay as much as we can this year for tax purposes. Since I didn't work for 8 months this year, much more is applied. 

Plus, let's be real, every month for me counts now. My AMH is like .7 and my FSH is 12.7. Not good. Not horrible, but not good. This will be the last shot with my eggs - period. If this doesn't work I'll crawl into a hole until we are able to consider the donor egg option. 

I have to say that having my first 2 surro cycles in India did not prepare me for the complicated mess I would  have to endure here in the US. In India we just had to show up and they directed us for everything else. Here we are on are own and have to stay on top of things like a frenzied squirrel. Crimmy, I'm even going to have to give myself shots. With my ADD, this is not encouraging. 

Some of the things I've been juggling: 

• Coordinating 4 individual schedules with tight deadlines on when specific things have to be done. Guess who's schedule always gets the shaft (to be expected.)
• Countless phone conversations occurring middle of the day, for a length of time, that has me leaving my trusty cubicle to go hide talk in a conference room. Lest my cube mates get to hear me go on-and-on about the FDA required STD tests I have to take. "Yes, I need you to add Chlamydia  Gonorreia  HIV, Hepatitis  PPD, ... to my blood order. Oh I'm sorry, you want me to repeat that LOUDER for the 3rd time? Ok."
• Working with 3 different pharmacies to find out which can give me the best price, without sacrificing reliability/comfort level of getting all the right things at the right times. All of this again on the phone during business hours. All pharmacies have been given the Rx by doctor and are ready to ship ship ship. "Yes, I'm confirming the order. OH WAIT, you are with whom?"
• Phone interviewing lawyers with experience in surrogacy to see who can meet our tight deadline (are you sensing several themes yet?) 
• Going BACK AND FORTH with my new primary care physician office to try and convince them to add STD blood tests to my blood order for my physical. This way there is a chance insurance will cover it, but I had to go back and forth with them for about 2 weeks. Otherwise it's a couple grand out of pocket.
• Getting a physical so that additional items will be covered under insurance that wouldn't under my RE.
• Multiple doctor visits. Blood drawn yesterday AND today because I had to use 2 different labs. Trying to juggle all these without raising a flag (hopefully) at my new job has been an incredible feat. I'm a contract employee and want to go perm when my contract is up in April. 
• Psych evals - and while I appreciate the "concern" over my emotions, it really was a total waste of time/money for my husband and I. Everything that was discussed in the group session we had already discussed with them privately. I totally "get" why you would want to have one with the surro and the surro spouse, and even a group one, but I don't think every IP couple needs to have this done. Especially if you've been through the process before (even in another country). Thankfully the doctor put the ones for hubby and I as a "family counseling" code - hoping insurance will at least cover that. 
• Trying to get surros insurance documentation to make sure there is no surrogacy exclusion. Not their fault, but company's fault it is taking so long. 

There is more I am sure, but between balancing that and everything else in my life, my brain is kinda fried at the moment. I still have Christmas shopping to complete. Hell, I haven't even gotten all my cards out yet. 

On a Happy Happy note. Insurance covered a HUGE portion of my fertility medications. The pharmacy (Village Fertility) checked on a whim for insurance coverage (even though I told them it wouldn't be covered) and apparently a big chunk was. Had to pay just a little over 1K out of pocket - which is awesome since it was looking to be about 6.5K. She explained that even though we have BCBS for medical (THE SUCK for infertility treatments), the pharmacy is different and is quite good. Covered under Medco, formerly Express Scripts. I guess the lesson is: always check to see if insurance will pay. Even when you are sure they won't. 

On an unhappy note - I had no idea that the attorney was going to be so much. 2500 for the surro agreement (REQUIRED) and then another 4K if we make it to the second/third trimester. They have to go to court and petition that our names are put on the birth certificate. Otherwise we would have to adopt our own child. GAH! Oh well, I guess we should totally HOPE/PRAY/RAIN DANCE that we are so fortunate as to get to shell out the money in the future. That would be a good thing - right?

That's it for now. And to prove how busy I am at the moment, I'm going to publish this after only "checking" it once for mistakes. That's HUGE for me. Normally I read it and change it 10x. THAT'S HOW BUSY I AM. Or crazy. You choose. 

Money, Get Away

"Money, get away
Get a good job with more pay
And you're OK."

Clearly The Pink never went for infertility treatment. Which is weirdly funny given their nickname.

We are entering our third and final cycle with my eggs and with a person close to us doing the surrogacy (without charge). Approximate cost: 35-40K. That's not a typo. That's how much it will cost us out of pocket. Paid in full by months end. In addition to all we have already spent.

And now, all of a sudden, a little voice inside me is very scared. To spend this much money and use my long shot eggs. Actually I'm quite terrified.

Where Can I Get My Drugs?

No seriously. Who has the hook up? I need advice on who the cool [read: GOOD], reliable, fast online/mail order companies for fertility meds? Fairly certain that the email I just read from our clinic was saying that I will need to order mine (and our surrogates) in the next few days.

Here was the reply when I asked about getting the meds:

Once you are ready to get started, I will send this prescription to a mail order pharmacy and they will call you to set up payment and shipment of the medications.  You will need some of them within 14 days of starting a cycle.  The others you will need a few weeks after that.  I would recommend getting the meds as soon as you are ready to proceed.

Honestly I don't know if that means 14 days before my next cycle or 14 days after my current cycle start - which now that I think about it, is the same thing really. Since my period started on Sunday, that means I need to get the full list and make the purchases.

I hate having to rush rush rush everything, but it looks like that's where we are now. Have no idea about what happens with being able to claim this on taxes for anything that spills over to next year. I know you have to reach a minimum percentage of your income to claim medical, but can you only claim what is OVER that percentage, or do you to claim the first part too? I'm trying to figure out how vital it is we make our Dec 31st deadline. It's vital from an old eggs perspective, but I don't know how much it will end up costing us if we can't claim it all on our taxes this year.

Any tidbits you guys can throw my way I would really appreciate. The last two days of trying to balance 4 individuals' schedules for treatment, make sure everything is asked/answered for our upcoming cycle, work, getting a plumber out (yay! We have water!), make a community meeting that we will be a named plaintiff in, more work, AND cart my 12 year old Min Pin back and forth to the vet for dental surgery (9 extractions!) has my head spinning.

(BTW - my Min Pin is a total hillbilly now. All of his front teeth, bottom and top, were rotting due to age and not enough space, and had to be removed. He won't show me now and is working the cheese angle.)

No wonder I need a good hook up for meds. Give me a heads-up and I'll keep it on the D-Lo. 

In Today's Surrogate News...

image from: here

The long awaited surrogate news is here! 

Our surrogate and her husband are still gung-ho - YAY!!!! Ms L went for her hysteroscopy and HSG testing Thursday and Friday. We haven't heard the official news from the clinic yet, but she is under the impression that everything came back great. Double yay! I'll let myself have that little bit for now.

On the flip side, my surrogate and her husband, both whom are very close to us, are having trouble quitting smoking. If she doesn't quit soon, then it will be a no-go. Quitting smoking is super-tough and she feels awful that she hasn't been able to quit yet. Was there myself once-upon-a-time and it sucks.

We went ahead and asked them if they wanted to try Chantix (we'd pay for it) and made sure with our clinic that it would be ok for them to take. They both wanted to give it a shot and we were happy when our RE said it was ok. We were about to go meet them on Saturday when our water heater expansion tank sprang a leak. Fortunately showered just minutes before the leak was discovered... 

Anytime you find a large puddle of water on your floor you should probably be concerned, but honestly I was more concerned about meeting with Ms.+ Mr. L. We called a friend and my dad to ask some questions, turned a faucet valve that was connected, let hot water run out in the sink, placed a bucket under the leak, and left to go meet them. 

Meeting went great - picked up Chantix Rx and then grabbed dinner with both of them and their little one. Afterwards we had a get-together at a friend's house where it was pretty paramount that we show our face. It's a close friend (he introduced us!!!) and we think we weren't invited to his wedding a month ago because we have been soooooo MIA - we hadn't even met his now-wife until last night. They had been dating for a little over a year. When we returned home much later we found the leak still going strong. A little digging around outside and in the garage led to the discovery of another valve to turn off ALL water. The first one turned out to be just for hot water. 

I hope the Chantix works. It helped me quit smoking years ago, but I know some people report serious side effects and can't take the medication. Chantix is not covered under their insurance either, but Mr. L's doctor gave him a $75 coupon. Oddly enough, Ms L's only have her a $40 one. Weird huh? We were able to use the $75 one. 

Now we go full speed for the other things. On the schedule of phone calls tomorrow is lawyer (required by our clinic), blood work for all, and psych tests for all. Wait what was that last part??? Yea, our third party coordinator said that we would have to ALL have a psych eval. Having a psych eval doesn't bother me (it probably should!), but after 2 failed surro cycles in India I really don't understand why it is necessary. I sent an email to our third party coordinator asking about the necessity (ie. requirement), of this for my husband and I. If it isn't required then I really don't see the need to spend additional monies on it. We didn't have it in India and I don't feel like we need it now. (The surrogate did have one in India and I understand why it is required here.) 

And I'm not sure how we haven't really talked with the financial coordinator at our clinic thus far, but I guess we need to schedule that as well. Sigh. At least then we will know better what to expect. Our original information from the clinic did not include costs for surrogacy. That becomes an entire new list of line items. 

I don't know how I'm going to take off all this time from work. All day psych evals? Appointments at an attorney office? More medical stuff? I don't know how our surrogate is going to be able to take the time off either - though of course we will give her money for any missed work. She starts a new job next week and while we are both super-duper tight with her boss, I think it's still awkward to take time off when you first start at a company. Even if the boss is totally ok with it. 

Sigh. So that's the update. Prior, I steeled myself to expect the worst with her hysteroscopy/HSG tests and now I feel unexpectedly elated. Even after feeling all doom-and-gloom about the cigarette stuff for the last week and a half. I'm still going to be cautious about getting too excited with regards to that, but I've let myself be hopeful for the weekend.

Course not having water it beginning to suck. Guess I should put "plumber" on my list of phone calls for tomorrow. Wouldn't that be funny if that was the phone call I forgot to make tomorrow? (I refused to pay Sunday plumber rates.) My BFF called earlier and said we could take a shower at her house if necessary. Since she could smell me all the way from there... She's a keeper. :-) 

Now Back to Our Regularly Scheduled Program (Almost)

Shew - I'm done. Loved participating in ICLW week and I've found so many great new blogs to follow. On the downside, I'm behind on some of my favorite blogs and, well, ahem, actual posts of my own.

For those not familiar, ICLW has an "Iron Commenter" status you receive if you go to every blog on the list and leave a comment on at least one posting. This is not as easy as it sounds, especially if you are like me and make sure you read an entire post. Some very long. Usually the great ones. God forbid you feel the need to flip around on a blog to find "just the right post". Yea, I did that a couple of times.

But I did it. Posted a comment (or two or three) on every single one of them. Yay for me! It's a little thing, but sometimes completing a task like this makes me feel awesome. Just think: I had an extra 44 minutes to spare before the midnight deadline. For some reason I'm having vague flashbacks of college...

Today's readings:

1. It Is What It Is (Or Is It?): Pain and Discomfort
2. Growing Griswolds: I am officially cray-cray
3. 1000 Oceans: our little squiggly & welcome iclw
4. Breathe Gently: The weekly run-down: 19
5. Dear Finley: The Sad Mother
6. Life of an Army Wife: Written Off Part 2
7. The 2 Week Wait: Me- Failure
8. The Barreness: Detachable Penis
9. Patience is Not My Virtue: More Bloody Bloodwork
10. Carney Exploits: The IVF Consult
11. Waiting For Baby: BF
12. Survive and Thrive (This site was hacked and thus unable to leave a comment. This makes me angry, but I will make sure to go back and read it when it's available.
13. Life with Roozle: Roozle's Plate
14. Dancing My Way Through Life, Loss, and Books: Catching Up
15. Feeling Beachie: A Long Road Ahead
16. Stirrup Queens: It’s Totally Cool to be Baby Crazy*… If You’re Fertile

Slacker, Community Peeps, 10 Second Rant, & ICLW

I confess. Super Slacker on the post reads today. Mostly because I didn't get home from a meeting with some local community folks (and then dinner) until almost 10pm.

The short of it involves them asking us to be a "named plaintiff" against a big box store that wants to move in right next to me. They need someone who lives close and I don't think you can get much closer than we are. Did we acquiesce? Damn straight. My quality of life goes down the tubes if the stupid mass retailer moves in. So much for me liking my privacy (both as a named plaintiff and/or if they move in.) Le sigh.

It probably doesn't help that I missed taking my supplements most of last week and now that I am taking them again, I have to deal with side effects. Rage Balls with your side of DHEA anyone? Hopefully it will pass quickly. While I have that going on, I'm going to use it as an excuse to go into a 10 second rant on something that drove me bonkers last week. 

10 Second Rant:
I am not a grammar Nazi. I swear I'm not. If you want to know the truth, I'm fully aware that my own grammar isn't that fabulous most of the time. But I hate - really, really hate - when someone's is awful. (If someone is disabled, from another country, uneducated, or similar then they totally get a pass.) There are blogs I can't read anymore because of the writing. Not minor things, but things that make you want to poke your eyes out.

I want to read the story, not try and decipher the jumbled up mess. Maybe it's because of my ADD, but when it's a jumbled mess, it's HARD for me to read. In the end, I just don't read them; it's too frustrating.

And I'm willing to bet, at least a quarter bet, that I am not the only one. That actually makes me a pretty crappy and judgmental person, but I can't help myself at times. I wish I could. This is the part where if I was smart I would erase this whooooolllleeeee section. 

End Rant

If you are visiting from ICLW then
A.) Sorry you had to see that rant. I'm not normally like that I swear. Ok, maybe sometimes.
B.) What took you so long? (LOL Just kidding) and
C.) You might want to start HERE instead for a tiny blurb about me and better posts to read. Except you are at the end of this one already so you might as well stay here.

Today's Readings:

1. (Still) Trying to Conceive: Languages
2. Hobbit-ish Thoughts and Ramblings: Sunday Night Chit-Chat Recovery Mode
3. Crazycatladywantsbaby: I Must be Stupid - TMI Post
4. Bébé Suisse: What does a girl have to do to buy a Doppler around these parts?
5. Follow Every Rainbow (nope - need permission. :-(  )
6. Team Harries Beat Infertility: Willingness to Wait
7. Tesseract: Eighteen Years
8. Thought Provoking Moments: Well, Well, Well
9. Genuine Greavu: the "A" Word
10. the misadventures of missohkay: When World's Collide
11. My Fertility Blog: And Then There's Good News

Daily Readings and a Teaser

Have a bunch to write, but I'm too tired. If I hadn't challenged myself to read all the blogs participating in IComLeavWe at Stirrup Queens, then I probably would have written some today and yesterday. Shrug. A girls gotta do what a girls gotta do.

If you're new and want to learn a few quick things about me, my post from yesterday will help with that. (See how lazy I am today?) Have to say, despite my whining, I really do enjoy discovering all these new blogs. 2 more days! By Friday I should have test results from our surro, and dare I say a real blog post? Mayhaps. Stay tuned.

(P.S. I need to remember to write a rant on the book Gone Girl. There's some IVF stuff in there as part of the story line that made me want to throw my book against the wall. Until I remember that my book was a Nook.)

Today's Readings:
(I'm kicking myself for not keeping a side list of my favorites. Maybe next month.)

1. Home Grown Love: Surviving the Holidays
2. for all the things we hope for: The path to knowing
3. Waffle-Wednesday: Night if the Living Oblivious
4. A Daily Miracle: Double Digits and Braxton Hicks
5. Simple|South: I Like a Good Challenge
6. Gonna Do It For Baby: Thanksgiving Announcement
7. Believing in June: What I don't Believe About Infertility
8. Dreaming of Dimples: 4 years 
9. Life in Little Hispaniola: So What Do You Eat Anyway (Part 1 of 3)
10. Our Work of A.R.T.: Welcome ICLW!!!
11. Three Quarters Full: In His Own Time
12. Pollination Chronicles: ICLW, FET, and a 2ww.
13. Arete Aspirations: 21 December 2012
14. Our Journey Through this Lovely Life: Nope. Nada. Nothing. Negative.
15. Ready for My Bundle: Friday Night at the ER...
16. Welcome to the Road: Waiting...Again...
17. Things Couldn't be Better: You have died of dysentery

ICLW Readings and a 10 Second blurb About Me

Quick blurb about me for our ICLW gang from over at Stirrup Queens.

I turned 40 in April and was married 2 years ago in March to a wonderful man whom I adore (usually). My husband is originally from India and I am half Swedish/half American mutt (originally from south FL, but living in Atlanta since my teenage years.) From a previous short-lived marriage, I have a fantastic, 20 year old son.

Due to a surgery I had 4-5 years ago, I can not carry a baby. My now-husband and I discussed this when we first met - and talked about having a surrogate if/when the time came. It kills me how naive we were back then. No real knowledge of the "biological clock" and what we did know we stupidly didn't think really applied to us. We've been through 2 IVF cycles with surrogates in India. First one failed, the second one was a chemical pregnancy. We will give it one more go (either here or India) with my eggs and then we will have to see what we see.

Post of mine that may be of interest (since this one isn't) if you are participating in ICLW Week:
What makes the elephant charge his tusk in the misty mist, or the dusky dusk (Courage, going to India alone for IVF.)
Special Lady Cocktails ([Mostly] self-Rxd supplements and feeling ridiculous.)
Another Option (A new, amazing surrogate option presents itself.)
Failed Again (Finding out we had a chemical pregnancy.)


Blogs I read today (from ICLW):

1. Dreaming of Dimples: 4 years
2. Pepibebe: Sweet Dreams
3. FrozenOJs Concentrated Life: 30 Days of Thanks: Day 21
4. Emma in Mommyland: What is a "Rainbow Baby"?
5. It's the Journey: Furbabies
6. Who is this "Fertile Myrtle"?: First Appointment for Removal
7. One Day at a Time: Infertility Etiquette
8. The Buggy List: The bewbs are back 
9. Comatised: Scum Bustin Makes Me Feel Good (comments not allowed)
10. My (In)fertile Confessions: ICLW
11. Sweet Dreams are Made of This: Dear Birthmother Letter
12. We Three Crabs: Friendship
13. IUI to Roux-en_Y to??: ICLW, OB Update, 25 Weeks
14. Life is Simple, it's Just Not Easy: November ICLW :)
15. A Virtual Hobby Story and Coffee Haus: How Campus Racism is a Post-Election Reality
16. Unexplained Rantings: Expectations
17. Creating a Family: Creating Embryos Specifically to Donate/Sell
18. A Bliss Filled Life: Life Before the Bliss
19. Wandering Wonderment: IComLeavWe Intro
20. A Glamorous Mommy Life: My Story Part 1

Blogs I read from yesterday. Yes, you may notice I did the ole "start from the bottom" with regards to the ICLW list. Actually, I started randomly and then decided to try for Iron Commenter status.  THEN I started at the bottom. Then I read a few of my regular blogs. Below is list of what I can remember I read. 

1. Gypsy Mama’s Misconceptions
2. If You Don’t Stand For Something
3. Upper Middle Mom: So Thankful
4. Old Lady and No Baby: Decisions, Decisions & You Want Me to Stick it Where? & First Blog
5. Journey to the Finishline: From First to Second (&ICLW)
6. Life As I Know It: Giving Gifts
7. InDueTime
8. Scrambled Eggs
9. finding the peace to the puzzle: A New Beginning
10. The Quest for the Golden Egg: Still Stuck and Still Tired
11. Compromised Fertility
12. Things Couldn’t Be Better: November ICLW
13. Enjoying the Course
14. IVF Over 40: A Confession
15. Rasta Less Traveled: 7 Months 
16. My Fertility Blog: For Those of You Who Are Pregnant & Sad News & Today is Another Day
17. Tandoori Viking: Eye Candy :)
18. 10 Miles Uphill in the Snow: Swallow Study Results
19. What Am I?: Enjoying It & I Am Thankful & Sick Again
20. Stupid Stork: Acting
21. Stirrup Queens: 419 Friday Blog Round Up

I've Been MIA, but Still Here

I've been MIA for a little bit. Sorry about that. Nothing life shattering, but just a few things I'm not ready to blog about yet. My new job and prepping for Thanksgiving has left me a bit behind as well. Not only with blogging, but with my favorite past time of reading other's blogs. And well, to be perfectly honest, I've had baby showers and friend's babies that I've had to embrace. No break downs - internal or external - yay for me!

Meanwhile, I know it's IComLeavWe week! (Ok, the weeks half over - better late than never.) Welcome welcome welcome. I realized this morning that most people participating inn ICLW would probably stop at the first post unless directed otherwise, so I'm listing some of my more interesting posts in the last few months (though feel free to stop at my spur of the moment, last- blog-post: 'Ode to Chai' tribute, check out the side bar, or search for tags.)

These aren't in any particular order. Next month I'll try and put this up BEFORE ICLW starts. Here's some of my favs in the last few months.

What makes the elephant charge his tusk in the misty mist, or the dusky dusk (Courage, going to India alone for IVF.)
Special Lady Cocktails ([Mostly] self-Rxd supplements and feeling ridiculous.)
Another Option (A new, amazing surrogate option presents itself.)
Failed Again (Finding out we had a chemical pregnancy.)

Thanks again to Stirrup Queen for all she does and for organizing ICLW. If you are not already familiar with her blog and are in this horrible Land of IF (infertility), I highly advise you to check out her website. She organizes TONS of blogs on the subject and has a weekly breakdown of favs every Friday.


Oh yea! HAPPY THANKSGIVING EVERYONE!!!

Don't Forget the Biscuits: Ode to Chai

From: http://www.crazyfortea.com/howtomakechaitea.html

My first introduction to chai was through my now-husband-then-boyfriend. Given the fact that I've heard the comment "would you like a little coffee in your milk?" on more than one occasion  it's no surprise that I instantly fell in love with this wondrous drink: chai - otherwise known as "Indian tea".*  With it's high caffeine content a novice has to be careful of his/her consumption, but it's still my favorite drink. I just can't drink it as often as I would like.

Imagine my surprise, after having traditional every day chai (sometimes several times a day when my Indian in-laws visited), when I ordered my first Starbucks chai. Not. The. Same. Thing. It was like autumn had taken all her baking spices and threw up in my milk steeped tea. Which I suppose is fine if you are expecting it and haven't had it the normal way 100+ times, but not so much if you are used to it less spicy. Kind of funny when you stop and think that a US way of doing something is more spicy than the average Indian way. (Not to be confused with chai masala - which by definition is spicy tea.)

Let me point out - there are a TON of ways to make chai and in my experience even the same family can argue over whose is better  (naturally) - but it still isn't going to stop and make you wonder if there is pumpkin pie floating around in the saucepan. You still taste the TEA. That's kinda the main focus: tea and milk.

Let me also point out that you should never call it chai tea. It's a little on the redundant side. If you want to get technical, I believe that chai is the plant and tea is the product, but blah blah blah blah blah - yea just don't call it chai tea. Most people in the know will just tell you it's like saying "tea tea". There's a recipe floating around on pinterest that not only calls it chai tea, but also included powdered creamer in it's list of horrendous ingredients. I'd post a link, but the lady seems nice enough and people like her version. Who am I to go all internet cray-cray and be like "HOW DARE YOU!!!!" as if I've been drinking it since birth.

This post really was just an excuse for me to post an internet recipe for chai I like. So here is the basic recipe I follow. And no, I don't like this recipe simply because she agrees with a bunch of what I have written here. I like it because this is very similar to what we make here at home, and what we most encounter over in India. We usually add around 4-5 crushed cardamon pods for 2 large mugs of chai. Sometimes we use ginger and every ONCE IN AWHILE we use nutmeg INSTEAD. We also add our sugar later as to not boil too much off, but that's something new we are doing so we can add less sugar.

And don't forget the biscuits. Because my father-in-law would be disappointed with you and he is a very nice man. Definitely don't forget the biscuits.


*In certain parts of India when I ask for chai, I am served English tea. I'm fairly certain it's because I am caucasian  because it never happens to my husband, but I've learned to specify "Indian tea" when I want my beloved chai. 

** Disclosure: If you are going through IVF treatments, then you are supposed to limit your caffeine. That might be hard to do once you drink chai a few times, so don't say I didn't warn you. 

Creme de la Creme

I love reading all of the blogs on my current roster, but I'm always interested in reading more. Have a great blog? Or maybe just a post you dug down deep within and want to share? Add it to the list here.

Get your submission in for 2012 ASAP. The deadline is December 15th. Personally I just picked one on the fly, because I tend to forget easily and knew if I didn't submit right away then it wasn't going to happen. What are you waiting for? Do it! You started a blog - now share it with others. 

BTW, if you are not already familiar with Stirrup Queens, I highly recommend it. You can get a good highlight of other blogs that are available that may offer great advice on something that you are dealing with. Melissa has organized all the different blogs into "rooms" that you can find here. Here is an image connected to her site to give you an idea of the different rooms (though if you click on the link you can get a MUCH better idea of the level of granularity that goes into each room. 

On Feeling Alone

I know that there are TONS of folks that face infertility, but damn it, sometimes this path feels so lonely.

• The hormones.
• The feeling less of a woman.
• The weight gain and the realization none of your clothes fit. 
• The money. (You can't even think of buying new clothes).
• The daily meds or supplements.
• The feeling of failure.
• The limitations of what you can eat/drink/do to make sure you have "the best chances".
• The no baby. 
• The doctor visits
• The pretending everything is fine.
• The pretending like you really want to hear and be invited to every baby event.
• People asking "so when are you guys going to have kids?"
• The CONSTANT reminder that you are old (or at least your eggs are). 
• The roller coaster that just won't seem to stop no matter how long you've been on the ride. 
• The worry that wanting to use your own eggs raises the chance of health issues in your child. 
• The worry that I'm becoming obsessive or annoying.
• Worrying about my in-laws
• The invasive procedures
• The worrying over every little unknown pain will cause a problem
• The money (yes, this is big enough to write twice).
• etc...

My BFF is a guy and I don't think he can completely relate. Actually, I take that back. His situation is worse.
Me: "This sucks. I can't carry a baby. My eggs are getting old. And we pay a fortune just to be on this stupid roller coaster ride."
BFF: "I think my MS, being single, no chance of kids, and the eventually that my walker requirement will turn into a wheelchair requirement triumphs. My insurance alone is over $900 a month and I can't work."
Me: "touche. Let's go grab lunch. It's on me."

My second BFF just had a baby, so it's not like I want to rain on her parade or have her feel like she's walking on eggshells. She's so totally awesome and her baby is as cute as cute can be.

My husband, though tremendously patient with me, doesn't alway understand how this physically and emotionally this affects me. And as many of you know, it's a doozy  Nor do I, having been a parent before and not from a culture who puts the highest importance on having children, understand all of his internal turmoil. On dealing with the emotional side of IF, we probably both stuff it down in order to appear brave for the other.

If I tried to discuss things with my mother, then she would be incredibly sad worrying about me. That would only add to my stress. No thanks.

In blog land I sometimes worry that I am offending others. In my posts and sometimes my comments; both farthest from what I am actually trying to do. Just trying to convey my thoughts at a particular moment in time. Or trying to avoid feeling sad. Or trying to be helpful. Or funny.

In work and with friends, I'm limited to what I can say. Sometimes because I'm trying to protect myself (lest I am fired for going through IF like I alluded to here) and sometimes I just don't want everyone knowing my business. Nor do I have the desire to be the discussion of gossip as can happen when you have a large group of friends. Nor do I want to be the person that constantly complains and whines as that drives me crazy. Little bits are fine, but when you run into that person who has had problems for soooooo long, it becomes exhausting to talk to them. I certainly don't want to be "that" person.

Yet life goes on. Everyone is busy discussing their kids, sharing fun photos, and doing fun family projects. I'm sure it's a grass-is-greener type thing (after all, we've had some AMAZING travel adventures over the last 4 years), but if I see one more Luvs commercial on Hulu, I'm going to scream.

Weekly Update: A Job, Land of IF, Being a Proud Parent

So many things, so many things. I've forgotten half of them already. Let's just hit the highlights and see what else I can remember.

Hi Ho, Hi Ho, It's off to Work I Go.
Had to go back to work. Money is just too tight right now. Me not working for 8 months has finally taken a toll on our finances and if we want to continue in this Land of IF, then we can't do without my paycheck.

My first week of job hunting was really me just talking to recruiters. I figured I had put enough off during my travels to India, that now was the time to dig deep. That's always an adventure, but by week 2 I had a job - fortunately my area of expertise has an extremely low unemployment rate. It's a contract to perm position in IT, doing what I have over a decades experience experience in. I will be making over 10% more than what I did at my last job and for a company that has a big name all over the world.

What about my dreams to do some sort of humanitarian thing in the non-profit industry? Selfishly, our dreams of a family rates higher on the scale, thus I had to give up on a career choice that would pay just over 1/3 -1/2 of my current salary. All is not completely lost as the project I am working on helps people from 9/11. At least I can believe in the project. Some of the companies that wanted me to interview were BLECH. (Have had enough of soul sucking from my last job thank you very much!)

Speaking of Land of IF...
1.) Just starting reading the book Navigating the Land of IF: Understanding Infertility and Exploring Your Options by Melissa Ford of Stirrup Queens fame. Only on chapter 3 (have had to study for work - <sad face>), but it is pretty awesome. Have my own mini-collection of IF books, but this is the one that most interests me right now. Probably because it's not all doom and gloom fact based. Melissa does an excellent job of making the reader far more relaxed over a very NON-RELAXING subject and everyone is included. It's a hard road and the recurring theme is that we are not alone. And that it's ok to be all emotional. I'll write a full review when I'm finished.


2.) Our friend and her husband who offered to do surrogacy for us are "both feet in". YAY!!! That's the first hurdle. We've consulted with our local clinic and there are a couple of things we have to address, almost all of which we expected. Then there is the insurance issue. We don't know yet if her insurance has a surrogacy clause. Trying to find that out without sending up red flags. They aren't known nationally to cover these things...One step forward, two steps back.

The item I had not thought about was that my doctor wants to retest my FSH. It was high last january (12.4) and with the decrease in my AMH, she wants to make sure that it hasn't shot up to the high teens. I know, I know, it's a Big If. Wish me luck. If it comes back too high, then we could be in holding pattern for years for the DE as I've previously mentioned here and in other places.

Proud Parent
Some of you might remember that I have a 20 year old son. What I don't think I have ever mentioned is that he is in seminary school. Which is perfectly natural since his father is Jewish, my husband is an ex-Hindu, and I have had a lifetime of "trying to figure it all out". (Try not to laugh.) Anyhow, my son has a religious podcast now and I am very happy to see him do something he enjoys so much! Of course as the proud mama I had to listen to it right away and I was tickled in doing so. He was great! Very few people in life get to have the career that they absolutely love and I think he will be one of the lucky few. We have the best discussions and I'm thrilled that not only am I his mother, but also his friend. He dives into projects where he can bring help to those who need it and I am so incredibly proud of him.

-------------------------------------------------
Well, that's all I can remember right now. Still recovering from the flu, which is interesting with starting a new job. I'm exhausted.

Complaining About a Nurse

A pet-peeve of mine: bad doctors or bad doctor staff. It truly drives me insane. When I was younger I would sit by and do nothing, but as I have gotten order I realize the EXTREME importance of being your own advocate. If you don't, then all sorts of problems can arise.

Yesterday I ran into an issue with a nurse at my new OB/GYN's office, that can best be explained by just including the letter I sent to what I hope is my doctor's email address (and compliant boards). Names have been removed to protect identities  (Let's be honest - mainly mine.)  Chime in on your thoughts.

--------------------------------------------------------------------------------------------------

Dear Dr. W,

You may remember me. I am a new patient that recently was locked in a bathroom on my first visit due to a mechanical problem with the door handle. I received your letter recently and I was extremely impressed that you took the time to hand write and send me apologies. In this day in age, that is not only rare, but extremely impressive. Thank you for taking the time to do so; this speaks volumes about you. The door was clearly not your offices fault and just one of those things that sometimes happens.

Unfortunately, I am writing to you today to discuss another issue. Namely your nurse M. W. and her extreme rudeness, as well as cruel words to me on the phone yesterday. Our phone conversation ended with me requesting that either you or someone else, anyone else, from your office call me to discuss my case. Not only was I in tears for a long time after our call, but I am concerned that she will either delay or not have someone else contact me from the office. I will give the details of the situation below.

On Friday I went to the ultrasound that you and I has spoken about previously in your office. The person that did my ultrasound was professional, pleasant, and caring. I'm not sure of her name, but she is an outstanding individual and an asset to XYZ. After my ultrasound, I asked her if there was a cyst on my right ovary. I specified the right ovary because I am familiar with pain that has shown to be related to it and I was having it. The ultrasound technician stated I did not have a cyst, but I did have some free-fluid. When I asked some more questions, she told me that the images would be sent to someone else and a report would be passed to my doctor, who would discuss the findings with me. Perfectly reasonable and professional, as I shouldn't expect her to make a diagnoses.

This week my cramping on my right side became slightly more intense, but as I have also developed the flu, I decided to patiently wait for the call from your office. By Thursday it had not come, so I put a call in myself. My call was returned a few hours later by whom I have since been told was M. W.. What happened over that call not only put me in shock, but others as well.

Ms. W told me that my ultrasound was perfectly normal and showed no problems. I asked about the free-fluid and stated I was concerned, because many years ago I had free fluid that eventually landed me in a 5 day hospital stay with a PID infection. During the period, it took me almost 2 months of dealing with pain to recover. Ms. W's first response was to get extremely curt with me and say the ultrasound technician had NO BUSINESS telling me that the free fluid was an infection and started going on a rant. I interrupted and explained that the technician had NOT said that and had only stated that there was free fluid, but the rest was from my own personal experience  She continued to rant and I again iterated that the technician in NO WAY, had said anything other than free fluid.

I then went to explain to Ms. W., that my husband and I have been going through IVF and we will be starting our last cycle soon. I explained that due to my age, this would be our last cycle, so it was EXTREMELY IMPORTANT, that anything, such as an infection, be taken care of now rather than have it possibly cause a problem with my cycle, or delay it, which is also a problem due to my age. I further explained that the pain in my pelvic region was continuing. Ms W. was combative at every step. While that is bad enough in itself, Ms. W. took it upon herself when given NEW facts regarding my case that should have been considered by my doctor, to diagnose me herself. And her diagnoses was that there was nothing OB/GYN related wrong with me. She stated that the free-fluid came from a cyst bursting. I'm not sure how one could tell if it is from a cyst bursting or possible other infection (without testing the fluid), but she simply didn't allow for such questions from me. She only wanted me off the phone and off her charts.

She told me to call my primary care physician, to which I explain I have just gotten all new doctors due to moving, and the earliest PCP appointment I could get with XYZ was over a month away (already scheduled). She then told me to go see my IVF clinic. This is not practical for me as 1.) My main clinic thus far has been in India, though I am returning to my American clinic 2.) Insurance will not cover these sort of things at an IVF clinic. She then told me to go to the ER if I was in pain. At this point I asked why I could not speak to the doctor or at least have the new information relayed to him. She said that NO doctor calls back his patients. While this may be the policy at XYZ, I can assure you that I've never had an issue with this with any other doctor. I gave her an example of an OB/GYN I had for 20+ years that always called me back when requested, but she didn't really seem to care.

I told Ms. W. that I wasn't trying to take it out on her, but that I didn't understand why she was trying to hem-haw and not let me get the patient care from what I felt was a OB/GYN issue. She dismissively told me that pelvic pain could be from many areas and that she felt it wasn't an OB/GYN issue. I may be wrong, but I really think that it is out of place for a nurse to be making these decisions without conferring with the doctor. Especially if I have introduced new information that the doctor was unaware of.

The pinnacle came on her final berate of me that I can only describe as the most callous and unprofessional interaction I have ever had with a doctor's nurse. She sarcastically said to me "Look. I'm sorry you can't get pregnant......" and I have very little recollection of what she said after that - I was in tears and shock. She doesn't even know my case to be saying if we can get pregnant or not and it is extremely cruel to interject this statement when it has no bearing on the issue at hand. Especially to someone currently going through IVF treatments. I'm not sure what else was said except that I finally interrupted her rant to say I needed to speak with the doctor or someone else from the office. That I could no longer speak to her. Her response was "I have no idea when the doctor can get back to you" to which I responded "Anyone. Have anyone call me back besides you. I need to speak with someone about my case, and I can not speak to you." After about an hour, I was able to collect myself and call back XYZ to find out the name of the nurse whom I had spoken with. The receptionist looked up my notes and said it was M. W..

At this point I have no idea if she even passed on my information to anyone else. I am horrified by her treatment of me, especially given that I am going through infertility. I would expect an OB/GYN's office to be the last place this sort of thing would occur. An OB/GYN staff should be the opposite of this and in my 25 years experience with OB/GYN offices, it always has been.

To recap:

1.) Ms W. took it upon herself to diagnose me without speaking to a doctor about new developments in my case

2.) She was combative and unnecessarily cruel

3.) I have very little confidence that my information was ever relayed to anyone else, much less my doctor. Thus I don't know what the next step for me to take with my care is and I sit in limbo wondering.

I have written very few letters of complaint in my life, but I felt that this was important enough to write one. These are never one time occurrences and nurses who speak to patients like this should not be in such a delicate field as OB/GYN. Please let me know if and when I can expect a call from your office to discuss my case and concerns. Thank you very much.

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UPDATE: The office is part of a very large hospital and medical teaching school. My email has already created a stir and I received the nicest phone call from my doctor's office and an email from someone I don't know, but is with the organization. There will be an investigation into the matter and I'm hoping there might be phone records. While I certainly don't like to get people in trouble, I feel much better knowing my complaint is being dealt with quickly and that it's important. Besides my complaint  the person that called today is making it his personal duty to get answers to my medical questions ASAP (doctor is out today). He was really really nice and soooooooo much easier to have a normal conversation with.

UPDATE 2: Doctor called and not only was really nice, but alleviated my fears after lengthy discussion with me and pulling up all my records. He also made a funny comment about the nurse wasn't loved enough as a child as has no business being a nurse. Apparently this was not an isolated incident.