#*@%&# insurance…

Yup…my insurance, which is normally fantabulous (seriously, I think they just paid out close to $2000 for me last month…and I didn’t have to pay anything but co-pay) really pissed me off today.

When I had my beta tests, they also checked my progesterone levels.  They were low both times (10.3 and 11.4).  When I went in to see the MFM doctor for my ultrasounds I asked him about this and told him I had some left over prog from my last IUI.  He suggested I take it and when I run out to get a new RX from my ob/gyn.  Okey dokey!  I thought I had about 2 weeks worth, enough to get me to my appointment (which is next Monday, fingers crossed) and then get the new RX then.

Did you know that if you have 21 pills and take 2/day, that’s only 10 days worth, not 14??  Yeah, I didn’t either!  However, maybe you don’t suck at math as much as I do – I mean really, I suck at math.

So, once I realized my error, it was this past Friday.  I didn’t get time to call during the day, so I left an after hours message, hoping they would get back to me at least by Monday, as I would run out on Tuesday.  Monday came and went, no phone call.  I think, “well, maybe they were closed Monday due to the holiday.  I’ll give them Tuesday.”  So, yesterday came and went – no phone call.  Getting pretty frustrated, as they always call me back!  So, I took my last pill last night and hoped it would all work out today.  Left a VM for the nurse at 9 am (knowing my doctor would not be working today, but hoping someone could give me the RX anyway…).

I get a call back relatively quickly.  Give them the name, amount and the location of my Target pharmacy.  Done!  No problem!  Figure I’ll run to Target over lunch and pick it up!  Great!

Well, about 2 hrs later, Target calls.  They tell me that they just got my prescription, but that my insurance does not cover any of the cost and it’s going to be $437 – WHAT THE &#)(&)%(@!!!!  Not only that, but they didn’t even have that medicine in stock and would have to order it.  I was livid to say the least.  Call the nurse back right away and she actually answered the phone instead of VM.  I told her the situation, asked if there was a generic?  She had put in a RX for 30 day supply.  We decide she will call Target and see if they can get a generic.

I call my wonderful, loving husband.  I think he had a small heart attack  when I told him how much money they wanted.  I remembered that when we got this last batch of progesterone, it was at a smaller pharmacy that had it in stock.  He agreed to track down the name of it, and we decided to just get a 10 day supply to get me through until my appointment and then go from there.   I decide to also call my insurance company and see what the heck is up.

I call them.  Here is the conversation:

Me: I’m trying to get a RX that I very much need and I’ve been told there is no coverage for it and I’d like to know why.

Insurance Guy: Let me look that up.

***on hold***

Insurance Guy: Yes, it looks like there is 0% coverage on that particular RX

Me: I know, I want to know why.  I’ve had it before and it wasn’t covered then as it was part of IF treatments, which are not covered – but this is for a pregnancy and prescribed by my ob/gyn.

Insurance Guy: It doesn’t give a reason why, just that it’s not covered.

Me: *deep breath*  Okay, this is very frustrating.  I need this medication.  If I don’t get it, my baby will die – I’ve already lost one pregnancy when I stopped taking this due to cost.  I don’t have the money for it.

Insurance Guy:  Well, in that case, would you like to file an appeal?  I can send you the forms and you fill out your reason and can even get your doctor to sign it.  It’ll take about 2 weeks.

Me: That will be too late.  Thank you. *click*

I know it wasn’t this guys fault, but I just get really flustered and angry when stuff like this happens – when I have no control over something this important.  It’s easier to just hang up on them rather than releasing the fury.

So, plan 2.  Justin does manage to find the name and address of the other pharmacy.  I call my doctors office back, and leave a message with the name and address, tell them just to order 10 days worth and we’ll figure the rest out later.

About 20 minutes later the new wonderful pharmacy calls me back and says they have my RX and when can I come pick it up?

Me: Well, I have a question first.  How much will it cost?

Lovely Pharmacy Man: Well, let me ask you a question, do you have any insurance I should know about?

Me: I do, but they’re not covering any of it, bastards (I didn’t say the last part, just thought it.)

Lovely Pharmacy Man: Okay then, when I’ve already enrolled you in our discount insurance program.  It dosen’t cost you anything, just saves you money.  So, it would normally be $150 but with the discount it’ll be $124.

Me: Thank you!  I’ll be there during my lunch hour!

So, still kinda spendy, but no where NEAR the Target price, even for the 10 day supply!  I remember liking this pharmacy a lot last time we went there.  It’s just a small little building, and all they do is RX’s and over the counter stuff – nothing else.  They are always very helpful and friendly as well.  I may have to go there more often.

So – that was a very long tale.  Basically it boils down to my insurance screwed me over and I love this new pharmacy.  I’m also very happy again with my switch to the new ob/gyn.  It’s hard to get an appointment with her, but she and her staff are always helpful and willing to work with me.  Thank you!  Oh, and if you’re in Chicago and want a new pharmacy, let me know and I’ll give you the hook up.

my drug habit…

I went in for my last (hopefully) blood test for a while.  It was to check my homocystine (?) levels, which is realated to the MTHFR.  I’m not sure what will happen if it comes back that I have that, too…more meds?  Don’t know.  Anyway I’m really hoping that we’re now at the point where I can get pregnant and sustain it all the way through.  Sadly it’s taken 3 doctors, 3+ years and 2 lost babies to figure this all out.  I’ve learned that I need to be more proactive about my own diagnosis and fight for the things that I want.

When I first went in to see Dr. Freakin’ Awesome (the MFM doc) I was asking him all kinds of questions about baby aspirin and lovenox, since I know so many of you ladies have been put on one or both of those.  At that point (rightly so) he didn’t think it was necessary, since we hadn’t run the blood work yet.  I was kind of just feeling out what might be used for some treatment.  Now with the MTHFR diagnosis he has put me on baby aspirin, plus the extra folic acid.  I’ve been doing a lot of “research” (by that I mean, Dr. Google has been consulted on this), and have found that most women diagnosed with MTHFR are then put on the baby aspirin, extra folic acid (on top of a prenatal) and then when they become pregnant are prescribed lovenox or heparin.  I’ve found this article, that I have now printed off to put in my files.  If (when…) I get pregnant I will be using it to convince whatever doctor I have at the time to put me on one of the two of those.  I hate needles – really hate them, but whatever it takes ya know, as I’m sure you all understand.  I also stumbled across a blog called The Expecting Father – MTHFR gene mutation and pregnancy.  It’s written by a man who’s wife had recurrent miscarriage (2) and then was found to have the MTHFR gene mutation.  When she became pregnant again she was given lovenox and delivered a healthy baby boy.  They have since had another baby boy just a few weeks ago with the same treatments.  I also know my dear blog friend K of Waiting for Sunflower has used the same treatment and her little guy should be coming in the next few weeks!!  You can be sure I’ll be very proactive about getting this same treatment for myself.

In other news, I’ve scheduled a consultation appointment with a new ob/gyn (for May 24th).  I found her by searching online (I know, kinda scary) – but she was reviewed on Yelp! and all of the reviews were 5 stars!  She is covered by my insurance as well.  I’m hoping to go in to the meeting with all of my medical records and just be very straight with her what I want.  I’m hoping she has some experience/knowledge of infertility issues, specifically PCOS and now MTHFR.  She sounds like a great doctor, but if she can’t meet my needs, I’ll be looking for someone else.  I’ll let you know how it goes.

Okay, now on to the actual reason for this post!  I wanted to do a show and tell of my new drug habit (sorry this beginning part kinda got away from me).  First off, I’ve turned into an old lady – yup, I bought a pill box.  I figured though if I need a pill box to keep track of everything, it may as well be a “hip” pill box, so this is what I got:

It’s individual canisters that screw together to make this stack.  There’s an extra lid so if you’re going on vacation, you can just take the days you’ll need.  It’s pretty fun, and allows me to see if I’d remembered to take my pills for the day.  I just put my morning dose in the jars.  I have an alarm set on my phone to go off to remember to take my Metformin at lunch and bed time.

Here’s a shot of the bottles of pills:

The big jar is the pre-natals (some generic brand my insurance company picked out…).  The next generic looking jar is my Metformin.  The yellow is the extra Folic Acid (I’m supposed to take 1 mg a day, but they only came in doses of 400 mcg, so I take 3 of those) and the smallest jar is the “baby” aspirin, which isn’t for baby’s at all, they just call it that.  Though it is chewable and orange flavored!

So the grand total for the day is 8 pills: 6 in the morning and then then other 2 through out the day.  Here they all are!

Nice, huh?  The prenatal is a very vibrant pink.  There is even a warning on the bottle that it may turn your pee colors for a while…yeah, really.  Luckily I didn’t get that side effect!  I don’t know why they had to make it so pink!

That’s my update for now.  Hopefully my results will come back soon and I know for sure the full treatment for me, and hopefully, it’ll work!  Oh…and btw, I’m on CD-21, and no sign of ovulation.  My temps have been all over the place throughout this whole cycle.  I forgot to do my OPK this morning.  Might do it tonight and see what happens…

*  *  *  *  *  *  *  *  *  *

Okay…so, I was just getting ready to hit PUBLISH and my phone rang.  It was Dr. Freakin’ Awesome’s office and my blood work came back normal!  Yay!  So I just stick with the above until it works!

it has begun…

Yup, started my Metformin last night!  Yay me!  So, here’s the scoop:

I was given 500 mg Metformin and told to take it 3 times a day.  However, thanks to suggests from you all here on my blog (especially Maybe Baby?) and also from my IF sisters on Twitter I’ve decided to ease into it.  I’ll do 1 week with just one pill, then week 2 switch to 2 and week 3 be up to the full dose/day.  I’ve also restarted my pre-natal vitamins.  I know, I know…don’t even say it.  After the last BFN I pretty much went through my house and threw all of my IF supplies into a bag and shoved it in my closet (the needles, syringes, left over Endometrium, Pre-natals, etc…).  This morning I dug around looking for the bag and pulled the Pre-Natals out and took one this morning.  Yes folks, hope is again knocking on my door…and I REALLY want to answer.

I’ve also decided to hold off on the Clomid that I was prescribed.  I wasn’t expecting it in the first place, and I’ve always been a bit wary of Clomid, just from things I’ve read about it.  So the plan right now is taking the Metformin to regulate my cycles and also using OPK’s and BBT to make sure things are happening the way they “should” happen.  Once I’ve had a cycle or 2 (or 3) that seem “normal”, we will do one of two things.

1) Call the endocrinologist that was recommended to me (may do this earlier if it turns out insurance will cover it) and talk with her about the Met and possibly starting the Clomid.

2) Call my old fertility clinic and do one last try at IUI (which we are saved up for and can do whenever, but want to try this Met stuff for a while first)

So – there it is!  Hopefully something along the way will work for me and I’ll be pregnant BEFORE my next birthday (which is the big 3-0.  Yikes).  It’s just really nice at this point to have some freakin’ OPTIONS rather than sinking into a pool of despair.  Yay!

I’ve also been working out regularly.  I joined Curves and I got 3 times a week as they recommend.  I haven’t missed a week yet!  I’m feeling pretty good about that, and hoping also that now I’m on the Metformin it’ll help me loose weight, too.  The next hurdle is the diet.  I’ve never felt that I eat poorly, per se, but I don’t eat as well as I should.  And I love carbs.  I LOVE CARBS.  Give me a loaf of fresh bread anyday!!  Yum.  So, you can see we have a bit of a problem there, but one I’m willing to work on.  The DH and I were on the South Beach Diet for a while and it was working pretty good…I lost 10 pounds on that – before we crashed and failed!  So, I might try to somewhat go back to that, or really, just be more conscious about what I eat.

So far, no side effects to report on the Metformin, but I purposely started my doses at night, so I could sleep through whatever may happen on them…at least for the first week.  Really hoping I don’t get hit too hard with stuff.  Usually, if I do experience side effects from meds, it wears off eventually, so I’m hoping I keep up that tradition.  Okay…hope you are all well!!!!

um…okay…

So just got back from my gynecologist to discuss taking Metformin (or as DH calls it “metrosexual”) for my PCOS.  shockConversation went like this:

DrT: How are you?

Me: Good.  You?

DrT: Good.  So what can I do for you?

Me: Well, I’ve been going to FCI and they’ve diagnosed me with PCOS for the past 2 years.  I’ve read and heard from people that Metformin is commonly prescribed for PCOS so I wanted to talk to you about possibly going on that.

DrT: Sure, I can do that for you.

Yup…it was that painless!  Actually, she was pretty surprised and shocked that my fertility clinic never prescribed Metformin to me after the PCOS diagnosis.  Needless to say, I have been shocked and surprised by that as well!  She also decided since I was over due for my pap and check up to do that today too.  Usually I have some time to mentally prepare for that, but all went fine.

Okay, but here’s the kicker – she gave me Clomid too!!  What the…what do I do with that??  I’ve read putting Met and Clo together often work better than either one on their own, but I don’t really know what to do with Clomid.  We skipped that step with the RE because we only had so much money to work with and we wanted to jump straight to IUI since it had a better chance of working (which turned out to be true on the 1st try, it just didn’t last).

So…Clomid vets, HELP!!!  All I know is that I’m supposed to take it on days 2-5 of my cycle.  She told me to start the Metformin right away.  I’m not going to have any monitoring for this, as her clinic is not set up for that.  She did give me a referral to an endocrinologist, but I’m pretty sure insurance wouldn’t cover that, so I can’t really go.  I’m going to turn to good ‘ole Dr. Google and WebMD, but any insight and help I could get from all of you would be great too.

Can I just take the drugs and then BBT and use OPK’s and go from that?  Should I do anything else?  I’m already working out 3x’s a week.  I really need to start eating better, so that’s on the schedule too, but anything else?  Pre-Seed lubricant?  I’ve heard that supposed to help…I know with Clomid it can dry up your cervical mucus, so I should probably use something to help.  According to DH, we’ll just have to, as he so elegantly put it “boink” every night (yeah, he’s at the bar with some friends right now…).

my 2ww…

So, it’s not THE 2ww, but it is A 2ww…

I’m waiting for my appointment with my gynecologist next Thursday to discuss going on Metformin for my PCOS.  I’m really antsy.  They called today to tell me I either had to move my time up on my appointment or push it back until the following week.  I REALLY didn’t want to push it back, but I have to leave work to get to the appointment so I wanted a later time – oh well.  I’ll be going in around 2pm now instead of 3:30 pm.  It’ll make the wait shorter, but I’ve already missed so much work because of all this crap…

Anyway, I don’t really have much new to report except that I’m going CRAZY sitting around waiting for this appointment.  I really hope that she is willing to work with me on this, since it’s basically the only hope I have right now of ever having a child…we’ll see how it goes.

let’s get this party started…

Just called in to my gynecologist. Set up an appointment for November 5th for a consultation (I’m very happy she had an opening so soon, she’s usually pretty booked up). I’m intending to ask her to put me on Metformin. I’ve just recently discovered (as in, yesterday) that Metformin is a common treatment for women with PCOS. That would have been nice to know 3 YEARS AGO!! Not that I’m angry…it’s just that I’ve been going to a fertility clinic for almost 2 years now and this drug was never even MENTIONED to me! Forget the fact that it could have regulated my cycles, or had me ovulating on my own w/o shots, or even the fact that it seems every other woman diagnosed as PCOS has been prescribed Metformin…forget all that. What MOST upsets me is that this drug is also given to women with PCOS in their 1st trimester to guard against miscarriage. If I had been given this drug, if I had even KNOWN about this drug, my little Zippy may have been born this month, instead of dying in March. That’s what pisses me off the most!

Hopefully my OB/GYN will listen to me and agree that I should try Metformin. The hubby and I talked last night and seemed to agree that we could do the Metformin alone for a few months and if nothing happens naturally, try IUI on Metformin one more time at our fertility clinic. Either way, this is the first breath of hopeful air I’ve had all month and it feels good. Drowning in the darkness of depression is no fun. I much prefer the bobbing up and down in a sea of hopefulness – at least I’m not below water any more!

So – all you Metformin vets, I need your help! I’ve printed off the WebMD article that I linked to above, and also some articles that the blogger Birds and Squirrels linked to in her blog back in April (thanks again to Maybe Baby? for pointing that blog out).  This is all I have right now, but if there is any info you think would be helpful in pleading my case to my doctor, I’d very much appreciate it.  Even just your personal stories of using the drug and how it has helped you?  I’d take any advice/help you could offer!  Thanks!

Needles, needles everywhere…

Had appointment #1 for IUI cycle #2.  It was hard.  I did not want to be there – I should not have had to be there!  But I was there, and I had to deal.  I had a few moments where the tears threatened to fall, but I held them back.

So, had baseline ultrasound and blood work.  I hate the bloodwork.  I usually get the same lady, and most times she has to stick me twice to get it in correctly.  Luckily she got it the first time this time.  I know next time will be 2 though.  My right arm does not appreciate being repeatedly stuck with needles, so they usually have to draw from my left if I’ve had any blood work recently.

I spoke with one of my nurses after the appointment, as she had set aside some drugs for me (bless her heart).  We’re paying for all medicines and procedures out of pocket as my insurance does not cover infertility treatments (of course).  In the past we’ve used gonal f and follistim.  Both of these drugs as many of you may know are crazy expensive.  We’ve been lucky to get many samples from FCI for these drugs, but when we do purchase them, the gonal f is about $600-$700.  This time we were given bravelle – you need to mix the bravelle yourself, but it is MUCH cheaper, and they have a program called “Heart” that you can enroll in for $10 and then the drugs are $20 less per vial!  A box of bravelle if you’re in the program is $225!!!  Hurray!!!

brevelle

We also got a bag full of needles!

needles

Should I feel like a drug addict??  I think so 🙂

Tonight (Sunday) we begin with a dose of 150 (2 vials) and tomorrow as well, then 75 on Tuesday and Wednesday.  Thursday morning we have another appointment to see how things are coming along.

And of course we’ve gotten our ovadril to use, in case the cycle goes as planned and we are able to do the IUI:

DSC06293 (1)

So yeah, time to be stuck with a needle everyday now.  The joys of infertility!