There are amazing doctors here, but finding specialists who can treat me or handle an IVF cycle is impossible.
Because they simply don’t exist.
As a result, my doctor’s office has a relationship with Seattle Reproductive Institute. They coordinate together throughout the cycle. This relationship is the difference between having to fly to Seattle for every appointment while also needing to be there for the entire cycle (1 month), and being able to go to Seattle for only the 10 days surrounding egg retrieval and implantation while being monitored the rest of the time up here in Alaska.
This relationship really is the reason I am able to do IVF. Without it I’m not sure I would have been able to handle all the extra travel expenses as well as so much time off work.
Yesterday I met with the doctor who will be coordinating my cycle from Anchorage for the first time.
And she made me cry.
OK, I take it back. It wasn’t really her fault. She was a very nice lady. Incredibly pleasant and warm.
But it was the first time I have met face to face with anyone who will be involved in my IVF cycle.
And it was scary.
I needed to have an ultrasound done to check my egg reserve (which really - after having my ovaries hacked away at twice now - was scary enough in and of itself). So there I was; naked from the waist down with only a piece of paper covering me while I waited for her.
Nervous as could be.
I am a believer that once you’ve stripped down, the time frame for the doctor getting to you should be relatively quick. No one should be forced to sit there naked and alone in a room by themselves for too long.
The mind wanders.
But unfortunately, things did not go my way this appointment, and I was sitting there pants-less for over 20 minutes.
Did I mention I was a nervous wreck?
So, I fidgeted. I tried to play on my iphone, but I couldn’t concentrate. Instead I took photos of the vagisound.
All the while thinking that if someone walked in on me doing that it was going to be mighty embarrassing.
I didn’t care. That little sign there said “Please remember to soak the probe.”
I don’t know why, but it made me laugh.
The amusement only lasted about 2 minutes though, and then I was still sitting there.
Naked.
At one point I managed to tear the piece of paper that was covering me. I didn’t mean to. But I did. I tore a giant glory hole in the only thing protecting my modesty.
I frantically looked around for a new piece of paper, and of course found none.
Then I realized “Does it even really matter? She is about to stick that probe up inside of me and count my eggs. Dignity is lost.”
Really, what is the point of that piece of paper anyway? Because from what I can tell, the only person it protects from seeing anything is the person it is covering.
Everyone else gets up in there, but at least you don’t have to see your own vagina.
Yep. It was the longest 20 minutes of my life.
When she came in, she sat down to talk first. I was hoping this conversation would happen in her office after the appointment, but nope. There I was, trying desperately to cover my glory hole; naked and still attempting to reach for my notepad of questions.
Classy class.
The first order of business was my period. If I don't have it by the 1st of next month they want me to come in. That means I have a week and a half to bleed on my own.
Teeny did a number on me today as a result. She really thinks the pain I had two weeks ago may have been ovulation. I've never been one to be in pain when I ovulate (especially not that kind of pain), but I will give it to her as a possibility. So here's to hoping for some uterine shedding in the next few days.
All my financial questions got shut down. My financing will not cover anything in Anchorage. Which means that all of these monitoring ultrasounds I will need between now and Seattle (at $450 a pop) will be coming out of my pocket.
Deep inhale of breath.
Why oh why does Alaska not have a fertility clinic?
And why did I leave a state where fertility insurance is not only required, but fertility clinics seem to be on every corner?
Poor planning, that’s why.
OK, I’m only half kidding. I love Alaska. And the truth is that before the job I got up here, I hadn’t had health insurance at all for years. It is actually a miracle that I wound up with coverage just a few months before problems began.
But that still doesn’t make this easier now.
So then we moved on to other issues that I had been waiting to ask someone about, and she let a gem slip I had not been prepared for:
“One ultrasound will happen right before your cycle to check for cysts. If you have any above a certain size, we will need to cancel your cycle.”
Wait. What!
My endometriosis presents as cysts. Endometriomas take over my lower quadrant. They rule that zone. I had new ones just a month ago!
She assured me that I shouldn’t have any because of the Lupron. I assured her that I just had new growth last month.
Clearly she hadn’t read my file.
I have to say that it kills me how new doctors get this look on their face like I am making things up when I describe the aggression of my endometriosis. Then they always act shocked when they realize I wasn’t exaggerating.
Kills me.
My panic mounted and yes, I was fighting back tears. No one told me my cycle could be canceled. No one told me this could happen. With how fast my endo has spread and grown in the past, how do I prevent that? What can I possibly do?
I’m pretty sure the woman now thinks I am a crazy lady control freak.
After I finally calmed myself down (and really, that process involved an entire conversation with myself – out loud – where I told my panic mode to shut up and not worry about things it can’t control), she gave me a wary look (I’m not kidding; this woman thinks I’m a nut now – I’m sure of it) and we started my antral follicle count.
For those of you outside of the infertility world, antral follicles are basically the places where potential eggs could mature. As you age, those follicles disappear because there are no longer any eggs behind them waiting to reproduce.
When I donated my eggs, my antral follicle counts were in the 20’s. I produced 14 viable eggs each time.
Yesterday, my antral follicle count was 13.
13.
(Community Discussion: If you've had your antral follicle count, what was it?)
Granted, this is not the worst it could be. In fact, 13 is still considered to be “normal” (on the lower end of normal, but still there), but…
It is a lot lower than it was before.
Half lower.
I used to be perfect.
And I’m sorry, but reminders that I have slipped so far from perfect reproductive health in just a few years still knock me down.
I knew my count would be lower. Both of my ovaries have been through a lot, and both have had some tissue removed.
But….
It still made me want to cry.
Again.
The good news is that she said she didn’t see any cysts that would prevent a cycle at this point.
But there is still that voice in the back of my head telling me that they could crop up at any moment.
My endo was never supposed to spread as fast as it did on the pill either. But it happened. You can’t tell me that endo couldn’t ruin this now. I won’t believe you.
I will not lie and say I left that appointment filled with hope. I will not pretend like I left bounding with excitement and joy.
Because I didn’t. I left scared. I left knocked down.
I left $450 poorer.
In the last 24 hours I’ve made some big decisions as a result of that appointment. They almost seem counterintuitive to the information that was received, but suddenly changing my mind about a few things seemed only natural.
It seemed only logical.
I’ll let you in on what is going to be happening differently…
Tomorrow.
