Commence TWW

Hey guys, I updated my IUI #3 on my menu, with all the details and drama of the last 2 weeks (with updated drama and stats from insemination day). I have to go back and edit to include all the drugs and supps I’m taking–including the prednisone–aka prednisolone if you wanna act British (or if you are actually British). Yes, Dr. Angel kindly obliged my request for more drugs. He really melted my heart when he suggested to begin Heparin after a positive pregnancy test–love this guy–now that’s one less thing I need to badger him about (I hate badgering people). I believe (I choose to believe) that I ovulated within a few hours of my IUI yesterday, and it was confirmed (via dildocam) that I did ovulate within the 24 hours post-insemination. And today I will begin progesterone suppositories. And now I wait.

I’m a “pro” at taking corticosteroids. I’ll take a moment to explain how they work in case any of you were wondering. First off, people confuse corticosteroids with anabolic steroids–they are TOTALLY different. Corticosteroids (most commonly prednisone) stimulate your adrenal glands to secrete cortisol and adrenaline. This, in turn, suppresses your immune system. Cortisol is known as the “stress hormone”–it is secreted when you are stressed–which explains why you are more likely to become sick (like, with a cold) during times when you’ve been under a lot of stress for an extended period of time. Unfortunately, while cortisol is prodigious at quieting your immune system (and suppressing inflammation) it has a host of sh*tty side effects that you’ll notice if you take it over a period of time. One is that you feel *stressed* (cortisol) and another is that you feel *anxious* (adrenaline–your ‘fight or flight’ response hormone). Also, you probably know (from Dr. Oz or from some commercial) that cortisol causes you to retain fat in your midsection–this is a fact. Corticosteroids actually do the EXACT OPPOSITE of what anabolic steroids do–corticosteroids screw you over ROYALLY because they preferentially break down your muscle and use it as energy, rather than using your fat. And if that wasn’t bad enough, corticosteroids encourage your body to store any carbs or fat that you eat as bodyfat (especially on your stomach), rather than using them for energy. You all know that eating protein builds muscle, right? And we’ve established that corticosteroids ‘eat’ your muscle and store any carbs and fat you eat (conveniently) in your midsection, right? So then, it’s imperative that you eat A LOT of protein and as little carbs and fat as possible when you are on corticosteroids long-term. Currently I’m only taking 10mg, which is not much, but when I’ve had to take 40mg a day for extended periods (months), I couldn’t afford to eat poorly because of the consequences.

Anabolic steroids are the kind that bodybuilders use to add muscle and cut fat. Your doctor will never prescribe you anabolic steroids (well, incredibly rarely). So, if any of you have a reason to take corticosteroids, now you’ll understand that they WON’T make you bulky like a bodybuilder, and in fact, they will waste your muscle and add fat to your midsection with a quickness if you don’t eat properly (high protein, low carbs/fats). Corticosteroids also make your face puffy (it’s called ‘moon face’) and I get that even on 10mg. But I don’t care if I have ‘moon face’ in Myrtle’s wedding pictures, if it means I’m pregnant at her wedding. And, I am careful to take my prednisone in the morning, so that I can take advantage of the adrenaline and have a nice burst of energy to start my day and the cortisol doesn’t affect me too much. DO NOT take corticosteroids at night if you can possibly avoid it, because you won’t be able to sleep and may find yourself rocking back-and-forth and crying on the couch all by yourself at 4am (why yes, that has happened to me, MANY times). Don’t know if y’all wanted to know any of this stuff, but I just felt like sharing it. XO

Hail Mary, Full of Grace…

I’m practically grinding my teeth right now. I don’t know what possessed me, but I decided that I needed to look for scholarly articles about “pregnancy outcomes in women with positive anti-nuclear antibodies”, because ever since my first miscarriage I’ve felt that everything traces back to my fickle (auto)immune system and I cannot stand the thought that I would have to fail another IUI or have another miscarriage before anyone will treat my issue–the treatment is corticosteroids, which are immunosuppressant drugs, and docs do not prescribe them lightly, however, due to my autoimmune issues I’ve taken boatloads of steroids so I’m not your average girl.

Let me back up to say, that I tested negative for anti-nuclear antibodies (ANA’s) in November of 2012. But I tested HIGH POSITIVE with a ratio of 1:160 post-miscarriage in February 2013 (just over a year later), and I had elevated liver enzymes (which is related). A couple months post-miscarriage my ANA’s fell to 1:80, which is still positive (and really, once you’re positive, having a lower number doesn’t mean much). Then, I went on to have a ‘chemical pregnancy’ (early miscarriage). I am 100% sure that my immune system “picked off” my first pregnancy–the evidence points to it–but I can’t prove it because my (former) stupid OB didn’t have me “test the products of conception”. Since the chemical pregnancy I have been ttc for 6 months and 5 of those cycles have been medicated–3 of them are IUI’s with injectables (though this third one doesn’t count yet because I’m in the middle of it now). It’s quite suspicious that I haven’t conceived by now, in my opinion, given our heroic efforts and the fact that we conceived twice naturally. What I’m pointing at is this: antibodies get ‘smarter’ and ‘faster’ each time they are exposed to a “pathogen”–you know, like when you build up immunity by being exposed, like chicken pox, and each time you’re exposed your immunity grows stronger. Well, I believe that my anti-nuclear antibodies are getting more keen to my pregnancies, and “picking them off” before they can even implant. It explains my pattern.

And guys, I just can’t bear the thought of losing another pregnancy–another baby. I can’t bear the thought that I might fail IUI #3 and waste more time and have to pay for MORE expensive tests at an RE’s office and be shoved toward IVF, when I could simply take 10mg of prednisolone and baby aspirin (I’d prefer Levonox as a prophylactic, but the baby aspirin should work with ANA’s). It simply drives me mad to think there’s something else to be done that isn’t being done.

And I really feel like my angels (particularly my Mom) were gently pushing me to look for scholarly articles on pubmed today, so that I can show them to Dr. Angel and make a case for the prednisolone. I hesitantly suggested it a week ago, and he said he’d consult with his RE, but he hasn’t had a chance. Plus, this RE doesn’t know me so even if he’s aware of the connection between implantation failure, miscarriage, and positive ANA’s…he may tell Dr. Angel it’s not a necessity. But what I’m seeing is that it most certainly IS a necessity. I’m going to post the abstracts from the articles I looked at. And I want you to tell me what you would do if you were me? Would you move heaven and earth to make sure you had the damn steroids? Cuz I feel prepared to do that. In fact, I think I’ve said it before: there’s nothing I WON’T do to have a baby. There’s nothing I WON’T do to protect my baby…from myself. And really, 10mg of prednisolone is child’s play compared to the Remicade I was on, so what’s the harm? I can’t keep doing this. I PRAY Dr. Angel looks at these abstracts and agrees to give me prednisolone. I really feel like this might be the magic ingredient for me and I feel like I have everything to gain and nothing to lose by taking it. I didn’t properly cite these (like, for you aspiring professors out there).

So, here’s the abstracts if you’re interested–this first one even suggests that my poor ovarian response may be linked with having ANA’s:

Immunol Invest. 2012;41(5):458-68. doi: 10.3109/08820139.2012.660266. Epub  2012 Mar 19.

Antinuclear antibodies predicts a poor IVF-ET outcome: impaired egg and embryo development and reduced pregnancy rate.

Abstract

To investigate the impact of anti-nuclear antibodies (ANAs) on the outcome of in vitro fertilization-embryo transfer (IVF-ET), 66 (96 cycles) infertile women positive for anti-nuclear antibodies (ANA+ group), and 233(285 cycles) infertile women negative for ANAs (ANA- group) were enrolled. The clinical characteristics and IVF outcome were compared between the two groups. In the ANA+ group, the proportion of MII oocytes and two-pronuclear zygotes (2PN), cleavage rate, number of available embryos and proportion of available embryos, number of high-quality embryos and proportion of high-quality embryos were significantly lower than those in the ANA- group. In addition, the pregnancy rate and implantation rate in patients positive for ANA was markedly lower than the ANA- patients (28.1% vs 46.4%, 15% vs 25.7%, respectively). Thus, our findings suggest that the presence of ANAs significantly interfere with the oocyte and embryo development, as well as reduce implantation and pregnancy rate in patients undergoing IVF treatment.

J Reprod Med. 2005 Jun;50(6):383-8.

Results of prednisolone given to improve the outcome of in vitro fertilization-embryo transfer in women with antinuclear antibodies.

Abstract

OBJECTIVE:

To evaluate the association of antinuclear antibodies (ANA) with outcome of in vitro fertilization-embryo transfer (IVF-ET) as well as the effect of short-term immunosuppression with prednisolone on implantation, clinical pregnancy and live birth rates following IVF-ET.

STUDY DESIGN:

The study group consisted of 120 women, 22-42 years old, in whom IVF-ET was performed and whose ANA could be measured. Prednisolone (15-60 mg/d for 5 days) was administered starting 1 day after oocyte retrieval to some women with or without ANA, without randomization. The 223 IVF-ET cycles were divided into prednisolone-nontreated ANA-negative cycles, prednisolone-treated ANA-negative cycles, prednisolone-nontreated ANA-positive cycles and prednisolone-treated ANA-positive cycles. Retrospective analysis of rates of implantation, clinical pregnancy, and live birth were evaluated in the four groups.

RESULTS:

Overall, ANA positivity was noted in 20.0% of subjects (24/120) and 25.1% of cycles (56/223). Implantation and clinical pregnancy rates in the prednisolone-nontreated ANA-positive group were 0% (0/41 transplanted embryos) and 0% (0/15 cycles), significantly lower than in the other groups. The live birth rate in this group was significantly lower than in the prednisolone-nontreated ANA-negative group and non-significantly tended to be lower than in the other 2

CONCLUSION:

Implantation, clinical pregnancy and live birth rates following IVF-ET were low when ANA was detected. Implantation and clinical pregnancy rates were improved significantly by prednisolone, but the live birth rate was not.

Fertil Steril. 1998 Dec;70(6):1044-8.

Prednisolone plus low-dose aspirin improves the implantation rate in women with autoimmune conditions who are undergoing in vitro fertilization.

Abstract

OBJECTIVE:

To evaluate the effect of prednisolone plus low-dose aspirin (PSL/LDA) in women with autoimmune conditions who were enrolled in an IVF-ET program.

DESIGN:

A retrospective clinical study.

SETTING:

In vitro fertilization unit, Niigata University Hospital, Niigata, Japan.

PATIENT(S):

Three hundred seven women who underwent IVF-ET between January 1996 and December 1997.

INTERVENTION(S):

Prednisolone (10 mg/d) and aspirin (81 mg/d) were administered to the women with autoantibodies who chose to participate.

MAIN OUTCOME MEASURE(S):

Pregnancy and implantation rates with IVF-ET.

RESULT(S):

Women undergoing IVF who had positive antinuclear antibodies, with or without antiphospholipid antibodies, had significantly lower pregnancy and implantation rates than did women without autoantibodies (14.8% versus 21.7% and 6.8% versus 10.4%, respectively). The administration of PSL/LDA to women with antinuclear antibodies significantly improved the outcome of IVF-ET (40.6% pregnancy rate and 20.3% implantation rate).

CONCLUSION(S):

A high proportion of women who are undergoing IVF-ET have autoantibodies, which are associated with poor IVF outcomes. The administration of PSL/LDA to these women may improve their implantation rate.

 

 

Do Y’all Have Any Idea WTF Is Up With This…???

I just posted my protocol for IUI #3 (click here) or you can click ‘IUI #3’ on my menu. I’ve used an INSANE amount of Bravelle. I have a high AMH (4.57). Yet…I still only grew 2 follicles…please read my protocol and give me any insight you can about how the f*ck you can have “high AMH” and “poor ovarian response”–this seems to be an anomaly. And, my right ovary flatly refuses to produce a viable egg–Dr. Angel says most people have a ‘dominant ovary’–do y’all have a dominant ovary? Anybody else have a protocol that got you less-than-stellar results (what was it)? And then, what did you do that worked? I mean, seriously, I want as much information as you’re willing to offer about what drugs you used, how you responded, and anything else that might make me understand how 23 viles of Bravelle can yield 2 stubborn follicles? Anyone??? I bet you I am the only blogger on here with an AMH high enough to be PCOS-ish BUT barely responds to injectables…I said I wanted to be ‘unique’ NOT ‘special’. Dammit. *Sigh*

Burn

“Things get bad for all of us, almost continually, and what we do under the constant stress reveals who/what we are.”
― Charles Bukowski, ‘What Matters Most is How Well You Walk Through the Fire’

Tis the season of pregnancy announcements. More specifically, two of the most gorgeous, most sweetest girls you ever met–girls who’ve never had a legitimate ‘fat’ day, who never needed braces, who never rub anybody the wrong way. I’m pleased for them both. But, I had a moment where I felt insecure like I did back when I was on the track team in junior high school; a talentless misfit who excelled at sucking. I didn’t mind training but I hated sucking…I think I kept doing it (track) because I was hoping I would magically morph into a thin, popular, athletically talented young woman (with boobs).

That never happened. I didn’t “morph”.

What did happen, was that I got really lost (sex, drugs, rock ‘n roll). And then I started to realize that “fitting in” is highly overrated. And I let my colors fly. And I made lots of friends. And I got (bought) boobs. And when I found a sport I loved I realized that I am a very talented athlete. I learned my strengths. I reconciled my weaknesses. I stopped wanting to be someone else.

I surely didn’t “peak” in junior high or high school (or even college). I’ve had to work hard and roll with the punches to become the person I wanted to be, mind-body-soul.

I’m never surprised when things don’t come easily to me. Things like boobs, athleticism….pregnancy…babies. But honestly, I’ve adopted the motto that “something is only worth what we must sacrifice to attain it”. And I’ve found it to be SO true–the things I’ve had to work the hardest and sacrifice for are the things that I’m proudest of–the things that ultimately define my character.

And dammit, I’m fighting like hell for motherhood. I’m up in Dr. Angel’s office EVERY day, getting my shots and monitoring, for 14 days per month (3 months in a row now). I won’t put anything in my mouth that might contain gluten–no matter how hungry I am. Even when I’m tired I force myself to do 30 minutes of cardio because I’m convinced it helps my “follicles grow”. I bicker with Freedom Pharmacy at least once a month. In the last year I’ve spent thousands of dollars out-of-pocket to see specialists and run tests, all in pursuit of justice for my lost pregnancies and the desperate need to protect another pregnancy. I f*cking stick an enema up my butt every night to quell the inflammation in my colon. There’s really nothing I won’t do to have a baby.

So while those two beautiful, blissfully ignorant ladies (swans) announced their pregnancies on facebook at barely 11 weeks gestation (as only a fertile would)….

I proudly walk through fire on my path to motherhood. I see myself as a Phoenix that will rise from the ashes. Swans are simply beautiful. But the Phoenix is the epitome of strength, beauty…and (re)birth. And Phoenix’s don’t do pregnancy announcements–that sh*t is for swans.

"Phoenix from the ashes" by Christoph Jaszczuk

“Phoenix from the ashes” by Christoph Jaszczuk

I Can See The Horizon!

 

I’ve been wanting to update, but we moved all our stuff into a new unit (same property, identical unit–different building), and I have no cable or internet, and updating on my phone is practically impossible–so for those of you who may have been concerned after my last “FML” post–I’m sorry it’s taken me so long to update and thanks for caring 🙂

Monday: No good, very bad day which turned into a horrible night, when I wrote my last post (click here for post).

Tuesday: Wake up feeling defeated and ask Mr. MLACS if he intends for me to cancel is appointment to give his “specimen”. He looks defeated too, and said “No, but I can’t move forward this month unless Dr. Angel calls us back and we’re able to talk to him”. Fair enough. I called Dr. Angel’s office and got the ‘usual’ receptionist (I’ve spoken to a couple of others this week that I’m not used to and got mixed results–obviously Dr. Angel didn’t call me back so I didn’t get the result I had hoped for). I told the ‘usual’ receptionist that Mr. MLACS and I are having mixed feelings about going forward with IUI #3, and we really won’t be able to do it unless Dr. Angel can see us TODAY, since Mr. MLACS is leaving tomorrow. The receptionist *communicated (*key word) that Dr. Angel was doing a C-section and would not be available for her to speak with him about accommodating us until the early afternoon–I totally understood and trusted that the ‘usual’ receptionist would follow through and get our message to Dr. Angel. She returned my call late morning and offered that Dr. Angel could see us at 3:30 that afternoon–perfect! Because Mr. MLACS was scheduled to give his ‘specimen’ right up the street at 3pm, so I took this as a ‘sign’ that this cycle might work out. Mr. MLACS agrees to give his sample, and I agree that we will wait to make our decision about doing a January cycle until after we’ve spoken with the doc. I decide to take my gifted Bravelle with me, because I just can’t dose myself without the doc’s consent (though I was not above considering it).

Mr. MLACS walks into the clinic (where we’re collecting/freezing his ‘specimen’) with swagger. I get a kick out of him boldly walking up to the window and stating his business–no hunched shoulders or looking side-to-side to see who’s listening. A’ta boy! As I’m waiting for him to *ahem* finish, a couple of young mothers with small children walk into the clinic (which is an infertility clinic)–I was taken aback, and I totes understand what other bloggers mean when they lament how insensitive it is (not to mention annoying) for women to bring their (poorly behaved) children to an infertility clinic–I’ll put that on my “offenses not to commit in this lifetime” list. We then jaunt over to Dr. Angel’s office, not knowing what to expect—we were both apprehensive and full of emotion.

But, all that angst was for naught. Dr. Angel greeted us warmly. I didn’t even know where to begin, so I just told him “We didn’t expect IUI #2 to fail, and we weren’t prepared for it, and we want to know if you have any idea why, and then what you think we should do”. And he basically said he 100% believes we will have a baby. He doesn’t know why these IUI’s failed because they “Looked good” but that it’s totally normal and it doesn’t mean there’s something horribly wrong with us. We really, really needed to hear this from his mouth, because after 2 natural pregnancies followed by 4 failed medicated cycles (including 2 IUI’s with injectables), we were starting to feel panicked and insecure. He admitted he may not be aggressive enough with his treatment and we may want to consult with an RE that he (and everybody else in town) recommends. But then, I told him that I’m not asking for 6+ follicles, just 4 follicles…and I mentioned my interest in taking low-dose steroids with the idea in-mind that I have at least 2 elevated antibodies (ANA’s and NK cells) and the ANA’s in particular may be the issue and may respond to the steroids, PLUS they’ll only help my Ulcerative Colitis. And Dr. Angel offered to consult with him on our behalf, to see what–if anything–the RE would do differently. And Dr. Angel agreed to my request to begin 150iu Bravelle on CD5, so I got my shot in the office 🙂 Furthermore, the receptionist said our insurance has been paying on the scans and we didn’t need to plunk down any money to start the cycle–AMAZEBALLS!!! We left feeling relieved and stoked that we can actually afford this cycle without having to “rob Peter to pay Paul”.

Wednesday: Took Mr. MLACS to the airport in the city to catch his plane to work, and went to the old chiro/acu doc I used to work for and got treatment. It was great to see the doc (he is hilarious) and I know the treatment did me good. I raced back to town (2+ hour drive) to see Dr. Angel in the afternoon. I had wanted to dick around in the city, but my friends were all busy and I wasn’t about to tell Dr. Angel that I couldn’t make it to an appointment the second day out of the gate. Mission accomplished. 150iu Bravelle.

Thursday: Go to Dr. Angel’s office at 8:45am and get sent away for “30-45 min”. Get Starbuck’s (half-caf) and come back at 9:30…wait in the office for a bit and get sent away with “doc is still at the hospital and we’ll call you to come in once he’s done”. Cool, so I get called in somewhere around 2:30, and probly wait another 1/2 hour after I get there. But honestly, I don’t mind. Dr. Angel looks dog tired from delivering babies this week–poor guy. The ‘usual’ receptionist tells me the only time he can see me the next day is 11:45, which I agree to. 150iu Bravelle.

Friday: Wake up and make plans to work out with a friend at 10am. But then new receptionist calls me from Dr. Angel’s office and says “So the only time Dr. Angel can see you today is 10:30”, no explanation–but I don’t require one–I simply agree. I postpone my workout with my friend and tell the maintenance guy I will call him when I get back so he can service the washing machine. I show up at Dr. Angel’s office and ‘new’ receptionist says (contritely) “So your appointment was at 8:45” and I quickly respond “oh no it wasn’t, that was yesterday. Today I was told 11:45”, to which she responds “Well it says 8:45 here on the schedule”, and I say “Well if I had been told 8:45, then I would have been here. I was told 11:45 by ‘usual’ receptionist'”, to which ‘new’ receptionist replies “Well do you have an appointment card???” and I’m pissed….so I snap back “I DON’T NEED ONE. This is no less than my 30th appointment and I NEVER screw this up.” Like, wtf is your problem dimwit? Honestly, Dr. Angel was standing right next to me when ‘usual’ receptionist said 11:45–she looked AT HIM and said “your only time is 11:45”, so hopefully this was brought to his attention and I believe he would remember just as well as I did, if not better. And he did mention something during our visit that prompted me to say “Seriously, I was told 11:45–and I take this VERY seriously, just like a job”, to which he chuckled “I don’t doubt it, you’re one of the most punctual people I know”. Damn right I am. I’ve done everything he’s told me to–from paging him to showing up for appointments–TO THE LETTER. I’m the only one who ever has to wait–not him. So, I hope I don’t have to interface much with ‘new’ receptionist because I may snap on her if she antagonizes me again. The f*cking nerve. Dr. Angel asked me to page him at 8:30am tomorrow, and I’m tired but I set my alarm for 8:20am. 150iu Bravelle.

Saturday: I dutifully page Dr. Angel, who cheerfully answers the page and informs me that he is going to be a few hours yet because he has yet another delivery. I think women who are delivering in January got pregnant in…April last year? I guess “spring fever” is legit, because Dr. Angel remarked that he has “A WHOLE BUNCH” of due dates this month, and I’m pretty sure he’s delivered a baby (or two) every day this week. The man has stamina! So I wait….all day…and finally page him at 2pm to see if he has a plan…and he has me come to the office then. Two lead follies and four small ones–I’m hoping that two of the four smaller ones can mature in time to trigger, so I can get my ‘Fabulous Four’ I’ve been gunning for this cycle. 150iu Bravelle.

I feel a helluva lot better than I did on Monday. I’m feeling optimistic about this cycle. I feel ‘touchy’ but not overly psycho and my bloating is much less (than previous medicated cycles), which I’m attributing to not taking the Letrozole this time around. I’m going to be cautious and start doing OPK’s tonight, because I’m feeling certain that I will ovulate much sooner than previous cycles.

My Grandma has her lumpectomy (for breast cancer) this coming Friday, so that’s a big deal this week…a really big deal. Thanks for keeping her in your prayers–she’s a special lady. Her prognosis looks good!

I gotta unpack all the boxes in the new place–been procrastinating. Well, but then I’ve also had A LOT of stuff going on…regardless I gotta get my house unpacked so I can resume cooking in my kitchen and stop eating out (though I’ve been eating mostly salads). It’s hard to motivate cuz I’m lonely and the place feels foreign and most of all, I don’t have cable yet. It would be SO much easier to motivate to unpack my living room kitchen if I had the Food Network or Bravo to keep me company. Mr. MLACS hooked up his PS3 in the bedroom so I can play dvd’s, but all his dvd’s suck (action movies) except for ‘Kung Fu Panda’ and ‘Juno’. Now I’m not going to watch ‘Juno’ for blatantly obvious reasons, although I do like it. So I’ve been watching ‘Kung Fu Panda’ on repeat, and I’ve probably seen it 5,000 in the last 3 days…but I really like it. I admire Asian culture and philosophies anyway, so I can appreciate the Zen teachings that are subtly communicated in the form of a cartoon movie. I love Po, the unassuming Panda who possesses the abilities to save his village and recognize his dreams to become a kung fu master–everyone tries to change the goofy panda, but what they all learn is that he doesn’t need to fit their image of what a kung fu master should appear to be, he just has to be his best version of himself and apply himself. I find it very inspiring. XO

 

 

I Can’t Take Anymore

I just…I’m bereft. I’m laying here sniffling in between sobs with huge tears rolling down my face and they just keep coming in waves.
First of all, I’m sick. I have an infection in my throat/sinuses–the last time I felt like this was nearly a year ago, just before my first miscarriage (hello ugly flashback). Dr. Angel is supposed to be my PCP so I called today (CD 4) and asked to see him for several reasons: 1. I’m sick 2. To begin injectables 3. I needed to know how to handle Mr. MLACS giving his specimen for the anticipated double IUI this cycle (with his frozen sperm) 4. I just needed to see him/speak to him to ask questions (like “can we do the IUI’s at 24 + 36 hrs precisely” and “what if this doesn’t work? what’s next?”) Dr. Angel is very hands-on (re: controlling). His nurse had NO clue what I was talking about (didn’t know if it was even possible to freeze sperm at the clinic where they do the SA) but she said she’d check–I figured they’d want 2 samples at least 24hrs apart to do a double IUI. Dr. A’s (clueless) nurse called me back after speaking to the clinic that does the SA’s and informed me it’s an extra $150 to freeze it (so $260 total) per sample AND that they require 24hrs apart and scheduled him Mon & Wed. Well, Mr. MLACS leaves Wed morning, so I asked why we couldn’t do Mon & Tues–24hrs apart. Dr. A’s nurse replied “well that’s what they told me had to be done”, and I asked for the # to the clinic to see if they were amenable to Mon/Tues. Called the clinic and Sara answered, very nice, and I explained my husband is leaving town but can do 24hrs apart. She cautioned me it may be a waste of $ but I explained his counts are off the chart even with only 24 hrs to replenish–good news was she said that he should only need to give one specimen then. Good thing, because we were moving all day today so it would’ve been insanely bad timing for him to leave in the middle. Nurse told me Dr. Angel doesn’t want to see me until CD7 to begin injections…

WHAT the WHAT?!!
The whole mf’ing point of skipping femara is to start injections early, I figured at least by CD5 (tomorrow) we’d start because the POINT is to recruit more follicles–my goal is 4 follies–to increase our chances. I’ve only been getting 2 follicles with his femara/bravelle protocol and I’m sick of him warning me about sextuplets–that’s highly unlikely….do you know what IS likely? That our money and precious drugs will be wasted because he’s not taking advantage and being aggressive with the injectables. I said CD7 seems late and “clueless nurse” said I could talk to Dr. Angel about it and she’d have him call me. And he didn’t call 😦

And I wonder so many things…I wonder if he’s sick of me. I wonder if he’s bitter that my friend who referred me broke up with his son (I know he’s bitter because he’s made some remarks about her–which I kept to myself–but I did tell her he seemed perturbed she wasn’t spending Christmas with them (pre-break-up) and I’m afraid maybe I’m caught in the middle of all this?? I’m feeling paranoid and insecure…what should I do? Dr. Angel is in posession of 10 vials of my bravelle (that is, if he didn’t use it on someone else–another fear of mine, that he’s stalling me because he gave away my drugs). But I’ve not informed him that my friend sent me her leftovers…what if I dosed myself for a couple days? And maybe showed up with 2-4 follicles beginning to take shape on CD7? I would feel awful keeping that secret. On the other hand, it would cost double to have an IUI at an RE’s office, so…I called Walmart to see if you need a script to buy syringes–you don’t.

All this anguish about how to proceed with no explanation from Dr. Angel, while I am sick with a throat infection (swollen glands, rotten smell, body aches, rosy cheeks, low fever–but no white spots), in the middle of moving for the 2nd time in 3 months (with DH’s truck in the shop)…and that old b*tch (OB) from my GI’s office called and flippantly informs me that my appeal (the one she took her sweet time to submit) for my Delzicol (UC meds) was DENIED. She didn’t care one damn bit. I was just floored. So we can’t recoup the $300 OOP we spent this past week and I’m going to have to start a new med and possibly get very ill before anybody will pay attention.

I’ve been off my Remicade now for 12 weeks thinking it might help me ttc (maybe it’s oversuppressing my uterine NK cells?) And I don’t even know if I can get back on it if I fall out of remission with these new meds I’ve never tried. Hell, maybe the problem is my elevated ANA’s and I should be taking prednisone to get/stay pregnant–I don’t think Dr. Angel will go for that though (one good reason to consult an RE). The prednisone would help my colitis too, “kill 2 birds with one stone” so-to-speak.

So here I am, floundering, and Mr. MLACS starts b*tching about the money for the IUI’s. And here’s the thing: we could ttc NATURALLY if his job wasn’t switching his schedule so he’s gone. I only agreed to this job because he said he’d be home during the latter half of the month (my fertile window). We conceived TWICE naturally and he’s pissed the Clomid & IUI’s w/injectables have yielded no return–who would’ve thought? Certainly Dr. Angel never prepared us for failure–he always talks about multiples! I wish Dr. A would’ve been more realistic with us about the possibility that it wouldn’t work the first couple of tries with IUI. Sure, DH doesn’t mind taking a cycle (or three!) off because he has his beloved career. BUT WHAT HAVE I GOT?! If not this?

I found the Penicillin I barely touched because I was pregnant and afraid to take it last February–then I miscarried anyway. I felt better within an hour of taking the meds, but creepy that this came up NOW (I would’ve consulted Dr. A if he would’ve seen me, but didn’t want to go to urgent care$). We went to dinner and it was tense, and after dinner we got in the car and I just started shaking and sobbing and I couldn’t breathe–basically a panic attack. It’s not “out of nowhere”. I’ve been sick all year. I’ve had 2 miscarriages and I didn’t cry I just dusted myself off and said “don’t cry, go get pregnant”, and…
I’VE GIVEN EVERYTHING I HAVE to the quest of getting pregnant and being a SAHM. I haven’t worked. I’ve postponed school (cant afford classes now with these IUI’s). I’ve given up weekends with friends and lived my life in a series of two-week-waits. I’m fat and sick and tired from miscarriages and now the hormones I’ve been taking the past few months. I’ve devoted my body, mind, and soul to this quest–and what do I have to show for it? I’m a mess. I’m childless. I’m fighting with my emotionally retarded husband. Seriously, he heard me crying and yelled at me “are you gonna talk or just stay in there and cry” in an accusatory tone. He dumped pillows on my lap in a passive-aggressive way and scared the cat (who was on my lap). He pointed his finger and said “I’m not jizzing in a cup so you’re just gonna have to wait til April (when his schedule changes)”. He’s upset and feels I’m blaming him so he’s picking a fight–meanwhile all I was doing was crying and lamenting my losses. He didn’t comfort me. He didn’t say “We’ll keep trying” or “I hate to see you so sad”…he said “you’re overreacting” and “I’m not made of money so we won’t do whatever it takes”. I could hear him crying in the other room. And I feel like he’s a coward. And I feel like it was MY TURN to be comforted. And why can’t he be an adult about these things instead of being a bully and then acting like a victim?

And most of all: WHY aren’t we pregnant?
Why?……….. And have I wasted my life and my love on a dream that will never come true and a man who doesn’t have it in him to fight for it WITH me (not AGAINST me)…??? I know he cares but when the going gets tough he regresses to an angry child–finger pointing, mocking me, and contradicting everything I say nonsensically.

I feel empty but the tears keep coming.

I’m Rambling Cuz I’m On Drugs…

So, to quote myself from my last post “It can ALWAYS get worse”, and guess what–I’m not f*cking kidding about that. Mr. MLACS has a big diesel truck that is the apple of his eye, and yesterday his clutch was being impossible, and we had to accept the fact that…on top of EVERYTHING else…we are going to have to repair or replace his clutch (anywhere from $500-$1500). That was really the last straw for Mr. MLACS. Another gem is that his company (for whom he is invaluable on their multi-billion dollar projects) is nickel-and-diming us on our last move–they want US to pay off the $3000 on his expense account for our move…in what f*ing universe is that acceptable?! This is on top of expenses we paid out-of-pocket AND we lost a MONTH of wages because their HR pulled him off his old job and didn’t have his Visa ready to go to his new (international) job–that completely screwed us over after we had only JUST gotten on our feet after the LAST move (which they also screwed us on). It’s maddening, and we are both sick of this BS from this company. Thing is, he has stayed with the idea-in-mind that he was fast-tracking it to management$$ and other companies can’t offer him the salary. But I had to level with him: it would be better for him to take a pay cut and for us to stop losing money on moving, than for us to continue this way…and it’s hurting our relationship–the stress of moving causes fights…the money situation creates tension…I’ve given up several jobs due to the moves…overall, we’ve got to make a change. And look at us–we could try naturally this month but that’s not an option because his work switched his schedule and he won’t be home. It hurts Mr. MLACS that his 5 year plan is being blown to smithereens, and that the company that he’s given his blood, sweat, and tears to (literally he works from before dawn until well past dusk–he’s got stamina) is still so quick to f*ck him (us) over. And then he’s also devastated that I’m not pregnant. And he’s concerned about the money (me too) that we’ve been shelling out for these IUI’s–with Dr. Angel giving us false hopes by saying “watch out for triplets!” it makes ZERO babies a harder pill to swallow. And really the last 18 months have been SO much drama, with his last project being a nightmare and the miscarriages and me being sick, etc. and it has FINALLY caught up with Mr. MLACS (it “caught up” with me LONG ago, and I’m burnt to a crisp) and he said to me, with sad eyes and quivering lip “I just want it to be done…I just want it to stop…I’m tired of EVERYTHING being SO HARD”…and for once I comforted him. It will be ok. It really will. I’m glad he just gave in and allowed himself to be vulnerable so that I could show him that I can take care of him too–we take care of each other. And we have been like peas ‘n carrots.

What else…been packing up the house to move. We are moving to a new unit that is exactly like ours but in a different building (one street over in our development). I don’t really mind moving and setting up house all over again (ok, YET) but packing is no fun. And that reminds me–maybe I had an intuition that this was going to happen and maybe that is why I was so disgusted with all the “stuff” I got for Christmas–what I wouldn’t give right now to have the money instead of the stuff, because now I have to do something (pack or donate) all the stuff I got, and it would be a brilliant time to have gift certificates or money to use for the expenses of this ordeal–maybe I just knew in my soul that all hell was about to break loose and maybe that is why I was so disillusioned with Christmas (far fetched but interesting, eh?)

Also, it’s SO much fun packing when you’re having some of the worst cramps of your life, right?! No, no it’s not actually. Today is CD1 and I am in PAIN. I took a Soma a little while ago and drove Mr. MLACS to go pick up (gluten-free) pizza for dinner, and I was driving like a ditz but for the first time in…oh hell who knows…I felt pretty damn good! Mr. MLACS and I have had some good laughs today. It was maddening:

1. Get up, eat breakfast and go to our apartment to continue packing and wait for the maintenance guys to assemble to help us after lunch

2. It starts pouring rain. We decide to take some of our stuff to the new place. The driveway is a mess of ice/snow/slush. The garage is being used as storage for the maintenance guys and they’ve yet to clean it out. Uh…

3. We are informed that we will postpone the move until Monday, we are told the hotel will not be comped tonight but we are invited to stay in one of their model homes until then…but it’s already PAST check-out time at the hotel…seriously?!

4. We RACE back to the hotel to plead with them not to charge us for tonight. They agree (whew!) I trick the cat into his carrier and we lug everything (and kitty) through the rain and load the car (again), Hillbilly style. The cat commences to scream, because he HATES car rides. Awesome.

5. We go buy liquor for the maintenance guy and wine for the management–they have been helpful and a little PR goes a long way.

6. We go the the model home to settle in and…it’s actually COLDER inside than it is outside…Mr. MLACS messes with the thermostat while I let kitty out of his prison. Turns out, the thermostat doesn’t work! We call management and sit there and wait for the maintenance guy–who comes and informs us he’s got to replace the thermostat, then leaves.

7. F*cking figures. We sit there shivering and then make the executive decision to return to our old apartment–where there’s heat and cable tv. Ambush kitty AGAIN and both of us get scratched in the process–I don’t blame kitty, because this is BS.

8. Return to our apartment–they’ve removed the noisy fans–we breath a sigh of relief. Kitty is happy to be in his familiar home.

9. I commence to call doctors to see if my appeal has gone through for my meds yet (as we’ve been spending all sorts of money out-of-pocket) and…nope. I made an appointment with a new GI at a well-respected hospital about 2 hours away (same city where take Mr. MLACS to the airport). Dr. Angel was supposed to have called in a script for me but Walgreens says they don’t have it, so I call Dr. Angel’s office to report CD1 and to ask about the script. Dr. Angel never calls me back, and I begin to wonder if he hates me for being such a needy pain-in-the-ass. Mr. MLACS calls about his truck and they haven’t even looked at it yet. (*&^%#@$

10. I have SO many things I want to do, places I want to go, people I want to see, and DEBT I want to pay off. I’m fully committed to the idea of getting a job (preferably not full time) and I perused craigslist. There’s some medical office stuff I’m interested in. Everybody has been RAVING about Dave Ramsey (financial guru), so I talked to Mr. MLACS and told him that, though there’s a lot of things I want to do, I’m wiling to commit 100% to getting our finances in order in 2014 if he’s willing to make and stick to a PLAN with me (because goals mean sh*t without a plan in place–he’s an engineer so he should understand that you have to plan life goals just like you have to use a blueprint to build a house…but he’s a guy and he hates directions…I digress…). For my contribution, I want to get a job so we can save up and do some fun stuff, while also paying our debts (credit card, medical, etc.) AND, I can still go take night classes even with a day job (though I’m not taking classes yet–planning to start in March).

11. Here’s some good news: My Grandma’s breast cancer is Stage I, and she’s scheduled for a lumpectomy at the end of this month (an outpatient procedure) and then radiation for a month. This is GREAT news!

12. A couple of my blogger friends have offered me their leftover drugs. For this I am SO grateful and I just cannot even thank them enough. Seriously, I’m sure I don’t deserve their kindness but I’m in no position to refuse. Bless you, thank you, R. and Steph.

13. I feel SO FAT. Like, I looked in the mirror in the horrible lighting of the hotel bathroom and was almost moved to tears. How did THIS happen?! I was already not on top of my game due to all my health issues, but these last couple of months of hormones have just…the cellulite…my friend (who hasn’t seen me) asked me if I wanted to do a boudoir photo shoot with her–make-up, hair, everything included (for her portfolio) and I had to be like “GURL, I don’t even like pictures with my clothes ON”, but it made me SO SAD because when she saw me 18 months ago during my wedding, I looked and felt AMAZING! I am going to be a bridesmaid in two weddings coming up and intending to attend a baby shower (yes Steph I want to look good for your baby shower) and I feel like an absolute TROLL. I’m really ready to reclaim my body–why can’t I be one of those women (like you Steph) who takes the hormones and sees absolutely no change in her weight or attitude?! Instead of morphing into a ‘superhero’ I morph into a ‘villain’ (fat and evil) and it suuuuuucks. Plus, I was starting to get on a role but this whole flood/moving thing just ruined it, and now I have to start over again. Uhg.

So…finally my cramps became unbearable and since I can just sleep in tomorrow I did myself a favor an popped a Soma, then Mr. MLACS and I went and picked up pizza–we were going to dine-in but the place was like a daycare with no supervision where all the kids are high on pixie sticks–kids were screaming and running circles around us while we were in line, so we took it home and ate it on paper plates (cuz my plates are packed). The drugs and the (gluten-free) pizza are a nice end to a stupid day (Stupid WEEK).

Thank you ladies for your support–I’ve been b*tching A LOT lately–I hope you get a laugh or two out of my rants and lamentation.

 

You’ve GOT To Be Sh*tting Me

I thought that pissing on my hand and yielding a failed pregnancy test was the event that had ruined my f*cking week. I was wrong…some of you are aware, but for those who are not…it can ALWAYS get worse.

I decided to make breakfast for me and Mr. MLACS, so I mixed up some gluten-free pumpkin muffins (with chocolate chips) and popped them in the oven for me, then mixed up some pumpkin pancakes covered in butter and real maple syrup, and served them to Mr. MLACS with a tall glass of milk. While my muffins cooled, I blogged about my BFN and drank my cup of coffee. I shared my post with Mr. MLACS and sat down to eat my consolation muffin…when Mr. MLACS suddenly exclaimed “Hey, do you hear that? What is it?” and I listened and picked up on a rumbling sound and replied “It sounds like an earthquake, but nothing is moving?!” I tossed my muffin aside and jumped out of my seat to see if I felt the earth moving…then the buildings fire alarms began to blare and Mr. MLACS and I began to panic, but still confused about the circumstances…then Mr. MLACS shouted “WATER!” And as the word escaped his lips I watched in horror as it began to pour down the wall and windows behind our couch…”Oh sh*t we gotta get outta here!” I screamed as I listened to a river begin to flow above our heads and imagined our ceiling crumbling on our heads “Where’s the cat carrier?!” I exclaimed as the cat sprinted under the guest bed, requiring a joint effort to get him in his temporary prison. I was shaking with fear as I realized that I may lose everything I own (and yelled at Mr. MLACS for not getting renters insurance because I only carry $25k, which is not enough). As Mr. MLACS watched and listened and did useful things like moving the couch away from the impromptu waterfall in our living room and shutting off our electricity, I threw the cat in my car and tore through the house gathering our important documents, medications, wedding pictures, clothes, etc. and shoving them into bags. After I had my essentials I ran out our door into sub zero temperatures and searched for someone who looked guilty–I wanted to STRANGLE someone–I looked around and screamed (to no one in particular) “Where are you, you incompetent son of a b*tch?!” Thinking this was the mistake of a maintinence man or second-rate plumber. Then I sprinted toward the manager’s office in a fit of rage, threw open the door and saw she was with potential renters but to hell with politeness and discretion, I scared the sh*t out of everyone when I  screamed “MY HOUSE IS FULL OF WATER! IT’S FLOODING AND WE HAVE TO EVACUATE! IT’S F*CKING RUINED!” And then turned and ran out the door screaming, arms flailing. Unapologetically and undeniably insane. I’m surprised they didn’t call the authorities. By the time I reached my front door water was pouring into our hallway. I walked in and looked at Mr. MLACS and clenched my fists and screamed. I. was. PISSED. I stalked around the house and listened…to the sound of water running through the ceiling and the walls…watching helplessly as it streamed from our electrical outlets…I became more enraged. WTF. Who’s responsible for this? Who the hell is going to fix it? Where will we stay tonight? Will we move–surely we must? Why THIS? Why NOW?! My heart beat wildly as the fire alarms continued to remind me how WRONG everything was.

The manager came round (cautiously eyeing me and keeping her distance) explaining what Mr. MLACS already knew: the pipes in the sprinkler system had frozen and burst–hence why the fire alarm was sounding. What she didn’t ssy (which Mr. MLACS also knew) was that it was indirectly their fault, because they have a lot of vacant units and had (unwisely) chosen to spare the cost of heating them during these cold winter months. It took forever for management to decide how they’d like to accommodate us, but I hastened their decision by planting my (homeless-looking) self and the cat in the middle of their fancy clubhouse and  FINALLY around 4:30pm they extended the offer to comp us $80 for a hotel room. The cat doesn’t mind his temporary prison but he HATES car rides. Mr. MLACS had donned his Carhartt work clothes and steel-toed boots to supervise the chaos in our apartment, and he mocked me by imitating kitty’s pitiful howling as I pulled away and smiled through clenched teeth, my car loaded like the Clappits, with kitty crying in the passenger seat. Not fun.

Thank God we’re all ok. Thank God that (so far) nothing of ours has been ruined. Thank God Mr. MLACS was HOME! I’m counting my blessings…but Lord Jesus can this be IT for awhile? I have reached my limit. Amen.

 

 

 

Nope.

Today is 12dpo, I took a FRER this morning…do I really need to tell you how that turned out? Nope. I haven’t even cried–but I bet I will when AF arrives–if it’s anything like last month I will be glued to the couch with my heating pad.

This opens up a whole new can of worms. Do I stick to my idea to take off January to re-group? Cuz now I don’t want to take a break. I feel desperate to just get this (trying to conceive) over with already. And I don’t have the option of trying naturally, because Mr. MLACS’s schedule has changed and we physically will not be here during my fertile window–I don’t like the idea of not trying at all. Plus, I’ve been doing acupuncture with the lovely Star, and maybe it’s starting to work…but I can’t afford to keep doing this for months on end so since I’ve already invested in this treatment I don’t want to “pause” it in January (and backslide) and then “resume” in February or March–that seems counterproductive. What if the Remicade is the reason I haven’t conceived these last 5 months? My last infusion was October 24th and I was due for another one in December–which I declined–and I’ve managed to keep my Ulcerative Colitis in remission without it…I can’t take this for granted…next month or the month after that I could find myself VERY sick again, and my docs are always impressing upon me that it’s important for me to be in remission while TTC. There’s a lot of reasons to push forward and do an IUI in January.

Although, I would definitely like to change my protocol–I want MORE follicles, and I believe the way to accomplish this is to dispense with the Femara altogether and begin Bravelle CD3, with a healthy dose at 150iu, in the hopes of recruiting more follicles to begin with. Then, I’d like to trigger no later than CD14 (preferably CD12 but that’s probably not realistic for me). And I want to do a double IUI with Mr. MLACS’s “spermcicles” (frozen sperm) since we won’t be able to have sex.

The failure of IUI #2 is particularly frustrating because I got pregnant twice naturally in 2013, but since then I’ve done 2 rounds of Clomid and 2 IUI’s with Femara + Bravelle and NOTHING…it’s been 5 cycles since my last pregnancy (one natural cycle in-between Clomid and starting IUI’s). WHY? Is it the Remicade (that I started as I was having my chemical pregnancy at the end of July ’13)? Is it that my body hates the hormones and I’ll never get pregnant on medicated cycles? Is it stress? Are we TRYING too hard–do we “just need a vacation”?!!!  Is it Dr. Angel’s IUI protocol?? Is monitoring every day bad? Did we “miss” the egg by not having sex post-trigger and then doing the IUI post-ovulation? Is he making poor use of my preciou$ injectable meds? Is there something else…an infection in my uterus? Could I benefit from dexamethasone to further quiet my immune system? I’m gluten-free but do I need to quit dairy and grains? Do I need to eat pineapple core? I don’t even know where to begin…

This is getting expensive. Mr. MLACS is getting tired of the roller coaster too and he’s not sure he wants to do an IUI in January, but he says he just “wants to see me happy”. I don’t even know what will make me happy right now. I need a shower–I’m sitting here in clothes I’ve worn for 3 days with bed-head and I feel like a troll. Maybe I’m just so sick of doing my due diligence (taking meds day and night, etc.) that I’m subconsciously rebelling by not taking care of my other needs. That’d be redundant.

I worry about things…like “Myrtle’s” upcoming bachelorette party and the bridal shower I’m supposed to throw and then her damn wedding in April. I don’t want to go to the bachelorette party–I despise her when she’s drunk, the weather is awful, and I don’t want to spend the money, but it’s coming up mid-January and I don’t know what to say to get out of it. She point-blank asked me in front of a room full of people at her family’s Christmas gathering “SO HOW’S THE BABY MAKING GOING?” To which I, after a pause, calmly replied “Nothing to speak about”–let her wonder–she doesn’t even CARE she’s only asking to be nosey and because she wanted to see if I’d be weaseling out of her upcoming hen party or not fitting into the bridesmaid dress. I refuse to speak to her about any of what’s been going on with me–I still haven’t mentioned that my Grandma has cancer (though that may be my excuse for skipping the hen party). I don’t mind throwing the shower, but this means I’m going to need to start planning it for mid-March. And the wedding…but I wish I wasn’t in it. She doesn’t have a big budget, but she has enough, and for some reason she has decided that–instead of hiring someone–she wants her wedding party and guests to clean up the venue post-reception? I think that is ridiculous, but I’ve already been ‘snapped at’ for telling her not to pair black opaque tights with her navy blue eyelet lace sundresses for the bridesmaids, so I won’t be making any more suggestions. Uhg. Why do I worry about this BS? And “Myrtle” really wasn’t the point of this post. But…it’s sort of relevant because I was thinking “I’d be right at 16 weeks when the wedding rolls around” and now…I won’t. I may be zero weeks when the wedding rolls around, and I need to accept that instead of feeling panicked about it.

I conceived January 19, 2013, and after my 7w2d miscarriage, I never thought I would be here a year later, with no pregnancy and no baby. I may have feared it, but I never believed it would happen.

And so I’ll leave you with the ‘Serenity Prayer’–one which you’re probably all familiar with, but if you haven’t prayed it in awhile (as I haven’t) now may be the time. XO

God-Grant-me-the

She’s Lucky I Don’t Have A Weapon…

So, my husband’s insurance has changed–we have a new prescription provider, CVS Caremark. I thought I hated Express Scripts THE MOST, but now Caremark has taken over the #1 spot. I went to get my Delzicol (extremely vital med I take for my Ulcerative Colitis), with my new prescription card in-tow, naively thinking that I would shell out $75 and walk out with a 30 day supply. WRONG. Never, ever assume anything when it comes to attaining your medical care. Turns out, Caremark (the irony that “care” is included in this name…ha) will require an appeal by the prescribing doctor, stating why Delzicol is used and not some other prescription. Now, I get it–Delzicol is an expensive, patented brand-name drug with no generic substitute, and if it’s not necessary to pay these inflated prices then Caremark doesn’t want to pay them. But I was told it will take a minimum of 72 hours for the appeal to be processed, and I can’t even begin this process until I get a hold of my doctor on Monday (it’s after 5pm Friday). I NEED MY DRUGS NOW. I can’t go all weekend without them, I can’t even skip a dose or my ass starts bleeding. So…I realized I had a prescription on file for another (less effective but supposedly equivalent) drug, called Asacol HD. And guess what?! Asacol HD is also a patented brand-name drug that requires an appeal from my doctor in order to get coverage. So I’m left with: pay out-of-pocket for a weekend’s worth of meds OR go without meds. Of course we paid out-of-pocket…EIGHTY TWO DOLLARS…$82 mother*cking dollars for 2.5 days worth of Delzicol. OMFG. If you ever feel sorry for yourselves, just please be glad that you don’t have a chronic life-long disease that is sucking the life out of your body and your pocket book–just please count that among your blessings.

Oh, but it gets better. Today I had to call my GI to see about 1. getting some samples of something to tide me over until I can get a prescription of Delzicol and 2. Getting them to appeal the Delzicol. You see, it was actually prescribed by my former GI in Las Vegas, so Walgreens sent his office the notice to appeal for the Delzicol, but it’s really not his job at this point. So I called up my current GI’s office (which is small and full of old ladies) and the first lady asked me what I needed, so I started to explain and she cut me off and forwarded me to a woman who I assume must be either and RN or an MA (most likely an RN, because oddly most of the Dr.’s offices in this town still rely on RN’s and haven’t switched to MA’s). We’ll call her OB (short for ‘old b*tch’). I begin to tell OB about my medication drama and she keeps f*ing cutting me off–very rudely. I’m not being long-winded either. I try to tell her about the Delzicol and she says “So then we must have gotten the paperwork sent to us by the pharmacy already”…NO, b*tch, you DIDN’T because it wasn’t prescribed by you, it was prescribed by my former GI and new GI approved me to continue. Then she says “Wait a minute, I have here that the doc prescribed you Asacol HD, so why are you taking Delzicol”….well B*TCH, that is because I wanted to switch to Asacol HD because it’s easier to swallow than the Delzicol, but unfortunately I had blood and mucus coming out of my ass so obviously it wasn’t working, and I switched back to Delzicol, which immediately stopped the blood/mucus–the doc already knows this. Then OB says “Ok, so we’ll just send the appeal to them and you should be able to get your meds” and I said No, that the Caremark people told me the quickest way to submit an appeal is over the phone, and they had given me a phone number, to which she replies “Well I DON’T UNDERSTAND, I do this EVERY day and it always works so I don’t understand, blah blah rant rant…”…and I cut her off to say “Well I don’t understand either, all I know is what they told me. But if you’ve worked with Caremark before then I trust you know how to get it handled”. And then, I asked her if she has any samples of anything I can use until the appeal goes through, and she named off a couple, including Lialda–which I’ve taken before with success. I mention to OB that I’d like to try the Lialda, and I also mention that it’s actually covered by Caremark without an appeal, to which she replies “Well then why don’t you just take that if your insurance covers it, because it’s ALL THE SAME THING, it’s all Mesalamine”…OMFG why are nurses SO STUPID?! These meds are NOT all the same, they are in different preparations and release differently in the body–most recently I have not done well with the extended release meds (such as Asacol HD), and Lialda is an extended release med. Just because I took it 2 years ago and it worked doesn’t mean it will work NOW. And NO THEY ARE NOT ALL THE SAME, you stupid stupid ignorant *&^%$#!–if they were truly all the same, then we’d all just take the motherf*cking generic and not bother ourselves with calling your sorry ass to make an appeal. Right?! Right. Geezus. So, after I made it VERY clear that I still wanted her to appeal for the Delzicol, she said “Oh by the way, the hospital called to say that you didn’t show up for your most recent Remicade infusion, so I assume you’re going to call and do that this week”…well, no actually, I’m NOT, because I just talked to the doc on the phone the other day to discuss pushing out or possibly permanently suspending the Remicade, because I’m currently under control and trying to get pregnant. And he approved. And THIS is why I so urgently need to get my meds–so I can maintain remission WITHOUT the Remicade. Do. You. Understand. Me.? She said she’ll leave the Lialda samples at the front desk. Click.

There’s more. I called Caremark yesterday because it occurred to me that they may not give me the sweet ass deal on Bravelle that Express Scripts was giving me ($75 all-you-can-eat, first time Dr. Angel ordered 10 viles but this last time he ordered 20 viles and either way it only cost me $75 dollars, whoop whoop!) I got a really nice guy named…Bobby? I think. So anyways, first Bobby looked up Bravelle and found that it’s not covered. And I said “Ok, well do you have a biological equivalent that is approved?” And Bobby asked me what kind of med it is, so I explained is a reproductive medication, called Follicle Stimulating Hormone, or FSH. Bobby put me on hold for a few while he looked it up, and came back with: Pregnyl and Human Chorionic Gonadatropin (he couldn’t say the words so I asked him to spell them)…well, those are both HCG shots, not FSH. So Bobby put me on hold some more and dug deeper. What he found was that Bravelle IS covered WITHOUT an appeal required, and I could hypothetically get 20 viles from a retail or specialty pharmacy for $300–for two refills–and then I’d have to go through the CVS mail order pharmacy. And I said “God willing Bobby, I won’t need more than two refills”. It’s more expensive than Express Scripts, BUT $300 for $3000 worth of meds is nothing to complain about. So, at least there’s that–BUT it’s only hearsay at this point.

Mr. MLACS will joke sometimes when someone pisses him off (usually while driving) that if he had “one bullet a day” that person would’ve gotten it. So I do it too now, when people piss me off I’ll turn to Mr. MLACS and say “one bullet a day” and he giggles. So I leave you with this: Today, OB is lucky that this is just a joke, and I don’t even know how to shoot a gun. I’ma go pick up my damn samples and she best hope I don’t see her sorry ass when I do. *spits on the ground, mean mugging*