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*

Are We There Yet??????? Geez….

Sorry, bullet points:

The Essentials:

  • 2 follies on left ovary: ‘19.5’ and ’17’, hopefully tomorrow morning they’ll both have grown a couple millimeters.
  • My OPK was very negative, so I’m not terribly concerned about ovulating early (although I’d be lying if I said I was totally unconcerned).
  • My Estradiol was 665 today (but I still don’t have my lab results with Estradiol + TSH that were drawn last Friday)
  • I’m CD15 today (Monday) and today was my 8th consecutive day of 75iu Bravelle shots
  • Tomorrow (Tuesday, CD16) I’ll take my HCG trigger shot
  • Wednesday (CD17) Mr. MLACS will be ‘called to duty’ (a nod to his video game) and we will have our IUI
  • I’m still sick with a head cold and it’s making me pissy and nervous because I’ve obligated myself to cook a big Thanksgiving dinner on Thursday

To Expound Upon that:

  1. I saw Dr. Angel this morning and waited all day for Dr. Angel to call me back to tell me if I am to have a Bravelle shot or the HCG trigger shot today (he said one or the other but not both). I was wrong about my 2nd follie measuring so close to my lead follie the other day–it wasn’t. Today the lead follie is at 19.5 and the 2nd follie is only at 17, so Dr. Angel decided that I should have my Estradiol drawn (oh and I still don’t know my Estradiol & TSH values from 3 days ago) before we decide if we should trigger today (CD15) or trigger tomorrow (CD16). I freakin’ forgot to take my OPK earlier…maybe that’s because…
  2. Every day for the last 4 days Dr. Angel has asked if I can wake up at 6:00am and page him at the hospital to see if he is available so he can meet me between 6:15-6:30. Every fuggin’ day some pregnant lady has either been delivering or in some kind of crisis, so I’ve been told to wait for Dr. Angel’s call. So that is my life now, just waiting for Dr. Angel to call and invite me in for some QT with the dildocam and a shot in the ass. I’m on my 8th day of the everyday monitoring & daily shot in the ass, and it’s not as exciting as it was in the beginning. Now it’s just tedious.
  3. I’m SICK with a nasty head cold, which came on about 4 days ago. I’ve been sleeping like sh*t. I feel like crap. The skin under my nose is eczema-like from all the wiping and nose-blowing–being sick makes this whole song-and-dance with Dr. Angel far more annoying and inconvenient. It’s like, I’m either waiting on phone calls or trying to sleep or just trying to entertain myself and I migrate between the couch and the bed like a zombie. Cranky? Sho’ nuff.
  4. Mr. MLACS was gone for over 3 weeks…then returned home last Friday…and we have not been intimate because Dr. Angel told us not to since he was expecting to trigger Sunday and do the IUI Monday–since I’ve been sick and he’s been tired it has not been a big issue. BUT NOW Dr. Angel has pushed the trigger shot to Tuesday and the IUI to Wednesday…Mr. MLACS is only home for 2 weeks! I’m thinking about just having sex tonight (Monday) since we’re not doing the IUI until Wednesday, because MFI is definitely not our issue so I’m not worried about him not having enough sperm. But then…I’m not really in the mood either, I think I’m more-or-less just bored and mostly I want intimacy with Mr. MLACS, not necessarily sex…but he can’t be lovey-dovey with me because he’s horny like a 16 year old boy. So it’s like, either we go “all the way” or we “wait” until our IUI, as there is no in-between with him right now. Super frustrating. I should probably just wait until the IUI, right??
  5. Ok, so I called Dr. Angel’s office circa 3:30pm to see when he wanted me to come in and which shot he intended to give me based on my Estradiol. They had me come in and get the Bravelle shot today (Monday), and (as noted above) pushed the trigger to Tuesday and the IUI to Wednesday–because my Estradiol was only 665 (which is good but leaves wiggle-room for stimming one more day). I had the shot today and it hurt like a mofo–Dr. Angel must’ve just hit the wrong spot.
  6. I’m supposed to page Dr. Angel tomorrow morning circa 8:30am and aim to be in there by 8:45am to get my HCG trigger shot (unless another pregnant patient takes precedence again).

I’m ready to get off this roller coaster, and I don’t just mean with the stims and the dildocam appointments. I’m ready to finish settling my house and get into a routine with Mr. MLACS and this new job and schedule. And I’m very f*ing done with this head cold–it’s making everything seem much harder than it ought to be. And as a disclaimer, I know plenty of you have endured worse on your ttc journeys, and I may sound like a big whiney baby…and all I can say is…you might be right; maybe I am a big whiney baby. Kudos to you for being so hardcore. XO