Daring To Dream

To recap my last post:

  1. I had the Stelara infusion a week ago and it is working–no blood in my stools and I feel better all-around.
  2. I’ve gained 10 lbs and lost a lot of hair since I started taking 6MP (mercaptopurine) a few weeks ago.

Well, I spoke to the IBD Specialist’s Nurse Practitioner via email (patient portal–so convenient) and she told me to go ahead and quit the 6MP. So I have not taken it the last 2 days and so far, so good–no blood.

Speaking of blood though, I am having my first *real* period in 6 months–it’s very heavy but not painful, just uncomfortable. It’s a good thing though, because it means my body has healed enough that it is willing to consider getting pregnant.

I was cleaning the guest bathroom yesterday and stumbled across some brown paper bags of medication, and I knew they were mine not Mr. MLACS’s, but I had to stop and think of what it was…??

And it stung me like a bee–it’s Crinone (progesterone to support a pregnancy). The Crinone I had bought and paid for back in December after I met my new OBGYN and expressed to him my desire to start TTC (trying to conceive) again. Just before all hell broke loose with my UC-turned-Crohn’s. I shelled out $300+ for this stuff, and I wonder if I will ever get to use it.

Mr. MLACS has been very flirty with me lately, and instead of feeling “blah” about it, I have felt more interested. I got a babysitter and we went on our…2nd?…date, just him and me, since BG was born (28 months ago). We went out to eat at a fun Caribbean-style restaurant–I even had half a glass of wine! I had been thinking about having a glass of wine and I finally felt good enough to try it, and I was tipsy but my liver appears to be worse for the wear. We talked about having a second baby, and we are both ready to try (Mr. MLACS is most def ready to resume our sex life).

We are actually in a much better position to TTC *now* than we were before I became ill. Before I became ill, we had no idea how we were going to get our (burnt to a crisp) dream home repaired. Our marriage was strained from the stress of moving to a place where we knew no one, our house burned down as soon as we signed the contract, and Mr. MLACS’s job was grinding him to the bone, leaving me alone with BG and to do ALL the things by myself. We were miserable. And *then* I got sick and that was the “stick that broke the camel’s back”. Things had to change, there was no trudging on the way we had been. I couldn’t. And at first everything got much, much worse. But when you hit rock bottom, the only place to go is up… So things have been steadily improving. Most importantly, our trials have made our marriage stronger. Well that, and I am not afraid of being unable to parent BG through a pregnancy and another baby, because I managed to do it through my illness. Plus, Mr. MLACS really stepped up and now him and BG are very close–she doesn’t need me as much. If you recall, he was away for work most of the first 18 months of her life, so we were all used to me being the primary caregiver, even when Mr. MLACS was home. But when I got sick, he had to take over and that was actually a good thing, because they have a very strong bond now.

So there are silver linings to my illness–we are stronger as a couple and as a family. We have had time to settle our affairs and we are going to move into our new home soon–we are finally out of the stress and the depression/funk we had in the wake of our house burning down. Mr. MLACS’s job has become a much less toxic place and new management is very “pro-family”, so he is home on time a lot more and a lot less stressed.

We are in a good place to have a baby.

I just have to wean off the prednisone before we can try. I’m going to drop from 32.5mg to 30mg tomorrow. I can’t imagine that my weaning will go completely smoothly–I’ll probably have to hold several weeks at various doses, pending my symptoms. But I am daring to dream that the Stelara will quell my immune system and allow me to wean off the prednisone, given patience and time.

Assuming I can straighten myself out, then we’ll *just* have to work on getting pregnant (ha ha ha ha ha–because it was SO easy–it *only* took 6 IUI’s to conceive BG).

I mean, everybody’s gotta have a dream, right?

XOXO,

MLACS

 

June 16th

It was three years ago on June 16th that I conceived my BG upon my 6th IUI (intrauterine insemination). It was a “hail mary” attempt, as I had not planned to have an IUI that cycle. According to my RE, I had cysts on my ovaries and likely wouldn’t ovulate anyway (due to massive amounts of fertility drugs–I’m talking 400iu of Gonal-F, which is an IVF dose). But I decided to go see my OBGYN, Dr. Angel, and have him take a look mid-cycle to see what I was dealing with. And what we saw was one perfect follicle (no cysts) getting ready to ovulate.

And this fire was LIT inside me, that I had to try this month after all. I didn’t think it would work–truly I didn’t–but I could not stand the thought of not trying.

Of course Mr. MLACS was 3,000 miles away working. So I did the only sensible thing–I told him to ditch work and bring his ass home to impregnate me. I was 110% serious. He offered to fly me to him but that would have cost like $2,000 and I said I would rather put that money toward IVF (because again, I did not think this was going to work). We argued. We fought. We both cried.

I had another option, but I didn’t want to consider it. I had a vile of frozen sperm “on file” at the RE’s office. But he. (the RE) was such a f*cking pompous prick to us after our 5th IUI, that I did not ever want to set foot in his office again. However, my desire to “try” this cycle trumped my desire to punch the RE in his face. So without monitoring, I simply waited until I got a “smiley face” on the CBD ovulation predictor–this happened on a Sunday. And first thing Monday morning I called the RE’s office and “ordered” my husband’s thawed sperm as one might order a mcmuffin at mcdonald’s. The receptionist balked but offered to check with the RE (who was on vacation). And luckily, I was given the “green light” to come in for an IUI at 11am. I was glad the RE wasn’t there and his nurse unceremoniously inseminated me. I didn’t even lay there or put my legs up like I normally would–the moment she left the room I pulled my pants on and got the hell outta there.

During the TWW (two week wait between ovulation and menstruation) I ate what I wanted, exercised vigorously and drank a lot of wine at a wedding–things I wouldn’t normally do after an IUI. This is NOT to say that it worked because I “just stopped trying”–that is bullsh*t and don’t ever suggest that to a couple who is struggling to get pregnant. But it is to demonstrate how little faith I had that I was pregnant. I was sure I wasn’t–every other month I swore I was pregnant but this time I didn’t bother. I was busy researching IVF clinics.

But I actually was pregnant–finally–a year after my 2nd miscarriage and so many infertility drugs and needles and vaginal ultrasounds and fights with Mr. MLACS and worry and TEARS…so many tears…

So June 16th is one of the best days of my life, because that is (without a doubt) the day I conceived my BG.

XOXO,

MLACS

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

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*

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

 

 

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*