All Clear

I just finished up with my first mammogram! For whatever reason, I thought that the stories of having your boobs smashed between a vice were exagerations. Um, no. It's a very accurate description. But for what it's worth, it was a nice change to need to undress from the waist up!

I'm sure you've guessed from the title, I'm breast-cancer free, and even more surpising, cyst free. Apparently I'm just "lumpy". :) I don't know how this lump went unnoticed for so many years? (by me or my Drs.), but it's nothing.

Yayyyyy!!!

So I guess I'm still on track for IVF to begin in a month.

On a very sucky note, my 16 year old cousin got his 16 year old girlfriend pregnant. My family just found out and of course everyone is in shock. I'm less upset for me and more upset for them. Clearly they've been stupid and don't have a clue. I'm hoping that adoption is strongly considered for ALL involved.

Bump in the Road

Thanks for your warm thoughts, it's much appreciated.

So there's a little bump...in my right breast. I went into the gyn-y yesterday for my yearly pap. The ARNP that I see was doing my breast exam and found a small lump so I'm off for my first mammogram/breast sonogram on Monday. Woohoo.

I'm not overly worried, the lump moves around, and cancerous lumps don't, or so I've read. I'm betting that it's a cyst and hoping it will go away on its own, perhaps after I start my period in a few days. I just hope this isn't something that will get in the way of the IVF.

On a more positive note, I had all of my blood work taken care of yesterday for the IVF, 8 vials worth! I'm happy to have that all out of the way now.

Now I just have to figure out where M should go for his blood work. I don't know if I should just call our GP or if I should call the NY RE and have orders sent so that he can just go to a lab.

Oh, and even better news, I don't need an HSG!!! I misunderstood the RE over the phone, he was saying that I need a saline-sonohysterogram. I thought it was odd that he would order and HSG for IVF, so this makes much more sense.

So far the NY RE and his staff have been great. I had a question after the consultation, so I called the office. I was just hoping a nurse could tell me if the RE had handled the next step or if I needed to get the ball rolling. She took the message and the actual RE called me back to say that balls are rolling! I was more than shocked, it was a simple question and most likely a nurse could've handled it.

I guess I should mention that M and I have made a decision about when to go forward with the IVF. We're going to wait a month, it just makes more sense than starting next week. So that puts our estimated start of BCP's in early March and if I make it to retrieval that would be mid April. Almost exactly a year after the first IVF.

I think that sums up the latest and greatest.

Sad For Me and My Family

My uncle and friend is gone, I just got back from his funeral. I don't even know how to feel, it doesn't seem real and I'm trying hard not to let it hit me all at once. I'm grateful that he isn't suffering any longer, but of course I want him back, alive and well. 37 is ridiculously young to die of a stupid, random disease.

First Consultation Completed

Whew.

We had our first consultation with the NY Dr. this evening. It went rather smoothly, only 30 minutes behind schedule. ;) That's pretty impressive actually!

I printed out the questions I listed on my last entry and had them ready for him, although I didn't ask him every single one. But here is a run down of his answers:

• Do you think my FSH is too high for IVF? He practically scoffed at that. He considers my high of 11 to be in the "grey" area and still completely acceptable. He treats patients with FSH in the 20's! Whew, sigh of relief.
• Is there any testing to determine my most likely outcome, Clomid challenge test or Inhibin B testing? No, they are predictive, but he said he's seen enough people do poorly and still succeed, so he wouldn't bother. IVF is the real test.
• Do you believe in doing an antral follicle count before proceeding with IVF? Yes, he likes to see an antral follicle count. He said it gives him a heads up on how much medicine to give, but that he wouldn't cancel based on the count alone.
• What do you think of my poor response to Follistim/Menopur (especially since it was no better than my cycles with Clomid or Femara)? He advised trying more drugs, that will be the best indicator of my fertility. If I don't respond, well then I have serious issues. I didn't ask him this directly, he answered it on his own.
• Would you be more aggressive with the same drugs or recommend a new treatment? He said he'd stick to the same, just up the dosage. The same thing my local RE was planning actually. He seemed pleased with the information from my last IVF so I guess it wasn't a total waste.
• Would you recommend doing a microflare protocol, estrogen priming protocol, or an antagonist protocol? He recommended the antagonist, which I believe is the same as before. He said the microflare is the last ditch effort and hopefully it won't come to that. He didn't seem to be behind the estrogen priming protocol, it sounds like it's not something he's done before, or at least not often.
• Will I need to spend the entire treatment in NY ? The Dr. said he's comfortable with having my local RE do all of the monitoring and I can just come up for the retrieval/transfer or whatever combination works for us. I just wonder if the local RE's are down with that or not?! I know some of you have experience with the multi-clinic scenario, any advice?

The Dr. also recommend that I have an HSG to rule out any polyps that could have developed since my laparoscopy...bleh, from what I've read, they're no picnic. M and I also have to have all of our screening labs done again since it's almost been a year and they're required by the state.

M wants to start ASAP, but next month seems too soon to me. I haven't had enough time to process the idea but I guess I could be back on the cycling bandwagon again -soon.

More on Medical Records

The medical record saga continues (and hopefully concludes)...

I went up to MD for a long weekend to visit family* (can you say freeeeeezing!) and returned late Monday night. I was really hoping to have my medical records from my local RE show up in my mailbox (as was agreed upon) Tuesday, but instead I got a phone call at 3:55 pm letting me know they're ready for pick up. Of course they lock the doors at 4:00 pm, and wouldn't open them for me if I drove over straight away. Grrrr.

Anyway, I picked them up yesterday and thankfully decided to double check them while I was still in the office. It's a good thing I did, because they neglected to include any of the Drs. chart- notes, all I had were lab results and a drawing of my uterus from the mock transfer! Niiiice.

On the bright side, they printed out my charts at no cost and I've mailed off all 54 pages of my IF medical history. The New York office should have it by Saturday, in time for Mondays consult. :)

Of course I poured over the most recent information and the reality of my situation came back to me with a side of hopelessness. "Mini-stim IVF cancelled due to less than expected response of 2-3 dominant follicles. Day 3 FSH 9.9. She and husband have no other complaints or issues." Gahhh, it sucks to see it in black and white!

I'm just going to keep moving forward until I hit a wall, it shouldn't take long LOL. I guess I need to figure out what questions I want to ask the new Dr.

Here's what I've come up with so far:

• Do you think my FSH is too high for IVF to work (aka, am I a lost cause)?


• What is the cut off point for you/your clinic?


• Is there any testing that can be done to determine my most likely outcome (do you have a crystal ball)? Clomid challenge test perhaps or more FSH testing?


• Do you believe in doing an antral follicle count before proceeding with IVF (would it have saved me from doing my unsuccessful mini-stim)?


• What do you think of my poor response to Follistim/Menopur (especially since it was no better than my cycles with clomid or femara)?


• Would you be more aggressive with the same drugs or recommend a new protocol?


• Do you think my main fertility issue is endometriosis or low ovarian reserve or both?


• Do you have a strong opinion about treating endometriosis with GnRH before proceeding with IVF?


• Would you recommend doing a flare protocol or antagonist protocol

Any suggestions?!

*My uncle is not doing well at all. I hate so much that he has cancer, it's such a fucking miserable way to die.

Annoyance Subsiding

I finally heard back from my local RE's office. The woman who called me was very sweet and apologized for turning me into a stalker. She said that the woman who handles the medical records is no longer there. I guess that explains a few things.

Anyway, I faxed in a formal request for my records and should hopefully have them by next week. That will give me just enough time to make copies and mail them off to NY along with all of the forms the new RE needs.

I guess I need to start working on a list of questions to ask the new Dr. when I speak to him. First and foremost on my list will be questions about my egg quality and his opinion about even going forward with IVF. I would like to have a few more tests to help determine if I do have low ovarian reserve/poor egg quality or not.

I know it's probably unlikely, but I still wonder if my high FSH could have been caused by the accupuncturist. It seems so strange that my FSH suddenly spiked as I started the treatment that I really disliked.

I guess we'll see what he says in two weeks!

Annoyance

We have a phone consultation scheduled for the end of the month with a new RE in NY.

Yayyy?!

Of course I need to gather all of my records from the local Drs. office. I called last Monday and left a message on the record departments v-mail, several days go by and nothing. I called Thursday afternoon and they'd switched over the phones early, so again nada. Grrrr. I called and left a message again Friday morning, zip. I called and left a message again this Monday (yesterday), still nothing. I called again today and pushed zero to talk to a real human being, she had me leave another message for the records department. In case you've lost count, that's 5 phone calls and 4 messages over the course of 9 days and as of 4pm today I still haven't had a returned call.

I hate when Drs. offices put the patient in the awkward position of stalking them to get results!!!

The office staff sure is making it easy to move on to a new RE! I don't know if it's because I'm no longer an active patient, or because medical records are low priority, but it's pissing me off! M wants me to go to the office in person to get my records...it might make an impression, ha ha. Probably not a good one though. ;)

Does anyone else have this much trouble communicating with their RE's staff?