Monday, March 2, 2009

Moving on to injectables

Dr. Dunn and I met today (I told Jamie not to worry about taking another day off work). We talked about my lack of responsiveness to the estrogen patches. He said he discussed my case with a few other doctors in the practice, and the general consensus was that each of them had some patients with my condition that just couldn't ever seem to get the lining to regenerate in a favorable way. No one really knows why some people recover better than others, but it is what it is, right?

So, he said at this point, we basically have 3 options.

1. Continue the estrogen for an even greater period of time to see if we can get something good to happen.

2. Try injectable medication.

3. Find a surrogate.

I asked him what his recommendation would be at this point. He said he wouldn't try #1, simply because I've already taken so much estrogen (orally, vaginally, and patches) and we haven't gotten good results. He said he would recommend trying #2 before resorting to surrogacy. He was honest, and said the injectibles are not likely to work...but he said it is worth a try, since we want to exhaust all of our options before giving up. Injectables raise the body's natural estrogen production, and natural estrogen is always going to be better than a synthetic form of estrogen taken via pill or patch. It's going to be the identical and unique match for my body.

The injectable cycle is going to run around $1,500 per attempt. He said if it's going to work, it is usually successful within 2-3 cycles. So, you can do the math...this could be up to $4,500. For something that is not likely to work. Ouch.

Ironically enough, I was just in a discussion on Mommy's Online earlier today about the cost of fertility treatments. It's one of the hardest aspects of not being able to conceive naturally. You feel like all this possibility lies before you, but it is financially unattainable. I put $2,000 in my medical flexible spending account this year, so I have the money available to do one cycle. I feel like I *have* to try it to avoid regrets down the line should we end up not ever achieving pregnancy. What mother wouldn't pay $4,500 for their child? If it works, there is absolutely no doubt that it was worth every penny. Surrogacy runs around $30,000, so when put into perspective, it makes the injectable cycles look cheap!

At any rate, I have a whole packet of instructions. It will be a flippin' miracle if I don't screw it up. I am supposed to begin Provera immediately, which is supposed to bring on the start of a new cycle.

Then the protocol is as follows:

CD1-3: Baseline scan & lessons on doing my own injections
CD3: Begin injections (will continue daily through approx. CD11)
CD7: Scan and Estradiol level blood draw
CD9: Scan and Estradiol level blood draw
CD11: Scan and Estradiol level blood draw
CD12: Trigger shot (assuming follicles are mature)
CD14: Intercourse (how romantic)
CD16: Begin progesterone supplements (will continue daily until CD28, or until pregnancy is ruled out)
CD24-26: Schedule pregnancy test and appointment with the doctor to discuss results

I am not sure which injectible I will be taking, but I was told it will either be Gonal F or Follistim (they work in the same way). Dr. Dunn put me in touch with a mail order pharmacy that gives a $200-$500 discount on the 2nd cycle if the first cycle does not result in pregnancy. His nurse faxed my Rx over to them today.

My thoughts...Wow, one cycle will wipe out my entire flexible spending account for the year, and it's only March. I guess I should have maxed it out at $5,000. If we do get pregnant, there won't be any money left for the delivery. But I guess that would be a very welcome problem to have. Each injectible cycle requires 5 office visits, 4 of those being scans. I don't even know how to ask my boss for time off 5 times in a 28-day period. And I'll have to be gone one day soon to take Elise to the pediatrician for a behavioral evaluation (and that is a whole different story that I don't even begin to have the energy to type).

I'm pretty overwhelmed right now with the issues we are having with Elise at school. I'm overwhelmed by the cost and intense monitoring required for this upcoming cycle. We are in the midst of baseball tournament season, so I'm overwhelmed at home too. It's just a lot to deal with all at once. But I know it's all going to be okay, one way or another.

I passed a sign on the side of the road the other day that said, "Don't add up your problems. Instead, count your blessings." I'm trying to adopt this as my new, personal mantra. So, I have to end this post on a positive note. There is some hope. It might not be a lot of hope, but even a little hope is better than none. I'm blessed with a wonderful support system and family who has rallied around me during the past few difficult weeks. I've been humbled at the level of support I've received, especially from my Pitter Patter group - and I love you guys for it more than I can tell you! I'm so lucky. This journey is really causing me to grow in my relationship with God - I think this is the best part of all. And Jamie and I have been blessed with a great group of friends who called us last night and convinced us to book a 5 night trip to Jamaica with them....I am getting my escape after all! We will be in a group of 6, and it's sure to be a great time. I'll finish up by posting a link to where we will be staying. Every time I feel my anxiety level creeping up, I just click on this site and watch the pictures in the slide show. Ahhhh....I cannot wait.....

Click here to daydream with me


d e v a n said...

You deserve that vacation. Good luck with the injectibles. I'll be praying for you!

Heather said...

The best of luck w/those injectibles. I will keep you in my thoughts and prayers. Many many hugs!


Maggie said...

Good luck! I will have to look up tomorrow if the dr appt to acheive pg would fall under FMLA........ Hmmmmmmm... that is one I have not yet encountered lol

Tracy said...

What a fun trip! I want to go now, too. :)

I am praying the injectibles are the ticket, Melanie!

Angie said...

I have my fingers crossed for a positive injectable cycle! :)

Lisa said...

I hope that this is the answer! The trip sounds heavenly! You are continually in my prayers M!

Melanie said...

Thank you all! I am trying to be realistic, yet hopeful.