Monthly Archives: September 2006

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What’s up with DAT?

A while back, Mr. Warrior found that there are several direct access testing or DAT services where you can get lab requisitions without having to go through your doctor. (See here for some background. These links are for companies in the US. I think these type of companies also exist in the UK.) There is no hassle trying to convince someone to let you get the test done and it’s usually a lot less expensive than going through your doctor. So, I started doing some research on the various ones available. Most, but not all have FSH, E2 and progesterone testing available, so I focused only on those that do. The range of prices were anywhere between $32 to $150 per hormone test (note that insurance companies will not pay for these tests).

The way this works is you pay the service up front (cost depends on the test) either online or by calling the company. The lab req is then either faxed directly to the lab draw facility (or “patient service center” in DAT-speak) or emailed/faxed to you to take in when you do your lab draw. Then you visit the vampire and in most cases, the companies claim you get the results within 24-48 hours via email or logging in online.

When I checked to see the lab locations in my area to get my blood drawn, I noticed that all gave the same list of places and they were all L@bcorp facilities. I found that very interesting as it suggested that it might not matter which company I actually used to get my lab req, the testing would be done in the same place. Later with more digging and googling, I found out that DAT companies set up a contract with patient service centers, which, in part is why they’re prices can be so low. L@bcorp* seems to be the favorite or maybe the only facility to make these contracts with. When I called up the lab draw location I planned to use, to see what experience they had dealing with a couple of specific DAT companies, I found out that some tests are actually down in-house. FSH, E2 and progesterone were included in the in-house tests that they do. So, for these specific tests anyway, it didn’t matter which service I used to get my lab req as they would be tested by the same place. I chose the lowest priced DAT comapny and got a lab req for a progesterone test. I went to get my blood drawn last Wednesday (7dpo) and got my results online Friday morning. I was very pleased at how easy and smooth the process was! I was also happy with the company’s response to a couple of questions I had. They were very quick to respond.

I plan to get my FSH, E2 and progesterone tested for at least the next 2-3 cycles. If I stay with the same DAT service, I would only be paying $105 total for the 3 tests (compare to the $690 I paid to have my FSH and E2 tested last October). I may even keep monitoring my cycles for longer if I don’t get tired of all the lab draws and I think it can help me get a clearer idea of what my body is doing (or not doing). At the very least, I figure I will go into my IVF consults with more information than I have now and that may help the REs evaluate our chances and also help us in deciding whether or not to try with my eggs or go straight to donor eggs. (Of course, more information doesn’t necessarily mean more answers or a better understanding of the situation, but for now let’s just pretend it does.) I would still like to get some day 3 antral follicle counts in the meantime, since FSH is an indirect indicator of the number of follicles, but I haven’t decided whether I want to make that call to talk to the doctor at the university medical center I had been seeing. Each of the ultrasounds were billed to my insurance at $400 a piece and though I haven’t been billed for those visits yet, I know my insurance doesn’t cover any fertility treatments. What the price of the u/s would be if I pay cash, I don’t know, and I’m not sure I need to know my antral follicle count for successive cycles. It’s really out of my own curiosity that I want to know. Plus, I plan to do at least one inhibin-B test and that may tell me more than monitoring my antral follicles for a few months.

So, have any of you had experience with this kind of testing? What did you think?

*For a list of all the tests they do, go here then click on the alpha pad to the left for the first letter of the test you are interested in. They seem to have every test imaginable and many of the DAT companies say on their website that if a certain test is not listed, you should still call to see if they can get it for you. It’s likely any test L@bcorp can perform is accessible through these any of the DAT companies even if it’s not listed on their website.

Disclaimer: I’m not trying to promote the use of these DAT services or trying to advertise for them. This is something I have looked into doing and am using them for the reasons I’ve explained in this post. I’m writing about it because I think it may be useful for others.

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The plan for now

Ever notice how dealing with infertility means making plans, having them fall through midway then making new plans? Anyway, here is infertility plan #1367.

We will shop around for IVF clinics to get some opinions on what different REs believe our chances for live birth with my eggs are and to find an RE that we feel comfortable working with. Since it is likely that we will move in a few months and the wait for a consult appointment can be as long as two months, we will wait until we move to Northern California before starting any IVF cycles of any kind. But, my main priority is to wrap up this phase of my career and get my PhD and get out! Not being finished with grad school is becoming a serious anchor to achieving what I want the most right now, which is to have and raise children. So, that will be where the focus of most of my time and energy will be for awhile. In the meantime, I’ll do some research on different IVF clinics and monitor some of my hormone levels (especially FSH) to see what they look like over the course of a few cycles. When we have a better idea when we will actually make the move, I may go ahead and start making appointments. We could always try to do phone consultations or make a trip up for a consult, but with the last months of my graduation winding down, I may just be too caught up in finishing my thesis and all that is involved with that. But, monitoring will take minimal time and it will help me feel like I’m doing something towards resolving our fertility issues. And that will go a long ways in helping me focus on the things I need to do to graduate. I plan to do the monitoring on my own (in fact I’ve already started) using a direct access testing center. I’ll tell you more about that in my next post.

On a related note, I received those medical records without having to wait a full 10 business days (the person I talked to must have took pity on me!). I’ve only read through them once, but then put them aside because it had the records from my miscarriage including a copy of the ultrasound of my empty sac. Seeing the u/s and thinking about those days and my dropping hcg numbers always make me sad, so I haven’t gone back again to look carefully at the doctor’s notes from my original consults and my IUI’s. But, it’s good to have my records and there are several mentions of follicle counts, so at some point I will go back and track down what day of my cycle that information is from.

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35 minus 1

In a few days I will be adding another year to my age. I’m usually not one to hate my birthday, but this year I found that it was weighing on my mind more than usual. Of course, most of it is because of infertility. I’m one year closer to that big year of 35 which typically marks the time your fertility rapidly declines. I know my fertility has started the rapid decline already, and my ovarian age may be more like that of a 45 year old, but I am starting to dread my age.

This was going to be another poor me post, but then it occurred to me that even though I have all these negative feelings about my birthday on Friday, I am really glad that year 33 will be ending. It was a few weeks after I turned 33 that I got my high FSH reading. That kicked off a year filled with periods of sadness, depression, confusion, feeling lost and a multitude of other bad things. Though there was the bright spot of my wedding and the brief period of hope and light when I went through my IUI’s. The hope of the IUI’s, however, crashed and I’m still in the throes of recovering. In the last few days, though, I’ve made a plan for the next few months (I’ll give details in another post) and realized that while I may dread the beginning of year 34, I can also take comfort that year 33 is almost at an end. In some ways this last year was just as hard as the year of my miscarriage if not harder. That year, I only lost one dream (having the baby), this year I think I lost at least two or three (sex will get us a baby, baby will be genetically related to me, I will soon be a mother). But the coming year, I have my graduation to look forward to which means we can move back to Northern California where we lived before I started grad school. It’s an area we have enjoyed living in and where we plan to settle down for good, or at least for a long time to come. I also think that no matter what path we choose to take in dealing with infertility, there will be some resolutions to what we can/will do or can’t/won’t do the coming year. And that is also something I look forward to.

I wouldn’t say I’m hopeful that the next year will bring good things, but I do feel a little bit like I am wiping an area of my slate clean. Not the whole slate. Some of my scribbles of worry and sadness will stay, but I’m clearing a space to allow new things in. And maybe these new things will be better than the things they’re replacing.

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All things are difficult before they are easy*

I’ve been neither here nor there lately. Monday was just an emotional day because of the anniversary of 9/11. I had spent part of the weekend and the day of reading 2996 tributes. To say that it was gut wrenching is an understatement. I tried to do other things to get my mind to think about other things but, it only helped a little.

Still haven’t made any decisions on what exactly we’ll do next in terms infertility treatments. What makes sense one day doesn’t feel right the next. I thought getting my medical records would make things clearer, but for some reason the medical records office for the hospital and for my doctor’s office are separate. Can you guess which records I received in the mail this weekend? Yep, everything having to do with every single appointment I ever had at the medical center except my appointments with the REs. So, now I will have to pay another processing fee so that in 10 business days I can find out if there is some other oddity that will keep me from finding out just what the doctors have seen so far of my (non)reproductive parts. I’ve had so much practice with two week waits, it should be a breeze, right?
In non-IF news, I started a new knitting project. I got a book on knitted animals and it’s got some great but easy patterns in there. I’ve knitted all the pieces I need for a turtle and currently doing the finishing. It’s turning out to be really cute. I’ll post a picture once it’s done.

*Thomas Fuller

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Ciao bella

 

norma-taddei.jpg

No one knows how long they have on this earth or the kind of life they will have. Will it be long but miserable? Short but sweet? A rollercoaster of bad happenstances interspersed with unspeakable joys? In our most challenging moments, will we rise to the occasion or languish in our fears?

Most of us will live and die without much of the world knowing we had lived. We will do nothing deemed worthy of a TV movie of the week or scandalous enough to be written up in the gossip column. Yet in our lives, we often have people we only get to know from chatting in the hallway or getting coffee in the break room, but feel connected to nevertheless. You know the people I’m talking about. They always have a quirky story to relate or an infectious smile when you pass by.

Norma Taddei was 64 years old when she died. At the time, she worked for Marsh and McLennan, an insurance and consulting company. She and about 1700 employees of the company worked in offices from floors 93 to 100 in the North Tower of the World Trade Center, the same floors that took a direct hit by the first plane to hit the Twin towers five years ago. Norma was one of almost 300 employees who died that day.

Norma was a grandmother who always had a smile for her granddaughter and a kitchen filled with food. She never missed remembering any of her goddaughter’s birthdays and treated her coworkers with kindness and a loving spirit. Her smiles were often accompanied by cheerful exclamations of “Ciao bello!” or “Ciao signorina!” at the office. Norma was the nurturing type. She considered herself the office mom–encouraging one just-out-of-college coworker not to be intimidated by senior members of the company, helping her develop a level of comfort working in the corporate world. Norma brought an affectionate aura to those around her. One ex-coworker wrote, “[i]n an environment that, at times, was pretentious, I truly appreciated her warmth and graciousness.”

I wish I knew more about Norma to share, but internet searches only provide these few snapshots of her life. It seemed she carried a warm smile wherever she went. I hope, wherever she is, she is still smiling.

 

 

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This tribute was culled from messages and articles from various 9/11 memorial sites. Any mistakes or misrepresentations are solely mine.

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Click here to read about the 2996 project and for links to additional 9/11 tributes.

 

This post will stay on top for the time being. New posts will be added below.

 

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It takes a village…to heal a nation

This weekend before the 5th anniversary of 9/11, as I read the other 2996 tributes, I find myself wondering what other people’s experiences were of that day. Not just the ones who lost their lives or their loved ones on that day but those of us who had no immediate connections to the people who died or to the places where the attacks occurred, yet were profoundly affected by the day’s events.

What are your stories, your experiences (you can read mine here)? Where were you on that day? What were you doing? What were the thoughts that ran through your mind that day? The day after? Has the way you viewed the world changed?

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If I were getting a PhD on my infertility issues, I would want more data

So, I think I am slowly coming out of my poor me state and my avoidance to post anything fertility related. I don’t know why I felt that way because I have been doing some IF related things. I guess actually sitting down and writing a post requires getting in touch with my feelings and I haven’t been sure where my feelings will take me these days and were a little scared of them. In any case, I feel better today and wanted up to posting about some of the things I’ve been doing and thinking.

One of the things I realized is how confusing my test results have been over the past year and how different doctors interpret my results. I haven’t been consistently forceful asking for the results/data they are basing their interpretations from and end up feeling later that the doctors were either too optimistic or too pessimistic. I always seem to be asking myself afterwards, what is really going on? So, I sent off a request to get a copy of all of my medical records with this doctor’s office which should date back to the miscarriage in ‘04. This way, at least, I can see for myself what the results/data are that these doctors are basing their opinion on. Supposedly, it will take about 10 business days, so at least it’s not too long of a wait.

I have also been mulling over my erratic results with high FSH, low FSH, some antral follicles and no antral follicles. I knew from my research on high FSH that fluctuations occur, but do antral follicle counts also fluctuate from having follicles to not having any at all? I also wondered what my temperatures would look like over this month if I had no antral follicles. So I started temping a few days after my baseline u/s a few weeks ago. I also used the OPK’s I had bought in anticipation of a second IUI cycle. What I found was that I had an LH surge and a temperature shift that I typically see (and which I always took to mean I ovulated). In the months I took my temps, way back in the early days, I found I had a weird temperature shift where it would rise above the coverline but not by much, for 3 days then go higher for the rest of my cycle. This is what I saw this month. I always assumed this was the stair-step temperature rise, but knowing now that they saw no follicles on day 2, I’m not so sure. With no visible antral follicles on cycle day 2, an LH surge and what looks to be a temperature shift, did I ovulate? If not, does that mean those months where I thought I had a temperature shift and was ovulating early mean that I was not ovulating at all? If I did ovulate this month, then why did the doctor not see any antral follicles? I know they said there were no follicles in one ovary and the other had a large cyst. Could the cyst have had obstructed their view on a follicle?

It occurred to me that if I was my own thesis experiment, I would want more data. So, I’m considering either calling back my old doctor’s office or going to an IVF clinic to just monitor my antral follicle counts for a few months. Along with the monitoring, I may use one of the direct access testing places to get my FSH, etc. tested on those cycles. It’s cheaper than doing through my doctor and there’s no hassles with trying to convince doctors to get the tests done. I guess what I hope to get out of all this is a clearer understanding of what my body is or is not doing. Then, maybe the better decisions on whether to try IVF with my eggs at all or go straight to donor egg IVF will be easier.

I don’t know if my doctor’s office or any IVF clinic will go for that (just counting my antral follicles for a few months), but I suppose it can’t hurt to ask. I just wish this clearness of what I want to do next could last long enough for me to do something. These last few weeks, I have made many decisions on what to do next, yet when I think about it more the next day, I come up with a completely new plan. This teetering back and forth is getting tiring and it’s getting me nowhere except more confused and alone feeling. How I wish I could feel confident enough in the opinions of at least one doctor I’ve seen so far to trust him/her to go back and talk to them some more. They all seem to contradict each other eventually and I don’t know who to trust. Have I just not found the right doctor and should just keep looking and trying new ones? Yet, it takes so long to get an appointment with them, I am always tempted to go back to the ones I’ve worked with if only to get an appointment at a reasonable time.

Ok, I can see I’m starting to ramble and lose myself in the labyrinth of decision making. I better just stop here.

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An infertile’s dream

I’m getting ready to jump in the shower and I notice I am dripping. With cervical mucus. Almost gushing with cervical mucus. I am confused as I try to figure out what day of my cycle I am in. I remember peeing on OPK’s this month and knew I had already ovulated once. I must be ovulating again! But this time, with a good egg! Yes, it must be a good egg, because I haven’t had so much cervical mucus in years! Yes, that must be what it is. My mind and heart are racing and I wonder if Mr. Warrior has already left for his morning run. That’s when the bathroom door opens and Mr. Warrior walks in.

And I wake up. With that sinking feeling you get when you realize it was only a dream.