Shots Wait for Nothing
Sometimes, you're out having fun at Carowinds when you have to give yourself a shot. So you sit down between rides and do what you gotta do!
Small Insurance Victory!
I'm so grateful that I've worked in the medical field and been around insurance jargon the last 5 years. As has been talked about in many previous posts, insurance is crazy and difficult to understand. Most people don't understand what they can do to try and prevent paying more than necessary, and if crazy charges come back, they don't realize they can appeal those, or at least talk with someone about what's going on.
My most recent "insurance win" is getting all these estrogen patches! That's 180 of them, and I got them for $10!
When I originally called the pharmacy to see what the cost would be, they told me insurance would cover approximately 16 patches for my $4 copay, but I would have to buy the rest out of pocket and they would be $550. And that was for a total of #72 patches (what my doctor has prescribed). This is because insurance companies have set standards for what the believe is good quality care regarding medicines. Each medication has a 30 day quantity limit that insurance says "we won't cover more than X pills in 30 days because any more than that is unnecessary because we are your doctor and went to medical school and we know what is best for you."
Well because I knew I had a good reason for needing so many patches, I asked what else I could do and they suggested submitting a prior authorization for a quantity override. This is something the doctor's office needs to do.
I contacted my clinic and explained the situation so they would be expecting the form from the insurance. I also stayed on top of Cigna's pharmacy to make sure they sent them the PA to fill out. I never really heard what the decision was, but a week later received a gigantic box of 180 patches with a $10 bill. Not too shabby!!!
It never hurts to ask questions, to see what you can do to get a better deal. The other important thing is to be ahead of the game and ask questions BEFORE you get a bill for $550. I'm definitely glad I knew about prior authorizations before this experience because I had to do many of them when I worked at the pain clinic. Doing them can be a pain in the butt so I made sure to profusely thank my nurse for filling out the paperwork so that I was able to save a lot of money!
Also, as a side note, this is only an option for drugs covered by your pharmacy benefit. Most of the Starbucks plans do not cover any of the injectables under the pharmacy benefit...they go towards medical. If the drug is something you have a co-pay for, it falls under pharmacy.
My most recent "insurance win" is getting all these estrogen patches! That's 180 of them, and I got them for $10!
When I originally called the pharmacy to see what the cost would be, they told me insurance would cover approximately 16 patches for my $4 copay, but I would have to buy the rest out of pocket and they would be $550. And that was for a total of #72 patches (what my doctor has prescribed). This is because insurance companies have set standards for what the believe is good quality care regarding medicines. Each medication has a 30 day quantity limit that insurance says "we won't cover more than X pills in 30 days because any more than that is unnecessary because we are your doctor and went to medical school and we know what is best for you."
Well because I knew I had a good reason for needing so many patches, I asked what else I could do and they suggested submitting a prior authorization for a quantity override. This is something the doctor's office needs to do.
I contacted my clinic and explained the situation so they would be expecting the form from the insurance. I also stayed on top of Cigna's pharmacy to make sure they sent them the PA to fill out. I never really heard what the decision was, but a week later received a gigantic box of 180 patches with a $10 bill. Not too shabby!!!
It never hurts to ask questions, to see what you can do to get a better deal. The other important thing is to be ahead of the game and ask questions BEFORE you get a bill for $550. I'm definitely glad I knew about prior authorizations before this experience because I had to do many of them when I worked at the pain clinic. Doing them can be a pain in the butt so I made sure to profusely thank my nurse for filling out the paperwork so that I was able to save a lot of money!
Also, as a side note, this is only an option for drugs covered by your pharmacy benefit. Most of the Starbucks plans do not cover any of the injectables under the pharmacy benefit...they go towards medical. If the drug is something you have a co-pay for, it falls under pharmacy.
40 Years in the Making
Yesterday was the 40th birthday of the world's first IVF baby. Since then, there have been at least 8 MILLION babies born using IVF technology. That's the population of Hong Kong!
I got a little teary yesterday reading articles about what a miracle this is. The more you learn about IVF, the more unbelievable it actually is. I mean, how the heck do they have a glass pipette small enough to pick up a single sperm and insert it directly into a single egg?! If you've never watched a video on youtube of this, you really should. It's completely crazy. And to think someone did that for us, and created all these possible future babies that our bodies wouldn't have been able to do on their own.
I truly am grateful for the doctors and scientists that have made this technology possible. For the doctors today that continue to research and study human reproduction and embryology so that every woman has the hope and chance to carry her own baby.
I am grateful that I was born in this day and age and not 40 years ago. I'm not sure how I would feel about the whole process when it was first starting. I can understand how some people may be uncomfortable with the idea of "playing God" and creating children in a science lab. I probably would not have understood it when the technology first emerged either. So I'm grateful for the women before me who've pioneered the way. For the women who I personally know who have gone through this process. For the peace I've always felt when learning about IVF, even years before I knew I would take part in the process. For supportive friends and family. For Starbucks. For my Starbucks manager for giving me the chance.
My story, and the story of so many other men and women, started 40 years ago and I'm glad there's a day for me to remember that!
I got a little teary yesterday reading articles about what a miracle this is. The more you learn about IVF, the more unbelievable it actually is. I mean, how the heck do they have a glass pipette small enough to pick up a single sperm and insert it directly into a single egg?! If you've never watched a video on youtube of this, you really should. It's completely crazy. And to think someone did that for us, and created all these possible future babies that our bodies wouldn't have been able to do on their own.
I truly am grateful for the doctors and scientists that have made this technology possible. For the doctors today that continue to research and study human reproduction and embryology so that every woman has the hope and chance to carry her own baby.
I am grateful that I was born in this day and age and not 40 years ago. I'm not sure how I would feel about the whole process when it was first starting. I can understand how some people may be uncomfortable with the idea of "playing God" and creating children in a science lab. I probably would not have understood it when the technology first emerged either. So I'm grateful for the women before me who've pioneered the way. For the women who I personally know who have gone through this process. For the peace I've always felt when learning about IVF, even years before I knew I would take part in the process. For supportive friends and family. For Starbucks. For my Starbucks manager for giving me the chance.
My story, and the story of so many other men and women, started 40 years ago and I'm glad there's a day for me to remember that!
The Trial Transfer
The clinic called me on Wednesday saying they needed to reschedule the trial transfer. It worked best for me to just do it this morning (Thursday) and for me to go into work late. I actually am covering at another office today so I felt kind of bad, but I only got there 2 hours late and they had only had a few patients, so it worked out well!
The trial transfer was actually more uncomfortable than I was expecting! I was not prepared for it. It was just uncomfortable because I had to have a full bladder and they've got an ultrasound pressing right over the bladder, plus a speculum going up the other way, with a probe.
The reason they do the trial transfer is to check for polyps or anything else that may compromise the integrity of the transfer. Polyps can develop during stims because of all the extra hormones and you can usually not sustain a pregnancy with a polyp.
Everything went great and they cleared me to continue on with the process! Glad I don't need any additional surgery or time to wait for this transfer!
***As a side note, after the fact...the clinic did bill insurance for the trial transfer and it was covered 100%! Not sure if this is the same for all insurances, but Cigna at least did not have any problems. The clinic said doing this was pretty standard so most insurances with fertility benefits should cover it.
Next Steps
I feel like the last few months everything has been so focused on the egg retrieval. I knew the process and the plan and everything went great! Then last week I started feeling really lost. Like, what do I do now that I have 7 eggs frozen?
Today I went back to the fertility clinic to have another consult with the doctor to discuss next steps. we decided to plan for a transfer sometime this fall, after my body has had sufficient time to recover from the retrieval. I'm hoping to have it done by October 1st because that's when the Starbucks insurance year starts again so I'll have to meet deductibles all over again etc.
The first step is completing a trial transfer. I am scheduled to go in for this on Friday after work at Starbucks. I was thankfully able to give myself enough time to run home and shower before heading over.
OMG He's So Cute
So far I haven't posted too many personal things on here (like life outside IVF!) so I just wanted to take a minute and say how cute my husband is!
This whole process has been hard for him because he sometimes feels like it's more "my thing" than "our thing" since it's basically me going to the doctor all the time, and giving shots, and having procedures. It's not really 50/50 like traditional baby making. Because of this, it's been harder for him to get excited about everything going on.
But today I got this text from him...
I mean is this not the best ever?! It made my heart so happy. Nate researches everything before buying it. No matter how big or small. Usually it's tech stuff. He looooves new tech. So when he tells me he's spent so much time looking at baby stuff, I really can't describe how happy it made me!
It wasn't just baby clothes, but baby swings, car seats, strollers, monitors, cribs, and more!
Also, no, we did not buy $400 worth of baby clothes for a baby we don't know if we're having yet ;)
This whole process has been hard for him because he sometimes feels like it's more "my thing" than "our thing" since it's basically me going to the doctor all the time, and giving shots, and having procedures. It's not really 50/50 like traditional baby making. Because of this, it's been harder for him to get excited about everything going on.
But today I got this text from him...
I mean is this not the best ever?! It made my heart so happy. Nate researches everything before buying it. No matter how big or small. Usually it's tech stuff. He looooves new tech. So when he tells me he's spent so much time looking at baby stuff, I really can't describe how happy it made me!
It wasn't just baby clothes, but baby swings, car seats, strollers, monitors, cribs, and more!
Also, no, we did not buy $400 worth of baby clothes for a baby we don't know if we're having yet ;)
The Longest Week
The egg retrieval doesn't end your worrying because we got 26 eggs...it's only the beginning!
Eggs have to be at the perfect maturity in order to fertilize. Of the 26 eggs that were collected, only 19 of them were at the right stage to fertilize.
We had a procedure done called ICSI (intracytoplasmic sperm injection). In traditional IVF, they put the best sperm in a petri dish with the eggs and let them naturally fertilize. With ICSI, they individually take a sperm and inject it into an egg. HOW DO THEY DO THIS?! It seriously blows my mind. They literally have a little glass pipette that picks up a single sperm and injects it into an egg. How do they have pipettes that small?? I really wish I could get a tour of an IVF lab!
So when you leave the clinic after your retrieval you know how many eggs they retrieved. Your first update phone call comes the next morning when they tell you how many of your eggs are fertilized. As I said, 19 were at the right stage to fertilize and of those 19, 12 of them took to fertilization. We were a little disappointed by this. It seemed like such a big drop to go from 26 to 12 overnight! And fertilization seems like the easy part to me because how could the egg not fertilize when it's injected with a sperm?! I don't really know.
The next day you don't get an update. Ahhhhh the wait!
On day three they called to let us know that of the 12 fertilized eggs, 11 of them were still growing. The embryologist at the lab rattled off a bunch of numbers of how many cells each one of the eggs had because they were all at different stages but I didn't understand most of what she said. At the end I just said "so how many of those are good?" haha That's when I realized despite all of the mumbo jumbo she said, 11 were still good and growing. This was definitely more hopeful for me!
Day 4-- no update.
The clinic had been calling with updates around 8-9 am on update days but day 5 I didn't get a call like I expected. Not a huge deal except we were at the lake and going to go out on the boat for the day. When we got to the boat I had a missed call from the clinic even though my phone never rang! I had the ringer turned all the way up and held it in my hand the entire time because I didn't want to miss it. I thought they would leave a voicemail but no such luck.
I was really confused by this because I gave them explicit permission to leave me voicemails. Then I realized maybe my mailbox was full. My phone has a bad habit of not notifying me when the voicemail was full so I was super bummed! Since it was a Saturday there was no way for me to call them back. Day 5 is an important update too because they will freeze eggs that make it to day 5. So these were the final numbers of how many eggs we will have to work with!
We had a fun day on the lake and got home late in the afternoon. A couple hours after we got home I had a voicemail come through! Why it took sooooo long, I do not know.
They said that 4 of the embryos were far enough along to freeze and that they were going to continue watching another 4 that were slower growing but still growing.
Day 6- Our final update! The embryologist said 3 more had reached the stage where they could freeze them so we have 7 total to freeze!! This is really the best scenario I could have hoped for! I feel so happy having seven. It feels like the perfect number. It's more than just getting one try, but the likelyhood that all seven will result in a pregnancy is small so even if half of them took, we can still have multiple children! It just gives me so much hope for the future.
Eggs have to be at the perfect maturity in order to fertilize. Of the 26 eggs that were collected, only 19 of them were at the right stage to fertilize.
We had a procedure done called ICSI (intracytoplasmic sperm injection). In traditional IVF, they put the best sperm in a petri dish with the eggs and let them naturally fertilize. With ICSI, they individually take a sperm and inject it into an egg. HOW DO THEY DO THIS?! It seriously blows my mind. They literally have a little glass pipette that picks up a single sperm and injects it into an egg. How do they have pipettes that small?? I really wish I could get a tour of an IVF lab!
 |
| Not our egg...just a picture of what it would look like. |
The next day you don't get an update. Ahhhhh the wait!
On day three they called to let us know that of the 12 fertilized eggs, 11 of them were still growing. The embryologist at the lab rattled off a bunch of numbers of how many cells each one of the eggs had because they were all at different stages but I didn't understand most of what she said. At the end I just said "so how many of those are good?" haha That's when I realized despite all of the mumbo jumbo she said, 11 were still good and growing. This was definitely more hopeful for me!
Day 4-- no update.
The clinic had been calling with updates around 8-9 am on update days but day 5 I didn't get a call like I expected. Not a huge deal except we were at the lake and going to go out on the boat for the day. When we got to the boat I had a missed call from the clinic even though my phone never rang! I had the ringer turned all the way up and held it in my hand the entire time because I didn't want to miss it. I thought they would leave a voicemail but no such luck.
I was really confused by this because I gave them explicit permission to leave me voicemails. Then I realized maybe my mailbox was full. My phone has a bad habit of not notifying me when the voicemail was full so I was super bummed! Since it was a Saturday there was no way for me to call them back. Day 5 is an important update too because they will freeze eggs that make it to day 5. So these were the final numbers of how many eggs we will have to work with!
We had a fun day on the lake and got home late in the afternoon. A couple hours after we got home I had a voicemail come through! Why it took sooooo long, I do not know.
They said that 4 of the embryos were far enough along to freeze and that they were going to continue watching another 4 that were slower growing but still growing.
Day 6- Our final update! The embryologist said 3 more had reached the stage where they could freeze them so we have 7 total to freeze!! This is really the best scenario I could have hoped for! I feel so happy having seven. It feels like the perfect number. It's more than just getting one try, but the likelyhood that all seven will result in a pregnancy is small so even if half of them took, we can still have multiple children! It just gives me so much hope for the future.
Egg Retrieval Day
Whew! What a day it's been!
Since the retrieval wasn't until 10:15 I actually got to sleep in this morning. Usually I leave for work at 5:45 and we didn't have to leave for the clinic until 8:00. Nate working from home definitely has benefits so he was able to take a call in the car on the way there and work while I was in surgery so he didn't have to take a day off.
My clinic has their own surgical center in their office which is so convenient. It's so stressful when you go somewhere new and have to figure out parking and checking in etc.
After checking in, Nate went upstairs to give his contribution and I was brought back to my "room" to change and get comfortable. One of the nurses came in to talk me through the procedure again and go over all my post-op instructions. I also met with the nurse anesthetist who administered my IV (it was way easier than I was expecting or else she was really good!).
My doctor wasn't able to be there the day of the retrieval so one of the other docs from the clinic did the procedure. He came in and again went over the procedure and what I could expect post-op. Nate made a joke about not being able to go to Carowinds this afternoon and he didn't quite know what to make of it until I started laughing and he realized we were joking. However, he did tell me I was not allowed to just lay around all day. My estrogen was really high and I was at an increased risk for developing blood clots. He encouraged me to get up and do something in the afternoon.
All ready to go!
As they were putting me to sleep I noticed the clock on the wall...10:15 exactly. Man, they are good!
Super attractive post-op picture ;)
I was really worried about coming out of anesthesia but think I did great! It's just like I was sleeping and then I woke up and felt just fine! I don't know if I said anything goofy earlier because Nate had to wait in the lobby until I woke up. By the time he came back I was pretty much back to normal. Pretty much. I did take a post-op video of myself where you can tell I'm still a little loopy haha
I was definitely sore after the procedure but they had a heating pad on me which felt so good. Anyone that knows me knows I looooove a good heating pad. I should really buy one. I just have rice pillows I heat up in the microwave that I use all the time for cramps or just for a sore back and neck. They are my favorite thing ever.
Before leaving, the doctor came in to let us know we had 26 eggs retrieved! That's way more than I was expecting so I am super happy about that!
In total, we were at the clinic only 2 hours! It was super quick!
Since I wasn't able to eat or drink anything that morning, we went to find some food before going home. We settled on Panera since we hadn't had that in forever. As a side note, I really love Starbucks new Kitchen Sink cookie but Panera's put theirs to shame...it was so delicious!
When we got home I slept for 2-3 hours and it felt so good. Nate reminded me I was supposed to walk around some so we went to Sam's Club to do some grocery shopping. Then we called up our friends, the Bolin's, and went to dinner at Bad Daddy's then to see Uncle Drew in the theater.
I really wasn't in a lot of pain, but I was taking pain medication so it was doing it's job!
I'm debating on whether or not to go to work tomorrow. I had heard it was fine to go but then another nurse told me she wouldn't plan on it. I thought about going in for a few hours but since I'm still taking the pain medication regularly, Nate wants me to stay home. I think that's probably the best decision, even though I feel really bad not going because I missed today and I'm taking Thursday off to go to TN with Nate's family.
Since the retrieval wasn't until 10:15 I actually got to sleep in this morning. Usually I leave for work at 5:45 and we didn't have to leave for the clinic until 8:00. Nate working from home definitely has benefits so he was able to take a call in the car on the way there and work while I was in surgery so he didn't have to take a day off.
My clinic has their own surgical center in their office which is so convenient. It's so stressful when you go somewhere new and have to figure out parking and checking in etc.
After checking in, Nate went upstairs to give his contribution and I was brought back to my "room" to change and get comfortable. One of the nurses came in to talk me through the procedure again and go over all my post-op instructions. I also met with the nurse anesthetist who administered my IV (it was way easier than I was expecting or else she was really good!).
My doctor wasn't able to be there the day of the retrieval so one of the other docs from the clinic did the procedure. He came in and again went over the procedure and what I could expect post-op. Nate made a joke about not being able to go to Carowinds this afternoon and he didn't quite know what to make of it until I started laughing and he realized we were joking. However, he did tell me I was not allowed to just lay around all day. My estrogen was really high and I was at an increased risk for developing blood clots. He encouraged me to get up and do something in the afternoon.
All ready to go!
As they were putting me to sleep I noticed the clock on the wall...10:15 exactly. Man, they are good!
Super attractive post-op picture ;)
I was really worried about coming out of anesthesia but think I did great! It's just like I was sleeping and then I woke up and felt just fine! I don't know if I said anything goofy earlier because Nate had to wait in the lobby until I woke up. By the time he came back I was pretty much back to normal. Pretty much. I did take a post-op video of myself where you can tell I'm still a little loopy haha
I was definitely sore after the procedure but they had a heating pad on me which felt so good. Anyone that knows me knows I looooove a good heating pad. I should really buy one. I just have rice pillows I heat up in the microwave that I use all the time for cramps or just for a sore back and neck. They are my favorite thing ever.
Before leaving, the doctor came in to let us know we had 26 eggs retrieved! That's way more than I was expecting so I am super happy about that!
Since I wasn't able to eat or drink anything that morning, we went to find some food before going home. We settled on Panera since we hadn't had that in forever. As a side note, I really love Starbucks new Kitchen Sink cookie but Panera's put theirs to shame...it was so delicious!
When we got home I slept for 2-3 hours and it felt so good. Nate reminded me I was supposed to walk around some so we went to Sam's Club to do some grocery shopping. Then we called up our friends, the Bolin's, and went to dinner at Bad Daddy's then to see Uncle Drew in the theater.
I really wasn't in a lot of pain, but I was taking pain medication so it was doing it's job!
I'm debating on whether or not to go to work tomorrow. I had heard it was fine to go but then another nurse told me she wouldn't plan on it. I thought about going in for a few hours but since I'm still taking the pain medication regularly, Nate wants me to stay home. I think that's probably the best decision, even though I feel really bad not going because I missed today and I'm taking Thursday off to go to TN with Nate's family.
More Options
As egg retrieval gets closer I get more nervous that they won't get good eggs, or none will fertilize, or only a few will make it to day 5 to be frozen. There are so many factors!
One thing that I realized today is that if I don't have a good number make it to the freezing stage, I can just redo this whole process before transferring one to try and get pregnant. The part up through egg retrieval is what is the most expensive, and it wasn't nearly as bad as I thought it would be. I could totally do this again! I don't really have a specific number in mind that I want frozen, but I'm thinking if I have less than five I may do a retrieval again.
Hopefully I won't have to, but I feel really good knowing I have options and can best utilize this $15,000 infertility coverage while I still have it!
One thing that I realized today is that if I don't have a good number make it to the freezing stage, I can just redo this whole process before transferring one to try and get pregnant. The part up through egg retrieval is what is the most expensive, and it wasn't nearly as bad as I thought it would be. I could totally do this again! I don't really have a specific number in mind that I want frozen, but I'm thinking if I have less than five I may do a retrieval again.
Hopefully I won't have to, but I feel really good knowing I have options and can best utilize this $15,000 infertility coverage while I still have it!
The Trigger Shot
It's really amazing how they have all the timing of everything down to exact hours. I've been injecting the Cetrotide for 4 days to prevent my body from naturally ovulating. Now, the doctors want me to ovulate so they can retrieve the eggs. They time this out to the minute!
My egg retrieval is scheduled for 10:15 Monday morning. This means I give my trigger shot at 10:15 Saturday night because ovulation occurs 36 hours after the injection. There is no wiggle room with this one like the other medications where you could be an hour off and it wouldn't make a big difference.
I am spending the night at Teresa's house because our husbands are out of town on a job together and neither of us like being home alone!
The lupron was the worst one because it's so much medication to inject! Basically the whole syringe was full so it took a good 20 seconds or so to push it in. But now I'm triggered!
I will go in for bloodwork tomorrow morning before church to make sure the injections worked and then surgery Monday at 10:15!
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Signing Off...for now
It's been a crazy year and a half but it's time to say goodbye to this blog for now. I may post updates occasionally, but you know ...
