A winding path
In my last update, I was in the midst of my 5 days of Letrozole, the medication that helps follicles develop. I was feeling optimistic about this next cycle. If I got pregnant the first cycle, maybe it’s not too far reaching to think that I’d get lucky again on the second.
That quickly turned to a brush with reality, which involved my follicles growing at a slower rate than last time. Instead of triggering at day 14, I couldn’t trigger until day 17, and my lining was pitifully thin again at 5mm. The timed intercourse was then ‘prescribed’ the day after trigger instead of the day-of, which confused me. But we did as doctors ordered.
And no pregnancy last month. Okay, not a big deal, let’s keep it going.
NOPE. The nurse said, “well in your notes, the next step is to meet with Dr. RE. So I’ll just transfer you to the assistant, okay?”
Blink. Okay, I guess? Not starting another cycle? “This is what the notes say.”
I am able to schedule the consult with the doctor two weeks later. “She probably just wants to talk to you because you had poor results.”
Poor results. I got pregnant 1 of 2 attempts. How is that poor results? A chemical pregnancy isn’t terribly uncommon. Why am I considered to have poor results? Callous, thoughtless words. I feel my optimism of our chances of getting pregnant drop twenty points.
In the mean time, I am furious. Two weeks of wasted time, where I could start letrozole again and begin monitoring. If we have to stop everything and talk to the Dr., does that mean she has bad news? Why can’t we keep going in the mean time? What if she sees something in the results that is really bad?
On two occasions, Mr. Druzy used the phrase “if we have kids”, which is like lightening in my brain. Is there still a reality where we do not have children?
I did a pretty good job at not fixating and counting the days ’til the appointment. Just temping as usual, waiting. We decided to book a trip to France in the spring, paying for the extra coverage that lets us cancel if we need to, including for reasons of pregnancy. Just in case. But fuck you, if I can’t have a baby to look forward to, let me have a vacation to look forward to.
At the RE’s appointment, we come prepared with a list of questions to make sure to answer. What can we do about the thin lining? What are the odds of another miscarriage? What do we need to know about IVF? What does our insurance cover?
We also arrive on the heels of a conversation about how far we’re willing to go, my husband and I. I still don’t know about IVF. It feels stupid to think of “giving up” while there are viable options still available to us, if ever the Dr come to us and says we need to move forward. But I also just really don’t like the invasiveness, the expense, the hormones, the risks, the unknown. Mr. Druzy and I don’t really have a clear boundary defined, but talking about our feelings helped.
“So, did you take Letrozole this cycle?” the Dr. asks.
“Um. No. The nurse said I had to come see you.” Blink. Hackles raising.
“Oh, well you could have just started the next cycle.”
The fake smile on my face flickers, I can feel it. “Well, that’s really annoying, because I was not informed of that.”
The Dr can sense the change in my disposition and apologizes a few times, typing furiously on her keyboard for a moment. I hope reprimanding whichever shitty nurse didn’t communicate that.
We move on. The Dr seems quite pleased that I got pregnant and had obvious implantation, and not to worry about the miscarriage. No reason to think there’s any higher chance of having another one. My lining thickness is a bit of an issue, but healthy pregnancies can happen with less. She says I can take a blue pill to, er, get estrogen nearer to the site where it would be helpful to boost the lining. Sure. I’ll do it.
She mentions that we could move on to IUI, but that it only gives an extra 2–3%. Mr. Druzy and I are both happy to proceed with regular ol’ sex, thanks.
She also mentions that we can move on to IVF at any time, but she saw no reason to not try another couple cycles with our current protocol. That gave me a sigh of relief. She mentioned IVF a couple more times, but didn’t actually push it on us. I am grateful for that. We’re not yet at that bridge.
In terms of moving forward, I assumed I’d have to go on the birth control pill to “reset” my body, but Dr. RE said that because my cycles are so long (up to 200 days), I should get a baseline test done the next day and maybe I could just start with the Letrozole if things look okay.
I’m pleasantly surprised at the option. That is the first good news I’ve heard in a while. She schedules my appointment, we’re awkwardly whisked off to the nurse before we can ask any more questions, and unfortunately Dr. RE disappears completely. But at least we are moving forward again.
So the next day, I get another blood draw and ultrasound. I always tell myself, “I’ve had so many blood draws, this one will be fine,” but they always manage to hurt just as much. The ultrasound technician said that she saw a few small follicles, and one measuring more than 10mm. That’s means one is beginning to mature, so I’m skeptical about being able to start letrozole.
I wait for the nurse to call. I have a two hour presentation that takes my mind off it for most of the day, but 2pm rolls around and I get annoyed that I haven’t heard anything yet. I left a message at 3pm. At 3:30, I get a call from the Dr’s office—not from the nurse, but from the financial department.
“We can’t proceed with your next cycle because you have an outstanding balance from March.”
My heart jumps. Oh, crap! How does this happen. We never received a bill in the mail, or an email, unless it got lost. I ask how we would have been notified about the balance. The woman on the phone pauses for a second, a though she is squinting her eyes at whatever screen.
“Oh, um, it looks like we never actually billed you. They tried to get your husband’s semen analysis covered by insurance, but it wasn’t, and we never sent the bill to you.”
“…” How the fuck does this sort of thing happen.
“I’m so sorry, you know what, I’m going to just put this through so that you can get started, and you’ll get a bill in the mail next week.”
“Okay,” my heart lightens a little. Not actually a roadblock. We hang up, and she promises I’ll hear from the nurse soon.
At 4pm, finally I hear from Abby, one of the nice nurses.
“So you can start Letrozole tonight, and we’ll schedule your first monitoring appointment on September 16!”
I am taken aback, surprised, happy, but—“But I don’t have a prescription for the Letrozole, the special pharmacy always had to mail it overnight to me.”
“Oh no worries, I can call it in to your local CVS and you can pick it up tonight.”
I am relieved, but I inform her that Mr. Druzy and I are going out of town on the 19th for 5 days. Abby the nice nurse says there’s no way to tell if that will interrupt monitoring or not, and to just hope that it won’t. So there’s a chance this could get fucked up, but, I won’t think about that until it actually becomes a problem.
Well, yay! I have happy news for Mr. Druzy when he gets home. At 6pm, we take the dog for a walk down to CVS and wait in a long line at the pharmacy counter. Finally I give my name to the pharmacist, and she pulls out a suspiciously thin package. I look at it to confirm.
“No, this is not the correct medication.” I point out. It’s actually the auto-refill of birth control that I told them 5 times via text message to not refill. “My doctor called in another prescription at 4pm today.”
The pharmacist is confused by my preposterous story and calls for backup. They tap away on the computer. The other pharmacist says, “We don’t have anything in our system. What is it for?”
“But my doctor called it in two hours ago, it’s for Letrozole.” I feel annoyed by being “outed” and having to say the medication out loud, to the other people in line around me.
“We don’t have it. Sorry,” and she waves me on.
I. am. livid.
It’s now 6:15pm and my doctor’s office is long closed. I step out outside and wait through the emergency line prompts.
…if this is about X, call 9–1–1, if this is about Y, wait until business hours, if this is about Z, wait for the zombie apocalypse…
I’m not exaggerating, it was 3 minutes of prompts. Finally, I end up leaving a message with someone, who will pass on my information to another someone, who will then call me back in the next twenty minutes. Thankfully, she does not that long after.
“Not to worry, they probably just haven’t checked their voicemail even though they’re supposed to ever hour. Abby wrote down the pharmacy’s information here, and she called it in at 4:11pm. I’ll call and find out what’s going on for you. You’ll get your Letrozole tonight!”
This person is so nice and calm. I thank her a hundred times, and when she calls back just a few minutes later, her voice is bright.
“They didn’t know if it was on their voicemail or not, so I just gave it to them over the phone, no more room for error!”
Praise be! I did get my Letrozole in the end, and started taking it last night. Vivid dreams abound, I am glad to be officially started on medicated cycle #3. Let’s just hope the timing around monitoring works out.
