Monthly Archives: May 2014

A good decision is based on knowledge not numbers – Plato

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We learned early on during J’s health issues that you try to find the most knowledgable doctors possible and hope that they know enough about their speciality that they fix you. We didn’t find that in Atlanta, so we went to NY (Mount Sinai to be exact) and we found really smart doctors. Unfortunately their “smartness” didn’t continue past two brain surgeries, so we went and got smart doctors in Louisville. And there you have the team of doctors.

I am saying all of this, because we went to GRS because they are smart. They know what they are doing. I realized this even more when Dr. Perloe did all the research on Follistim for Jesse. LEARNING POINT: Makes sure your doctors are listening to you. Make sure they ask questions. Make sure they do their research and understand what you are going through. No infertility journey is the same, so don’t let them treat you like it is.

So you remember we decided to do IVF before we came back from Louisville…when we got back to Atlanta and met with Dr. Perloe, he was pretty sure that we should try 2 rounds of IUI before IVF. J’s #’s were way better and it was silly to not try. And not to mention we still had to see if the Follistim helped. PLUS– there was a IVF trial that they were hoping to do and maybe we would be candidates for it if it actually happened. Hence the title to this post…when we were in Louisville we made a decision to do IVF based on numbers, but we decided to go down the IUI route based on knowledge. But before we did anything I had to have a HSG* done. I was totally petrified about the idea of having dye shot through my fallopian tubes to make sure there was no blockage. FYI– don’t google it. Everyone says it is the worst pain they have ever had. I promise you…it’s not. My friend Christina told me it was a piece of cake, and she was right. If you are reading this and you are going to have one…deep breaths, its over fast and you will be fine.

Making the decision to do IUI was one that meant we needed to plan. We had to time things based on my cycle and of course we had a vacation planned right smack dab during that time that it was supposed to happen. One of the weirdest things that has happened to me during this journey is that after 23 years of always being like clockwork, I am now always late…and March was no different.

*HSG – Hysterosalpingogram – is a uterine xray where they shoot dye through your fallopian tubes to make sure that they are open and ready for the egg to travel.

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Money vs Desire

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While we were in Louisville we got a call about J’s recent sample. Numbers went up and Dr. P felt like we could try IUI twice, and if those didn’t work, we would move to IVF. What?!? He was almost at nothing 4 months ago and this was HUGE. Problem was, IUI costs anywhere from $1000-$2500 depending on meds, and we were still looking at a $24,000 IVF bill if they didn’t work. That’s when we went into Mindy and Jesse decision mode. We went to different corners, he thought it through and I thought it through and then we would come to a decision. What I am about to say will sound cold to most people, but I promise you, it has been the only way we have been able to get through his health issues and this. We have learned to look at everything without emotion.

When you are trying to have a baby, and you go through the emotional realization that it isn’t going to happen naturally, thats when you have to leave it at the door. You have no control. You can’t plan. All you can do is make the best decision for you and your partner and hope that you make the right one. We had to weigh the financial impact of choosing IUI, the emotional part would have to be the least important. We know that we can get through anything emotionally. Financially is a different question. It’s a lot of money.

But like I said we make decisions as a team, and we both came back and said,”IVF!” However, if Dr. P says that IUI has a chance, then we go to IUI and that will be that. But he better come with some solid evidence that this thing would work!

HERE IS A LEARNING POINT: You have to go into this as a team and understand that while you may think you can control anything and everything…you can’t. Yeah I know what you are saying…”Mindy, of course we are a team! We are married ” but I am telling you that you aren’t a team just because of that. You are going to have to abandon all sense of being an individual and make decisions on how it will impact you both. Don’t make decisions based on how badly you want something. Make them based on what you feel like you can handle. Don’t think that one person’s feelings are more important. Don’t belittle the others opinions bc they aren’t yours. Listen, empathize and let the experts give you guidance. You don’t know more than your doctors. Nothing is a guarantee. The only thing that is a guarantee is that this is hard. This will challenge every idea you have around your life. But if you are a team when you go in, you will emerge as a team (and hopefully with one more member)!

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Well HELLO Georgia Reproductive Specialists!!

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January 15, 2014 at 2:00 pm, Jesse and I walked through the doors of Georgia Reproductive Specialists (GRS) for the first time as a couple. We had our pages of paperwork filled out, we handed them our insurance cards and we waited. The insurance card thing was more of a formality, bc neither one of our plans covers anything related to fertility. I found that out way before that day. That’s right folks, everything was going to be paid for with cold hard cash. When you start down the infertility path, you have to accept that you are either going to be one of the lucky ones with fertility coverage, or you are going to feel like an atm, always handing out money. However, I will tell you that this is one of the only times I don’t resent having to pay. We want a child. We are lucky to have two great jobs. We will figure it out.

Anyways, we had our first consult with Dr. Perloe and Jaclyn (his IVF nurse) and they were amazing. Welcome to the team GRS! He reviewed everything, and just like every doctor who sees Jesse’s history, was excited to take on the task. Jesse’s #’s with the HCG had gone up on a test he did a couple weeks prior (YAY!!!), but they were still in the lower spectrum,but that test was also a bit early, so he had Jesse come back in for another sample. Dr. Perloe also suggested that we add follistim* to the protocol. (In fact, he read several case studies and called me that night to tell us that he was confident that would help…that’s right…on his own, he read journals and called other doctors to find out their opinion… ❤ ❤ him!) Even with all of that, he felt that IVF* with ICSI* was going to be our best route. B/c of my age, and the fact that we probably would want two children, we would do two egg retrievals, to maximize the # of eggs we would get, and ultimately the # of embryos we could make. Plus, much to J's chagrin, I am not really too excited about the twin thing (it scares me), so I wanted to opt-in for the embryo testing to hopefully only have to do single embryo transfer.

After Dr. P, we met with Jaclyn. She is the IVF nurse who goes over the financial side of things. Actually, I met with Jaclyn. Jesse left me to hear the hard stuff to go back to work. Did I mention we are paying out of pocket? 🙂 I can't say I was shocked at the number. But I can say it was a bit daunting. All in (two egg retrievals, ICSI, genetic embryo testing, medicine and procedures) we were looking at $24,000. (Don't throw up…I didn't…and it really isn't this expensive for everyone…I PROMISE) I joked about the fact that I was going to create a line of baby clothes for IVF-produced babies called $25K ($24k wasn't as pleasing to the eye). In fact, I still might do it! That $24,000 became our reality and I left that meeting encouraged and hopeful.

We were headed to our Louisville team that next weekend anyways, we had to confirm with is endocrinologist (Dr. A…he is awesome too) that he was ok with the follistim, and then we would get moving. Jesse dropped a sample before we left and we hopped on a plane and met with team Walker to make sure we could make the baby.

*IVF – in-vitro fertilization: woman gets all hopped up on egg producing meds, they put her to sleep for a few minutes, grab those eggs, and depending on fresh or frozen, get those eggs together with the sperm (either "natural introduction" or ICSI) The eggs/sperm then hang out and some become strong embryos for transfer

*ICSI – intra-cytoplasmic sperm injection: instead of letting the little guys meet the eggs in a petri dish and do their thing, they isolate a strong one and inject it directly into the egg. AKA–some pretty cool shit.

*Follistim-a medication used for ovulatory stimulation, there has been significant research that shows in conjunction with HCG, it has helped significantly increase the sperm in a man.

Testosterone? We don’t need no stinking testosterone

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So as I mentioned in the last post, testosterone is the villain in our infertility journey. When someone has their pituitary gland removed, like Jesse, you have to supplement the loss of that with meds and injections. So in October, after my doctor first mentioned IUI* (anytime you see an “*” I will include a definition below), we realized that we needed to change something in the protocol. We have an amazing network of doctors in Louisville who manage Jesse’s care. We joke about the fact that every time we find a new hurdle, we just add another person to our “team”. We think we have enough for a full basketball team at this point. Our team decided to take J off of the testosterone and put him on HCG. The HCG needles are huge and jesse takes a lot of it…it makes me sad.

IUI is a tricky thing. You need “borderline normal” counts, and in the world of infertility, that is at least 5-million post wash* sperm. The average male needs about 90 days to to develop new sperm, so starting all of that in October basically put us to December/January before we could really even look at starting IUI. That three months gave me a lot of time to immerse myself in reading WAY TOO much stuff on the internet.

I am what you call a “google-aholic”. I google everything. I now know all about morphology, motility, LH surges, estrodiol levels, HSG, IVF, ICSI…and the list goes on and on. It also led me on the journey to find the right reproductive endocrinologist and practice. I live in Atlanta, as many of you know, so there isn’t a shortage of places to go. Georgia Reproductive Specialists (GRS), Reproductive Biology Associates, ACRM, Emory Reproductive, etc. I called them all. I googled them all. I read every single post on their pages. One called me back, and it happened to be the one I was going to an open house for: Georgia Reproductive Specialists (GRS).

Don’t get me started on how great they are at GRS. Dr. McCarthy-Keith did the open house. She spent time with all of us, answered any questions I had, and I knew at that point I was going to like this place. I didn’t realize that I could like it anymore, until I met Dr. Perloe, Jaclyn, Yolanda and all of the amazing nurses and staff. But that didn’t happen for a couple weeks…and that’s when things got real.

*IUI – Intrauterine Insemination: Basically they take the man’s sperm and use a syringe to inject it directly into a female’s uterus. Think of it as the often joked about “turkey baster method”. Expect only cooler.

*Post Wash Sperm – So when a man does the “deed” in the awkward room, they hand the sample over to the clinic. When having sex, only the strongest sperm get to the uterus, however with IUI they shoot it directly there and there is risk of infection if those “lesser” sperm get up there. So they take the sample, and filter out the strongest of the strong and that is the sample that is used.

***Please note, I am not a doctor. These are my simplistic explanations, but they get the point across***

Houston we have a problem

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After Jesse was sick, he was put on so many medications it wasn’t even funny. We have pills, we have injections, the only thing missing was a suppository, (don’t fret, those come later). You never know what medication does to you. So many different cocktails and mixes and even though they make you feel better, in the end you really don’t know how they impact your chemistry.

Months passed and Jesse was getting stronger and healthier. We started to realize that we actually may have everything in the rearview. The super hero was coming back and that was a good thing. Fast forward to September 2013, and we were reminded that we weren’t normal. While we were lucky enough to get pregnant, we were just as unlucky to lose it. Nothing prepares you for a high so high as seeing “pregnant” on a test, and the low that you hit when not only two days later you see “not pregnant”. It was at this point I knew I needed to go to the doctor.

Ahhh, the doctor. I am the girl who hadn’t been to the ‘lady doctor’ in 4 or 5 years. I called my amazing friend Lisa and she recommended Alliance OBGYN, Dr. Hsiao to be exact. Hsiao is amazing. He is funny. He is just what I needed in my life at that point. We did ultrasounds. We did blood tests. And we ordered tests on Jesse. You see– when you are 36 and you are trying to get pregnant and it doesn’t happen, you break out the big guns. My tests were easy and relatively not embarrassing. However, you men…well, you guys have a different story…sorry about that. 🙂

Fast forward to the test results and we find out that the medicine that was keeping Jesse healthy (testosterone, he has no pituitary gland) basically makes it impossible for him to have strong swimmers. So for all of you meatheads out there that are shooting up to get big…you should stop if you want to have kids! Luckily science has an alternative in HCG, so the injections switched and we kept on down the path.

So for those keeping track on where we are at this point in 2013: Pregnant… Miscarriage… testosterone is evil…HCG isn’t.

It’s funny the way things happen…

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April 23, 2011, I married Jesse. We had our whole family surrounding us (minus my daddy) in one of my least favorite places in the world, Las Vegas, and we made it official. We knew he wasn’t 100% healthy, but nobody knew what was wrong with him. I joke about it now, telling him he did the bait and switch, but in reality…things got bad…REAL bad. The next two years saw more hospitals, medications and versions of Jesse than I ever thought possible. I saw a man who was as close to a super hero as possible, become a man that was on the brink of death…twice. And yet we emerged from that two-year “life coma” stronger and more determined than when we entered it.

We knew our life was never going to be normal. What normal 30+ year old has to take a bag full of medications and syringes when he goes away for a weekend, but it has become our norm and we are really ok with it. I guess our acceptance of this made what I am dedicating this blog to a bit easier. I have been pretty transparent that “something” is going on in our life, and most people have figured it out, but our “normal” has now taken us down the infertility road.

I have been amazed at how taboo the subject is. Many women and men take this journey in secret and feel like there is some sort of shame around it. I refuse to do that. I know that our journey isn’t going to be an easy one. I know that the medication that keeps my husband healthy is the same thing that started us down this road. But the most important thing I know is that science is the only thing preventing us from having a baby…but it is also the #1 thing that will allow us to have one.

I promised the ladies at my reproductive clinic that I would blog. You see, they are encouraged and amazed at how Jesse and I are getting through this, and felt that if one person could read how we are embracing everything and let it help them, then it would be a good thing.

So “My Life in the Rearview Mirror” is now dedicated to this journey. I have a lot of catching up to do…so the blog posts will be going back in time, but I promise to be 100% transparent and 100% available to anyone reading.