Disclaimer: I have no qualms about sharing very personal details. The purpose of this blog, aside from my own need for it, is to be a support to other same-sex couples going through the process. If an anxious woman can get some sense of what to expect, or just find comfort in someone else's sharing of their real experience, both the good and the ugly, then I will be happy. There's no point to me in having this blog if I just offer pretty summaries. So if you are not a fan of TMI, here's your warning.
My fertility doctor told me to go for the ultrasound to assess my cyst as soon as I started my next period. My last period was two weeks late, which has never happened before, so it threw me off in my counting. I tracked from that period, which would put me at my next one around Halloween. However, I guess because that one was late, my body was off, and it came a full week earlier than I'd expected.
I woke up Wednesday thinking, "Oh no. Not today. I have too much going on today to call out sick and go into a radiologist. It was supposed to happen next week! I kept those days clear of anything necessary! Today I have a meeting that MUST happen by the end of the month, and I know one of the participants has no other flexibility before then. And I'm scheduled as the closing supervisor, so I'd have to call around for someone to cover for me. Maybe Nicole can drop me off at the radiologist first thing in the morning and then I can take a cab to the train and maybe, just maybe, still make it for my 11:00 meeting. Oh why today!!"
Oh little baby, you are but a twinkle in your mama's eye and you are already giving me a lesson on sacrificing for you and on accepting what little control I have when it comes to you. There is no such thing as perfect planning - life has a mind of its own, and is not concerned with my schedule!
It ends up that there were no available appointments before Friday morning, so all of that went out the window and I had no choice but to wait until two days into my period. I was signed up for the Third Annual Transgender Conference in Manhattan for Friday and was bummed about not being able to go, but knew it would be far from ideal to wait until Monday - plus, Monday was another crazy day that I didn't know how I'd get out of. The world wouldn't end if I couldn't go to the conference.
I followed the instructions on my referral to a tee: empty my bladder an hour and a half before the appointment, and then drink 48 oz. of water. (I have a small bladder capacity, plus I'd had caffeine that morning, so I drank 24 to keep from bursting.) My appointment was at 1:30 and was less than five minutes from Nicole's office, so I swung by her a little after 12:00 for a lunch date. What a treat!!
When I signed in, the receptionist asked if I'd drunk water, and I said I had. Then I gave her my referral, and she looked at it and said, "Oh, you didn't need to do that for this. Go use the bathroom if you want!" I happily obliged. Then the radiology tech came to get me as I was leaving the bathroom and said, "Oh, you emptied your bladder? It'd be ideal to have it full, but that's okay." Gar!!!
After already having had a Pap smear and an "initial consultation" transvaginal sonogram, I was more comfortable getting into position in the stirrups. Still a little awkward, of course, but it was my third time in less than a month!
The tech started with an external pelvic exam. It was strange to have ultrasound gel rubbed over my empty abdomen - not an experience I associate with non-pregnancy. She pressed around for quite a while, and then proceeded to do the transvaginal sonogram. The fertility doctor had had the wand in me in a second like a boss, but the tech slid it slowly down the outside and told me to tell her when it was in position so she could push it in. AWKWARD. I said, "I think you're there. I'm married to a woman, so I'm not used to these instructions." She blinked.
The internal exam seemed to last FOREVER. It had to be at least 20 minutes, possibly longer, and felt like an hour. I felt it only mildly for a good 80% of it, and my mind would actually drift to mundane things. Then there would be a lot of pressure and discomfort and I'd watch my breathing the way I've been learning to do in our five-part meditation series at temple, in an effort to stay calm and kind of dissociate. We tie the weekly Torah portions into the meditation, so I focused on that imagery. "Ow ow ow Abraham sitting in the opening of his tent. Ow ugh ow Noah floating at sea with no control just letting the waves move him." I wonder what my rabbi would think about this first experience of using the practice outside of the classes!
When the tech made conversation with me, she was sweet and encouraging about the fact that I was doing this as a precursor to fertility treatment. She said, "so you want to have a baby, how exciting!" Then after the exam, after she'd given the pictures to a doctor for approval that she'd gotten everything she needed, I swear she gave me a super sympathetic look as she said goodbye. Like a sad "Good luck with everything." It really made me apprehensive. Clearly she would have a pretty good idea of what she was seeing, but there had been a large sign on the wall that said, "Technicians are not at liberty to discuss results with patients," and I had respected that. So now I have to wait up to a week for my fertility doctor to get the results and call me. I don't anticipate much more than, "Yep, big fat cyst, that bad boy's gotta go. When do you want to schedule the surgery?" But the tech's mannerisms with me at the end really threw me for a loop and made me a bit anxious.
Luckly, I'm a pretty go-with-the-flow personality. Nothing I can do til I hear from my doctor, and fearing the worst or hypothesizing what unlikely things could be happening is not my style. It certainly won't help or change anything.
So now we wait.
wedding
Friday, October 25, 2013
Saturday, October 12, 2013
First Consultation
FINALLY the day had arrived!!! I was giddy-excited every day for about a week before our appointment at a reputable fertility clinic nearby. I had all my paperwork filled out for well over a month, and I had it all in a folder to bring with me Friday morning. Nicole had begun to get quite anxious and couldn't talk about it at all. For instance, I just mentioned to her one day that I had looked up the doctor and she was Finnish, and she said, "Can we not talk about this right now, please?" She took the day off work and was a rock for me throughout the appointment, but she could not handle the anticipation of it and had to try to keep it off her mind til the last possible second. We are learning a lot about how to respond to each other's needs throughout this process!
We met with the doctor first so she could go through my medical background. She asked many questions that I had already painstakingly answered on the huge stack of paperwork that she was clearly not reading. She asked me to tell her more about my concerns regarding possible hormonal imbalances, which I had mentioned where it asked if I had any additional comments or concerns. (I guess she read the "comments" section, at least.) I told her that many of the women in my family have hormonal issues and that I just wanted them to know that since I have never been tested for anything like that and it could affect my fertility. She said my thyroid levels are normal and that my menstrual symptoms (such as breast tenderness) and regular cycles lead her to suspect that I ovulate regularly and don't have any hormonal issues. Great news! This had actually been my primary concern, so once she said that, I relaxed a lot. Not so fast there, Rach.
She did a basic transvaginal sonogram to get a sense of whether there were any major fertility issues to start with, and saw a huuuuge cyst on my left ovary. There are several there, but one of them was pretty massive and of concern to her. She also said my left fallopian tube looks dilated, but that it was hard to tell because of the cyst and it could just be related to that. She gave me a referral for a radiologist to get more information and said we will go from there. She said the cyst will likely need to be surgically removed, and that it has to be taken care of before we can do anything else.
As I struggled to keep my tears under control, I let the assistant usher me to the person who would counsel me on cost and insurance coverage. I was told that my insurance will not cover any treatment unless there are diagnosed fertility barriers - not necessarily total infertility, but anything that could make it more difficult, such as PCOS. If there are no diagnosed barriers from the start, then I would have to have 12 failed inseminations before my insurance would cover treatment, and by that point we would already be moving on to other alternatives anyway because it shouldn't take anywhere near 12 in a healthy, fertile woman of my age. This is consistent with the information I'd gotten in advance directly from my insurance company, but I had hoped that the clinic would know some way to get around it.
If the next ultrasound shows that my left tube is in fact blocked, they can probably get it covered by my insurance as "pathology" even though my perfectly healthy and functioning right ovary should make it pretty easy for me to get pregnant. However, if my tube is NOT blocked, then once the cyst is removed, I will be considered fertile and healthy and will need to pay $1900 per insemination, on top of the $500-$1000 for each vial of sperm.
My heart sank. At that price, we would only be able to try maybe three times in a year! It's ironic for us that, after our initial relief that the fertile one of us would be the one trying to get pregnant, Nicole would automatically be covered by insurance if she were the one trying. It's also ironic that I am hoping and praying for a dilated, blocked fallopian tube. (I think it's unlikely, though, considering that I tested positive for ovulation every month back when I was checking. Shouldn't it only be about every other month if one side was out of commission?)
This certainly wasn't what I expected going into this appointment. Aside from the pregnancy issue, it shook me up to know there is this huge cyst on my ovary that might have to be surgically removed. I didn't expect to leave there possibly needing surgery before I even try to get pregnant. I'm still trying to wrap my mind around that. But it is what it is, and I'm glad to know now and to move forward. I have to get the ultrasound as soon as my next period starts, and then I should be contacted within a week of that by the doctor to discuss next steps.
Let the journey begin...
We met with the doctor first so she could go through my medical background. She asked many questions that I had already painstakingly answered on the huge stack of paperwork that she was clearly not reading. She asked me to tell her more about my concerns regarding possible hormonal imbalances, which I had mentioned where it asked if I had any additional comments or concerns. (I guess she read the "comments" section, at least.) I told her that many of the women in my family have hormonal issues and that I just wanted them to know that since I have never been tested for anything like that and it could affect my fertility. She said my thyroid levels are normal and that my menstrual symptoms (such as breast tenderness) and regular cycles lead her to suspect that I ovulate regularly and don't have any hormonal issues. Great news! This had actually been my primary concern, so once she said that, I relaxed a lot. Not so fast there, Rach.
She did a basic transvaginal sonogram to get a sense of whether there were any major fertility issues to start with, and saw a huuuuge cyst on my left ovary. There are several there, but one of them was pretty massive and of concern to her. She also said my left fallopian tube looks dilated, but that it was hard to tell because of the cyst and it could just be related to that. She gave me a referral for a radiologist to get more information and said we will go from there. She said the cyst will likely need to be surgically removed, and that it has to be taken care of before we can do anything else.
As I struggled to keep my tears under control, I let the assistant usher me to the person who would counsel me on cost and insurance coverage. I was told that my insurance will not cover any treatment unless there are diagnosed fertility barriers - not necessarily total infertility, but anything that could make it more difficult, such as PCOS. If there are no diagnosed barriers from the start, then I would have to have 12 failed inseminations before my insurance would cover treatment, and by that point we would already be moving on to other alternatives anyway because it shouldn't take anywhere near 12 in a healthy, fertile woman of my age. This is consistent with the information I'd gotten in advance directly from my insurance company, but I had hoped that the clinic would know some way to get around it.
If the next ultrasound shows that my left tube is in fact blocked, they can probably get it covered by my insurance as "pathology" even though my perfectly healthy and functioning right ovary should make it pretty easy for me to get pregnant. However, if my tube is NOT blocked, then once the cyst is removed, I will be considered fertile and healthy and will need to pay $1900 per insemination, on top of the $500-$1000 for each vial of sperm.
My heart sank. At that price, we would only be able to try maybe three times in a year! It's ironic for us that, after our initial relief that the fertile one of us would be the one trying to get pregnant, Nicole would automatically be covered by insurance if she were the one trying. It's also ironic that I am hoping and praying for a dilated, blocked fallopian tube. (I think it's unlikely, though, considering that I tested positive for ovulation every month back when I was checking. Shouldn't it only be about every other month if one side was out of commission?)
This certainly wasn't what I expected going into this appointment. Aside from the pregnancy issue, it shook me up to know there is this huge cyst on my ovary that might have to be surgically removed. I didn't expect to leave there possibly needing surgery before I even try to get pregnant. I'm still trying to wrap my mind around that. But it is what it is, and I'm glad to know now and to move forward. I have to get the ultrasound as soon as my next period starts, and then I should be contacted within a week of that by the doctor to discuss next steps.
Let the journey begin...
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