delays.

I had my appointment about a week and a half ago now.  It was the big appointment I'd been waiting and waiting for -- where they'd do my mapping and give me the run-down on my schedule.  I had anticipated and anticipated it, and then suddenly it was here (after much frustration that you can read about in recent posts),

When I got to my doctor's office, I was welcomed with the same warmth that I always was.  I was instantly relieved to be there and so eager to learn everything that was to come during my appointment.  My wait was short, and when it was my turn to be seen, they took a full IVF work-up of blood work that will test for all kinds of STDs and other viruses ... They took quite a bit of blood, but I'm so used to it by now that I actually felt excited to be sitting in that chair with the nurse and a needle in my arm.  Progress!

I spent a few more minutes in the waiting room until the infertility nurse and RE could see me for my ultrasound, but it wasn't long at all.  They took me back and had me change and prepare for the ultrasound.  They performed a transvaginal ultrasound to take a look at my system and measure the depth of my uterus and of my cervix, as well as to note the shape and curve of my uterus (something I had never considered before).  They were pleased that there wasn't an extreme curve to my uterus, so I was pleased, as well -- not really knowing why that was such a great thing until I asked.  Apparently the less curve you have to your uterus, the easier it is for them to transfer the embryos via catheter on the big day.  Yay for not a lot of curvature!

They counted the number of follicles I had going on each ovary and seemed really shocked to see as many as they did.  Remember, I had 27 cysts when I was diagnosed with PCOS -- no dominant follicle(s).  So when they revealed their surprise, I was totally freaked.  The doctor even mentioned that he couldn't believe I had as many as I did after being on Lupron, the pill, and Metformin.  In my mind, I was thinking everything I had been through wasn't working.  I was afraid I couldn't move forward.  I was afraid we would have to try something else, or they were going to tell me this was the end of the road.

They continued on with the actual mock embryo transfer which involved them actually threading the catheter through my cervix and extending it all the way to the fundus of my uterus (back of the uterus).  The catheter literally poked me in the back of my uterus.  (This was just for measurement purposes and they will definitely not poke me on the actual day of transfer.)  My nurse kept her hand on my belly during the whole procedure letting me know it was normal to feel crampy or to feel painful twinges.  She said some girls have a harder time with it than others.  I did completely fine the entire time.  I didn't experience any cramping or pain, and the only discomfort I felt was when I was poked in the uterus.  Such a strange experience!  It kind of made me feel queasy just because it was so bizarre.

All of this was over in a matter of a couple of minutes.  It wasn't a big deal, they got the info they needed, and they assured me things looked good.  This is when I asked about all those follicles...  The nurse looked at me and said, "Oh, no, that's a good thing!"  Ah!  All my worry from before melted away.  Apparently I had 20 follicles, and she said that's exactly what they would want to see in someone my age.  I guess they just weren't expecting to considering everything my body had been to.  The follicle count changes every cycle, though. So here's to hoping that it remains good news and is beneficial to my outcome.

The doctor was willing to answer any questions I had about the upcoming procedure, but between my previous conversations with him, with people who have been through it, and all of my own independent research, I felt like I understood what would happen.  They assured me I'd see him again, so I didn't need to feel pressured to ask all of the questions I would ever come up with.  I let him move on to the next patient so that the infertility nurse could go over everything with me.

She explained that we would go over the schedule and an overview of all of the prep info, and she would send me home with all of my consent forms and legal documents to go over with my husband.  The first item she handed me was a schedule of the entire process -- every appointment was scheduled and written for me from Oct. 30th to Feb. 2nd.  This made me feel so relieved after all of the stress I was put through with the most recent scheduling hiccup.

However, we received some bad news.

As I looked at the schedule, the entire procedure was set for mid-January.  She began explaining as soon as she put the sheet in my hands.  If you recall, we were planning to do our first IVF cycle in early to mid-December.  In fact, we had to do it then if we didn't want to wait until spring.  Apparently all fertility institutes that provide IVF services are required to shut down for a certain amount of time (more than a month) to inventory, clean, and follow whatever other regulations are imposed on them.  Most institutes close at some point in the summer, but mine always closed beginning at the holidays and then through January.  Hence, the December dates.

Apparently one week before my appointment, my nurse got a call from the institute saying they've had to completely rearrange their schedule to close in December and then open back up shortly after the New Year.  This meant that three women like me who are undergoing IVF with my doctor had to be rescheduled.  I didn't have a choice in the matter, and my doctor didn't have a choice in the matter.

My initial reaction was disappointment.  I have been anticipating this for months and months.  In my mind, I have established a schedule for the end of my semester and the holidays all based around IVF.  The more I thought about it, though, the more it seemed like it might be even better for us to wait until January.  And so, I am now completely at peace with it.

You see, I began my first semester as a full-time doctoral student in August.  I was accepted and agreed to attend on a Fellowship back in April, around the time of my surgery when I thought we wouldn't be able to try again for about a year.  I was scheduled to recover from surgery, be on Lupron for at least 6 months, bring my hormones back up with a few months of birth control, etc.  Instead, though, we found out that my husband is also infertile, that I responded really well to my Lupron, and that we should pursue IVF while time is on our side -- we're 27.  Knowing that I was entering into a big time of change and challenge, we decided to move forward.  What other option is there?  I know I can handle it, and I want this baby more than I want a PhD.

Our original IVF schedule was going to interfere with my finals, and I was going to be on all my meds starting right before Thanksgiving (a stressful time to be studying for finals and writing papers).  My husband and I had purchased plane tickets this summer so that we could be in San Francisco for my aunt's wedding over Thanksgiving weekend, so I had just come to the conclusion that I'd have to cancel.  We were going to have to stay home, away from our families for Thanksgiving since I wouldn't be able to travel on the meds.  I was going to have to take a pregnancy test on Christmas day.  I am in a dear friend's wedding on December 28th.  I absolutely dreaded the thought of the significance Christmas day would hold.  It would be magical if I received the best news of my life on Christmas day 2013, but I feel like it would add insult to injury to get a negative.  And if I did get bad news, I couldn't imagine being functional or a good friend in the wedding.

SO.  IVF in January means that my husband and I will not only be busy and occupied by the holidays and time with family leading up to the procedure, but we will also be coming off a long break from grad school for Christmas.  I hope that this means I am relaxed, at peace, and ready by the time January rolls around.  It will mean I can ask for massage gift certificates for Christmas, I can see my aunt marry the man she loves, my husband and I can have one last glorious California vacation, we can spend the holidays with our families, I can be a supportive bridesmaid to my friend, and I can look forward to the start of a New Year -- 2014 (I like even numbers way better, anyway).  Sounds like a good plan, right?

I'm feeling optimistic today, and I like it.  This could really happen.  In January.

I hope and wish and pray.

my appointment was made.

I called my RE's office literally the moment they opened yesterday morning, as I had planned.  I even ducked out of a meeting to stand in the hall and hit redial until it actually started ringing rather than going to their answering machine.

I spoke with the saint of a receptionist who continually tolerates me and supports me and comforts me.  And she had good news.  The RE and his fertility nurse had finally stayed late last night to play catch up from their absence and go through all of the waiting charts -- including mine.  They went through all of my info and my cycle timing and decided I could be mapped on Oct. 30th at 3:30 p.m.

I have a fucking appointment, thank god.  Finally.

I immediately felt relieved just to have an answer, to know that I can go in there and talk to someone face-to-face and get a read on how all of this will go.  I was truly, truly contemplating ditching the whole plan.  Not because my intense desire to have a baby is waning, but because I was losing confidence in the whole situation.  I was considering finding another doctor, starting over.

But that thought sent me into wild sobs, too.  I couldn't come up with a good plan that would make me feel better.  To find another doctor would mean starting over -- with everything.  I would abandon a whole year worth of work.  It would mean investing even more money in this whole process to retest what we've already tested.  It would mean a delay, and time is something I want to keep on my side.

If I can go back to my RE and achieve that feeling of We're going to get this figured out, then I will feel better again.  If I can leave there feeling cared about, then my questioning and doubt might go away.

Until then, though, I know I'll be nervous for this appointment.  I just want to be positive and feel good about every step I take moving forward.  I want to feel like everyone is in my corner, like everyone is rooting for my positive results.  I want to feel like I'm not just a patient to my doctor but someone he cares about and wants to succeed beyond how it reflects on his practice.  I want to feel like I did all the other times I had appointments there.  I want to forget that I was completely neglected for a month.

Really, more than anything, at the end I want this to work.  That's all I want.  That's all I want.

i'm freaking out.

A few posts ago I wrote about my futile attempts to get my RE's office to return my calls so that I could schedule my mapping (or mock embryo transfer) that was supposed to happen last week.

I called for the first time back on September 30th and have called 2-3 times a week since then.  Never have I received a return phone call to ease my mind or schedule the appointment.

Nothing.

I've spoken to the receptionist every single time I've called.  And I know it's not her fault.  She's the one who takes the messages and leaves them for my nurse.  She's the one who talks me through my frustrations on a weekly basis.  She's the one who apologizes profusely for my worry and stress and the fact that I'm not receiving the care that I should.  But it's not her fault that I haven't been called.

I was absolutely sure that I'd get a call today.  My RE and his fertility nurse were out of state at a conference all last week (when I probably should have been mapped) and then I found out that their two other nurses are no longer there -- so they're short-staffed.  I understand all of that.  I get that things are busy.  But I thought they'd finally get to my messages today.

At 4:36, I still hadn't heard anything, so I called.  I was fairly sure their answering service would pick up by then, but I thought I might as well try.  No answer.

The thing is that my mapping was supposed to be done last week -- during the third week of my third pack of birth control pills.  The timing is important.  And now my fear is that my IVF cycle will be pushed back.  Or maybe even worse that they'll go ahead half-assed just trying to get me "done."

The way all of this is being handled is really concerning me, and I have to say that I am not feeling more and more confident in what's to come as time goes by.  All of this has me wondering if I'm making the right choices -- about my doctor, about IVF, about everything.

I want a baby more than anything, and at this moment, I'm feeling like my desire and need are being taken advantage of.  I want a baby so badly that I will pay what I cannot afford, and I will put myself through hell -- for a shot at one.  And what do they stand to lose?  A dip in their success rates?

Tonight I lost it.  I talked to my husband for about an hour after I called this afternoon to no answer.  We discussed our options.  I shared my feelings about it all.  I got teary.  He suggested we drive the hour and a half to the RE's office and wait in the waiting room until someone will see us, that is if we don't get a call in the next day.  I resolved to call again first thing in the morning and be very, very clear about my frustrations and my doubts.  But I know it's not the receptionist's fault.  And I know she already knows what I'm feeling.

My mom called as my husband and I were wrapping up our conversation.  I answered, and she sensed irritation in my voice.  I had already told her about my frustrations two weeks ago, but she was surprised to hear it hadn't been resolved.  And then I lost control.  I sobbed and sobbed and sobbed to silence on the other end.  All she could say was how sorry she was.  I couldn't stop crying.  It was ugly and pathetic, but all of my nerves and anger and concern and frustration had to go somewhere.  And they did.

I remember the last thing my nurse said to me as I left my most recent appointment back in August was, "Remember just try to remain calm and stay positive!"  How can I be calm when no one is caring for me?  How can I remain positive about all of this if IVF hasn't even started and I'm already more than exhausted?  How can I stay trusting if my RE's office won't even communicate with me?

I need to feel like I'm a priority for this to work, and it's wearing on me.  Should it be this hard?