This morning, when I came out of our room after getting showered and dressed, Jill was working on changing Noah’s horrifying, scary, smelly, what-died-in-there? poopsplosion diaper.

I walked in to see a cookie disappearing into Noah’s mouth. This was something of a surprise, as we don’t allow cookies for breakfast.

Seeing my glance, Jill explained, “He found it. In a plastic container. On the table where we keep his backpack.”

I think this marks the end of pre-packed “just in case” snacks in (or around) Noah’s backpack. At least in transparent containers.

By the way, he’s gotten a lot better at using his super-cool, non-toxic, nearly-indestructible, recyclable and reusable, kid-size water-bottle. I think we’ll be investing in a few more and packing up the “babyish” sippy cups.

Have I mentioned that I loved Noah’s Sigg bottle so much that I ordered two more grown-up sized ones?

I read not long ago that plastic water bottles are some insane percentage of landfill matter. Between that, the fact that I prefer my water with some flavor added, and that Sigg bottles are cool looking, I made the switch.

I bought this one (1 liter) and also this one (0.6 liters). The 0.6 liter size is pretty much an ordinary soda or water bottle, the other is too large for me to really comfortably drink from directly.

And in other news, this cycle is looking good:

• 2 good-size and 1 runty follicle, just like in the cycle when we conceived Noah
• Follow-up doctor’s appt on Weds, when we will probably trigger ovulation
• Probable giant trek half-way to Tennessee first thing in the morning on Thankgiving, to do the insem
• That’s just before I turn 38
• And my mom brought me home from the hospital on Thanksgiving when I was a newborn
• And my due date would be a couple of days after Jill’s birthday

Did you know that last week was National Infertility Awareness Week? Or that infertility affects 12.5% of the US population? I saw a few blog posts about it, but didn’t get organized to add my $.02 until now.

I hesitate to declare myself part of the “infertility community.” I don’t have PCOS, I haven’t had any miscarriages, it only took me five cycles of trying to get pregnant with Noah.

On the other hand, getting pregnant is the same big, expensive, medical deal for me as it is for someone who spends six months or a year having sex with the intent of getting pregnant, and not succeeding. We go to the same doctors and we take the same drugs.

I’ve been lucky.

Since we’ve been trying to get pregnant, I’ve had jobs with great health insurance that included at least some infertility treatment. Still, here’s a rough breakdown of our out-of-pocket expenses:

From the beginning to Noah’s birth:

• 10 vials of Our Anonymous Donor’s sperm: $2850 in 2004. If we were buying the same category of donor today, it would be $405 per vial, so I’m glad we bought when we did. Also, we paid for this through my flexible benefit plan health savings account, the $5k you can withhold pre-tax. Who knew that sperm would be a “qualified medical expense?”
• ClearBlue Easy Fertility Monitor: $175, plus sticks to test with, $40/pack of 30, roughly $160.
• Doctor visits when we lived in DC: Roughly $1000. The doctor was out of network, we did three rounds of unmedicated IUI.
• Getting the sperm from the cryobank to the doctor’s office: Roughly $85 each time for 5 cycles = $425.
• Storing the sperm from January 2004 through May 2007: $1155
• Doctor visits after we moved to Atlanta: Roughly $500. I had coverage, the doctor was in network, but I had a $400 deductible and a 10% co-pay.
• Drugs: Roughly $50.

Total cost of infertility treatment resulting in Noah: $6315.

Total cost so far in the effort to have a second child:

• Evaluations etc for Jill, when we thought she was going to have baby #2: Roughly $1000. The doctor/facility was out of network, and we have a $1500 deductible EACH.
• Storage with the non-profit facility Jill was going to use: $10/m for 3 months = $30. (Because of the 3 ring circus of sperm transportation that I went through to move it to my RE’s office, they don’t seem to have entered it in their storage billing system.)
• Doctor’s visits for me: Roughly $1500. They finally agree that I’ve met my deductible, so we have to have hit that, but I can’t explain it all.
• Drugs: $105
• Bloodwork while out of area: $913 that I am still fighting with the insurance company about. Either they should pay it, or they should count it against my deductible. They should quit erasing it from their computers when they get confused.
• Second opinion doctor who was out of network but I have awesome insurance so that was still 70% covered: $560. (I haven’t gotten that 70% back, so I’m counting the whole amount. It’s still out of my pocket.)
• EDITED TO ADD more ovulation predictor kits and sticks for the Clear Blue Easy Monitor. And pregnancy tests. Not to be icky, but we in the ttc blogosphere call all of that gear “peesticks.” I would guess roughly $20/cycle, including the canceled & skipped cycles, let’s say $80.

Total cost of infertility treatment so far in round two: $4188.

Also? Add parking to most visits (all DC and the convenient Atlanta ones, but not the ones where I have to drive halfway to Tennessee). Let’s say $10 for each DC appointment and $3 on average for Atlanta. Call that $60 in DC and $45 here, or $72 in round one and $33 so far in round two.

That brings us to a current $10608.

If I get pregnant this cycle or the next, while it’s still 2007 and we’re still doing IUI, our additional out of pocket costs should be minimal, say $250 or less.

If we don’t, we’ll have one vial left and have to have a serious discussion of IVF. My insurance doesn’t cover IVF at all.

The RE practice with whom we had the second opinion consult told us, in great detail, that if we did IVF through them, it would cost between $12,000-$20,000.

I am officially not pregnant.

I knew that I wasn’t, having taken 4 home tests since last Wednesday, but there was the tiniest glimmer of hope that maybe the dollar store tests weren’t sufficiently sensitive to pick up the small amount of HCG. The RE’s blood tests are more sensitive, though.

We now have 3 shots left of the donor we used with Noah. I don’t know why, but 3 seems like a lot less than 4. I’m scared it won’t be enough.

And I had the most unproductive, irritating conversation with the phone nurse yesterday. (Who incidentally, never did call me. At 3:15 pm, knowing that they quit calling back at 4 pm, I called needing to know my results. It is so not-nice to leave infertility treatment patients hanging like that.) My regular nurse is out of the office until Wednesday. Let’s call the phone nurse Nurse Indecisive.

If you’re interested in more technical details, they’re below the fold.

(more…)

I thought I posted this morning, but apparently I’m on crack.

Or crazed from “popcicles,” as the case may be! Yes, it’s true. I finally surged on Saturday night! (For the first time ever, I started testing twice/day.) The optimal window for IUI with previously frozen little swimmers is 24-48 hours after the surge, which we hit this morning around hour 42.

It was the same doctor who succeeded with Noah, accompanied by a new member of their practice. I think my doc was showing off a little, which I appreciated, as he was so careful and gentle that I barely felt a thing.

My only complaint is that I had to wait for the doctors for roughly 45 minutes. That’s a long time to sit around on a table in a paper wrap. But they say there were 40 million little swimmers/ml in my teeny little vial, which is a goodly number for our purposes. Hopefully 1 is a good strong swimmer.

One week from today: progesterone test. Two weeks from today: pregnancy blood test.

I’m still kind of wiped out from the retreat, or more specifically, from Noah’s bad sleeping on the retreat. He was up at 3:30 or 4 on the first night, and rather than let him wake up the whole lodge, I brought him in to sleep on the twin bed with me. The second night he woke up completely and inconsolably and hungry at 2:30 am, and was up for at least an hour.

So:

• I think it might be time to get Noah out of the crib and into a big boy bed. He’s so heavy that he wakes up when I put him down, and then we have some back and forth with the screaming before he settles down.
• The atmosphere at work is less funereal this week than it was last week, although it seems like a lot of people are “mailing it in.” When I arrived at 9 this morning, I got a parking space that a month ago I would have needed to be there by 7:45 or 8 to get. But if I knew I only had 10 more days of work, I’d probably be doing the same thing.
• Hormone levels etc are looking like a go for TTC this month, although probably a few days later than I thought. The 200mg of Clomid produced an E2 level of  210 today, and there were 4 follicles: 17mm, 15mm, and two 13mm. Today is CD12; the doc & nurse today thought I’ll surge over the weekend and that it’s even possible I won’t surge until Monday. My gut feeling is that I’ll surge on Friday.
• I did a test recipe yesterday that turned out amazing. We’ll be taking a batch of these (among other things) to the new gay dads of twins at our church.

Awesome Parmesan Breadsticks, modified from Cooking Light:

• 1/3 cup regular flour
• 1/4 cup whole wheat flour
• 1/4 cup grated parmesan cheese
• 3/4 teaspoon baking powder
• 1/2 teaspoon seasoning (either fresh black pepper, rosemary, herbs de provence, or something else you think sounds good)
• 1 teaspoon olive oil
• 5 tablespoons water

Mix dry ingredients, add wet ingredients, stir until dough forms.

Place dough on floured surface and knead 4 or 5 times. Divide dough into 18 parts (roughly 1 inch balls).

Roll/stretch each ball into ~8 inch worms.

Bake at 450 for 10 minutes, or until bottoms are browned.

Total time: Less than half an hour.

This message is being auto-posted while I am retreating.

Never. Never. Never in all my life have the dual meanings of the word retreat been more perfectly aligned in my life.

Retreat in the active “run away” sense: Work. While I have confidence that things will work out in my department and area, there’s no denying that it’s been a stressful few weeks. Monday was awful, and Tuesday was worse.

Having a three day weekend at the end of this week? Excellent timing, and I think I speak for every single person employed or no longer employed by my company.

Retreat in the “calm quiet away from it all” sense: There are so many “about to get started” things going on for me this fall, it’s almost like going back to school, but without the tuition. It really is a good thing that I’ll be able to take some quiet time out from the day-to-day and weekend-to-weekend.
There’s the part where I have a new boss and am on a new team, and that we don’t know exactly what changes may happen within my personal responsibilities, if any.

There’s the part where I’m going to start teaching Sunday school to 4 and 5 year olds, some ridiculous percentage of whom have a parent who is an academic theologian. (That was intimidating when I was thinking it, but then I remembered that my closest friend has a parent who is an academic theologian, and I bet she was just like the rest of the kids in any Sunday school she might have attended.)

The fact remains that I probably am less familiar with the bible than any of the other people teaching Sunday school at my church. I’m 90% not worried, but the other 10% seems to be in charge of blogging.

And then there’s the part where I’m taking the fertility meds and hoping/worrying about trying to get pregnant. I know that I’m making all reasonable efforts to do this “right” … but last time it took 5 cycles, and every single one of them that didn’t work was heartbreaking. And if it works, then there’s the fairly intense prospect of growing an actual human baby, right there inside my very own (ha!) body.

Anyway, like I was saying, I’m off having a nice quiet RETREAT from thinking about all this stuff. Or in order to think about this stuff. Or in order to get to know more people. And learn something about the bible, I hope. Something that might interest children.

And at 8 am on Tuesday I have my mid-cycle check to see if it looks like a go for medical babymaking this month.

Sorry for the radio silence this week. Noah has taken to waking up at 5 am, which is prime blogging time for me.

This morning, I crept down as quietly as possible, and although from 5:10 am - 5:17 am were filled with murmured repetitions of “Mommy mommy mommy mommy,” it is quiet again for now.

I blame the person who delivers the paper, with her bright headlights and repeated “thunks” just outside his window. That and the sliver of light from downstairs and small sounds of the coffeemaker and the computer. And NPR, temporarily off while we work through Noah’s overly early hours. I miss you, NPR. I promise I’ll be back, and I’ll listen in the car!

Things I have been thinking about this week:

• My ovaries. We did an “ovarian reserve” test this cycle, to make sure I still had plenty of good eggs left. That means, basically, taking Clomid and doing lots of blood tests to make sure it’s working exactly the way it should.

  I think there’s a reason they call Clomid the bitch pill, and also, it made my ovaries swell up like oranges. I don’t remember even thinking about my ovaries before. Even when I was trying to get pregnant with Noah.

  And I’ll be taking a higher dose next month. Don’t you wish you were Jill?

• Last night I had a nightmare that Jill told a family with quads who were Noah’s age that we’d be happy to babysit them overnight, and then didn’t tell me until our house was filled with screaming toddlers and way too few parents. I woke her up to tell her not to do that.
• I actually think that was a work dream, more than a TTC dream. I’m not saying anything out of the public domain — there’s a wired blog link I can’t find that discusses it — but work is crazy with rumors about forthcoming layoffs and major changes. I don’t *think* I’ll be directly affected, but even if not, work is certainly going to be more chaotic and difficult after the fact. And I might be wrong, of course. While someone has to do the work I do, it doesn’t have to be me.
• I’ve been having the funniest debate on another blog. One of my closest friends, Erin, is not a blogger, but her sister Clare is. Clare did the personality test meme flying around just now, as did her parents (in the comments), then we all speculated as to Erin’s Meyers-Briggs personality type.

  I called Erin, as I often do, on my commute home yesterday. My plan was to tell her that she had to go read the comments and take the quiz, but Clare had already done that. Her first words to me were those three little words we all love to hear: You were right!