Big Box O' Meds

Well, il est arrive.  I'm happy to report that the big box o' meds arrived without incident and no one screwed anything up too much, not even me.  My name is misspelled on the Rx...and not even my oft-missspelled first name.  {Is anyone's last name "Baxtra"?}  Anyway, I'm also happy report that the meds cost 1/2 of what I was originally quoted by the clinic.  This is kind of twisted because no one should be happy about 'only' having to pay 1800 bucks for medication. I think the clinic just wanted us to be ready to pay whatever the cost, and highballs the estimate to soften the blow...or something...or maybe some people do have to pay 3500 bucks because they've got more diagnoses then I do and thus, more meds.

Today is our final appointment prior to next Wednesday's start date.  Gregg actually has to have another sperm count (but not a semen analysis....there is a difference) today because of his recent fever.  That's right, it's back to THE BATHROOM for him.  I also have to have a blood pregnancy test  in spite of the fact that I've been on birth control without taking the blank pills for like 2 months and I've been bleeding for like 2 weeks.  Birth control pills are wonderful. Severe nausea and then non-stop bleeding! Lovely!  I have achieved a new level of compassion for the patients to whom I prescribe oral contraceptives. Barf-o-rama! 

Anyway, I feel that I have a duty to post my medication invoice because I know there is someone out there right now trying to squeeze every drop of information about real IVF medication costs from The Google and they aren't having much luck.  I've been there.  I have AvMed health insurance.  They covered some medications.  Guess which ones?  Yeah, the ones that cost under 20 bucks.  So I ended up having to pay 1-4 bucks for meds that originally only cost about 20 bucks.  Thanks AvMed! 

(an aside:  This whole process has periodically brought out the bitter middle classer in me.  Too rich and too poor all at once.  I could write entry after entry about my personal experiences with health insurance companies, but I don't want to become violent. Besides, I've already taken political action by writing to my senators and representatives in support of health insurance reform because those companies are making life miserable for people every single day, including me and many of my patients. So there! Oh darn, I got angry. Phooey! @#%&$#!) (apologies all around)

So...here's the list.  May the Great Goog serve that obsessed infertile well.  I know she's out there. 

Initial Out of Pocket IVF medication cost list for a first time IVF patient with AvMed

Schraft's  Specialty Pharmacy  {a division of Walgreen's} 8/09

Follistim AQ cartridge 300IU $249.00

Follistim AQ cartridge 600IU $498.00

Follistim AQ cartridge 900IU $747.00

Human Chorionic Gonadotropin 10,000 U $44.95

Leuprolide 1mg/0.2 ml (KIT) $99.00

Progesterone in olive oil 50mg/ml (2) $90.00

Ovidrel Micro 2.5 mcg (1) $75.29

Dexamethasone  0.5 mg (22) $4.15

Doxycycline Hyclate 100 mg (20) $4.73

Methylprednisone  4 mg (16) $8.64

Tetracycline 250 mg (16) $2.37

Diazepam  woot woot 10 mg (1) $1.81

syringes (60) $0.00

needles (23) $0.00

GRAND TOTAL $1824.94

Schraft's said they gave me a discount because I'm self pay, but I don't see where it is and when I called to ask, they wouldn't tell me.  I don't understand this, but okay.  They did give me free needles and syringes though.  I did not get a biohazard box, but I guess I could bring my used needles to work and dispose of them in the office's biohazard box, which would not be very nice.  It would be kind of like stealing office supplies because we pay the hazardous waste company by weight.  I'll think on it.  Maybe my IVF clinic will give me one.  I'm sure someone will explain to me why I got 60 syringes and only 23 needles.  

I have been chuckling (or is it cackling?) to myself about one aspect of this medication getting experience....the medications I have to take cost $1822.57, and Gregg? Gregg's medication? $ 2.37.   

BWAAAAHAHAHAHAHAHAHA

Anyway....

I'm breaking my photo protocol. No flower photo, and more than 1 to boot.  Besides showing the impressive pile o' meds, I had to show Schrafts' logo and the cute picture on the bag o' needles which reminds me of my mom for some reason.  Something about pilgrims and bonnets...and also, the image is the nearly absolute antithesis of modernity, of which IVF is the near epitome.  What does Holly Hobby have to do with making humans in a petri dish?  That'll keep me busy for a while.  

           Yup, just waiting for the dumb 'ol stork to bring us a dumb 'ol baby hyukhyukhyuk. 

  Sure, he's cute, but he's a real pill pusher.

So is she.

I wrote this at 4:30 am.  The birth control pills give me nocturnal hot flashes....I can't imagine how I'll be sleeping when the Lupron induced menopause begins....oh crap, I just got nervous.  

T-11 Days

Here we are. Just sitting around waiting for IVF.  I said in my last post that I am feeling a little like this isn't really happening.   Yet today, after counting the actual days until we begin suppression (Lupron shots every day to shut down  my ovaries entirely so that Dr. B can have total control blahblahblah) I have a little flutter of...anticipation. Finally, this seems to be happening. In like 11 days. 11 days.  Can I stand the wait? Will there be disappointment? Further delays?  

We're expecting our "big box o' medications" (as it has come to be known in the IVF community) on Tuesday.  I am having the big box o' meds delivered to my workplace so that I can have total control over them from the minute they arrive within 200 yards of me.  It will take supreme self control not to hover over them every minute until I get them home to my safe...er...I mean fridge...

If I could have a fridge installed onto my person, I would.  And in that fridge? My big box o' meds.  That's right.  

Did you know that there are entities known as "specialty pharmacies"?  I wish I didn't know.  My big box o' meds will come from such a pharmacy.  

I'll post a picture of my big box o' meds this week after injection teaching.  We, 2 seasoned nurse practitioners [winkwink], must be instructed on the administration of these injections.  I'm the patient.  Gregg is the husband of the patient. Sue, IVF nurse supreme and my current number 1 lady, says that nurse patients are the biggest wimps about these injections.  I'll let you know, but i think she's correct. 

We've started watching Battlestar Galactica season 4.5 this week, which has reacquainted me with my obvious cylon origin.  Something about IVF is very...modern. I guess post-modern would be the term.  Maybe post-post modern.  I apologize for obscure references.  

Big box o' meds, coming right up.

Back to Life

Well. I thought this might happen and it did. Gratitude. I am actually very grateful that our cycle got delayed. I had way too much going on this month to also go through IVF. Let me see...lactation exam, cash for clunkers, family reunion, new glasses, new doctor at work, gardening. All big deals for me. And I am tired. Between call and stuff, this is my first free weekend in like 2 months. And did I mention that there are 3 potential hurricanes heading for Florida right this minute? If we were doing egg retrieval this very week as we were originally supposed to, I would be a basket case worrying about power outages and embryologists getting crushed by falling trees and stuff.
Note that I had to write the word "egg" in one sentence and "basket" in the other. This constitutes comedy to me, for some lame reason.  

Also, I almost forgot, Gregg was ill with a virus not unlike H1N1. About a week before he became ill, I said, "honey, maybe we should bank your sperm in case you get a fever which could kill all of your sperm after which we'd have to wait 3 months more to do IVF". He said, "okay", then proceeded to get sick enough to have to stay home for 2 days. My trusty IVF nurse Sue, my IVF guardian really, said that because his fever did not last over 24 hours and he didn't have a fever high enough to induce chills, we're still good to go. I only panicked and google obsessed for about 12 hours about sperm counts decimated by fever. Luckily the flu vaccine arrives at our office in 2 days.
So here I am ready to get ready for IVF, unburdened by all of that other stuff, including fear of influenza.  But, we work in primary care pediatrics, so illness is a constant threat. 
We actually have an official schedule. Come to think of it, the cycle really only got delayed by about 5 weeks. That's better than 8 weeks I guess...if I had to qualify the whole situation. The official cycle start date is September 1. That's when the shut down of my pituitary gland begins. Sounds nice, doesn't it? Egg retrieval (ER) is predicted to be on 9/23 or so which means embryo replacement will be around 9/28.
In the meantime, it's massage and acupuncture and knitting for me.
I'm pretty detached from the whole thing at the moment. It does not seem real. Our medications are getting ordered in one week and our teaching appointment is in 10 days. I'm sure it will all become much more real at that appointment, where they will teach me how to shoot up our life savings.