Saturday, August 18, 2012

Our initial RE appointment - take 2!

So, we have finally started this thing.

For months, years, it has felt like I am running, moving my legs like a cartoon, trying to gain forward momentum but never going anywhere. As if my legs couldn't gain purchase on the ground. As if I was not even touching the ground. Yesterday the ground was raised up and my toes dug into the soil and I have taken off. Forward. At last.

I have written previously about the veil of grey lifting off me. Now it is like the massive, oppressive weight of uncertainty has lifted. I wasn't even conscious of the huge effect this was having on me until it was gone. I am laughing and joking and the tension has melted somewhat.

We travelled to Hamilton for our second "initial consult" at the fertility clinic. Because the first didn't go so well.

This was were we talked with a reproductive endocrinologist about what we will do to try and get pregnant, to try and have a child together.

We need sperm retrieval surgery, IVF and ICSI.

Things will become official shortly when we get the letter saying we formally qualify for public funding. That letter will contain a date which will be our starting "month" for IVF treatment. Prior to that (about 6 months from now) my husband will have sperm retrieval surgery. And then IVF will occur about 18 months from now. It may be sooner if someone else on the program pulls out.

We spoke to both the RE who explained the procedures and the nurse who will be assisting. Neither of them seemed to have much experience with T1 diabetic patients, so I will be hunting down as much research as I can about how IVF drug therapy affects blood sugars. The nurse even told me outright that she had never worked with a T1 diabetic patient before. She told me that I should expect to "have to contact my diabetes management team at least 3 times while undergoing IVF treatment, you know, to monitor my blood sugar levels and adjust insulin, because you have to maintain a good level" Arrrrggg! said my inside voice. My polite, outside voice said something like "actually, I test my blood sugar about 15 times a day and do about 8 injections, all carefully adjusted by myself, too. I also have a pretty good HbA1c of 6.1%" The nurse did look a little flabbergasted at those numbers. I suppose she is used to having patients freak out at the prospect of injecting themselves once per day for a measly 2 weeks, not 8 in a day for 24 years! I wanted her to know what she is dealing with, and now that she has time to learn about T1, I hope she makes the effort. Both RE and nurse said they will work with my GP and my diabetic endocrinologist, which pleases me.

We opted to do an AMH blood test, which measures ovarian reserve. This will allow the RE to select an appropriate drug protocol for me out of the two choices she's whittled it down to. One is a 4 week protocol, and the other is a more popular 8 week protocol. The nurse made noises like she would put me on the shorter one, so my diabetes is less affected. But I said we want the one that will have the best chance at a good outcome. The $100 AMH test will be making the decision for us. Hopefully it is good news. Bad news would mean we have to act quicker, and as you know we can't afford to pay privately for treatment.

So nothing is set in stone, but is just an amazing feeling for me to know that we are on the waiting list now. Nothing tangible has changed, it's all still quite theoretical, but it's a huge change for me and I must say I feel amazingly light and, dare I say it, buoyant.

We got given a pack of phamphlets and books and a DVD. We have consent forms to sign.

I've been put back on 5mg folic acid, and will stay on it every day for up to 18 months+ We have to try and avoid caffeine, tea, coffee, and green tea even. (Being a T1 diabetic means that the only liquids I currently drink are water, milk, juice for treating lows, diet coke but not so much now that I get migraines from the aspartame, and black tea. God, I am going to miss my tea) Maintain ideal BMI. Be good. Take vitamins. Exercise.

There are a thousand details and questions, but the main things I took away from the appointment are that:

  1. Yes, I can work with this woman (RE), the one who destroyed my life 2 years ago. We will not be friends, but we will be able to have a professional relationship.
  2. We are finally getting some progress. We are finally starting. It is amazing to be here after fighting so hard for this.
  3. Surprisingly, we will get Hubby's part of the procedures done much sooner, so it will break the time up and make the new wait easier. The logical corner of my brain knew this, but 
  4. We can start to plan ahead tentatively. Things like accruing up some extra annual leave.
  5. Have found a great motel, and little things like knowing where we will be staying are important to me, the control freak lols :P

Yeah so that was positive, I am happy, it's good news.

We are starting. We have come full circle back to the start.