Pen pals

It’s true. I don’t post that often. Mostly cause our Internet at home is still completely jacked up. Four months in Israel and we still can’t get good Web access at home. It’s on the to-do list after “start family,” “learn Hebrew” and “orthodox conversion.”

Anyhoo, I started the Gonal F pen. 75 units a day. Today was day four of stims. Since then, I’ve had insanely bad headaches and have pretty much been in bed since late Thursday. There is also a trigger shot so hopefully we’re going to try and control things.

I will be dragging my sorry ass out of bed tomorrow morning for an ultrasound and bloodwork, and it’s my hope I will also have a chance to chat about this cycle.

Questions I’m hoping to ask:

1. Just out of curiosity, what type of cycle are we doing exactly? IUI or IVF? I know I’m on a need to know basis and all, but this might actually be something I need to know.

2. Any idea when the party in my uterus will be?

***

This is my first time using the Gonal F pen. Last go round, I had Gonal F shots mixed with Luveris. Here are my findings.

On the pro side, the pen hurts a bit less. I think this is because the gauge of the needle is smaller. But also, when I took shots last time, I had to stick the pen into the vial to extract the Gonal F and then stick it into the vial to mix the Luveris. And then I stuck it in once more to extract the Luveris. All this sticking into medical grade rubber stoppers = dull needle, specially when you then have to stick it into yourself.

On the con side, I’m all nervous that I’m not doing it right. Because you can’t actually see the measured dose going into you like you can with the little bitty syringes. And with my last batch o’ Gonal, I could just mix a new vial every two days, meaning I didn’t need to refrigerate it. With the pen (900 units) I have to actually keep it in the fridge or cool when I take it with me since it might last for more than one cycle. It’s a minor complaint really, but when you spend two to three hours a day on public transportation and don’t have a fridge at work, it’s a little more pesky.

***

A couple folks have asked me to compare cycling here (in Israel) to cycling in the U.S. The two could not be more different.

First of all, Israel takes infertility very seriously. Part of this is because of state-subsidized healthcare and a huge part of it is because we need all the little sabras we can get. But I think another vast part of it is just how medicine is conducted here. It’s a closer-knit community. The doctors seem to actually give a shit. And I don’t mean that as in, “whew, I’ll have good CDC numbers to report,” but as in “We really want you to have a gorgeous lovely family.” My doctor knows my name and my vital stats before he reads my chart. He knows my cellphone number – which is actually a bit freaky – but there’s no doubt he cares a great deal. As do the nurses and the pharmacy techs.

And the costs are less. My total pharmacy bill was just under $100 for 900 units of Gonal F and an Ovidrel trigger shot. I have been billed $5 so far for four ultrasounds and two sets of bloodwork. And the hubby was billed $5 for two sperm analyses.

On the other hand, for caring so much, I’ve never seen so much medical care where a significant portion of the treatment involves just winging it. Here’s a snippet of my call from Sunday from our nurse:

Nurse: Hi this is Nurse So and So. We are going to have you do injections this week. 75 units a day starting on Wednesday and we’ll see you on Sunday for an ultrasound and bloodwork.

Me: Okay great.

Nurse: See you then.

Me: Umm, wait. What am I injecting?

Nurse: Gonal F.

Me: So, should I come and get a prescription for that?

Nurse: Oh. You don’t have the prescription?

Me: No.

Nurse: Yes. Come and get it and then go to the pharmacy.

Me: Okay. And… and then the phone was dead.

So! Started 75 units of Gonal F on Wednesday at 3:30 p.m. Not because I was told to inject at 3:30, just cause it seemed like a nice time. And I am using the pen, which I learned how to use from the directions included and a short video on YouTube (as suggested by my pharmacy tech), not from an injection class. And I guess the trigger shot will be used at some point, but let’s just say it hasn’t been discussed.

There was no discussion about risk factors from OHSS, no consent forms, no risk of multiples discussed, hell, I don’t even know if I’m doing IUI or IVF. And yet I still feel I’m in better hands. Because I know that if I ask I’ll get an answer. And I know that they wouldn’t do anything to jeopardize my health. But anyhoo. It’s all a bit weird.

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4 responses to “Pen pals

  1. Good luck tomorrow & just keep asking!!! I doubt it is an IVF because IVF is managed by a hospital & not by a clinic.

    In any case, keep asking until you get the answers you need šŸ™‚ If you’re not satisfied with the nurse’s answers, ask them to call the doctor to ask him.

  2. We’re all keeping our various extremities in position to effect positive energies… (we’re rooting for you!)

  3. So weird, so different from America! But glad to hear that you feel like you are in good hands. Good luck!

  4. I’m living in Korea, and have found a similar difference between fertility care in the US and here. I feel like I’m in good hands, and my treatment DID work, but a lot of it really did feel like they were just winging it, and there were no consent forms whatsoever.

    Good luck with your cycle!

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