"...Now hope that is seen is not hope. For who hopes for what he sees? But if we hope for what we do not see, we wait for it with patience."
Romans 8:24b-25

17 March 2011

Deployments, Doctors, and Disregarded Time

I've been wondering lately what life in the realm of infertility will be like when my husband is deployed.  It's during his absences for trainings that I contemplate such things.

I would say that this will be uncharted territory for us, except for the fact that we already have a 15 month deployment under our belts that fell just as we were wading into the area of fertility treatments.

Medically (and I get it, even though I don't like it), that 15 month deployment cancels out a year and 3 months of our infertility.  Meaning- since we couldn't have sex for 15 months, then we weren't infertile during those 15 months.  It's silly, if you ask me, but I understand the strange logic in that.  

Early on, after enduring that 15 months and being told by a fertility specialist that those months didn't count toward our accumulated time of being infertile, it only slightly bothered me.  It knocked our number of years of "trying to conceive" from 4 years to a little over 2 years (or something like that).  It wasn't a big deal because we had accomplished a lot during that deployment. I had all kinds of testing done in preparation for my husband's return, I took birth control pills for a short time while he was away to get rid of some giant cysts on my ovaries, and I became educated in what we were about to face.  It made sense to me, at the time, when I was told that months without intercourse don't count toward infertility.

This time around, however, it's a bit different (and yet strangely familiar).  This time, instead of attempting IUI (intra-uterine insemination), we are trying to get our ducks in a row for IVF (in-vitro fertilization) treatments.

This time around, instead of 4 years infertile, we are 7 years infertile.

I say "7 years" with confidence.  In spite of being told last week that b/c of the 15 month deployment we are only considered 5 1/2 years infertile, I still say "7 years" with emphatic confidence, and here's why:

Seven years ago, we stopped preventing pregnancy.  For seven years we have been prepared to have children introduced into our lives.  Seven years ago an ever deepening longing to have children and to become parents began developing in our hearts and in our minds.  
The fact that we were only able to have intercourse over a period of two weeks during a 15 month deployment does not negate the reality that we wanted to have children.  It does not negate the fact that we used every opportunity we had during those two weeks to attempt to become pregnant.  
To take away from the overall equation those 15 months and reduce our status of infertility from 7 years to 5 1/2-ish years, is to rob us of our right to grieve over those 15 months.  We could not change our circumstances during those 15 months, just as we have not been able to change our circumstances over the course of these seven years.  
It's abundantly clear that having sex hasn't brought about pregnancy for us for those 5 1/2-ish years the medical world recognizes as our time of infertility, so then, why disregard a period of 15 months where we were unable to perform an impotent act?  
Clearly the issue for us in not that we are unable to become pregnant because of a lack of having sex.  I assure you, we've had lots of practice over the last seven years.  Basically, we have spent the last seven years trying the same thing over and over again and expecting different results (um...isn't that the definition of insanity?).  The times we have gone in for medical help, we have been almost chastised for counting 15 months (minus 2 weeks) when we were unable to perform that action.  My question to them is, "What does it matter that we couldn't?  Do you believe we are going to get different results?"  If so, then what does that make them?  Yes, insane.

My point to that tirade is that when we were newbies to this whole infertility thing, the logic made sense; we hadn't invested the very depths of our hearts into longing for children.  Now that we have walked this road for coming close to a decade, I say, "Give a couple some credit and count their full journey!"  I assure you, we wanted children very, very much during that 15 month deployment and it killed us to know we couldn't make many attempts at that, just as we still deeply long for children and it's killing us that all of our attempts at it are fruitless.  At this stage of the game, those 15 months should be to our credit, not discounted.

So, why the rampage?  (It's not really a tirade or rampage, although it would be fun to imagine my voice that way while reading this post...truly, I am very calm at the moment.)

Our big mystery, as you probably already noticed, is that we are moving forward toward pursuing IVF treatments.  We haven't shared this with many people because it's not a sure thing that we'll even be allowed to pursue IVF.  If this seems strange to you, let me introduce you to the military and the world of government health-care ;-)

In the military, it is not impossible to get a referral to a civilian doctor that specializes in something outside of general practice; it happens all the time.  What is almost impossible is getting a referral to one of four military hospitals across the country that perform in-vitro fertilization at a significantly reduced cost to those in the military.  (Before you go tooting horns about yet another example of how awesome government health-care is, keep in mind that you get what you pay for...bedside manner becomes terrible when doctors and nurses aren't competing for your business.)

Getting a referral should be the easy part, but where I live, it's not, thanks to the "lovely" lady I so sweetly referred to as the "fertility nazi" in a previous post.  I thought about my choice of words later and realized they are extremely politically incorrect and might offend some people.  If you have been offended by that, I am sorry, but I leave that title for this woman because I am still appalled, wounded, and angered by her behavior.

But, the truly sketchy part, after getting a referral submitted to the hospital, is what transpires afterward.  Apparently, there are a LOT of people in the military dealing with infertility and pursuing IVF.  Because of that, there is usually a waiting list for the treatments.  So, here's the basic process of "can I please have an IVF at a significantly reduced cost?"  

  • First, you get a referral.  This should be as simple as visiting your PCM and answering a few questions, but in my world it has involved me being given "the runaround."
  • After you get a referral, it is submitted to the nearest of the four hospitals conducting IVF where it sits in a pile for a MONTH before it is even looked at by anyone.
  • Then, someone picks up the referral, examines it for whatever parameters are required, and if it measures up, it is submitted to the powers that be to be considered for approval.
  • At this point, someone looks over the case, I'm assuming they request any testing that may be missing (I'm not sure), and then they decide if this couple is worthy of an IVF (and I don't know how they make that decision).  At which point they approve or decline the couple.
  • After approval, there is still a waiting list.  It can take anywhere from 4-6 months before the couple is called in for their first appointment.
  • Finally, the couple is called in, and the real fun begins.

So, because we don't even know if we will be judged "worthy" of IVF treatment by the hospital, we haven't really made any big announcements that we're traveling down this path.  It took a great deal of effort and a lot of running around (and going behind the fertility nazi's back) to get a referral submitted to the hospital.  It will be another month before we hear anything.  

Tomorrow I am having a redundant, slightly invasive test done (redundant because it's the second time I've had it and there's truly no cause to order it again, other than it's what the fertility nazi [FN] wants) to make sure that my uterus, fallopian tubes and ovaries are all still beautiful and in perfect working order (as they were the first time I had the test done).  We'll see what comes of it, but hopefully all will be well (mostly b/c if it's not then it means the FN was right and she prides herself on being right and having power).  

Then, at the end of the month, I am having hormone levels checked.  I'm okay with this test because frankly I'm surprised there isn't more emphasis placed on monitoring hormone levels when a patient presents with infertility.  It seems, instead, that a lot of time is spent controlling hormone levels because we have the power to do so.  But what if it's something as simple as a person producing too much of or not enough of a particular hormone that's keeping them from getting pregnant?  My only regret about the end of month blood test is that it reinforces the FN's sense of power and control.

I'll have to share my story about the FN later.  As it is, I have already written too much for one blog post.  Guess I'm making up for lost time ;-)

As for being in uncharted territory, it's a little difficult for me.  My emotions are less stable and more raw in this place and I don't have the luxury of comfort keeping me sane. I'm happy to invite you all along for the ride, but I fear I may not always be as uplifting and encouraging as I had hoped to be through this blog.  If you'll grant me a little grace through this process, hopefully there will be moments that will make it worth reading.

Grateful for your support,

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I would love to hear from you! The subject matter of this blog can be very sensitive. This is intended to be a place of encouragement and to be uplifting. It is never my desire to cause pain through what I write here, so please keep that in mind as you share your thoughts. Thank you.