Monday, May 31, 2010

Cats and Babies and Disney, Oh My!

The pool opened on Saturday!!! We went on Sunday for about an hour and Jack played in the pool with his dad. My mom and I sat on the edge of the pool and dangled our feet in. It wasn't too hot thank goodness.

My sister called me late Sunday night in tears to tell me that her cat was dying. She was 16, and her brother (my Toby) passed away in 2007. They were very sweet, social, and loveable cats. My sister hadn't seen Cuddles in awhile (she had been living with my sister's friends), and was really hoping she'd hold on long enough for one last visit in August. Unfortunately she called me today and told me that she went to sleep last night and passed away. I feel so badly for her because I know she loved Cuddles, and I know how hard it is to lose a pet. I also know that she probably feels somewhat guilty for not having seen her in awhile.

Today we had my mom over for a cookout. It was hot as Hades outside, but we had a nice visit. We watched The Blindside after lunch and it was a great movie. It helped that Michael Oher is on our hometeam-the Baltimore Ravens, and we are huge fans.

Archie and I talked a little more this evening about another kid. It's scary, I realize it's going to be alot more work having two. However, by the time another kid comes, Jack will be almost 5, so he'll be rather independent, and I think he'll be a really helpful big brother. He's so sensitive to other people's feelings, and just a true sweetheart. Granted he's mine, and I may be a bit biased, but I have never ever met a little boy so sweet and caring.

We had planned to take Jack to Disney World next year either in April or later in the fall. This is all up in the air based on what household/car things come up between now and when we book the trip (when we know what our taxes look like early next year). I'm leaning more towards the fall-late September or early October. I just think with April we run into kids on spring break, and to be honest, if we take a vacation in April, I'll be wanting one in summer too. But, if we book Disney for October, we might do a beach weekend in the summer and really look forward to our BIG vacation.

Anyway, enough rambling, back to our conversation. So I was telling Archie that I had originally thought maybe October for actually doing the cycle, but that would put me at delivering (a hopefully full-term baby) around July. And if I'm only going to be able to take 8 weeks, I'd like to be able to go on a vacation while I'm already off so I'm not using any extra time outside of maternity leave. Then we talking about the good part being that I'd be off most of the summer which would be awesome, but I'd also have a baby stuck to me in the heat and humidity which may or may not be well, sticky. Then I was toying with the thought of another cycle November/December, but that puts me hugely pregnant in the middle of summer. I might look cuter in a maternity bathing suit to be honest, LOL. But I imagine it's pretty awful to be huge and pregnant in the heat of summer. But there is always the pool! And, we could do a Disney trip in early October before I go back to work. This sounds like a good idea to me now, but my only other experience with a newborn 24/7 was with Jack and he was a super easy-going baby. He slept well (nap-wise), was a happy baby and just a complete joy. I think there is probably a slim chance I could get that lucky twice right? Most of my friends and at least in my family it rings true, that the second is more challenging than the first.

The Disney trip could be wonderful (good news is that Grandmom is going too probably, so everyone can get a break at some point), or it could be a mess. If it was hard because I made the decision to do our cycle late in the year so that we could do Disney, I would feel soooo bad. I do not want to do the Disney trip pregnant given my history with Jack. Being sick all the time is no fun, and now that we know about my cystinuria and the chance I may need a long term IV for fluids if I am like that again, it's just not worth possibly wasting the money. I think Disney after the baby is here would be a nice treat for the big brother, and if I had a really cranky little one in tow, I would just do maybe half days with the family and then hang out poolside or in the hotel room with the baby so we don't rain on Jack's parade. I just pray if we have another one, it's as easy at least in the infant stage as Jack was.

If you pray, please pray that I heal quickly so I can return to work soon. Please pray for my sister as she grieves the loss of Cuddles. Pray that we can pay down some of our debt before we try another cycle. Thanks!

Thursday, May 27, 2010

Wrist Update and Good News!!!!

The doc removed my stitches on Monday. I have to say that I was really surprised at how neat my incision looks. It is a very thin one, not raised at all. I guess it was surprising because of the other scars I have from when I had a pin put in my leg (broke that when I was 14). One on my buttocks is huge and raised, and then I have one on my hip, and one above my knee where the screws were to hold the pin in place, and those are actually a little sunken, but wider looking incisions. It was just not what I expected.

I have a green hard cast until June 7th at which point I will go into a removable fracture brace and start physical therapy. They had a physical therapist come in and do a little mini eval at my appointment the other day and I am losing range of motion in my hand which I suppose is to be expected when you've had limited use for 9 weeks. I am under orders to lift nothing heavier than a coffee cup. That's proving to be difficult.

In other news, our insurance's fertility coverage is going to change effective July 1st. Our coverage right now is that you are allowed 4 IUI cycles with $100 copays, and up to 3 IVF cycles or a maximum cap (for IVF only) of $30,000. We have a seperate med cap of $10,500. Basically as it was, we had done two IVF/ICSI cycles which we had used just under $25,000 of our IVF cap and just over $3,000 of our med cap. We had never done any IUI's as our sperm motility and count were not sufficient, and would have been a waste of time and money.

As you know if you've read some of the previous posts, I questioned our fertility doctor about whether our semen analysis last time would have been good enough for IUI and the thought was that it would have possibly worked, so we were going to explore that once we paid off half of our credit cards. Well, upon reviewing our upcoming changes in our coverage, we've come to new conclusions.

With our new coverage, any reproductive medical procedures including IUI's, IVF, meds, etc will be covered under a $40,000 cap. We will still have a $1,000 copay per IVF cycle, or $100 per IUI. Where previously our office visits, labwork, and diagnostic radiology were included in our cap, they now will be billed seperately which is good. They will not be reclassifying things that have been done previously, so they will not be going back and changing how much we've used so far. So, as of July, we will have used $28,174 of our $40,000 cap. That means we have enough for another IVF!!!!!!!!!!

So, when will we do this? I'm not sure. I've been out of work for 10 weeks already, and probably by the time I go back, I will have been out 15-16 weeks. Our short term disability works like this-you use your own time (vacation, sick, personal time) for the first month that you are out. Then your short term disability kicks in. It's different for maternity than it is for an injury. So at this point I am getting paid 60% of my base pay (no differential) by the short term disability, and I am using 12 hours of my own time to supplement my paychecks. I had something like 260 vacation hours, 70 sick hours, and 20 personal leave hours saved before I broke my wrist. By the time I go back to work, I might have 60 hours left.

For maternity leave, you use your own time for the first month, then if you had a vagina delivery short term disability pays you 60% for two weeks, and if you had a c-section, they pay you 60% for four weeks. I have no reason at this point to believe I would need a c-section as Jack wasn't a c-section delivery. So if I calculate how many hours I need to take a full 12 week maternity leave based on a vaginal delivery, I would need 384 hours. It would take me a year to save up 182 hours. So if I wanted to be sure I had that much time saved up, I wouldn't attempt to do another cycle for year and a half. I could do what many women have to do and just take 8 weeks. That would mean I'd need 240 hours which I could conceivably have in another year. So I could do another cycle 3 months after I return to work! We will probably shoot for the end of the year if I had to guess.

I've been asked if we will still try for an IUI first. My answer to that is that I'm not sure. It would really depend on what our labwork and semen analysis showed. I only have one patent tube which makes me think that maybe it wouldn't be as good of a chance, and I don't want to waste what money we do have available through our insurance on a shot in the dark. I am also nervous and scared to try IVF again given how horribly I dealt with our last cycle being a huge flop. I tried so hard to not get emotionally invested, let my guard down when our fertilization report came back ok, and then got smacked with the bad news. I felt like I was insane afterwards. I guess if we do that I will have to psych myself up that it will work (we will be going back to our protocol we did on our first cycle that was successful!), and I will not let my guard down. I have alot of questions for my doctor before we make any decisions, and we would have to have some more routine pre-cycle testing done before we could make a decision between the IUI and IVF anyway. The office told us to call a month before we want to do another cycle, so maybe in September we will get started.

Sunday, May 16, 2010

Post-Op Update

Hi everyone!

My surgery was on Thursday. Anesthesia came in to talk to me and get consent and their plan was regional. When I asked them to exlain that they said that they would numb from my arm down and put me into a little twilight. I said, enough twilight that I won't remember anything. They said, "well you shouldn't". Not good enough for me. When I said I was worried it was not only about knowing when they were drilling into my arm, etc., but I also didn't want to say something stupid like about what idiot doctor's can't read x-rays and how it's pretty bad when the ortho techs can do it better. I have a hard time adjusting my filter when I am not loopy, and I saw a recipe for disaster and therapy in my future if I remembered any of this or made an ass of myself.

So, I opted for general which meant I would be completely asleep, and the doc would only numb the area where he was working. They felt that the block would give me more pain control for a longer period and left that as an option available to me should I want it when I woke up.

I am happy to reprt that I don't remember a thing, not even getting into the OR. When I woke up I was in pain and they gave me a vicodin which didn't touch me. So the anesthesiologists came back. They said that normally they sedate people to do the block. That made me a little nervous about what was going to happen. They gave me a few shots of lidocaine in my neck area, and then gave a huge shot near my collarbone that worked BEAUTIFULLY for pain control! The only problem was that I could not move my arm, shoulder, hand on my own at all, LOL. I hit it on stuff a couple of times and never felt it. And to touch my own arm and try to lift it with my other arm was like dead weight and you would be surprised at how much a dead arm weighs...

The block began to wear off about 10:30 Thursday night. So it lasted about 8 hours. Lucky for me the nurses had told me to start the vicodin (and anti-nausea med) as soon as I got home and to keep up with it every 4 hours so that I wouldn't be playing catch up. I had to up it to two pills overnight and it was not touching me. I called in the morning and they switched me to percocet (it is stronger than vicodin which I did not know). Percocet was good, it didn't take away all of the pain, but made it tolerable and made me sleepy. I dropped down to one percocet every few hours Saturday morning and my last dose of pain meds was 2pm on Saturday. It is slightly painful, but nothing I feel like I need meds for and usually if I keep it elevated with ice for the swelling it'd not even painful.

I am in a soft cast (hard along the inside of my arm and all around my thumb to immobilize it, with an ace bandage the rest of the area) to allow for swelling until May 24th when I see my doc again. At that point he will decide which is next-hard cast or fracture brace (removable). In the meantime it's ice, elevation and relaxing.

Thank you for your prayers. If you could pray that this wrist heal correctly this time so we're done that would be great!

Wednesday, May 12, 2010

Long Time No Hear

I know I haven't updated lately. Mostly because nothing was new. Then when it was, I wasn't in a nice place. To be honest, I'm still not in the best of places.

My last post said my cast was due to come off in 3 weeks-April 28th. Well, I went in for my appointment, they removed the cast, and did some x-rays. I waited around in the waiting room for 3 hours after my x-ray. I was not a happy camper to say the least. During that time I washed my arm twice, after scratching the skin off of my raw, rashy arm, flexed my fingers and decided that either my arm was still broken or just normally sore after being in a cast for 5 weeks. It was rather sore.

So, the docs take me into the exam room, assess my arm, look at my x-rays and decide that I need another week in the cast because I am still pretty tender in my radius area (I personally thought it hurt more on the outside part of my wrist but no one was listening), and they can still see the crack on x-ray. My doc tells me that his wife is having a baby the next week (of course she is, so are half of my coworkers, and I'm still not even close!), and he's trying not to come in for clinic. He tells me and his physician's assistant (PA) that the plan is for me to come in, get the cast off and go into a fracture brace (removable) that I will wear for everything except for showers for the following two weeks. During the first week I will go to PT for range of motion excersizes, and the second week I will go for resistive therapy, then I can go back to work. Sounds good right? I was ready to go.

I go into the casting room to get my next cast, and the ortho tech is obsessing over my xrays. I'm thinking to myself, "the docs already looked at it, I've been here for close to 3.5 hours, just do your job and put my stupid cast on already!" He asked if I'd broken my wrist before. "No, many other bones, but this is the first wrist." Hmmm. Twenty minutes later, the resident comes in to look at the x-ray. "Huh, let me go get Dr. P." My doctor comes in with his team, looks at the x-rays, then comes over to explain that in 2-8% of wrist fractures the scaphoid bone is also broken. It appears that mine may be broken. "Are you afraid of closed spaces." Ha, I knew exactly where this was going. So that Friday, on the 6 week mark from the accident, I was getting a MRI-at 7 in the morning...

He went on to tell his PA to look over the MRI results for my appointment the following morning and go from there. He tells me that I could be in a cast for another 3 weeks and it may not heal, then I would require surgery. He told me that I should be thinking in the next week about whether I'd like to just go ahead with surgery. I asked if I'd be in a fracture brace post-op or another cast because I really need to get back to work. He says, "If you have surgery you'll go into a fracture brace for 2-4 weeks while you're getting PT and then you can go back to work." Ok. I really don't like the idea of surgery, but there's a chance it may not heal and I'll have to have surgery anyway. I'll think about it.

I did think about it. I thought about the fact that I'd already been in a cast for 6 weeks, and it hadn't yet healed, what more was 3 weeks going to do (although they now included my thumb in the cast for better immobilization). I thought about the fact that I really need to get back to work. I went for my MRI and my appointment that following Monday. My results on Monday were of course that the bone is broken. Big surprise. I have found something I do well-break bones, and I'm not about to fail this time! I opted for surgery.

The PA is filling out my OR information, and I ask if this will fix it for sure. She tells me that we'll know in about 12 weeks, if it doesn't I may require a second surgery with a bone graft. Well now my mind is reeling! I said, "Well I can go back to work in that 12 weeks right because Dr. P said I'd be in a fracture brace post-op." She then informed me that while he does surprise her sometimes, most of the time you're in a hard cast for 2-4 weeks post-op then in a fracture brace. You've got to be kidding me. I hope my doctor wasn't distracted last week when he was talking to me. I asked if I could take my brace off to scrub and wash my hands at work, the answer was yes. I asked if I could have it off for procedures and cares, and they said not if I want it to heal in that 12 week span.

I don't think my employee health department will clear me to go back to providing patient care with a brace on my arm if for nothing more than infection control purposes. I'm already looking into going back on light duty, maybe answering phones or something.

Anyway, my surgery is scheduled for tomorrow and I'm completely freaked out. When they set the bones initially in the ER, they mashed on my arm to get the bones back into place. They did so without pain medication or sedation, and I have to tell you that nothing in my life has ever hurt like that. Not a broken leg, pelvis (in 3 places), fractured skull, or even childbirth (I did have an epidural though). I still get panicked thinking about it. I asked the PA at my pre-op appointment if it was general anesthesia thinking that at least if it was I know I'd be snowed and completely out. It's not of course, it's regional. I asked what that was, and it turns out it's just twilight and they numb my arm. TO CUT OPEN MY ARM AND PUT A SCREW IN MY BONE. Are you kidding me???? I am sure everything will be fine, this is what everyone tells me. But given my recent experience where even Dr. P thought I should have been knocked out to set the bones, I'm a little skiddish.

So if you read this tonight or tomorrow morning, please say a prayer for me. Pray that I get really good drugs that will cause me to not remember anything about tomorrow's ordeal, that I get good pain medication for once I get home and everything else has worn off, and that my little boy is good for us tomorrow night and Friday morning until his dad gets home from work. And please pray that this will take care of my broken wrist and I will be done with this healing process quickly.

Thanks guys!