Wednesday, November 4, 2009

Home again, home again: Back from the one-day work up

We've returned from the Rocky Mountain clinic, and I have much to say about our journey, which will likely trickle out over the course of a few posts.

While out west, we saw a brewery called "Rock Bottom" and I thought, that's fitting. That's why we're here - we've hit rock bottom in this Trying To Conceive business.

We're so close to our absolute nadir of hope that we flew halfway across the country for potentially our last shot at having a genetically related child. We have long heard of this fabled Colorado clinic and had done a phone consult with their director way back in Feb. 2009. At that point, he had been quite sobering in his opinion, but had recommended a comprehensive chromosomal screening called microarray as our best option if we wanted to try one more time with my eggs.

To recap everything between the phone consult and now, we've done two more IVF cycles at our NYC clinic, planned to go out to Colorado twice, but gotten pregnant both times, and subsequently miscarried both pregnancies. So it feels a bit crazy but really kind of cool to actually finally make it to the one-day work up. We brought all of our information with us, curious to see what this clinic and specifically their head doctor, Dr. Schl. would have to say.

What a whirlwind trip - there was really not a moment of downtime. Will and I were both pleasantly impressed with the Colorado clinic's professionalism and efficiency. And honestly, at this point, I'm a bit cynical and am almost looking for something to criticize. So it was quite something that consistently we found this clinic to be really on their game.

For example, throughout the day of appointments, everyone we encountered had read my chart and knew our history. This clinic definitely gives an impression of knowing what they are doing. And when we met with Dr. Schl., he was perfectly pleasant and very informed and articulate, despite his reputation for not having the best bedside manner. He didn't sugarcoat anything, not a morsel of it. But he wasn't overly harsh in the way he delivered what seemed to be his honest opinion either.

Below is our schedule for the day. It was pretty back-to-back and well-organized. Lots of information presented and many tests and some procedures done. I expected this to all be (yawn) redundant (and I therefore predicted I would be annoyed) and some of the things were redundant of course, but there were a number of interesting things we discovered (in bold below):

9:00 - 9: 30: (but it ran longer): met with Dr. Schl (will post details in a separate post. Very interesting chat).

9:30-10:00: met with laboratory people and signed many consents.

10:30-11:00: very detailed ultrasound for me, semen analysis for Will. Turns out I have three fibroids that won't affect anything. According to some kind of doppler scan, I also have blood flow resistance to my uterus - for which they recommended 8 sessions of electro-acupuncture before embryo transfer. Who knew?

11:00-12:00: met with IVF nurse for full hour of education on how things work at this clinic in terms of contact with staff, cycling, testing, etc. Cool to see how they do things as compared to my clinic (more on this later). Geesh - this clinic really wants us to be informed - they presented us with a full binder of materials and literature - this is more info than my clinic has ever given me across two years of treatments.

12:00-1:00: lunch (was supposed to be a half hour but they had mercy on us).

1:00-2:00: met with IVF nurse for another full hour for education on genetic testing required for heritable diseases, required communicable disease testing, medication administration, etc. Good Lord, these people are thorough in their written materials and presentations (hmmm...does someone on staff have obsessive compulsive personality disorder, perhaps? Across the board, the attention to detail was...actually a little scary...but also kind of comforting.)

2:00-2:30: lots of blood work, plus was offered and accepted the chance to get the H1N1 shot - cool! - it's not available at my hospital yet. Don't have it in front of me so can't remember everything that was ordered in terms of bloodwork, but at least two things were new: AMH testing and CMV antibody testing. Will be curious to see results.

2:30-3:00: office hysteroscopy with Dr. Schl. Hurt less than I thought it would. (Given that this cost $645, I was slightly annoyed that as expected, everything in ye ole' uterine cavity is normal). Structural problems are not our problem.

3:00-3:45: met with genetic counselor (thought this meeting would be totally redundant and annoying, but it turned out to be quite useful and much so that I will tell you about it in a separate post).

We arrived home very late last night, picked up our puppy, and dropped like dead people into bed. Right now Will and I are trying to dig out from all that went on in our work while we were away and emotionally process everything we heard. As well as attend to Ms. Moxie who had to go to (gasp! she's just a puppy!) a pet sitter while we were away.

Everything we saw and learned gave us a lot to think about. I promise to post again soon when I can. Bottom line, at the moment, we are anticipating we will likely give this IVF with microarray thing a try. It may or may not help us, but at least we'll know. And maybe then we can move forward. Or, even better, although probably unlikely, maybe IVF with microarray will actually work and we'll end up with a baby. Wouldn't that be something.


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  1. Wow, that sounds incredible. I am so glad that you found it helpful, new and (hopeful?)!!!

    I am pulling for you guys - all the time.

  2. Wow! Sounds like a really productive day. So glad it wasn't just more of the same old. Can't wait to hear all the other posts from the day - and hoping this is the beginning of great things for you!

  3. Wow! Sounds like an amazing trip, and I'm also looking forward to hearing the rest of it. But even better? You sound hopeful again, and that's wonderful to hear. Here's me hoping, right alongside you.

  4. It sounds like it was a very good and productive day. I too look forward to hearing more.

  5. Wow! Sounds like a whirlwind! Am very interested in the electro-acupuncture. Sounds intriguing.

  6. Yeah it is a pretty impressive place. I loved the genetics counselor too, I always learn something from her, or think of what I know in new ways. Can't wait to hear the rest of your impressions of the place.

  7. I've only ever heard great things about that clinic, and what you're saying reinforces the message.
    Can't wait to hear more about your trip. It really does sound like it may be worth trying. Glad you got the 1-day done, and that it was a better experience than mister immunology dude.

  8. Whew, I'm exhausted reading it! Sounds like a productive and worthwile day. I'm so glad, and anxious to read more about what you learned.

  9. I can't wait to hear more details. It seems like the visit gave you some clarity so that is good.

  10. Wow, I'm so glad that you went. I think it's amazing that you can actually still learn things about IVF! Can't wait to hear more. :) So did puppy survive the sitter? Bet you had some butt wiggling going on with the wagging of the tail when he saw you!

  11. I look forward to reading all the specifics about your appointment.

  12. Sounds awesome. You're right, the Rocky Mountain clinic is a pleasant surprise - the way it functions like a well oiled engine!

    I can't wait to see your posts about your appt with the wizard, and with the genetic counselor.

    Good luck!

  13. So glad you went. They are amazing, and on top of every detail. Cycling there is an entirely different (and better) experience. Our luck changed when we walked through those doors, and I hope that's true for you and Will too!

  14. CCRM sounds very impressive as I anticipated! I so hope they the answer for you two! Can't wait to hear more about your meeting with Dr. S!

  15. My goodness, it does sound like an efficient and productive trip. I am glad that you got a good feeling about them, and that they are so professional and well organized. I'm sure it's a lot to take in though! I'm looking forward to hearing more about the trip and meetings with various people.

  16. Wow, they sound scary-organized.

    But that's a good thing.

    Sounds like you had a good trip. I'll be rooting for you guys whatever your next step is.

  17. Welcome home! I am exhausted just thinking about your day in CO. I am on the edge of my seat to read the next few posts - sounds juicy :) Here's to answers!!

  18. If you decide to cycle there you should stop by the IVF Connections Colorado board. You will find much useful info there.

  19. I have heard good things about that clinic.

  20. Welcome home.
    Sounds like quite the experience. I'm looking forward to hearing more details.

    Oh, and I used to live in Denver. Rock Bottom is the bomb:)

  21. You weren't kidding when you said "no downtime." Btw, I had the same poor blood flow issues, so before my second and successful cycle, I did two electroacupuncture sessions/week for a month (so eight sessions...). Apparently the protocol is more effective if you do the all eight sessions in one month period. It's not nearly as unpleasant as it sounds and the doppler u/s after my treatments showed normal blood flow. :)

    I can't wait to hear more details about your visit!

  22. I am glad that the trip was so informative and hopeful. I pray that everything works out for you two. Looking forward to future posts on this. Take care!

  23. dudes, I am exhausted just reading the recap. What a whirlwind. How nice to come home with some hope that doesn't feel like candy-coated optimism, but real.

    And you're making me wish I asked my acupuncturist to pull the e-stim out again. Damn. Maybe I will....

  24. So glad that things went well. I live in that area, so, if and when you come back, i would love to meet up and grab some lunch! Glad that things were informative!

  25. Hey,

    Glad everything went well, and envious of the H1N1 (good grief -- what a thing to envy!). Looking forward to your more detailed posts and hoping for you both, as always.

  26. Looking forward to the rest of the story. We have a Rock Bottom in my town too. Your post made me laugh. I don't go there very often, but when I do, it will make me think of you now. :) In a good way.

  27. Wow, what a day...and to think, you made it out of there in once piece. I'm glad you found most everything to be helpful and informative. It would've been a downer to just get the basic run down and be sent on your way with a big binder. Best of luck and I look forward to reading more about your visit.

  28. THAT would be something...and I hope you get that something. What a whirlwind trip though...sounded exhausting!

  29. Sounds amazing and thorough and yes I feel hopeful for you!
    yeah, wouldn't that be something! Good luck with the post-processing, and I will be interested to hear more- especially about how you feel about what you've learned.

    take care,

  30. Mo, I am a new reader. I am SO hopeful that this will make the difference for you guys. Although my IF history is different than yours, I went to CO after 4 failed IVFs at 2 other good clinics - traveling across the country just like you. Dr. S. got me PG twice, I have him to thank for my kids. I hope this trip is the beginning of great things for you.
    They also diagnosed me with somewhat restricted uterine bloodflow and I did the electro acu with one of the clinic-recommended acus. I can tell you who I used if you want to let me know where I can email you.

  31. Hey Mo,

    Your post reads like Deja Vu, right down to the blood flow issues. Mrs IVF and I came away from that place thinking if this place cant help us with this level of detail and attention, no one can. I think there is a certain solace in that.

  32. I too had fibroids that they said wouldn't matter (and didn't) and also had the electro-acupuncture for blood flow issues. At first it was a bit like being hooked up to a car battery, but it really did get the blood flowing. I always felt energized after those sessions and my skin was flushed.

    For the most part, CCRM does run like a well-oiled machine. I have a lot of faith in them and particularly in Dr. S. Like you said, he doesn't sugar coat things, so if he thinks there's hope, there's good reason to believe him.

  33. Hi Mo!!

    Thanks for the update. I'll be praying!! My egg retrieval is this Sat. I am praying that there will be at least one good egg that sticks. Will be praying for you as well.

  34. I have a friend who miscarried time after time and it was eventually found that a large portion of her eggs had some genetic defect that would never let her carry to term. There was a clinic in CO (same one?) that was able to test the fertilized eggs for the defect prior to implanting. The only place in the country that would do it. She was implanted earlier this year and delivered a healthy baby boy on 10/30. I wish you the best of luck!

  35. Thank you so much for writing about you experience at the clinic. Some of their advanced techniques and combined with their professionalism and attention to detail sound like the type of place I would want to go. I really really hope that this works out for your both. Best wishes.


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