The Evil HMO

hmo

My HMO (i’ll call them hotdog) is known for not covering necessary procedures.  They recently got sued because they have been providing terrible mental health services for a long time.  A few years ago, my ex husband and I had to threaten a lawsuit and go through a grievance process to force them to pay for his therapy after he was hospitalized. Good times.

I had to choose a new OB in my area because I’ve only been seeing reproductive endocronologists since I moved back up here.  I figured I would have a much better shot getting this covered if the referral came from an OB and not someone in the infertility department.  The doctor was pretty clear that the removal is necessary foe me and my future (fingers crossed) baby to have  healthy pregnancy.  It is not related to getting me pregnant, so it should be covered under my plan.  But given my past experience I don’t trust them a bit.

The OB was nice enough.  She said that doctors are split on whether fibroids really need to be removed.  She suggested I get a second opinion and implied that Dr. Cowboy might be trying to make more money by insisting I need surgery.  I told her that my doctor doesn’t even do those types of surgeries and that he was writing a letter to them to ask that they do it.

I left very confused and frustrated.  I just want someone to tell me what to do.  Based on my conversation with this OB I think getting this surgery is going to be a fight.

The count.

the-count

I just got back from my antral follicle count.  The doctor met with me on a Sunday…yes a Sunday.  Do rich people with fancy insurance always get to go to the doctor on Sunday?

The office was like a spa.  No screaming, angry kids, and sick and annoyed adults.  Instead the waiting room had a freaking water fall and the fanciest tea I’ve ever seen (i stole a few packets for home).

Dr. Cowboy is one of the sweetest and most calming people I have ever met. He did the procedure very slowly and asked several times if I was uncomfortable.

The good news: my follicle count was a 22!  The doctor said women with a good ovarian reserve usually have a count of 12 so I’m in great shape.  He also said that in this case PCOS puts me at a fertility advantage.  Go team PCOS!

The bad news: I have two large 400 and 600 MM fibroids on the back and in the muscle of my uterus.  They are about the size of a grapefruit.  Luckily the fibroids aren’t in the lining of my uterus (which would impact implantation/fertility) but he is concerned that they could grow to the size of a baby’s head if I get pregnant-which would subject me to all the pain/risk of a twin pregnancy without the extra baby.  This could include pre-term labor.  He thinks they need to come out which will delay my plans a bit.  My heart sank when he told me this.

The plan is to do the retrieval as planned (beginning of November) and put those guys on ice; do the surgery on my fibroids ; and give my body time to heal before the frozen embryo transfer-likely in January/February.

Ughhh.  I am less than thrilled about having surgery but more bummed out that this will push things back even more! Dr. Cowboy is going to write a letter to my HMO to recommend that they do the surgery.  There is no way I can afford to pay for it out of pocket.  The thought of fighting with my HMO about this gives me a stomach ache.

I also felt my singleness a lot after this appointment.  I felt so lonely driving back from the appointment that I started to cry. I forced myself to sing along to Sleater Kinney and spent the rest of the day watching netflix in my pj’s.  Yay for self care.

Eating like a cave woman

I am absolutely not into the idea of this turning into a weight loss blog so I won’t give you progress on that.  What I’m comfortable sharing is that I’m feeling pretty amazing.  I have been eating paleo since I got back from the woods. I’ve spent a lot of time making fun of the paleo diet over the last few years.  When you live in the SF Bay Area it’s hard to not get cynical about nutrition fads.  I

That said, paleo seems to be working for me.  I’m not hungry and I’m generally satisfied with my meals.  To keep my sanity, I’ve been allowing myself a few breaks on the weekend as long as they are gluten and dairy free (usually pizza or a sandwich).  I’m also subscribing to this amazing meal subscription service called Sunbasket that has paleo meals.  It’s a bit expensive but it’s all locally sourced, organic and antibiotic free stuff and its delicious.

In addition to having a lot more energy, it feels great to be something positive toward my fertility goal.  It’s also such a big motivator.

I’m having my antral follicle count on the 18th and am hoping for good news…

paleo-cartoon1