An eventful weekend, and it's only Saturday at noon.

[judecorp]

I'll start backwards because it just happened and because it would seem weird at the end: I just passed my last social work exam! EVER! This morning I took my ASWB Clinical exam and got an 81 (needed a 75) and now, as soon as they send me the paperwork and I fill it in and send them even MORE money, I will finally be a Licensced Independent Clinical Social Worker. Which is pretty much the "end of the road" in my career, and means that I can be a program manager and a supervisor and an independent clinician and all of that. Which is good.

I didn't tell many people that I was even taking the exam today because I felt there was a very good chance I wouldn't pass... and if I didn't, I'd have rather kept it on the DL, especially at work.

~//~

Yesterday I had my follow-up with my incredibly sexy fertility doc with the British accent, and it went /awesome/. He was pretty much ready to start sperming me up right away, like... ASAP. I actually reigned him in a little bit, heh. He wanted to give me a prescription for Provera (to induce menstruation) yesterday so I could start a new cycle, take Clomid, and get going like, immediately. I told him, though, that I'd been doing fairly well at getting my period on my own and I wanted to wait a couple of weeks and see if it would come without taking hormones first, which he agreed with.

We had a brief but productive talk about all of the big questions I had for him, specifically about his thoughts on Metformin during pregnancy, his thoughts about Clomid increasing cancer risks, his thoughts about home monitoring vs. expensive medical monitoring, and about my battle with the insurance company. It really couldn't have gone any better.

1. Metformin during pregnancy - His policy is to stop Metformin when you get a positive pregnancy test. He said that there is not enough research to definitively prove that taking Metformin during pregnancy (or even the first trimester) significantly reduces miscarriage risk, and that there's definitely not enough research on the risks of Metformin on fetal development. He said that with no guaranteed benefit, and a number of possible risks, it's a no-brainer. I couldn't have been happier with that answer, because it's pretty much exactly how I feel. So, yay!

2. Clomid and cancer - He reiterated to me what I'd read elsewhere, that the Clomid studies were done in the 80s and did not use good research methods. He said that the professional community had pretty much debunked everything that was done in the 80s and nothing has been discovered since... almost 30 years later. So, yay!

3. Home monitoring vs. Office monitoring - He very honestly told me that while office monitoring (lots of bloodwork and ultrasounds) is more thorough, he didn't think it actually /improved/ chances of success, and that if people were diligent with their home monitoring, it could be equally as effective. He said that office monitoring also includes a shot (I forget of what) if a dominant follicle is discovered on ultrasound that makes you ovulate the next day, so you can plan better. So it seems kind of like a whole lot of process for a little bit of convenience, and he was cool with us wanting to try to frugal-er route first with our new fertility monitor and charting.

4. Insurance - I mentioned to him that I'd had a couple of conversations with the insurance company about how I thought it was crap that my claims could be denied because I "don't have access to sperm" when I was married for several years. I told him that the insurance person told me that there was nothing I could do, really, until a claim was filed and rejected - then I could appeal. So he told me he was willing to fill out the paperwork to try to file the claims, and he would include that I have a history of infertility with a pervious male partner. The office's billing coordinator person is supposed to call me in a couple of days to chat about all of this. So that's fun! As I told him, "The worst thing the insurance company can say is, 'No,' and then I'm back to paying for all of this stuff." And he agreed. In his sexy accent.

He was /so/ ready to start that he was asking me if we'd selected a donor and purchased sperm yet, and I was all, "Errr, no..." Heh, I wasn't expecting him to be all, "Let's do this right now!" I really thought he was just going to go over bloodwork and say, "Okay, what do you want to do?"

Speaking of, all of the bloodwork was fine. I don't have any STDs (duh), I don't carry the gene for cystic fibrosis or Tay-Sachs, and I am already immune to CMV so I don't have to find a CMV- donor. My kidneys and liver were fine, although he requested another kidney/liver check yesterday because of my increased Metformin.

When the nurse was giving me my bloodwork order to take to the lab, and a 3-month prescription that I can send to the mail-order pharmacy, she gave me a little tip that we don't have to buy the special IUI-prepared sperm, since they prepare ("wash") all the sperm before IUIs anyway, no matter what. Since IUI-prepared sperm is about $100 more per vial than unprepared, that rocks! Thanks, lady!

They are all so nice and chipper and optimistic there. It's kind of nice. I can dig it.

So, holy crap... we could be doing this as soon as I bleed again (and I told him I would call him in 3 weeks-ish if I have no sign that I ovulated and no period in sight). WOW.

Comments

[damdyke.livejournal.com]

Congratulations twice over!

Fantastic news about your test, and it sounds like you found a wonderful, positive doctor!

Good for you, Jude. Gosh, I've got warm fuzzies. It's nice when life goes good for folks.

[judecorp.livejournal.com]

Good gravy, but this year has GOT to be better than last year or I will likely go batty. I'm just psyched that I can already cross one plan for 2006 (LICSW) off the list. Next up: baby, then house (hopefully)! Whee!

Thanks for all of the support. It means a lot to me, and really, was a lot of what kept me going last year and able to do this right now.

[haloform.livejournal.com]

I'm so happy for you and all your good news yesterday! :)

[judecorp.livejournal.com]

Thank you, me tooooooo! :)

[fatfeistyfemme.livejournal.com]

Wowwwwwwwwwwwwwww!!! Exciiiiting!

[judecorp.livejournal.com]

Yesssssssssssssssssssssssss. :)

[drainbead.livejournal.com]

What a great doctor! It's wonderful when you find someone who really wants to go to bat for you.

[judecorp.livejournal.com]

Oh, Libby, you have no idea how /hot/ he is, too. It's awful. I wish HE could be my donor! ;)

But yeah, they seem super supportive and I hope this is a trend that continues because I'm really particular about doctors.

[thatpatti.livejournal.com]

holy crap, is he the bestest doctor ever or what?

weeee!

[judecorp.livejournal.com]

And guh, he's so HOTT. I could just die! His accent and the way he moves his mouth are SO like Hugh Grant. So cute!

Lookit that baby! Yay! Now I want one for MEEE.

[communista.livejournal.com]

Yaaaaaaaaaaaaay!!

(HUGS TO BOTH OF YOU!)

[judecorp.livejournal.com]

*makes out with you*

It was so good to see you post on your community the other day (week?). I'm so glad to hear you're alive. Don't be a stranger!!

[changinglight.livejournal.com]

Congrats, you LI, you!!!!!!

[judecorp.livejournal.com]

Well, I'm not an LI /yet/. Massachusetts has to send me my license application first... and before they do that, Ohio has to send them /another/ proof that my license expired in good standing (because they lost the last one). :)

But THANK YOU. I am so glad to be DONE with those exams! The girl that came into the testing center with me was sitting for her LCSW exam, and she passed, too. So happy! A good day for social workers!

p.s. Now I can be your supervisor and you can get rid of your crappy one.

[buddhafly4224.livejournal.com]

Congratulations! (I got into the MSW program at Springfield College yesterday!!)

[judecorp.livejournal.com]

SO AWESOME. Yay for you! That is so great, you guys are on your way!

[indigodove.livejournal.com]

That is double fantastic! I am so happy for you! :-)

[judecorp.livejournal.com]

Thank you!

[estrange.livejournal.com]

very interesting! It looks like the metformin during pregnancy still hasn't been looked into as much as I thought. My doctor seemed to actually be aware of it this time however (she had no idea what I was talking about before with Devin) & said that people are taking it through the entire pregnancy. I don't like taking drugs during pregnancy either but I also don't like having a miscarriage. My miscarriage was horrible and was the worst thing that has ever happened to me in my life. I've never been so depressed before. I can't even imagine having another miscarriage so I think the metformin is worth it.

[judecorp.livejournal.com]

Well, I think Metformin during pregnancy IS being looked into, and like any other new interventions, lots of people have different opinions on it (which is okay). Right now I'm much more conservative about that sort of thing, but you can bet your butt I would probably be singing a different tune if I had a miscarriage. That's so awful and I hope neither of us will have to go through that (again for you). :(

My doctor said that if you wait until a positive pregnancy test, you end up taking Metformin at least until implantation and he feels like there is some benefit there. But yeah, if I ended up having a miscarriage I would definitely talk to him about that more.

[estrange.livejournal.com]

oh I forgot - the monitoring. I guess I have to have all the office monitoring. My doctor's office makes me have an ultrasound when my period starts to check for cysts because clomid can cause them and then I have another ultrasound to check to see if I'm ovulating. It is really expensive but I am glad I go in for the checks otherwise i'd have no idea if I was really ovulating or not.

[judecorp.livejournal.com]

Yeah, what I think we're going to do is try for a couple of cycles without the office monitoring and see what happens. And if nothing happens, we will "step up our game," or if he really recommends it. If we were only paying for the ultrasounds and monitoring, that would be okay, but we'll already be paying $700/cycle ($400 for the IUI and $300 for the sperm) or so... so the extra $500 or whatever for all of the monitoring would be a major expense.

So hopefully it won't be necessary!

[meglett.livejournal.com]

yeah for passing your exam, and yeah for the great RE visit! re: the office monitoring--there's maybe some more stress in making the appts for the ultrasounds and trigger shot, but it does give you a much more distinct time frame for when to insem (especially if one's cycles are not insanely dependable). But maybe i'd suggest (with a non-professional medical opinion, of course!) going a cycle or 2 with your planned home monitoring and see how things go.

at any rate, just happy for you and Jen that you're on the road to starting your family!

[judecorp.livejournal.com]

That's pretty much what we want to do - give the home monitoring a shot for a couple of months before we drop the even bigger bucks. It's not just the stress of making the appointments (although I have NO idea how I would take so much time off of work during multiple days in a week), it's the COST. With the cost of IUIs plus the cost of sperm already, the cost of the extra visits and ultrasounds and trigger shot... OUCH.

So we'll see if we can pull it off, and if we can't... well, by then we'll know whether or not the insurance company is going to cover me and we can make another decision.

[amyura.livejournal.com]

Hey, congratulations on the LICSW!!!! And best of luck with the baby odyssey.

[judecorp.livejournal.com]

Thank you, thank you!

[scirocco.livejournal.com]

YAY for everything.

[judecorp.livejournal.com]

Double yay!

[vorpalbla.livejournal.com]

"This morning I took my ASWB Clinical exam and got an 81 (needed a 75)"

I got an 84, nya nya nya...
I mean, awesome! Congrats!

[judecorp.livejournal.com]

Dude, I SO don't even care.

I was so surprised to even see the 81! I was hoping for a freaking 76!

=P

I got an 86 on my LCSW exam.

[vorpalbla.livejournal.com]

"he was asking me if we'd selected a donor and purchased sperm yet"

I may have missed the post, but how does that bit work?
Sorry for two replies--first was before reading behind the cut.

[judecorp.livejournal.com]

You can do it all online. There are a number of sperm banks that have all of their stuff online. My doctor's office has a working relationship with a number of them. Most of the time it's set up to offer a brief profile online, and you can choose a couple of people and then pay for a longer profile (if you want). Then you order as many vials as you want and you have it shipped to my doctor's office's cryogenic lab and you wait. :)

[snack.livejournal.com]

will have the MSW by May 6th!! wheeeeeeeeeeeeeeeeeeeee

congrats on the license!!

[judecorp.livejournal.com]

So awesome for you! :) Hooray for graduation!

[iansha.livejournal.com]

YAYAYAYAYAYAYAYAYAY!!!! :)
I'm so happy for you! (Even though I KNEW you'd do it!)

[judecorp.livejournal.com]

Awwh, you're the best ever. Seriously. I really, honestly wasn't sure if I would pass. (It wasn't false modesty.) But I'm psyched that you had so much confidence in me. You are the best!

xoxoxoxo

[afullmoon.livejournal.com]

Yea for you. I am excited to have good things happen for you. I did home monitoring which worked out okay. Do you use the home ovulations kits? Not the temp things but the pee on a stick and when the line matches you ovulate in 24 hours? Those work well although a box of ten cost 15 bucks. But worth it. I am keeping my fingers crossed for you.

[judecorp.livejournal.com]

I haven't started using any OPKs yet. I have a Clearblue Easy Fertility Monitor, though, which works like the OPKs but are easier to interpret. I am planning to start using it next cycle. :)

Thanks for the crossed fingers!