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

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.