Wednesday, September 30, 2009

medications, South American drug lords, and customs, Oh My

After much thought about cost and logistics, we finally decided to have the IVF and other extra meds ordered in the U.S. and sent here. Surprisingly, we actually saved money doing it this way, even after the actual meds and shipping were paid for.

I would burst into tears and quite possibly tantrum right here if I had to relive the process, but it’s almost over, I think. After what seems like a bazillion hours on the phone with a particular company in the U.S., the meds were delivered to my mom’s house on Saturday. Angel and hopeful grandparent that she is, she cared for the meds over the weekend. Checking the order, refrigerating them at the right temp, repackaging five boxes into one, freezing gel packs, you get the idea.

First thing Monday morning she packaged everything up and drove three hours to the DHL office near Minneapolis airport. Fortunately, DHL was extremely helpful and made the process as smooth as possible. My mom can’t say enough great things about their customer service (they will be receiving a lovely letter from us).

Enter the DHL tracking number. My husband has started calling me "Escobar" since I’m constantly on the computer, “tracking drugs.” Nice. Everything was going along swimmingly Minneapolis to Cleveland, Cleveland to East Midlands, UK, East Midlands, UK to Dublin, Ireland. BAM!

9/30/2009 11:05 am Clearance Delay Dublin, Ireland, Republic Of
10:15 am Processing for clearance Dublin, Ireland, Republic Of
6:52 am Arrived at DHL facility. Dublin, Ireland, Republic Of

CLEARANCE DELAY????? One panicked phone call to my husband later, I think we have it figured out. This is one of the times that having diplomatic status comes in handy, very handy. Even though the package is addressed to a certain place in which it should NOT have been held up in customs, it is. Therefore yet another angel has become involved in this process; he has secured a “dip note” and will be personally driving to the airport to fetch my package of drugs. “K” we owe you, BIG time!

Fingers crossed that within a few hours, 11K of meds will be safely residing in my cabinets and fridge, then I will take my first breath since Friday.

::bites nails:::

stamps hired on husband’s forehead

A little background: I’d rather not go into details in order to protect peoples’ privacy, but let’s just say that for my first IVF neither my husband nor I did any of my injections. We had help, wonderful, fabulous helpers that I miss dearly. ::dries tears::

Moving along....
I worked in health care, specifically anesthesia, so I am more than comfortable with medication, needles, and all things regularly seen in the OR, but let’s face it, drawing up meds to inject into yourself is a lot more stressful than doing it at work. Particularly when it’s been several years. I still remember how to do it and would probably have no problem doing the subcutaneous injects, but the IMs, because of location, would be a little tricky. Anyway, my husband has offered to learn and deliver all of my meds. Eep

This morning we had appointments at the same time for flu shots. I guess doing it that way meant the nurse has to run through the consent and aftercare spiel one less time. While the nurse and I were waiting for my husband to arrive, we were discussing the status of the IVF meds and I mentioned that my husband would be doing the injections. She thought today would be the perfect time for him to have his first lesson. Armed with some alcohol swabs, an ampule and vial of practice meds, a syringe, and a tangerine, we were ready for him when he walked into the health unit.

Under our watchful eyes and instruction, he practiced both the SC and IM injections on a defenseless piece of fruit and passed with flying colours. Then the nurse said he was welcome to give me my flu shot. He carefully drew up the med, wiped my arm, and bump, in went the needle. I can honestly say that had I not been watching him do it, I wouldn’t have believed it. He was so gentle; I didn’t feel a thing, not a thing.

Dear, you are hired!

update on the dishwasher

The repairman returned with the parts, worked for an hour, then left again to fetch more parts. Upon his final return, he “fixed” the dishwasher. He said he changed all of the hoses and clamps. When I asked if he had located the leak (the one he claimed didn’t exist earlier in the day), he responded that yes, the dish soap had “softened the hose and caused a leak.” As he was gathering up his tools, he pointed to the dishwasher and said, “well, it is from your country.” (it’s a Whirlpool). The final remark was something about not putting “washing up” soap in the dishwasher again. I was angry, though not nearly as angry as my husband was upon hearing the story over dinner. He just kept saying, “I can’t believe he spoke to you that way” and “it’s a good thing I wasn’t here”. Both true statements.

The dishwasher is now 30 minutes into a cycle. ::fingers crossed::

As for the phones, DEAD. The electrician will be back later today or tomorrow. ::sigh:: it’s ALWAYS something with this house.

Tuesday, September 29, 2009

house issues, edition 284 (I’m only half joking)

A little background, I detest our house, detest. From the moment we moved in we started having housing issues. The short list of what’s been replaced- refrigerator, freezer, dishwasher, microwave, dryer, washing machine, add in the numerous electrical and plumbing problems.

Last Friday, I started the dishwasher then came into the living room to check email and update my iPod. About 20 minutes later I noticed that the power cord on my laptop was out. Sure enough every electronic item in the house off. Somebody from Washington DC was in town to inspect the electricity in all government owned and leased housing, so I assumed he had arrived and somehow turned off the electricity before coming inside. Between the wording on the email I received and the timing, it seemed plausible. What do I know?

Hour after hour went by, no electrical expert knocked on the door. Several phone calls later, the powers that be were at the house and found the problem. The dishwasher was leaking and somehow water came into contact with something electrical in the dishwasher which then shorted out the circuit breaker for the outlets. Fair enough. The remedy: don’t use the dishwasher, we’ll contact the landlord and somebody will be out next week to fix the dishwasher.

Fast forward to today. Forty-five minutes late, the appliance repairman, whom I’ve dealt with several times before (see above list) arrived. He looked in the dishwasher, looked under the dishwasher, then said he knew what the problem was. He accused me of using regular dish soap in the dishwasher. Um, NO. I showed him the dishwasher pellets I use. Response, “well somebody used dish soap in there.” There are two people in the house and I honestly can’t think of a time my husband has ever used the dishwasher. He’s great about loading and unloading it, but given the task to actually start it, I don’t think he’d even know how (there are several buttons and it has to be done in a certain order). Mr. repairman continued to insist that I put dish soap in the dishwasher. Becoming increasingly angry over the accusation, I showed him my Williams Sonoma dish soap and told him in no uncertain terms that there is no way I would waste, I mean use that soap in the dishwasher. Ever. He said that he’d looked for leaks and didn’t see any. My instructions were to run the dishwasher without soap for a full cycle. With that, he left.

Twenty minutes later, another repairman arrived, this time for the phones. Don’t ask. While speaking with him about the wiring, phone and alarm issues, a lovely woman from the housing department called to check on the dishwasher repairman. I explained the “diagnosis” and let’s just say, she was less than thrilled that I’d been accused of putting dish soap in the machine. She also asked me to check for additional water since it was currently running. As soon as I walked into the kitchen, bam, the clock on the coffee maker went out, microwave went out. Hmm, it was like Friday all over again. The wonderful electrician who was at the house pulled the machine out, sure enough, water. He even had a few suggestions as to what was wrong and why it was short-circuiting the electricity.

A few phone calls and two hours later, the appliance repairman returned, even less thrilled to be here than the first time. The electrician tried to exchange pleasantries with him and was ignored. The appliance repairman was visibly upset when the electrician made a suggestion as to what might be wrong with the dishwasher. The repairman then said he had to go get supplies and would return in an hour. So, here I sit. tick tock tick tock

Fortunately the electrician was wonderful, phones are fixed, and I now have his number should we have a problem in the future. He also got bonus points in my book because he was really sweet to the cats.

Friday, September 25, 2009

Creating a Family

This morning I was checking in on one of my favorite infertility and adoption websites, "Creating A Family". In addition to her fabulous website full of resources for both infertility and adoption, Dawn Davenport also has links to her weekly podcats, which I subscribe to on iTunes. I decided to go back in the archives to see if there were any podcasts I had perhaps missed. I started at the beginning of those listed, 2007. As I read through the list, I realized that I had already heard all of the podcasts from 2007, 2008, and 2009. It’s hard to believe that we have been dealing with infertility for this long.

If you are looking for a fabulous resource for both adoption and infertility, please check out the Creating a Family website. Also sign up for the free, information packed, weekly podcasts on iTunes.

bcps, I hate you

During our 4 ½ year marriage, I have never taken bcps. I also didn’t have to take them for the first IVF. Apparently it’s standard protocol for this clinic, so here I am, on bcps.

They are HORRIBLE! My face is broken out, I feel like I’m about to crawl out of my skin, and the hunger, oh the hunger. I can’t stop eating. I try to trick myself with big glasses of water, hot tea, broth-based soups, anything to feel full. Nothing works, I just need to eat. Fortunately we don’t keep junk food in the house and I don't have a sweet tooth, so I’m only eating healthy food, but still, way too much food. I’m terrified to step on the scale. I know I’ve gained weight. The thought of throwing prednisone into the mix in a few weeks is terrifying. Follow that up with IVF meds. Eek!

Fortunately with the compromised immune system I’ll be on house quarantine, so yoga pants and t-shirts are acceptable attire, but considering that I never lost the 20 pounds from the first IVF cycle, I’m not looking forward to the additional weight gain.

Millers Pizza Kitchen, worth another mention

My husband had a birthday this week and when asked where he wanted to go to dinner, he chose Millers Pizza Kitchen. It’s within walking distance of our house and we’ve had consistently good food and service there, so off we went.

Normally I get the chicken Caesar salad, but the night we were there they offered a starter and main dish for €14.95, so I chose a Caesar salad to start, and the Hawaiian pizza for the main. The salad was huge! Fortunately my husband ate about half of it. I also ended up bringing most of the pizza home. As I said in my first review, Millers Pizza Kitchen should not be missed if you are in Dublin. Yum!

Millers Pizza Kitchen
50 Upper Baggot Street, Ballsbridge

Caesar salad

Crisp cos lettuce tossed with garlic crutons, shaved Parmesan, smoked bacon, Caesar dressing and finished with toasted pine nuts, basil and cracked black pepper

Hawaiian pizza

Ham, sweetcorn, mozzarella and pineapple, finished with fresh chives and basil

Carribean jerk pizza

Marinated roast fillet of chicken with roasted red peppers, fresh green chillis, coconut milk, Jamaican jerk sauce, fresh coriander, pimento, lime and finished with pineapple, coconut and jalapeno salad

Tuesday, September 22, 2009

We’ve hit the terrible twos, feline style

From the time we adopted the cats earlier this year, they have been loud and vocal. They are both quick to let us know when they want something, Bella yells, Guinness cries and whines. When I say Guinness cries and whines, not in a cat meowy way, more of a human “a WAH, a WAH” form. Or he’ll just wander around the house and whine.

They’re fairly well indulged *cough* spoiled, so there’s usually very little to complain about. However, Guinness has been relentless with his objection to not being allowed in the dining room. He’s not allowed in there because

A. it’s where people eat and most people don't like their dinner with a side of black fur
B. he has demonstrated that he can’t resist hopping up onto the fabric covered dining room chairs.

Daily, Guinness protests. He sits in front of the door and cries, he stands in front of the door and whines, he stands on his hind legs wishing to be tall enough to see through the glass window of the door. It’s pathetic.

Last night, our house moved into new territory, the terrible twos. Guinness had been seated by the dining room door, crying for at least 10 minutes when I walked out of the kitchen. He took one look at me, let out a long wail, and threw himself to the floor. I stood in disbelief, watching a full on cat temper tantrum. I yelled for my husband to bring the camera. Guinness continued with his fit, we stood above him, watching, laughing, and snapping pictures. He cried, he rolled around, he threw his legs in different directions. I realized we were giving him exactly what he and every other tantrumming cat or child want, an audience. We walked away, Guinness became silent, and pulled himself off of the floor into a standing position. The second I came around the corner, he threw himself back to the floor and the tantrum started again.

Ladies and gentlemen, my cat has entered the terrible twos.

angel food cake, my first attempt

Recently I asked my husband what kind of cake he wanted for his birthday; he said angel food. I will definitely never win any type of baking award, so I was a bit hesitant of making an angel food cake, the egg whites, confectioner’s sugar, beating until the peaks are just right.

However, not wanting to disappoint the man on his birthday I found a recipe and went to work. It was actually much easier than I had anticipated and even tasted good. He later told me it was the first time anyone had made him an angel food cake that didn’t come out of a box. Poor guy. Oh well, glad my first attempt was a success.

Mom, don’t look. (it’s whipped cream out of a can, she always made it from scratch)

Hard Rock Café, Dublin

Lately I have been craving American food, first TGI Friday’s, now the Hard Rock Café. Last weekend it was fairly easy to convince my husband to accompany me to lunch when I reminded him that the Hard Rock has chicken wings.

Off we went for our American feast. We shared some chicken wings, my husband had a pulled pork sandwich, and I had a chicken club sandwich. Needless to say, we brought a lot of food home with us; the portions are huge.

Overall, the service was decent, food was good, though a little pricy. Basically a typical Hard Rock Café experience. I will say, it’s much more pleasant to go during lunch; at night the music is way too loud. I must be getting old.

Friday, September 18, 2009

my apologies to blog land and everyone else

I’m behind, very behind. I’m behind with email, thank you notes, returning personal phone calls, and of course, the blog. It’s been one of those weeks in which if someone were to ask me what I do all day, I’d look at them as if they had two heads and invite them to shadow me for a day. The huge frustration comes from being as busy as I was all week and then only accomplishing a quarter of what is on my list, through no fault of my own.

Names of people, companies, and organizations are being withheld to protect the guilty, but seriously, the level of competency that some people possess is just baffling. Several times this week I have wondered how certain people cross the street by themselves let alone have gainful employment.

I wish you a relaxing weekend, and may Monday bring us all a more pleasant and productive week.

PS- to the few people who went out of their way to help me this week, thank you.

a few cat pictures

happiness is looking down at your lap and seeing this…

my husband put an ice cube in their water dish, Guinness wasn’t sure what to think

nap time

Sunday, September 13, 2009

September 11

Being overseas, one sometimes feels removed from events that have such a tremendous impact on the U.S. Fortunately the world remembers and grieves with us.

As seen outside U.S. Embassy Dublin on September 11, 2009.

A Taste of Mexico

If you live in Dublin and are looking for authentic Mexican food, look no further than “A Taste of Mexico”. Unfortunately this event only runs until Thursday, Sept 17. We went for lunch yesterday and were not disappointed. I had the chicken, green enchiladas. My husband had the fish dish for tacos. Of the two, we both preferred the enchiladas. Lunch and dinner served at the Hilton Hotel Dublin, Charlemont Place, Dublin 2

fish dish for tacos

chicken, green enchiladas

Information about this world-famous chef and restaurant owner
Menu for “A Taste Of Mexico”

Friday, September 11, 2009

How many REs does it take to screw in a light bulb? kidding, kidding

Forget the number of REs we’ve dealt with in Minsk and for consults in the U.S. Let's just count the REs at the clinic here…

There was RE #1, the RE we chose and met with for our first appointment
Then there was RE #2, the RE that did my SIS
Then there was RE #3, who went on to sub, sub specialize and is also a reproductive immunologist. He ordered the “Chicago labs” and has been working with us on the autoimmune issues.
Enter RE #4, no I am not kidding. RE #4 is the director of the clinic, also consulted on my case, and yesterday finalized the med list.

That leads to the big news. They ordered my meds today. Woot Woot! (though our bank account doesn’t share my enthusiasm).

The final list, drum roll please….

pre-natal vitamin (I was already taking this)
folic acid (already taking this one too)
baby aspirin
Intralipid iv therapy

Let the fun begin!!

SeptemberFest 2009

SeptemberFest 2009 is this weekend in Phoenix Park. I don’t know much about it, but from what I’ve heard and read, it’s a big festival of food, drink, and culture. For more information visit the SeptemberFest 2009.

Wednesday, September 9, 2009

ARGH! ::pulling my hair out::

Phrases I hate that I have heard at least 11 billion times today....

Thank you for holding. Your call is important to us. Please stay on the line for the next available representative.

Please state the nature of your call. ::pushes 0:: Yes, I realize you would like to speak to a representative. Please state the nature of your call. ::waits silently:: I didn’t understand you. Please state the nature of your call. ::steam pours out of ears:: Please state the nature of your call. ::pushes 0:: Yes, I realize you would like to speak to a representative. Please state the nature of your call. “overseas reimbursement”. For overseas claims, blah, blah, blah blah. I hope I have answered your questions today. Goodbye. ::RAGE::

::call back:: Please state the nature of your call. ::pushes 0:: and on we go. I NEED TO SPEAK TO A REAL PERSON THANKYOUVERYMUCH

And why you ask, did I put myself through this aggravation? Well, although our health insurance doesn’t cover infertility treatment, I thought maybe, just maybe they would cover the Heparin and Prednisone, clearly not fertility drugs. I checked with the online pharmacy that our insurance contracts with. Both generic heparin and prednisone have low copays. YAY!

Unfortunately, the online pharmacy for our OVERSEAS benefit plan will, wait for it, wait for it……

not mail OVERSEAS. ::faints::

However, they will ship within the U.S. “to a trusted friend or family member”, who can then ship to me overseas using DHL or Fed Ex, at my expense. If you’ve over-nighted a box using DHL or Fed Ex lately, it’s not cheap. Oh, and then there's that little thing called customs.

Hours upon hours I have been speaking, err, I mean on hold today. The insurance, then the pharmacy, then the insurance, then the pharmacy. I’m done, DONE I scream! And I could soooooo go for a glass of wine right now, except that I’m waiting for the clinic to call so I can tell them I need the Heparin and Prednisone filled here. ::sigh::

Monday, September 7, 2009

The importance of being a proactive patient

I was recently browsing some allergy blogs that I read and came across this post, Pharmacies and Food Allergies. It’s a good reminder to those of us with severe food allergies that we have to be particularly proactive about our health care.

I had a similar experience when I started IVF #1 in Minsk. My RE wrote down the names of the medications I would be using. My type A, has to know and understand everything self took the list home and began to research every medication. Much to my surprise, one of the medications I was to use contains peanut oil. For the average bear, not a big deal, for a person with a life-threatening allergy to peanuts, a huge deal. I took the list back to my RE and pointed out the problem. He was in no way negligent with my care, it’s just that food allergies aren’t common in that part of the world, so it never occurred to him to ask. Fortunately Crinone gel was available, so that’s what I ended up using, but again, just a reminder to all of us, particularly the allergic community, that we must be proactive about our health care.

leaving St. Stephen’s Green

anyone call for a taxi?

or if you are looking for a slower means of transport

or if you want to look like a tourist

American food in Dublin, T.G.I.Friday’s

We have been craving American restaurant food lately, so after my hair appointment on Saturday, we decided to walk over to St. Stephen’s Green for a late lunch. We’ve been to this T.G.I.Friday’s before, but that was pre-blog days. So here’s a review.

If you want great American food overseas, T.G.I.Friday’s will not disappoint. The staff are attentive, food authentic, and overall a great atmosphere. We decided to start with traditional buffalo wings, mmm just like home.

That’s when the pictures of the food came to a halt. We were too busy eating and enjoying our date. Wherever you are in the world, if you are craving food from the States, check for your neighborhood T.G.I.Friday’s.

Just for fun, here is a picture of the T.G.I.Friday’s in Minsk. When we lived in Belarus there was much debate as to who really owned this restaurant and if it was actually part of the chain. I noticed that it was recently added to the official T.G.I. Friday’s Worldwide website, so debate over.

looking for a salon in Dublin?

We have been going to “trim” for our haircuts for over a year. We’re very happy with the service we’ve received there and for us, the location can’t be beat. It’s a bit pricy, but competitive for the area. If you are looking for a quality salon in Dublin, look no further than “trim”.

Thursday, September 3, 2009

Chicago labs are in

The reproductive immunologist called yesterday with the reports. As usual, good news and bad news.

good news:
both cytokine tests were within normal range
me 23.8 high normal 30.6
me 8.9 high normal 20.5

Natural Killer cells were also within normal range 7.2

bad news:
I have extremely elevated cytotoxic B- cells (CD19 & CD5).
me 40 normal range 5-10

After doing additional testing involving my blood and other cells, then adding IVIG therapy, it was shown that IVIG worked and brought down the "degree of harm" to 10.7. I'm sure this will all make more sense when I see the lab reports myself. I was just writing down numbers and information as quickly as he was talking.

The reproductive immunologist and I spoke for a long time about what to do from here, the differences between IVIG and intralipid iv therapy, and of course, the cost. The other issue is that IVIG is a blood product, so although it is screened, there is also the very low risk of HIV, hepatitis, and several other blood borne viruses. The reproductive immunologist said that there have not been any reported cases of contaminated blood with IVIG, but I’m still kind of meh about the process. The other tiny issue is that I’m O-negative, and can therefore only receive O-neg blood. It’s always something….

He seemed to be really pushing for IVIG, but then mentioned several times that intralipids might do the trick. I’m definitely leaning toward intralipids for a number of reasons, mainly because it’s not a blood product and because it’s much less expensive than IVIG. Each IVIG infusion is $3500, plus after each infusion, they send additional lab work back to Chicago. Intralipids are about 15% the cost of IVIG, so that would save a lot of money. He was going to talk to my RE and consult with a few others, I will be doing the same.

The next step is getting the meds ordered. I’ll start heparin injections, steroids, and a few other meds several weeks before beginning actual IVF meds, so those need to be ordered soon.

I think I'll also start looking for an IVF or auto-immune infertility board to join online. Any suggestions?

ah marketing

Yesterday my husband brought home a container of “Swine Flu Wipes” for me to see. Apparently they are handing them out where he works. Don’t worry, he took the container back to work this morning; we are not thieves. I was glad for the opportunity to take a picture though and to have this product brought to my attention.

Now here is the million dollar question. How are these any different from your average Clorox wipes? Oh yes, the label. The marketing is brilliant.

Order your fancy swine flu wipes today, or just wash your hands with warm, soapy water. Follow up with a splash of Purell or Germ-X if you’re so inclined.

swine flu wipes

recipe 24: roasted red pepper, spinach, and feta omelet

We had breakfast for dinner earlier this week and it was really good. Another great recipe from the “Williams-Sonoma” Essentials of Healthful Cooking cookbook.

1 red bell pepper
3 teaspoons olive oil
¾ cup loosely packed spinach leaves, stems removed
Kosher salt
Freshly ground pepper
4 egg
2 tablespoons crumbled feta cheese

Roast the red pepper, remove the stem, cut the pepper in half, remove the seeds, ribs, and blackened skin. Cut each half lengthwise into strips. Measure out ½ cup for the omelet filling, reserve remaining for another use.

Combine the roasted pepper strips and 2 teaspoons of olive oil in a frying pan over medium heat. Stir until hot, about 1 minute. Add the spinach, heat until wilted. Transfer mixture to a bowl, add a pinch of salt and grind of black pepper.

In another bowl, whisk together the eggs, 2 tablespoons of water, a pinch of salt and grind of pepper.

Heat a 9 or 10 inch frying pan for 2 minutes over medium heat. Add the remaining teaspoon of olive oil, tilt the pan to coat evenly. Pour the eggs into the center of the pan, reduce heat to medium low. Cook without stirring until the bottom is set, about 10 seconds. Use a heatproof spatula to gently pull the set edges in toward the center, then tilt the pan so that the uncooked egg in the center runs toward the edges. Cook until softly set, about 2 minutes total cooking time.

Spoon the red pepper mixture onto the side of the omelet closest to the handle of the pan. Sprinkle with feta cheese. Use the spatula to fold the third of the omelet closest to the handle over the center third. Then hold the pan by the handle, tilt the pan so that the omelet rolls out onto a plate, seam side down. Cut in half, serve immediately.

Sorry, no personal picture. Although we enjoyed the flavor, my omelet making skills leave a lot to be desired, so it was more of a roasted red pepper, spinach, and feta scramble. Here is a picture from the book of what it’s supposed to look like.