Cultural differences - pelvic floor exercise

Welcome back to my Cultural Differences series! It's been a while…

First, to answer the question in my previous post, Fran and Mina were close, but not entirely correct…it is an intra-vaginal probe, a tool to measure the strength of your pelvic floor muscles (and yes, Mina, insurance covers it!).

Here's is the story that comes with it:

The French state is very concerned about our pelvic floors (among other things…) because to 6-8 weeks after you have given birth, you have a right (100% insurance covered of course) to several physiotherapy sessions to strengthen/retrain your pelvic floor and abdomen. You can go to either a midwife or a physical therapist.

After the birth of M. Sensible I went to the midwife I also did my birthing preparation with. She was young, but her methods were non-technological, so I wasn't introduced to the probe yet… I did have to do a number of exercises though. How did she check how much therapy I would need and how much progress I was making…? Yes, with her fingers.

After M. Gourmand's birth my OB/GYN recommended a physical therapist, who then introduced me to the probe (which I could take home, however I did not get a copy of the software...).

Apart from some general abdominal exercises on a yoga mat, the pelvic floor exercises were done and measured with the probe. Picture this: you lie in a gynecological position, therapist inserts probe, hooks it up to a PC, shows you the screen with some sinus-type wave on it and tells you to follow the wave by contracting your muscles. The therapist can adjust the strength level - so if you did really well on one exercise, she might bump up the level and then the next exercise you don't even come near the top of the wave… So much for morale, ha.

I must say that even though after several years at the RE, the weirdest thing for me was having something vaginally inserted which was then hooked up to a PC. But it was nice to see on the screen how I was doing compared to just having the midwife telling me if it was OK or not.

After 8-10 sessions I was good to go and got some exercises to do regularly at home. You know what happens with those…

Where you live (and if you have had the ability to give birth), did you receive any pelvic floor therapy sessions after childbirth? If so, did insurance cover them? If not, did you get any recommendations to do exercises at home? Did you follow through with those exercises?

Cultural differences - summer break

Welcome to the fourth installment of my monthly cultural differences series! I've missed two months (oops) with no real excuse other than that I've had the kids 24/7 all summer and not much time to blog.

It's August. We're in France. which means...

If you want bread, you have to walk the extra mile to a bakery that's open. The market is half the size it usually is. Don't try to find a doctor or a dentist. But if you want to park your car in the streets, don't worry about not having enough change - it's free this month. The city is deserted, everyone is at the beach.

When we just moved here we went on vacation in September and were a bit surprised that we only met retired people. Turns out that even people with small children that aren't tied to a school schedule yet will be on vacation in August because daycare centers are closed for the entire month and many sitters will be away too (our sitter, who is Portuguese, spends the entire month in Portugal - and the first Saturday of her vacation in a traffic jam on the high way).

Of course, historically, this is probably due to harvest time - everyone had to go harvest the crops in August so everything else had to shut down. But if I ask friends or colleagues why the entire country still goes en masse on vacation in August, they look at me as if I'm crazy, say 'well, it's always been this way / we don't know any better' or 'well, the industry closes (but if I ask why they don't have an answer to it!), so I have less work in August, so I might as well take my vacation then). School is out in the entire country from the first Saturday in July until the first Tuesday in September (for other school holidays the country is divided into three zones to try to avoid overly crowded high ways and resorts - or to give the tourist industry a longer period of higher income, however you want to look at it), but the family vacation is always in August - kids of working parents will go to their grandparents or summer camp in July.

The first Saturday in August is called "black Saturday" on traffic reports. It means everyone is standing still on the highways going south. (This year we thought we could go south the Friday before to celebrate my dad's birthday - it took us 6 hours instead of 3.5 - and that day was only classed as "orange").

Since we have kids and are more or less tied to the sitter's vacation schedule, we have been taking vacations in August, but still trying to avoid the huge crowds (so you won't find us at the Mediterranean beach then). This year we have a bit of a hap-snap vacation but will be going to the mountains next week, when the rest of the country is going back home to stock up on school supplies for "la rentrée des classes" (which will be the topic of my next Cultural Differences installment).

Is there a specific summer period when most of the people in your country take vacation or is it more spread out? Any other specifics to summer vacation time you know of?

Summer - part 1

I don't want to start each blog post with an apology for my absence, but truth be told I can't believe it's been almost two months since my last post!

School has been out since July 6th - and there was no better way to celebrate it than with M. Sensible's 4th birthday! We had seven of his friends over and they were having lots of fun in the garden, especially with the water hose. Around 6 pm the parents  came back and stayed for a BBQ and we all had lots of fun. The house was a mess afterward (almost more grass inside than outside) and we battled mosquitoes all night because we had left the screen doors (well, they're not really doors, they're screen frames, attached to the window/door frames with velcro) open, a small price to pay for such a good time.

Two days later we went to my dad's second home in the South of France for a week-long vacation. It was blistering hot, but thankfully the house has a pool. M. Gourmand came down with a fever the next day and in the evening we got a call from a doctor from some regional health agency informing us that a classmate of M. Sensible had been hospitalized with meningitis so we had to make a doctor's appointment for the next day to get a prescription for a preventive antibiotics treatment for M. Sensible. Of course I flipped a little bit with M. Gourmand having a fever and not knowing if the little boy had been at M. Sensible's birthday party... (the doctor wasn't allowed to say the boy's name - I found out via another mom who had heard from the teacher, and no, the boy hadn't been at the party). Luckily M. Gourmand was fine again the next morning, both boys were in great shape, so we weren't too concerned when we went in for the appointment. The doctor first started to lecture us about various forms of meningitis, viral and bacterial, and then the different bacterial types - as if we were all overreacting - but he quickly changed his tone when he had talked to the agency's physician on the phone. So he gave M. Sensible a quick check-up (but M. Sensible still managed to kick and scream...), wrote out the prescription and off we went. The rest of the week was pretty uneventful and relaxing.

I'd tried to contact the little boy's mother a few times but she wouldn't answer the phone so we had no idea how the boy was doing but luckily yesterday and other mom had crossed her with her kids at the market and the boy is fine! It turned out to be viral after all (although in the beginning they thought it was bacterial and of the meningococcal variety and he had spent one day in quarantine).

We'll take some more vacation in August (like real French people! - a good topic for a next Cultural Differences post) but unfortunately one of hubby's projects has changed its schedule (obviously this project is not in France...) and he now probably has to work exactly at the same time as our vacation. This really sucks for several reasons but mostly because it means that he won't really have time off and he's close to a burn out, so he really really needs some time off...

Cultural Differences - May Day

Welcome to the third installment of my monthly cultural differences series! I'm running almost two weeks late with this one but that's because I've adapted/resigned myself to the fact that in May nothing much gets done here in France (it's not yet as bad as August, but getting close!).

The reason why not much gets done in May is the sheer amount of public holidays this month, and the French custom to "faire le pont", which means you take one or two extra day off between the holiday and the weekend, so you now have a nice long break without having to take up too many vacation days (not that we lack those here - 25/year is about the minimum). It all starts on May 1st - May Day, a BIG public holiday in this socialist country. On this day everything (except the fresh market) is closed. And most astounding, in the city where I live, there is no public transport at all on May 1st. Power to the workers!

Many people might think that Holland is a socialist country too, and in some ways it is, but May 1st is no public holiday there and (obviously) it's not celebrated in the US either, so this was a whole new experience for me when we moved here (and I still can't get over the fact that there is no public transport service!).

Then May 8th is also a public holiday (WWII Liberation Day) and this year Ascension Day fell on May 9th, so obviously no one was working on May 10 (oh, yes, my hubby was - and actually the public schools were open too, but half of M. Sensible's classmates were absent) and many actually took that entire week off. And then last Monday was Whit Monday, so another short week. This all following on the 2-week Spring break and kids have no way of getting back into a normal rhythm (and there are only six weeks of school left before the summer holidays).

On the other public holidays in May many stores are "exceptionellement ouvert", so you can spend your free day with hundreds of others at the giant blue and yellow home furnishing store if you'd feel so inclined (or in my case, you can just go to the grocery store and don't have to think what's for dinner two days in advance).

Before we moved here I thought July 14th (Bastille Day) would be the biggest public holiday in France, but no, the post office will be closed that day but almost everything else will be open. May 1st though, is the sacred day in this laic country.

Which public holiday is most widely observed in your country? How much is closed/non-operational on that day?

Cultural differences - at the doctor's

Welcome to the second installment of my Cultural Differences series, now with it's own real blog button (thanks Kathy)!

After last month's topic of meeting someone, this time we'll go to the doctor's office!

In Holland I didn't go to the doctor very often. I was hardly ever sick, so didn't make it much further than GP and dentist. It was pretty simple: there would be a receptionist and/or assistant and the physician him-/herself. No nurses or other staff. If you had to have a physical examination, you would undress (behind a screen) and then be completely naked so the doctor could examine you.

When watching US sitcoms or movies I always thought that all those blankets and other cover-ups were because we were not allowed to see the actors without their clothes on, but that in real life those covers wouldn't be there.

Until I moved to the US... First there was receptionist/admin person who dealt with the finances, then there was a nurses station, where I had to fill in forms with medical questions. Then a nurse called me and asked me to step on a scale - fully dressed, even with shoes on! She then brought me to a room, took my blood pressure, asked me to undress, gave me all kinds of covers and told me the doctor would be there in a few minutes. Wow, I hardly knew which cover to put where... How did it all work? So it wasn't just for the movies...? And what took the doctor so long?

My sister, also living in the US, told me that she never used the covers, but I somehow grew to appreciate them (and got a little less clumsy with them too). Because naked is really very naked...

Then four years later we moved to France. I was getting out of my denial phase regarding IF, so a gynecologist was one of the first doctors I saw. There was a receptionist, and the doctor herself. After a short chat it was time for an examination. Please get undressed. Please lie there. Wow... I was cold. No covers. Just like in Holland. What I used to think was normal. They call it "à poil" in French. But hey, this is the first time I see this doctor (it was also the last time, but that's a completely different story). Hmm... ok, get over it, this is a doctor, they're used to seeing people naked...

After two pregnancies in France I've gotten pretty used to it - undress in front of the OBGYN, step naked on the scale, be completely naked during the whole examination. Get dressed quickly once it's over. It's normal. It doesn't really bother me. But hey, I wouldn't mind a little cover...

What is the usual practice in your part of the world when you have to get a physical examination? Are covers involved? Would you be shocked if you would go to a different country and it would be completely different than what you're used to?

Cultural Differences - La Bise

Welcome to the first installment of my Cultural Differences series!

Today's topic is La Bise - or how to greet someone.

In Holland, where I grew up, when you meet someone for the first time, you shake hands. If you know someone well (on a personal level) you give three kisses on the cheeks. If you go to school/college or work and you meet people you see on a daily basis, you just say 'good morning' or 'hello' and you join the group, or continue on.

When we moved to the US, it was quite similar, only the kisses were replaced by hugs (I like hugs, and I think they are friendlier for people wearing glasses than kisses).

But then we moved to France. The handshaking part was still the same. The kisses on the cheek at first seemed to be similar to those in Holland, but there were two instead of three - which then sometimes created awkward situations when we, used to giving three kisses, were aiming for the other person's right cheek again when he/she was already turning away - so not such a big deal. But then one day, shortly after we moved here, we were at the bank, it was around 9 am, so many employees were coming in (this was the head office). Each and every one of them stopped at the reception desk to give the receptionist two kisses. We thought this was a bit over the top, the poor woman was getting up from her desk to greet her colleagues about every 10 minutes! Couldn't they just say good morning and move on?

No, apparently not. When I got to work in an office, the ritual was the same. I know my husband doesn't do the rounds like that when he comes in, and I think some colleagues hold it against him (he, however, couldn't care less and prefers to have a few colds and stomach bugs less by just saying hello and going to his desk).

So it seemed clear: kisses are for friends and colleagues (male of female, it doesn't matter), if you meet someone for the first time, you shake hands.

No, no, that was all too easy! If you meet someone for the first time, but that person is family/friend/colleague of someone you know well and who is there with you (and you therefore greet with two kisses), you greet that person with two kisses as well!!

I met a client for the first time last week, but we'd had lots of contact by phone and email in the weeks prior to the meeting, so we greeted each other with... "la bise". And immediately after that I got to greet all her colleagues (OK, there were only three, and two of them I already knew) with two kisses as well.

Sometimes there is a little uncertainty on both ends - maybe with someone you have only met once when you were together with a mutual friend - and then one of you might say "on fait la bise, non ?", which you can then obviously only answer with a positive response!

So it seems I'm getting the hang of it, although there was a bit of an awkward moment a while ago when I opened the door to our babysitter. I just greeted her with a 'bonsoir' and let her in. But now that I think of it, she probably expected to 'faire la bise'.

We're probably seen by some people around us as the foreigners who just say hello, but I prefer it that way than making the faux-pas of kissing someone when it's not at all appropriate.

And of course, as there are exceptions in France to everything, there are exceptions to these greeting rules as well: this weekend we went away and stayed in a friend's apartment in a ski-resort. She was there too, in an another apartment in the same building, together with her parents. They invited us for a drink one day and - according to the things I just wrote - after greeting my friend with two kisses, I assumed we'd be greeted with 'la bise' from her parents too, but no, it was a handshake... (so now I'm confused again)!

How do you greet people in your part of the world? Is there a difference between men and women? Between personal and work contacts? Are you a reserved kisser/hugger too?

Sharing stories

A little over a month ago I had lunch with someone to ask her to come work with me and another woman on the organization of a one-day conference planned for November. It was the day of our first scan and somehow I told her that day that I was pregnant (I don't exactly remember why, but it had something to do with that she was telling me to go after this, do that, apply for jobs, etc. and I couldn't think of any good excuse so I just told her I was pregnant - it was also after that meeting that I wrote here that I felt like a complete professional failure).

Anyway… I knew that she had one child, and she mentioned that when applying for jobs she didn't mention her age, marital status and whether she had kids or not (it is quite common in France to provide all that info, including a picture of yourself…) because it had led to questions before about whether or not she wanted another child, etc. I didn't ask her about it, figuring there must be a story - secondary infertility, or something else.

She joined the team, got very active (which is great, and I love it, but it also drives me nuts because I see myself in her but can't do what she does right now because of my pregnancy fatigue) and last Thursday, during a break in our 6-hour meeting, she told me that she had had four miscarriages when trying for baby #2 - all just before the end of the first trimester. Her revelation was triggered by the fact that she asked about my pregnancy and I told her that I would have our 12-week scan next week (of course after hearing her story now I'm freaked out something is going to be horribly wrong - and the fact that hubby told me he has to be away for business that day doesn't make it any easier).

So of course I told her our IF story too, and heard more details about hers. When her employer found out about her first miscarriage, he summoned her into his office and asked her what the hell she had been thinking getting pregnant (as she had just been working there for nine months and recently had gotten a fixed contract - he made it seem like she was taking advantage of the situation). If I ever meet this guy I will punch him in the face!

Her doctors kept telling her that she was young and could still have lots of babies. Even after miscarriage #3… No one talked to her about RPL and she had to go back to her home country to get all the blood tests done (she did consult a lot with Dr Google, so she asked her doctors for lots of test, but most of them just ignored her), her new OB (a colleague of my RE - whom she also saw, btw, but then she fell pregnant again so he just referred her to the OB, who told her she was just worrying too much...).

When she started bleeding again - miscarriage #4 - and couldn't get hold of her OB, she went back to the one who delivered her son. Finally people started listening to her. She had a hysteroscopy, they found adenomyosis (endometriosis of the uterus). She's now under the care of another specialist, again trying naturally. I do hope she's now finally under proper medical care and her RPL will be taken very seriously. I cannot imagine how stressful those 13 weeks of the first trimester must be for her. I can only wish her lots of strength and luck.

The Dollars and $ense of Family Building

This post is part of an initiative by Write Mind Open Heart and Baby Smiling in Back Seat. The financial part of my story will no doubt be very different from those of most other participants, as I live in France and therefore enjoy the benefits of the French government healthcare system, which is very generous when it comes to ART.

There are two parts to this post – first an overview of my personal family-building process (with some special attention to finances) and second a Q&A part (questions provided by BabySmiling and Lori Lavender Luz).

Background story:
We started our TTC journey when living in the US. When I finally dragged myself to the OB to find out why I wasn't getting pregnant, we were 1.5 years along. Apart from several tests (for both me and hubby) and a first Clomid cycle, we didn't consult with an RE an didn't embark on any ART treatments. This had nothing to do with finances, but with emotions. All tests had come back normal, so I was still in complete denial that something was wrong. I still listened to people who said I should just relax. No-one had really sat me down and uttered the words “unexplained infertility”. Besides, we were planning on making our second transatlantic move and I didn't feel like starting all kinds of treatments a few months before moving.

The new country (with its own culture, language, job search rules) took quite some time and energy to get adjusted to. By the time I felt like finding an OB we had been there for six months. By the time I'd built a little network and got a referral to a great RE (the OB sucked and wasted too much of my time), our first French year had passed... By the time I finally convinced myself that yes, despite all the normal test results, if I wanted to have a baby I should really get some medical assistance, we were definitely “tourist off” and finishing our second year of French live.

We talked with our RE about the options. IUI or IVF. He suggested starting with IUI, being a lot less invasive than IVF and that sounded great to us (still struggling emotionally with doing all of this, absolutely not ready for IVF yet). The government health care system would reimburse a total of six IUIs and four IVFs in our attempt to have a baby.

We did the first three IUIs in a row. All BFNs. Then we had a break, took a nice vacation, and on the plane back home I just didn't want to deal with it all anymore and was in no place emotionally to start IVF. So we opted for another three IUIs... Well, what a waste of time (and taxpayers' money, but I couldn't - and still can't - care less). Again, three IUIs in a row, again three BFNs.

Finally, after five years of TTC and three years in France, we started IVF#1. And lo and behold, I got a BFP and am now the proud mommy of a gorgeous toddler. I did a post at the time about the total cost of an IVF cycle in France. If interested, you can find it here (I think some rates have gone up a bit and I might have forgotten some costs of the hospitalization for ER (which were all covered), so I'll try redo one for IVF#2 soon).

We would love to bring a second child into our family, so we started IVF#2 last February, which unfortunately resulted in a BFN. We had one embryo frozen and should be going for FET#1 as soon as AF arrives again.

Q&A:

1. Consider your now or future children as adults, and consider the fact that you had to spend money to either conceive them or make them part of your family. What effect do you think the latter will have on the former one day? What, do you think, your grown children might feel about the funds it took to create your family?

   I hope that we can explain to them – and that they will understand - the difficulty we had in conceiving them, that we paid a higher price (financially and emotionally) for them than couples who had no difficulty conceiving and that they made (and still make) us so incredibly happy. Plus that they will go through life aware of and sensitive to the fact that being able to have children is a real gift, not readily available to everyone.

2. How did/would you handle it if your child asks you, "Mom, how much did I cost?" How would you answer at age 7? At age 18?

   I would be extremely surprised if my child would ask that at age 7, mainly because ART treatments are very well covered within the French government health care system, so the financial aspect would not really be a topic of conversation that he/she could have picked up somewhere and then ask me about it. At age 18 it would be a possibility, as by then I think my child would know exactly what it took us to bring him into the world and therefore I would be completely open and frank about the financial aspect as well (in our case, the question could also be “mom, how much taxpayers' money was spent on me?”).

3. When calculating the costs of your family building, what do you include? The direct costs are easy (such as RE fees for a cycle or homestudy fees), but what about fees that didn't directly lead to your child's existence in your life, such as cycles that didn't work, adoption outreach avenues that didn't work, failed adoptions, avenues that were explored (and that cost something) but not pursued, etc.?

   My initial reaction would be to just calculate the costs of the cycle(s) that resulted in the pregnancy and subsequent birth of my child(ren). But when I would look at it as a whole (after deciding that our family-building journey has finished, whether by our own free will or due to health or insurance constraints), I think I would add everything up, all the testing, the six failed IUIs, the first successful IVF, the second failed IVF, and any future ART cycles we would have had...

4. To what extent have finances determined the family-building decisions you have made? How have you able to balance financial considerations against other factors such as medical, ethical, emotional...?

   When we were still living in the US, I never really thought about what the financial impact would be if we would have continued with treatments after the initial Clomid Challenge Test. Had I been emotionally more ready, it would of course have been something to make us pause. The bills for the few tests did make me realize once more that health care was so much more expensive in the US than what we were used to in the Netherlands, but part of it was covered by our PPO and we had no problem paying the remaining sum. I often thought that I wasted so much time with this 'not being ready', but I guess financially it has been a good thing that we waited until we were in France.

5. Has institutional and governmental support for certain family-building paths impacted your choices? For example, ART being covered by insurance, tax deductions for adoption expenses, etc.

   When we decided to move from the US to France, it had absolutely nothing to do with the financial aspects of ART, but you'd almost think it did! We are extremely grateful for living in a country where ART treatments are so well covered by the government healthcare system. For that (and for the 30 vacation days a year, and being closer to our relatives, and a number of other reasons), we happily gave up at least half of our salaries... The details of the French deal: everyone who legally lives in France is covered under its government health care system. ART treatments are covered for 100% (but there is a cap per treatment or consult and many clinics have set their prices higher than what the government health care plan covers – for that there are additional insurances that you can either get as an individual or through your employer – we have the latter). An IVF cycle counts as one if there has been ER. Any FET is for insurance purposes part of the previous IVF cycle and has to be done before you can try for another fresh cycle. Also, if you have conceived through IVF, and you want/need to use it again to try for baby #2, the clock will be reset and you can again try four times. We do always pay great attention when our employers are about to change plans on the additional insurance and will vote against it if the proposed plan includes less coverage for ART treatments.

6. Have you considered having ART treatments abroad, either due to lower cost or due to certain methods being unavailable or illegal in your own country? In your decision-making, how did you balance the financial savings against issues like the unknowns of the country, perhaps not speaking the language, and medical practices that may differ from those of your home country? If you did travel abroad for treatments, what was your experience? Would you do it again?

   My answer is a bit the other way around, as we were already in a foreign country. When we were starting the ART treatments here in France, I briefly thought about how it might be easier to be back in the Netherlands for this, especially because of language nuances on such emotionally charged procedures. But insurance-wise it would have been hell, and medically I prefer to be in France too to be honest (as Holland often has long waiting lists before you can even do your first IVF, ER without anesthesia, only pee sticks and no beta tests to find out if it worked, etc.).

Visit Write Mind Open Heart for more perspectives on the Dollars and $ense of Family Building and to add your own link to the blog hop by May 1st, should you want to contribute your thoughts.

Random thoughts

It's CD27, I'm anxious to start our FET, but I think my body is asking me to be a bit more patient. AF lasted almost until CD10 after the failed IVF, based on my CM I would say that I ovulated last week, but this morning I had this typical ovulation pain on the right side, so who knows what's happening right now (I didn't take any OPT). Consult with the RE is on Thursday (but he will not do any u/s or bloodwork, just talk for 10 minutes and charge me 70 euros).

I don't really know what to expect of his FET. We only have one embryo frozen, how big is the chance it won't thaw properly? It's the same Grade A excellent quality as one of the embies that was transferred for IVF#2 - which didn't make it. So why should I believe its frozen brother or sister will have a better chance?

With IVF#1 I was hopeful, but didn't expect much - we had six failed IUIs behind us, so BFN had become the norm. But it worked... Then with IVF#2 I was worried that they wouldn't be able to retrieve any eggs - there were less than the first time, but still a decent amount. Then I worried that they wouldn't fertilize - but they did, and actually better than the first time. So when those hurdles were taken, and we had three perfect embryos, I was convinced that it was going to work, just like last time, and that I might even be pregnant with twins.

So the BFN hit me hard. I felt exactly the way Sarah described it in her comment on my previous post. So maybe it's a good thing that I'm a bit pessimistic, it might work better (oh, the logic of an IFer...).

The insurance stuff is almost sorted. I got a confirmation for one of the forms I'd sent them copies of, but nothing had been reimbursed yet. So I called to check what happened to the other form and when I could expect to be paid back. Well, turns out they OK'ed all procedures (for both forms), but just bothered to send a confirmation for one. And regarding the payment - I have to send them back the printout of their electronic file before I can get paid. That's insane! We have an insurance card with electronic chip, which means that payments are automatically transferred from whichever medical office you're paying your bill for, to your insurance company and you will be reimbursed with a transfer directly into your bank account - no paperwork, no checks in the mail, everything electronic. Now I have to send them back a printout of these payments that were on-hold instead of that they just click a checkbox or whatever in their software at the same time that they OK the forms... Of course I did send the printouts back, because I want to be paid ASAP, but this is bureaucracy at its finest I must say.

FET plans and insurance stuff

When I picked my son up at the nanny's on Friday afternoon, I finally told her about the failed IVF. But I immediately wished I hadn't, because the reaction I got was so full of all the well-know clichés ("oh, just try again; you know, I know of this couple who tried everything, even adoption, then went on vacation, and tadaa, she was pregnant; the mother of one of the other kids she takes care of also had 'help' with kid #1, but then kid #2 came naturally, and then she had a m/c with kid #3 and they decided they that was it..."). I don't know why I had expected anything else, after all she's not the brightest of people (but even bright fertiles can say stupid things - my neighbor, who graciously helped out taking care of our son when we had to be at the clinic at 7 am for ER - also said something like "oh, it doesn't matter, just try again").

When I told my dad about it over the weekend, he had quite a good remark though: "maybe they just didn't know how to deal with your grief at that moment" (he must have been in similar situations since my mom died...). I guess he's right, but I also think that many people just don't understand that we IFers can really grief about a BFN. For me personally this BFN after IVF was a lot harder that the BFNs after IUIs (or timed IC), because with those I never even knew if fertilization had taken place at all, whereas here I had seen those two beautiful embryos...

On Saturday the paperwork for FET #1 came in the mail. A form to send to the insurance company so they'll reimburse the procedure + preceding u/s, bloodwork etc., a statement to sign for the clinic demanding the FET for our own couple (and thus proving we're still a couple, because, if you're not, then French law doesn't allow it), and the prescription. The treatment doesn't start on CD04, as the assistant had told me on Friday, but on CD07: 100 IU of Puregon on CD07, CD08 and CD09, then go in for first u/s and blood work on CD10 - continue until RE deems me 'ready' (no idea how long that would be - similar to IUI cycle?) - trigger - start progesterone suppositories two days later, (and ET also around that day?). So having read this I think I could have waited until my RE appointment on April 7 with getting all the paperwork and still cycle in April, but I'm still glad I already got everything, so now I know a little bit what to expect from the FET and I can get the paperwork to the insurance company well in time.

Regarding insurance paperwork - when we started to gear up for IVF #2, back in October, I was waiting for a confirmation from the state run, mandatory, health insurance/social security that my insurance had been switched from the payment center for salaried persons to the one for independent workers. I had set up my own business in May 2010, but the French bureaucracy of course needs almost six months before acknowledging the change. So when we had to fill in the insurance forms, I had to fill out the information from my old payment center, because I didn't know the details of the new one yet. Of course I got the confirmation of the change a week later, so I sent a letter to both payment centers, asking to transfer my file, especially those forms concerning ART... After a few weeks I got a new statement from my new payment center - confirming the 100% reimbursement of all procedures/meds concerning ART. Didn't hear anything about the two other forms I filled out in October, but with those it says 'if you don't hear anything within two weeks after submitting them, consider it approved'. So I didn't think about it anymore.

We had our cancelled cycle in November (due to my mom's passing), then our real IVF #2 in February, and then last week (on the day I got my BFN) I get a letter from the payment center that they got a request for reimbursement for these procedures (u/s, ER, ET) and they don't have the forms, so they can't pay me... (luckily these procedures are not as prohibitively expensive as they are in the US, it's 'only' 434 euros, but I'd still like to get it back!). So I sent them a letter, with copies of the two forms, copies of the letters I sent them before, and hope that that's enough. But now I want to hold off sending the new form for the FET, because some procedures on there (like the u/s, and ET) are similar to the ones for the fresh cycle, and I'm sure that if I send the form now, they're going to think this is in response to their letter and then when we'll have our FET, they will again say that the form is missing... Hmm, I hope I won't get tangled up too much into this bureaucratic stuff. I tried to call them this morning, but after being on hold for almost five minutes, the computer told me they had too many incoming calls at that moment and hung up...

French precision

I had to go to the lab this morning to get my blood drawn for an estradiol level check. If it would be below 500 pg/ml I would have to get a HCG booster shot... With IVF#1 my level was well above that (1982), but this time I wasn't so sure, as my boobs are still not sore (which starts freaking me out - to me this is the early sign of pregnancy, I had it with #1, but so far nothing this time). I first thought that if the level would be below 500, the chance of being pregnant would be about zero, but luckily, when I went through old emails I exchanged with a friend, I found out that she did have the hcg booster shot, and she had a successful pregnancy, so that eased my mind a bit.

It was very busy at the lab and the ladies were there usual charming self... I asked them at what time I could call for the results - important as if the level would indeed be below 500, I would have to go to the pharmacy to get the meds and then try to contact a nurse to give me the shot - they told me 3 pm.

So I called around 3:10 pm. "Are you sure the results would be ready at this time?" Yes, I asked this morning and you told me to call at 3... "Well, but normally we don't have the results before 4 pm". You told me to call at 3 pm, and I need to get this stuff sorted if my level is too low... After a few rounds of stupid music she finally came back to me to say that my level was above 1000. So no booster shot needed.

When I picked up my son at the nanny's around 5:30 pm I went by the lab to get the results (on paper this time). When she told me over the phone "over 1000" I assumed they hadn't completely finished testing or something and that the final number would be on the paper. No... the paper also says "> 1000". WFT? They can't give me a freaking number? I mean, it doesn't really matter, because it's over 500, so I don't need the shot, but come on, with IVF#1 they were able to give me an exact number, why not this time? You might wonder why I didn't ask them - well, she gave me the results in an envelope and I didn't open it until I was in the elevator on my way down again. As this was a tiny elevator, my son was freaking out (is afraid in small elevators since we almost got stuck in one a few weeks ago), so I didn't feel like going up again.

I'm really getting a bit fed up with this lab. This morning they also asked me twice what the date of my last period was. I told them, but I also said that it wasn't relevant, since I had a long IVF protocol... I'd prefer to have these IVF-related tests done at the clinic's lab - at least they don't ask stupid questions (like for the vaginal exam where the lab near my house manages to ask why I need this test done - do I have a yeast infection?) and they have their results a lot quicker than this lab. But the downside is that it's 30-45 minutes away by bus and metro while this other one is a 15-minute walk...

Anyway... I guess I'm happy that I didn't need the booster shot. Things seem to go OK inside me, at least as far as the lining is concerned... Still feeling bloated, slightly crampy sometimes, but not as much as last week, having night sweats and crazy dreams (but why don't my boobs hurt? - I googled a bit, apparently some women do have sore boobs with one pregnancy and not with the next. Hmm, ok, I hope I'm one of them then!). One more week until beta.

CD20 - stimming day 1

Started with 150 IU Puregon again today. Six days at home (or actually on ski vacation right now!) and then going in for the first u/s on Monday. Same protocol as last time.

We met with the embryologist last Friday. Not much news, she went over our bloodwork and admin stuff again, same thing the RE did in October.

There was however one thing we wanted to check with her. Hubby's sperm test results in October showed some tiny presence of streptococus, so the RE had prescribed him antibiotics and to redo the test two weeks after the treatment. He did take the antibiotics right away, but could only redo the test a few weeks ago because of my mom's passing and everything. The result was about the same, so he again got a letter from the RE with a prescription for an antibiotics treatment. However, he had just taken one a few weeks ago, this time for dental surgery, so we were a little hesitant to start a third round of antibiotics when the previous two apparently hadn't done their work.

The doc still advised to take the antibiotics, but wait until I had been stimming for about four days, so the meds would still be active just before ER and there would't be strep in the culture used for the IVF. So that's what he'll do now, hopfully that will all work out OK.

CD01

AF showed up this morning which means we're on for IVF#2! Exciting and scary at the same time (I'm already worrying on what to do for babysitting the day of the ER when I have to be at the clinic at 7 am...).

We went to the RE again on Wednesday. This time he was busier than a month ago and we had to wait for an hour to see him for only five minutes. Oh well... Got all the forms signed and took prescriptions home for all the meds for the entire cycle. The sperm test showed hubby apparently has an infection somewhere, so he has been started on antibiotics and has to redo the test in about three weeks, but luckily that doesn't mean we had to hold off cycling for another month.

I thought my recent pap meant I didn't have to go to the lab to get a vaginal test like last time, but unfortunately I was wrong. So I scheduled that in yesterday because I didn't want to run the risk of having my period and then maybe getting the test results in too late for my REs liking. It was OK, sort of. I hate it that they always assume there's something wrong (yeast infection etc), and then you have to explain 'no no, it's just a preventive measure before the start of our IVF cycle'. I still don't understand why the RE can't do it himself.

I went to see a nurse this morning to give me the IM shot of Decapeptyl 3 mg (replacing the Enantone that I had to use two years ago). Stimming starts on CD20. So nothing much going on other than stupid cramps (thank you AF) and hubby a bit afraid of me being very grumpy for the coming three weeks.

Past experience comes in handy

Before we meet again with our RE on October 20th, we have to get some tests done. I had my blood drawn last week, hubby still has to do his, which can be done at basically every medical lab in the city (of which there is one on almost every street corner here in France). But he also has to have his sperm tested again. Which of course he doesn't want do at a random lab, but at the one belonging to the fertility clinic. So he called... and they told him they didn't have space before October 28th, which of course isn't possible for us, as the RE needs to have the results on the 20th.

Luckily, we've done this before. And we know our RE. I remember several occasions where I would be in the waiting room, or in one of the transfer rooms, and he would come in, complaining to the biologists that nothing worked, etc. etc. So, I sent the RE an email, explaining the situation, asking if he could recommend another lab, or maybe find a spot at their own lab for us after all...?

Within an hour I got a call from the RE's secretary, who told me he had gone over to talk to the biologists (haha, I know exactly how that conversation went) and that we should call the lab again, ask for the biologist, tell him we spoke with the RE, say that it's urgent, and get our appointment fixed. If we still would have problems, we shouldn't hesitate to call or email the RE again. So I called. Appointment's set for next week Tuesday.

Update on resolutions

Well, about time for a bit more optimistic post since my last one which was pretty depressing. I'm doing a lot better now and as for the resolutions - I've got most of them covered.

Have been seeing a psychoanalyst for the past month and a half, it's interesting, to say the least. Baby has been taking the bottle for about the same time. Coincidence? Not really - a friend was babysitting when I went to see the therapist and she asked me if she should try to give my son the bottle - I said 'sure, good luck' and didn't believe she would manage - but she did - the next day he didn't want it from me, but two days later he accepted it from hubs and has been taking it ever since. What a relief! Still nursed evenings and mornings for a few weeks, until he refused to take the breast in the evening, than just early mornings, followed with a bottle including cereal around (our) breakfast time. But I haven't nursed the past three days because he woke up pretty late, so I guess the breastfeeding period will soon be completely over. Even though I wanted it, it's still kind of a weird feeling.

I've been taking yoga classes again as well - but only when hubby is not away on a business trip, don't find it important enough yet to get a babysitter for. Music is also on the program again - I can put my son in the playpen and play while facing him. The first time he looked quite startled, but now he just continues playing, and sometimes starts 'singing' along! I've also sent a message to my fellow musicians that I'm ready to take up the trio again, but haven't had a response back yet, hmm... maybe eight months was too long of a wait for them?

None of the daycare centers around the neighborhood had a free spot for my son (as the French system is all about equality, you can't just 'buy' a spot at a good center if you would have the money for it) but as of May I have a spot for 2.5 days a week with a nanny (at her home, with a maximum of four kids at a time) who also takes care of our neighbor's 2-year old girl. So that will be great, because I had a small work project for the past two weeks and it was nearly impossible to do - only time I could work was during naps, a little playtime and in the evenings. Took me a week longer than I had hoped.

No more faith in the French legal system

A bit off topic, but I have to vent...

I met a very nice woman about two months ago at a meeting of the local version of La Leche League - she had 6-month old twins, who she had been breastfeeding since they were born.
We met again by chance a week later and then found out we lived really close to each other. So we met up a few times to go to the park with our babies. She then mentioned the relationship with her husband was not good, but didn't go into detail.

Last Saturday she called me and asked if she could come by. I sensed something was wrong. And I was right: a few days before her husband had come in with a court order and snatched the babies - who were still (exclusively) breastfed! - away from her, on some false accusations that she was mistreating them (and him).

This is now more than a week ago. She still has no idea where her children are. She calls her husband every day, but doesn't get many answers. In the meantime, the judge acknowledged that she made an error, but nothing can be done until a hearing next Tuesday (two weeks after the babies were taken from their mother).

I first thought she just had a bad lawyer - found her a good one - but that one says the same.
It's true that I don't know the full story, and I haven't known my friend that long, but long enough to know she's very friendly and a loving and caring mother to her twins. So wtf is this? How can it happen that babies are taken away from their mother just like that, without hearing both sides of the story? I thought a mother always had a stronger position than a father when it comes to child custody... I find this all very upsetting.

The wait is over - our little man is here!

Our son was born on Monday, July 6 at 12:47 am, after 26+ hours of labor, weighing 3300 g (7 lbs 4 oz) and measuring 51 cm (20"). We're all doing great, and are now back home after three days in the hospital (standard in France).

I'll probably post a full birth report somewhere in the coming days and am also planning on starting a private blog with more personal info and updates on our little man. If/when I do so, I will of course let you know.

41w3d - 4th past-due-date consult

Yes, I'm still here and so is my big belly... which means we had to go to the hospital again this morning, for our DD+7 consult. Again, everything was fine. Little man was sleeping in the beginning and awake in the end, so his HR was somewhere between 130 and 150. My BP was back into its normal range: 115/63. No contractions registered to speak of, which is consistent with the last few days: the BH contractions don't really start until around lunchtime and get more frequent (but not more regular) in the evening.

More mucus plug / bloody show late yesterday afternoon and this morning, but other than that, no impending labor symptoms at all. The last consult is now scheduled for Sunday late afternoon - after that they'll either admit me directly and start induction by preparing the cervix early Monday morning with a prostaglandin gel, or if the cervix is ripe enough, I can go home again Sunday after the consult and come back on Monday morning to start the induction with oxytocin. Of course I still hope this won't be necessary after all and I'll go into labor on my own in the coming hours/days (the clock is ticking...)!

41w1d - 3rd past-due-date consult

So we went to the hospital again this afternoon for the DD+5 consult. They put me on the fetal heart monitor for almost 45 minutes - little man was awake and quite active, so his HR in a range between 130 and 170 bpm this time. The contraction monitor also showed more contractions than two days ago, although still mostly painless and irregular.

My BP was a little higher than before: 124/74. They also did a urine test, which came back fine. Cervix check showed basically the same as during the previous checks. I had hoped it would have maybe already changed a bit, since I lost the mucus plug this morning (yay! at least some development, although it is not a real indicator of impending labor).

The midwife told me that since I've passed the due date, I can no longer deliver in the 'pôle physiologique', as they want to monitor the baby constantly during labor, to make sure there won't be any complications or at least to catch them early. I really hope I go into labor on my own in the coming days, otherwise it'll be induction on Monday and I'd like to avoid that, because that also means that I can't do the first part at home and will be on the monitor (= restricted movement) quite soon.

Currently quite some BH contactions - rock hard belly most of the time, but all still rather painless. Next consult (DD+7 ) is scheduled for Friday morning...

41 weeks - BOO!

Still nothing.

After having to wait more than five years before getting pregnant, I apparently get to enjoy it until the very last minute!

Yesterday evening I had quite some BH contractions, so I was hoping that labor would start in the night... Nope, nada, today everything is quiet again.

I'm bored. I've run out of things to do. My neighbor suggested vacuuming the house might induce labor... but that just gives me a backache.

I'm hot too. It's 33 degrees C (91 F) outside, so I closed all the blinds in order to keep the apartment as cool as possible (no A/C). It's not going to get any cooler the coming days either.

I removed the babystrology widget from my blog because although it was still counting my pregnancy, it no longer showed an image of a baby, just an empty womb. I found that a bit morbid... (luckily the real one in my belly is still kicking around happily).

My parents have been here since Saturday. We had dinner with them on Sunday evening, to celebrate their 41st anniversary. Saw them briefly yesterday and this morning too. My dad complained that he would go crazy if he had to stay here in the city much longer (because every day he has to think of an activity to do...) and that he has to be back in Holland on Monday for an important meeting. I asked them if they really intended to leave on Sunday if they'd knew the baby would be born at the latest two days later (if nothing happens naturally in the coming days, I will be induced Monday or Tuesday)...

Ugh. First they say they won't come until the baby's here, then they come anyway because my mom wants to be close to me and then my dad gets bored... So maybe they're driving 6 hours down to the south of France tomorrow to stay with friends, who have a big house with a pool. Whatever. My dad did send out an email to his work though, saying he might not make the Monday meeting.