Wednesday, June 27, 2012

Psych Screening: Check!

On Thursday I completed my MMPI, after fighting horrible construction traffic on the highway I don't normally take on my regular route home.  I was panicking that I wouldn't make it in time, since my husband had told me earlier in the day it took him almost an hour and a half and that didn't leave me much time to get the test done before the office closed.  Eventually I just gave up and left that highway, took the highway I normally take even though it was a much farther drive distancewise, and managed to get there by 5:45.  (Note to self and other St. Louis residents: when driving at rush hour, no matter where you are going, Highway 40 is NEVER the answer.)

The test was, well, pretty dumb.  It was a scantron with over 500 true/false questions.  I would imagine that anyone with half a brain (personality disorder or not) would be able to figure out the "correct" answers to most of the questions.  I dunno, but I wasn't worried, and I whipped that thing out in an hour and was home to see my daughter before her bedtime.

Then yesterday morning was the actual in person psych evaluation for my husband and me.  We got there, resisted the efforts of the receptionist to try to pry my insurance card out of me (I KNEW no one would have any idea what was going on and try to bill me...this office is not organized.), and I filled out a "mood" questionnaire about my level of depression that particular day.  No, I didn't feel like killing myself, but thanks for asking.  I'm sure it was standard for the regular patients but I'm guessing I probably didn't need to fill that out.

Then we got into the room with the doctor.  He sits us down on the couch, and opens with, "So, you want to adopt!"  Seriously?  After we explained that we had to be screened so I could be a surrogate, he says, "Oh!  Well what am I supposed to do?"  "I guess you're supposed to make sure we won't have a mental break and run off with the baby after it's born?"

After that, we basically answered a lot of fact questions about the process of surrogacy, and gave him a general background on our families and relationship.  The doctor was actually really nice and was really easy to talk to.  It was a pretty pleasant hour.  At the end he told us he had no concerns about us, thought we were a wonderful "normal" couple, and that we were doing a great thing.  He hadn't gotten our MMPI results back yet, but said he wasn't worried about it.  He said he didn't put much stock in that test anyway, and even if it came back with something flagged he would still be able to clear us for surrogacy.  I promised him that they would be fine, since the voices in my  head told me not to tell anyone about them so I answered no on all those questions - the doctor just laughed.

I left the office with mixed feelings - it certainly wasn't what I expected.  We basically just discussed the surface process of surrogacy without actually getting much into the emotions involved.  Issues like termination/selective reduction, relationship with my IPs, and separation from the baby after it was born weren't even touched on.  On the one hand I was glad we had such an "easy" interview, but on the other I felt kind of guilty, like I was getting by without being properly tested.

I guess it went well, because the psychologist called my agency right after we left the office to tell her that he thought we were wonderful and would be writing up a report ASAP.  She asked me for feedback on him and I mentioned his initial confusion about the nature of the appointment, and said that I felt like we got off a little easy.  She assured me that his job is to catch personality disorders, which he can do while discussing any topic, and she was sure we were fine if he cleared us.  So who knows, maybe his strategy is to feig ignorance in order to glean our interpretation of what surrogacy is?  We'll say that.

Anyway, now we are just waiting for the official MMPI results and his report so we can (finally!) schedule my medical screening.

Wednesday, June 20, 2012

Silly Tests and Panic Attacks

I just realized I haven't updated my blog in a few days.  There are two major developments that have happened:

First, I got a call on Tuesday from the psychologist my husband and I are scheduled to see next Tuesday.  Well, technically I got a call from his secretary, but his intended message got so garbled that he ended up just getting on the phone with me himself.  He had decided that he wanted us to come in several days prior to our appointment to take our MMPI tests, so he could get the results from them in time for our meeting.  Fine, except I work 9-5 and was already going to be missing a couple of hours of work for the psych screening.  So he was nice enough to agree to let me come in directly after work, since someone is normally there a bit later in the evenings.  I will be going to take the test directly from work tomorrow.  The downside is that this will require me to drive across town at rush hour twice instead of once, but the upside is that my appointment on Tuesday will be shorter and I will have to miss less work.  Since my husband has a different schedule than me (he works 6pm-6am three days a week), I told the doctor he would have to call and schedule a time to come in separately.

After two phone calls with rude receptionists telling him they had no idea what he was talking about and that he can't come in because the doctor has no appointments available (he doesn't NEED an appointment, just a desk to take the test), he was finally able to convince them to let him come in and take the test tomorrow afternoon.  Hopefully when we get there they will have heard of an MMPI and will be able to find one for us to take.  To say that the office is disorganized would be an understatement.

Then, yesterday afternoon I got an email from the nurse coordinator (NC) from the fertility clinic in Chicago that is going to be going the embryo transfers.  The one we've been trying to schedule my med screening with for the past month.  After reviewing my medical records, the nurse said she needed a letter from my OB stating that I was medically cleared to be a surrogate.  OK, fine, I will get that this week.  Then she proceeds to say that I should make sure my OB has advised me of the risks of taking estrogen with my family history of breast cancer - she believed the estrogen taken in order to prepare my body for IVF would be ill advised as it can increase the risk of breast cancer.

Insert total freak out here.

My family history of breast cancer is very scary - my paternal grandmother and aunt were both diagnosed with and died of breast cancer in their 40s.  Based on the family connection and their ages, it is most likely genetic.  I know that my risk of getting breast cancer is high.  I choose to not think about it, figuring that worrying about it now won't keep me from getting it in the future.  But of course this email throws me for a loop - I didn't realize estrogen can cause breast cancer.  Why didn't anyone tell me before?  Why did two separate agencies medically clear me without a word about it?  It was time to consult Dr. Google.

First I start googling information on family history of breast cancer.  I learn that 1 in 8 women in the U.S. will be diagnosed with breast cancer at some point in her life.  I also learn that those with a certain inherited genetic mutation have an 80% chance of developing breast cancer.  That's a fun fact.  Now I'm really freaking out.  So I start googling breast cancer and estrogen.  Yep, high doses of estrogen (like those used in hormone replacement therapy for postmenopausal women) increase your risk of breast cancer.

Then I ask myself, with the risk factors that I have am I really willing to increase my risk even more to have a baby for someone else?  What happens in the future if I get breast cancer - will I always wonder if I had not been a surrogate if I would not have developed it?  Would I regret my journey?  Here is where I send a panicky email to my agency coordinator.

Then I think, wait a minute, I researched fertility medicine risks before I even considered this journey.  I didn't see anything about cancer anywhere.  So I go back to google to research more carefully.  It turns out that tons of studies have been conducted regarding fertility medications and their risks, including whether taking estrogen increases your risk of cancer.  All of the studies I was able to find, including ones that included women who received fertility treatments back in the 1960s, showed that there was absolutely no evidence of an elevated risk of breast cancer.  Not even if you already have elevated risk factors.  In fact, pregnancy and breastfeeding before the age of 32 actually decrease your risk of breast cancer.  While hormone replacement therapy gives you a constant dose of estrogen over long periods of time, the estrogen you take while cycling for IVF only lasts a couple of weeks, and it really isn't that much higher of a dose than it would be if you had ovulated on your own.

Today I left a message with my OB, and when I ask her to write a clearance letter for me I'm definitely going to bring up the estrogen/breast cancer question with her like the NC suggested I do.  But after researching, having a long talk with my coordinator, and getting input from other surrogates on SMO, I'm feeling  much calmer now.  Jesse and I decided that the NC is mainly saying that to cover her butt, and that it came across harsh because, well, that's just her personality.

So I'm not going to throw in the towel.  I'm still going to make my IPs' dreams come true.  I'm glad that the NC said something because it allowed me the opportunity to properly educate myself.  I may have been having a panic attack yesterday, but now I actually feel better than I did before about my choice.

Wednesday, June 13, 2012

Psych Screening is Scheduled

So I have my psych screening all set up for June 26.  It was more complicated than I thought it would be to get it scheduled.  My clinic requires that my husband and I attend a session for our evaluation, as well as take the MMPI (which I understand to be a long and tedious test of true/false questions designed to catch certain personality disorders).  It was difficult to find someone who was qualified both for a surrogacy pysch screening and to give the MMPI, but my agency managed to find someone located reasonably close to me.

Jesse is going to call the clinic and see if we can at least make an appointment for my medical screening now, or if we have to wait for the psych results to come back first.  At first I was super bummed that we had to do this process in two steps - normally a surrogate is able to get the med and psych screening knocked out at the same time, but every clinic has different requirements.  I was really hoping we could get all my screening done in June so we could do contracts and start meds in July and transfer in August, but it doesn't look like that will happen.

The reason I was really hoping for August was that we have a trip to Italy booked for October.  Because the weeks before and after transfer require so many meds and monitoring appointments, there is probably no way that I can do a transfer in September or October, so we will have to wait all the way until November.  Which means I will have to be hugely pregnant in St. Louis in the summertime.  And since contracts require that you are bound to your home state for most of your last trimester, there will be no summer vacations for us next year.

BUT, it will be nice to be able to take my once-in-a-lifetime trip to Italy without having to worry about first trimester morning sickness and fatigue.  It also means I will not be pregnant for my 30th birthday (also in October).  Probably the biggest plus for me, it also means that I can stop stressing about getting everything done quickly.  The last month or so I've been constantly checking the calendar to see which days in the coming weeks are best for traveling to Chicago for screening (my husband's schedule is a little tricky).  I've been counting up days in my head, trying to figure out the last possible day we need to get X or Y done in order to make an August transfer.  I think now that I have it in my head that I have all the way until November, I will be able to let all that go.  It's a relief to know that I won't be trying to rush through contracts or having a panic attack if there are any hang ups along the way.

Friday, June 8, 2012

A Note on My Agency

No word on my psych appointment yet, so I figured I would take this opportunity to insert a shameless plug about my agency.  I am working with Jesse with Pink & Blue Surrogacy, which is a small agency run out of Wisconsin that serves all types of clients from around the world.  Jesse is a three time surrogate herself who decided to open her own agency.  She has some staff members, but basically runs the whole show herself - coordinating with parents, surrogates, doctors, lawyers, etc. to make sure no balls get dropped and the process is as smooth and efficient as possible from matching through delivery.

During the past few months, Jesse has been FANTASTIC!  She's always super quick to respond to emails and will make time for a phone conference whenever I have questions.  She is great about shooting me a quick note or giving me a call whenever the next step in the process is made, or even just to check in and let me know she hasn't forgotten about me/us.  I know my IPs love her too.  They talked to several agencies before deciding to work with Pink & Blue, and said Jesse was the only one who made them feel like she really cared about them and their story.

Another thing I love about my agency is that there is a private online group for all the surrogates so we can all update each other on where we are in our journeys.  Even though the agency is super small, in the month or so I've been in the group there have been two adorable new babies born and three new pregnancies achieved!  It's a great way to keep me inspired and focused on the ultimate goal, which is giving my IPs their own little bundle of joy!

So anyway, if you are a potential surrogate or IP who is looking for a wonderful agency, I encourage you to check out Pink & Blue!

Thursday, June 7, 2012

Next Step: Psych Screening!

The caseworker from my agency called me last night to let me know that we have had some progress!  My IPs have picked an egg donor that they like, and it looks like the timing is going to work out well.  She will be available to cycle in August, which is our goal.

In addition, she heard form the nurse coordinator at the clinic about their surrogate requirements.  My husband and I have to have our psych screening out of the way before we can get our medical screening done.  Since we can't do them both the same day (as is possible for many clinics), my caseworker is going to find a psychologist we can go to in the St. Louis area so we only have to travel once.  She was going to start her search today and let me know as soon as she found someone, so hopefully I will be able to get that done in the next couple of weeks.

I'm really excited that we are getting closer to getting the show on the road!

Tuesday, June 5, 2012

First Appointment Down

Sorry for the long pause in posting.  I was out of town on vacation, and nothing was really going on before my IPs' first appointment anyway.

They had their appointment with the clinic yesterday and it went very well.  They are in the process of getting all the paperwork out of the way so that my screening trip up to Chicago can be arranged.  They are also going to be using an anonymous egg donor, so they are in the process of selecting one of those as well.  Luckily the clinic they are using has a fairly extensive donor database, so they don't have to shop around through different donor agencies to try to find someone.

On my end, I'm pretty much just sitting on the sidelines waiting for them to tell me when I can come to Chicago.  I know there's really not much I can do at this point, and all the initial arrangements and decisions need to be made by my IPs, but I don't like feeling like I'm out of the loop.  I haven't had much communication with my IPs since we met in person last month.  I think part of the problem is that I am very much an emailer and they are not.  I think there is probably also a certain amount of caution on both sides, with neither of us wanting to bug the other.  I have tried shooting a couple emails to the IF but haven't gotten much of a response - I know he's very busy as he owns his own business.  I don't even have the IM's email address or phone number and IF hasn't given it to me.  I really loved talking to them in person, so I'm hoping that once I am able to see them again when I go up for screening our relationship will start to blossom a little more.  Anyone have any advice for how to get a new surrogacy relationship off the ground?