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May 2005-Mark was scheduled to have his MESA retrieval mid-May and the week before his procedure I was
comparing prices since we were going to need to store the sperm for about 6 months. The place where Dr. Bastuba
was going to be doing the procedure was Alvarado Hospital, but we were doing my portion of the procedure at
Reproductive Partners. I was informed by Dr. Bastuba's office that they could change the referral to have the
procedure done at Reproductive Partners and then I wouldn't have to cart frozen sperm back and fourth. We had
already decided the sperm was going to be stored at Reproductive Partners after the procedure (for convenience and
they charged the least), so we thought it was wonderful that we could have the procedure done there.

Dr. Bastuba's office initiated the paperwork to have the referral location changed. Apparently Reproductive Partners is
a contracted doctor for my insurance, but I was told it was a newly created contract and hadn't been approved for
referrals from Tricare yet. So, they informed me that we wouldn't be able to do the procedure there. That was okay
with me, it really wasn't a problem to take the sperm to Reproductive Partners immediately after the procedure at
Alvarado Hospital.

We received a phone call the following morning that informed us in the process of changing facilities; Tricare had
requested more information about the surgery that was to take place the following Monday. The doctor's office
provided the requested information to Tricare and then Tricare denied the procedure as a non-covered benefit. So
now, instead of our procedure being covered by insurance and us only having to pay $250 out of pocket to store the
sperm, we were looking at paying a fee of $2500 to Dr.Bastuba and $1800 to Alvarado Hospital for the procedure
space and anesthesia. Mark and I decided that was not something we could afford at this time. Maybe next year when
he has completed his degree and is working, but not solely on my income. Needless to say, Mark and I were
heartbroken and I cried for quite a while about it. Not only did we have a set back in February, but now we were
running into one again, and this wasn't one we could fix immediately.

October 2005-Mark and I finally revisited the Urologist at Naval Medical Center San Diego and saw a new doctor there who had just returned from
deployment. As luck would have it, this urologist is incredibly knowledgeable about infertility and it is actually his specialty-our luck finally seemed to be
changing! We had our first appointment with him on October 18, and Mark's LH, FSH and Testosterone levels were incredibly and abnormally low-again.
He was just a perplexed as the previous doctors we had seen but he proposed that we have a TESE (Testicular Tissue Sperm Extraction) procedure done
on Mark. This TESE procedure would show whether or not there was normal spermatogenesis in his testicles. TESE is the surgical removal of a portion of
the testes for patients because of an absence of the vas deferens. It can be utilized for both diagnosis of sperm production, as was done in our case, or the
sperm can be harvested and used for IVF and ICSI. After a day of talking it over, Mark decided that he would go ahead with the procedure and we
scheduled for the following week.

The TESE procedure-This was in office procedure done with local anaesthetic. We arrived at the urology clinic at 6am on Tuesday and Mark had been
given specific instructions not to eat anything the night before after midnight and he grudgingly adhered to it. They placed Mark on a table and I was invited
to stay for the procedure. The doctor came in, along with two technicians who assisted him throughout the procedure.

They exposed the surgical area and sprayed him down with betadine, which they warned was very cold, especially at about 6:30am! They placed the
testicle into a loose clamp, simply so it could be held in the position the doctor needed it to be for the procedure. Then the doctor warned Mark he would
feel a very sharp piercing as he used anaesthetic to numb his testicles. Mark describes that shot as a burning sensation that was alleviated once the
needle was removed. The doctor then jumped right in, using an electric cauterizer to cut into Mark's left testicle. Mark describes the cutting as a burning
sensation with a large pressure feeling on the testicle. The doctor explained this feeling of pressure was completely normal but they couldn't do anything to
alleviate it, short of putting him under. They told him to SPEAK UP if he started feeling any pain because they could numb him up again.

Once the doctor had cut into the testicle, he exposed the testis and cut out a tiny portion of tissue. I saw this tissue and it was about 1/2 cm long and about
1cm in width. One of the technicians placed it in a petri dish that contained a medium to keep it pure for analysis purposes. The doctor then sewed that
incision up with self-absorbing stitches. The incision itself was about 3/4 of an inch to 1 inch.

He then made an additional incision on the same left testicle, a little bit lower than the previous incision. He again exposed the testis and cur out a tiny
portion of the tissue. This tissue was about 1cm long and 1cm in width. They again placed it in a petri dish with the same medium and sent it off to a lab for
analysis. They placed some antibiotic ointment on top of the stitches, placed a bit of gauze over the ointment and put a Jock Strap (can be purchased at
Walgreens, Rite Aid...) on him. He was instructed to wear this jock strap for 2 weeks minimum, longer if needed. Mark was asked to sit on the bed for about
5 minutes before he got up, just so he didn't pass out. The entire procedure, from the numbing to when they told Mark he could get up and put his clothes
back on was about 30 minutes.

The Recovery-I had picked up Mark's "post procedure" medications the afternoon before and they consisted of an antibiotic that he was to take for the
next 7 days and some Hydrocodone for pain. He was advised not to use Tylenol for 48 hours because it thins the blood and that could pose a bleeding
problem if something happened with the stitches. Mark got dressed and he walked from the office out to the car. I had taken that day off work to make sure
he could just rest and keep ice on the area the entire day. I also didn't want him walking around that first day and it wasn't recommended that he do so.

It was recommended he keep ice on the area for the first day, so I had brought a disposable ice pack with us. The moment he got comfortable for the short
drive home, I broke the ice pack and he placed it on the surgical site. When we got home, the couch was ready for him to lay down on and he took his
antibiotics and Hydrocodone. He ended up sleeping for about 4 hours straight and I snuck in and replaced the ice pack about every hour. When he woke
up he was starving and I made him some lunch. He said the area didn't hurt but he could tell that it was sore????? but no pain so I guess that's good. He
spent the entire day on the couch, and that was pretty much the plan anyways. We had rented some movies and spend the entire day making sure the
area stayed iced. Right before we went to bed, I put some antibiotic ointment that the urologists office had give us, on the site. That night he slept pretty
well and I got up once and got him new ice. We discovered that a TALL water bottle bought at the grocery store and frozen lasted through almost the entire
night. I had prepared snacks and food for the following day as I had to go back to work and I still didn't want him on his feet for too long.

On the second day, he set himself up on the couch again and kept ice on the site all day long. He only got up to eat and go to the bathroom on that second
day. Not that he didn't feel up to it, because he said that it wasn't hurting but he just wanted to be cautious. When I got home from work at about 5pm, Mark
had finished a lot of his homework and looked chipper and good. You never would have known he just had this procedure the day before. He kept ice on
the site throughout the whole night, just as he did the day before and I also put some more antibiotic ointment on the site.

On the third day (Thursday) Mark continued to ice the area and he was much more active. He even used the weight set we have at home and did and
upper body workout that afternoon. He iced the area that night too although he wasn't having any pain, and hadn't had any pain at all since the procedure.
He did express that the area was sore, especially when our 140lb Rottweiler ran into his groin but he was back to his normal activities on the third full day
after the procedure.

As I am writing this, we are almost 2 weeks post procedure and Mark is still wearing the Jock Strap for support but discontinued around the clock ice after
the third full day and night. He still used some ice a bit on the fourth day when he was sitting down doing homework or was sitting on the couch watching
TV. The area turned a bit purple and yellow on the fourth day, but the discoloration disappeared in one day and wasn't painful, just a bit tender to contact. .

What's Next?- Mark will have this procedure done again, but this time we will cryo-preserve the sample they retrieve so that when we are ready to do IVF
("again"-at least that's how I feel) we will have his sample and won't need to worry about CF medications or abnormal lab results. We are going to talk to the
urologist to find out if he thinks a MESA retrieval or a TESA retrieval will be the best way to go. Previously he had mentioned maybe taking samples from
both the testicular tissue (as was done in the TESE procedure) and samples from the epididymis. Then a lab can examine and analyze the samples that
look the best and most promising.

January 2006-We have been given the opportunity to pursue IVF once again thanks to the generosity of a family member. As you can see through this
journal, we have been weeks away from beginning the procedure on 3 separate occasions, only to have something fall through (health or financial). We
were content with me serving my time on the ship here in Washington State and pursuing the IVF in 2 or 3 years. We weren't happy about it but decided
that's what we had to work with and it is when we predicted the finances would next allow it. Now the only obstacle we are facing is that I am suppose to be
on a ship that is set to deploy later this year. On Monday the 9th of January I called Northwest Center for Reproductive Sciences and scheduled an
appointment. I saw Dr. Opsahl on Wednesday the 11th of January to do an ultrasound and an initial visit. The doctor said this was perfect timing to get
started, my period was due on Thursday the 12th. He wrote a letter for me to take to the Chief on my ship stating that I was starting on some medical
treatment and was going to have two minor surgical procedures in early February. I was given a prescription for my egg stimulating medications and told to
come back on Friday with my husband so the doctor could meet him, do a baseline ultrasound on me and do some blood work.

January 11 2006-I took all the information to my chief on the ship. He was quite upset with me and discussed with me that getting pregnant while on a ship
is not an option. I completely understand where he is coming from and why he is frustrated, I really do. But we have been working at this for 2 1/2 years
now and I just had to jump at this opportunity, I want a baby so bad, my heart and body just hurts and yearns for it. My Chief told me he was going to have
to speak to the command master chief and the Captain of the ship and figure out what to do with me. He was not happy with me, nor was I happy with
myself and I completely understand my new chief's frustration with me and the situation. ;Nevertheless, it's not like I just decided to do this out of the blue
today. We have been trying and trying, and now are in a position to finally be able to do it. I think I have a basic human right to have a child, whether I am in
the military or not, shore duty or sea duty.

January 12 2006-I Received a phone call from my chief that the ship was going to be deploying on Friday afternoon and I needed to report to the ship by
1000 on Friday. I explained to him that Mark and I had a medical appointment scheduled for the following morning at 0900 and 0930 in Kirkland, which is
about 45 minutes away from the ship. I explained to him that there was no way I would make it back by 1000. I also told him I hadn't planned on reporting
until my "report no later than date" which was the 16th of January. He asked if the appointment was for the IVF and I told him yes, one appointment for my
husband and one for myself. He told me to call him by 1300.

January 13 2006-My appointment went great, the doctor saw 10-15 follicles on each ovary and the lab called with the blood results later that day and I was
ok'd to start my birth control on Friday and my Lupron injections on Sunday the 15th. I called my chief at 1300 and spoke to the HM2 on the ship. She said
to me, "We aren't taking you Julie, if you want to play this game, we are going to play right back" I asked here where I was suppose to "check into" on
Monday the 16th and she said, "I don't know, call your detailer, we aren't taking you with all these problems". So I called my detailer and left him a
message. The detailer is the person who writes me my permanent change of duty station orders. He didn't call me back, but the chief from my ship did and
told me that I was going to be on the ship, and to report to the Naval Station on Monday morning the 16th, and not to be late. I asked him what I was
suppose to do about taking the medications. I had already started my birth control and was going to start my Lupron on Sunday. He told me I couldn't do
the IVF. I asked him what he meant by that, how could I be told that I can't pursue infertility treatment as infertility IS a disease. He told me that if I did
pursue it, he would take me to Captains Mast.

I immediately tried to call the legal department at the base to find out what I should do, can someone really tell me I can't seek treatment for a treatable
"disease", especially since I had been seeking treatment previously? But they had closed at 1200 for the holiday. I went to medical and talked to a civilian
who use to be a Hospital Corpsman in the Navy. She ran my situation, questions and concerns by the Senior Medical Officer of the Day and he didn't have
any information on whether o not someone could tell me that. He recommended I talk to legal as soon as possible on Tuesday the 17th. He did recommend
for health reasons, I not take the medications. So my next question was, "if I take these medications, will I be fit to go on the ship, can they send me onto
the ship when I am taking medications where I need to be monitored, and have tests and labs every few days". The civilian told me that if I did start taking
the medications to come back and see them and they would evaluate it. She was very nice and very helpful, but I left with no more information that I went
there with. I am really stuck. I talked to the Chaplain on call for the Naval station who was very nice and understanding, and recommended I set up an
appointment with the medical department and someone from the legal department. I was nearly hysterical when I called him, telling him that I had just tried
to call legal but they weren't available. I will do what he recommended as soon as I can on Tuesday, but in the meantime, do I start this medication? If I don't
start it, and I speak to someone and they decide I am entitled to/can do this IVF treatment, I'll have to start all over (expenses and all). If I do take the
medications and they send me out to meet the ship, which is deployed for about 30 days, what if something happens to my health. And what happens if my
chief does take me to Captains Mast. Is telling me I can't pursue infertility treatment a lawful order? So here we are again, with the finances to do the IVF
(just once though, we aren't able to afford to repeat anything) and now one more thing is preventing it. I am so sad, so heartbroken, so frustrated, I feel so
violated, I feel like it is SO unfair that those who can reproduce naturally can just 'get pregnant' at the drop of a dime and nobody really thinks twice about
it. Surely no chief would tell someone, "I am going to take you to Captains Mast for getting pregnant" naturally. I know I am not being discriminated against
intentionally, but it sure feels like it. ;I have posted more of my thoughts and feelings and concerns on a CF website, you can visit it by clicking here.