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Tuesday, June 11, 2013

departed denver discouraged


Yesterday was a rough one.
I have a little more perspective today but I'm still pretty bummed.
CCRM was not all that we hoped it would be.
No magic wands or unicorns.

A and I traveled to Denver to explore the area and do our IVF workup. Our trip was wonderful and we're glad we went. I will post pictures and write more on our adventures soon. But I've got to get my feelings about the medical stuff out of the way first.

If I'm being honest, we were a little underwhelmed with our experience at the clinic. Many people told me how impressed I'd be with how efficiently they get you through all of the meetings, tests and appointments. But we didn't see it as impressive.

Everything about the clinic was impersonal. 
It was a huge, massive building with a staff of several hundred people.
The clinic got a lot of publicity when G&B cycled and because they had crazy high success rates in 2010. As a result, the clinic grew like crazy and their success rates haven't been as high since then. It's hard to maintain the same kind of quality control when you grow that fast. It made us wonder if we are making the right decision. Our impression was...it felt very business-like. See as many patients as quickly as possible. We felt like cattle getting shuttled from room to room.

Not to mention...psychologically it wasn't good how they billed.
I saw A growing more and more frustrated throughout the day. We've accepted the fact that our insurance isn't going to pay for IVF. But our local clinic charged in one lump sum for everything. Or they billed our insurance for diagnostic and labs. We only had to come to terms with the ridiculous cost of IVF once instead of every 3 hours.

At CCRM, A said "I feel like we've been taken to the cleaners."
Drop your sperm. That'll be $660.
Hysteroscopy procedure. $675 please.
Talk with the doc and an ultrasound. Only $715.
4 vials of blood each. Swipe the card again for $760.
And before you go, why don't you give us $1,000 for a deposit on your IVF.

When I looked around the waiting room, I saw the faces of sad women and helpless husbands. Some ladies had tears in their eyes. Others had puffy eyes. Many wore the look of grief and despair. Occasionally, I'd make eye contact with one of them. The look that crossed between us said "I know. And I'm sorry you have to go through this." People go to CCRM as a last resort. Grasping at the final straw to make their dreams come true. 80% of CCRM's patients have experienced prior failed IVF cycles and 90% or more travel from out of state to seek treatment. I arrived super hopeful. I left a little depressed and discouraged.
me in my owl socks before my hysteroscopy
My hysteroscopy was awful. The carbon dioxide they used caused severe pain in my abdominal cavity and shoulder. After the procedure, we had a regroup with Dr. S. Apparently I was having a vasovagal reaction to the hysteroscopy. I started sweating, felt dizzy and nauseous. When I was trying to ask a question, I almost passed out. The doc went to get me a cold compress for my neck and some orange juice. I put my legs up and eventually those symptoms subsided.

Good news.
He didn't find any polyps, adhesions or fibroids during the hysteroscopy that would delay IVF.

Bad news.
The doppler ultrasound determined that the blood flow to my uterus is constricted. That is probably yet another contributing factor as to why we haven't gotten pregnant. Decreased blood flow makes it difficult for the embryo to implant. Before my IVF transfer, Dr. S recommends that I do 4 weeks of electro-acupuncture. Here is an article I found about increasing blood flow through electro-acupuncture. Trouble is that I don't think any acupuncturists in my area do this treatment.

Really bad news. 
Based on my previous Day 3 levels and my 7 resting follicles, the doctor thinks that we might get one good, quality embryo out of the deal. Yep, you got that right. One. That was a blow. I'm never going to be one of those ladies that retrieves 17-20 eggs and has to worry about what to do with all my extra frozen embryos when I get pregnant. I feel foolish that was ever even a concern of mine.

He said with natural attrition...I might get 5 eggs. Then with the genetic screening and my age...maybe one will be normal.

So Dr. S posed a scenario for us to think about. Since we are doing PGS, we will have a frozen embryo transfer anyways. We could cycle and retrieve whatever embryos possible. Freeze them. Cycle again to get a few more eggs. Thaw the frozen ones and test them with the fresh ones. Then we should have a few more normals to work with. It is basically like doing two IVF cycles but you save money on the genetic screening and transfer because you only have to do those once. 

I know Dr. S was trying to help. But A felt like "sh*t, now we are already talking about two cycles". And for me, I wasn't crazy about the way Dr. S worded it. He said something like "you two don't look like people who are going to be willing to give up if this doesn't work so think about this...". I've been thinking about his comment since I heard it. Are we people who are willing to give up? 

My husband is because this is not his dream. It is mine. But how much and how long am I willing to put us through this? We don't have enough money to do two cycles at that clinic. And even though my work has been great, that would be an additional 7-10 days that I'd need to be in Denver. On top of the 11-15 days, I'd need for one retrieval and transfer. 

Honestly, yesterday I felt like a person who is willing to give up. And give up now. It was just too much. A and I both felt so overwhelmed. We still do. But we've been able to comfort each other and try to find humor is our very unfortunate circumstances. It is a lot to take in. I'm thankful we have each other. For now, we are just trying to process everything.


57 comments:

Aspgriswold said...

Oh hun! I am so sorry about your experience. That is so devastating. I will be sending you lots of thoughts as the two of you work out what direction you are going to take. I am so sorry the appointment turned out to be a big disappointment.

Katie said...

jessah I'm so sorry that it wasn't what you hoped it would be. that sounds terribly overwhelming and so much to deal with. it's disappointing that you felt like it was an in and out business and not one where you are receiving loads of compassion like you should be. I know there isn't anything to say to make you feel better but know that I am thinking and praying for you.

Infertile625 said...

Honey it's during times like these, where we feel overwhelmed and helpless that we learn a little more about ourselves and what's important to us. Truely important. Try to step back from the initial slap and see the big picture. Weigh your pros and cons but remember that sheer numbers don't always win that list. Each pro and com is weighted. I remember making a list with the hubby when we were deciding to move to his home town to be near his wonderful family or to Vermont (which we love). The only thing on the pro list for his hometown was family. But the shear weight of how much that meant to us pulled us here. To his small hometown. And I've never looked back. Big hugs. You will figure this out.

kharini said...

I'm so sorry you had that experience, they are impersonal, it's true. I can imagine how you felt when Dr. S told you that you may need more than one cycle, that's about 50K, it's huge! I've spent 170K total and I still cannot believe it... You are smart on letting this all sink in, taking your time and see how you feel. As bad as it sounds, I think it's good he is telling you up front that if you want a baby you will probably need more than one cycle. I know how hard it is to hear but it's better to know that now and be able to make an educated decision...

Hang in there Sweetie, take your time, think about it...

In regards to the acupunture, most acupuncturist do the electro, it's simple, they just put little "pliers" on the needles to give the acu a bit of a booster. Every place I've gone to has it. I wouldn't worry about that.

xo

Rhonda said...

I'm sorry it was disappointing. Maybe because it's run like a successful business that increases their success? I don't know. I am just sending you a big internet hug.

waiting and wishing said...

Thinking about you and praying you can find an answer as you sift through everything you learned. It's understandable that you are feeling a bit overwhelmed- that is a lot to process in one trip- and I completely agree with you on the billing/check-out process one big bill instead of many smaller (yet still sizable!) bills is somehow easier to swallow.

Laura Rahel said...

I hope your experiance gets better! Don't feel bad about switching back to your local clinic if thats what makes you feel most comfortable and safe. This is supposed to be an exciting, hopeful time for you guys- that clinic sure doesnt sound like it's fullfilling that part of the experiance for you- baby or no baby.
Much love

Amanda said...

wow… that is a lot to take in. I can only imagine how overwhelming that would have been! I can't imagine my husband surviving that… he would not be a happy camper at the end of the day!

sending you lots of love and hugs as you and your husband decide on next steps!

Becky said...

Oooof that's a rough day! I'm so sorry the hysterscopy didn't go well and that you didn't get much in the way of good news. =( I definitely know the "cattle" feeling. We went for a consult with a Dr. who "competes" with CCRM and they have the same thing...it's huge and impersonal and they have too many patients and not enough compassion. We decided it wasn't for us and are sticking with our local RE. I hope that you guys take the time you need to think and process and decide what the next step is. Praying for peace and relatively easy decisions!

Becky said...

Oh! And I forgot to mention that I've done the electro acupuncture before...it's not very high tech! I would bet some of your local acupuncturists do it. They just hook the needles up to an electrical machine...it feels super weird haha!

Aubrey said...

I'm so sorry that your experience was so.... stressful. CCRM is definitely... different. They do see a TON of patients in one day. We felt very, very stressed after our work up. It honestly took me a few days to really process everything. I agree with Karini, and I'm glad that Dr. S mentioned the two cycles up front to you... I know it's discouraging to hear that, but hopefully that will help you to make a decision one way or another. Do you think you'll go ahead and send them your day 3 blood, etc? Thinking of you, girl!! xoxo

Mrs B. said...

Jessah,
I am so sorry that this didn't go as hoped. The whole experience sounds awful. He's not exactly given you any positive hope is he! I don't know how the clinics differ to Australia, but mine is quite personal and also the money thing... They don't ask for money up front but instead send out invoices so we can receive them privately and pay over the phone. I prefer this, when I got at $10000 bill the other day for our failed cycle I was so glad I could have the time to process it at home and cry at home.
I am sorry about this whole day! I really feel for you.
At least you have a chance to step back, catch your breath and think about what to do. Take care lovely x

Suzanne said...

I am so frustrated for you. You had such high hopes going their and I hate that they have let you down. I think after my recent IVF experience, I have felt in my heart that's what they will say to me as well. It's so hard, we keep going back and forth on whether or not that's where we should be to continue treatment. There is no easy answer and no crystal ball that's going to tell me which clinic is right for us. I certainly wish there was. xo

Megan Brink said...

Jessah, I am so sorry. It seems like you mentioned that everyone goes to CCRM thinking the doors open and butterflies and rainbows pop out and it's a perfect experience. I am so sorry you had the experience you did while you are, let alone the feedback. I will be praying for you and keeping you in my thoughts. Know there are so many people behind you.

Xo m

abrinkadventure.blogspot.com

Cristy said...

Damnit, Jessah. Damnit, damnit, damnit. Just reading this makes my heart sink for you as this experience was clearly disheartening. I'm so sorry that you're feeling like just another number. And I'm so sorry that the doctors aren't helping you guys with this. Thinking of you and hoping that as time goes on you feel better about this decision.

Sarah said...

Where are you located again? Too bad you couldn't use the clinic I used, it's a small clinic..very tight knit...the nurses and docs get to know you. And it's know where near the cost of what I think you might be spending there. But anyways, I'm so glad you had a nice get away together but I'm so sad that the clinic part didn't go well ;( I know it must be a lot to take in and think about :( Sending you a big hug! xo

Gypsy Mama said...

oh my... I am so sorry that you are in this place right now. I can totally imagine how stressful it was for A and you to go through that. Plus with so many emotions riding on this, it makes it that much more difficult. I can understand everything, from the stress of having to pay so many times, to the business-like energy of the clinic. Is there any way you could go back to your old clinic?

I hope you find some peace soon and whatever you decide to do, I hope you know we are all here to support you. I know you have a lot to think about and process right now. Sending you a big hug!

Erika said...

Girl, I am SO sorry for the confusing and less-than-stellar appointment. I can't imagine how frustrating...it was such a big decision for yall to make to pick CCRM in the first place, and now this? Sheesh. Praying that you'll have wisdom & peace about what steps to take next.

Ashley said...

I'm soo sorry that your experience was discouraging, but I am glad you were honest about it. I think that whatever you decide to do, go in it thinking positively. Yes the odd are against you, but a lot of people win on odds right? I know very well what it feels like to question your future dreams. Hang in there Hun!! Praying for you!

Leslie said...

Awe honey I'm so sorry. I hope all goes well. You two seem pretty strong. Everything will work out in the end.

Xoxo

Impatiently Waiting said...

Jessah, I am so very sorry. My heart aches for you.

I hope that you take some time to process all of this and take your time thinking about it.

On another note, I have done the electro acupuncture. I do believe most LAc do or can.

J and A said...

I'm so sorry this experience left you feeling this way. My heart hurts for you. I know nothing no one says will help how you feel but just know we are thinking of you. Hugs!!

Aramis said...

I'm really sorry to hear that. I know CCRM is like the Holy Grail for DOR patients, and it's got to be hard to get bad news right off the bat. Wish it wasn't so difficult.

changtry said...

I love you!!! You are the strongest woman I know hands down...

jAllen said...

I am so sorry to hear that the CCRM appointment was not what you expected. Thank you for being so honest with the assessment of your experience. I know you've debated the decision on CCRM for so long, and I know you'll make the decision that feels right for you..

Anonymous said...

I so wish you were in Australia where IVF is affordable. My heart hurts for your disappointment but you are so so smart, you will make the right decisions. Best of luck and take it easy on yourself. X Amy

JoJo said...

Oh, Jessah, I am sorry you went through that experience. I know you had great hope with CCRM. I 100% understand when you say "...it felt very business-like. See as many patients as quickly as possible." this was the reason why I switched clinics. I just couldnt wrap my mind around how impersonal it was. Take your time on processing all this information so you both can make the best decision.

Amber said...

Oh man, this is heartbreaking. I'm so sorry you are having to go through this and make such incredibly tough decisions. My body doesn't produce enough eggs either so I completely understand how tough that is. I'll be praying for you.

Well-intentioned said...

I'm so sorry to hear that the visit failed to meet expectations. I go to a small-med clinic and I think I'd also be turned off by a cattle like approach. Sending you support and encouragement and remember..."giving up" on one avenue could very well mean starting down another one.

Kristin J said...

I am so sorry it didn't go well. Do not let the doctors words get to you. His job is to try and get you to do more than one cycle if the first doesn't work. You aren't giving up if you decide to not continue you are moving on and doing what is best for you, your husband, and your marriage. Sending you hugs from Idaho!

Always Maylee said...

I have been thinking about you and wondering how your trip to denver went. I'm so sorry it was such a disappointment! I actually think it was good that the Dr. mentioned two cycles. I think he was just trying to be honest with you guys. It would have been an even bigger disappointment if you went through 1 cycle and THEN he told you, oh wait, we should do another one. At least now you can really weigh your options.

And remember, you only need 1 good embryo to get pregnant. Don't let the numbers get you down. Miracles happen all the time. Sending you a virtual hug! :)

xo, Yi-chia

Suzanne said...

I'm so sorry that CCRM was not all that you hoped for. Sending you lots of hugs and strength as you determined your next steps.

Just T said...

I read your post last night and it kept me up for hours thinking about everything you wrote.

I am SO very sorry that this clinic wasn't at all what you were led to believe and it feels like they failed you. I hate the fact that some places you go make you feel like it is ALL about the money and not the compassion or care to get you pregnant.

At this point, do what you and your husband feel comfortable with and PLEASE remember that your visit was only numbers! They can take an educated guess on how many good eggs you will have, but it is not a proven science. I think that regardless you will make the right decision on where to go from here. I can't stress enough that doctors are not always right and especially when it comes to guessing egg quality without biopsy etc.

Sending you so many thoughts and hugs.

Emily said...

I hope I don't sound too negative, but I've got to agree with you on a couple things.

1) Why on earth they make you pay all those charges separately is ridiculous. They can easily charge one fee and payout to payees on your behalf. I can't believe they do it that way. Stressful.

2) It REALLY bothers me that Dr. S made that comment "You two don't seem like the type to give up after one try" or whatever he said. Ok, this screams car salesman dimestore reverse psychology to me. That is like someone trying to sell you a more expensive "safer model" car and saying something like, "You two don't look like the type of people who want to sacrifice your lives in an automobile crash, so you need THIS ONE!" I really really do not like statements like the one he made, because it's playing on emotions not science. Yeah, sure it might be that it would save you $ in the long run IF AND ONLY IF 2 cycles were needed, or the hassle of one less screening for 2 tries, but ultimately he made the statement to sway you to agree to doing it that way. Is it just me? Maybe I'm overreacting?

You guys are smart people and you can make decisions with someone telling you what "type of people" you are. I can def see how you guys were rubbed the wrong way, pressured to make a decision you weren't expecting to make, and left feeling disheartened.

ksirahsirah said...

J-
I woke up and read your post this morning, and my heartfelt crushed for you. You had a "let down" which is never fun to experience. I agree with some of the other posters- take some time and process what you are feeling. It sounds like CCRM was very businesslike, but maybe that is what makes them so successful? And then consider what is most important to you? I am happy to hear that you and A are still able to find humor to help get you through. You two are amazing. Prayers for you both friend!

Lyndsey Davis said...

I'm sorry you were disappointed. It's so hard to have a plan that you believe will be the answer to all your problems and then it doesn't turn out the way you imagined. Prayers that you and your hubby will make the right decisions.

Wannabemom said...

It's not giving up. It's taking back control of your life from infertility and saying "enough hurt". I hope you can make the decision that is right for you.

Court said...

I'm so sorry that you had a rough experience at CCRM. I hope that you and A have time to talk things over and plan for your next step. I just think its awful how much everything costs. With my RE they ran so much through insurance to help as much as possible. They even coded lab work so that insurance would help more. Thinking of you!

JenS said...

wow. so sorry to hear it wasn't a good experience. Take your time and think about what you want to do. Maybe CCRM isn't for you after all? I hope you don't give up - no matter where you cycle.
Also, I did the electro-acupuncture. I think it's something all acupuncturists probably do.

Anonymous said...

Hi J - I wrote to you before when I was embarking on my first IVF at UCSD Reproductive Partners. Well, just wanted to let you that even though we transferred two pretty good embryos, my first cycle did fail. I do have a couple frozen ones and we will do a frozen transfer next. But I just wanted to tell you this because because it keeps things in perspective. It's true, there is no magic wand in all of this unless they are GOD. God has the wand - not any of these clinics. I thought that IVF would surely work - but at my age (close to yours at 35), I've been told it does take more than one time even if everything seems perfect.

I felt the same way as you at UCSD, they looked a bit fancy and impersonable at first - but ultimately as you cycle, you get to know the nurse and staff and they all really do care about you. UCSD obviously isn't as grand as CCRM but it is a business and you can sense that. It definitley was different than my local Kaiser office that was handling my case before transferring me to UCSD but luckily my wonderful RE is still working with us at both sites.

As the others have commented - maybe its okay if you reconsider your original clinic once again. Seriously, after my failure, I'm wondering if it matters at all the clinic. I guess it does to some extent, but with this experience behind me now, I think what's the most important is the care you get, that the dr's and nurses know your case, and work hard for you. I love my RE and I trust her with all my heart - I know she wants me to get pregnant and will do her best to get me there. The few days ago when I found out my cycle failed, she called me and she said...."I'm so sorry it failed, but in my heart, I know you will get pregnant.".......She said, in her heart.......and to me that was golden because she wasn't talking science and medicine anymore, she was talking about a gut feeling and that made it all okay. I guess my point is - you are not a statistic good or bad, so there's is only so much weight you put on those SART numbers. More importantly, is a clinic who cares about you as a couple and works to make your dreams come true.

Alicia said...

Hey. Awwww, I wish things didn't go this way. I wish I could say I can't relate. I wish that endometriosis didn't exist.

I don't really like how they told you that you don't seem like "giving up" kind of people. What does giving up even mean? I don't feel like I "gave up" on anything - I just opened myself to new opportunities. Did bringing J home mean that I gave up on something else? I don't feel that way. Would closing the door on IVF mean you're "giving up"? No - I think it would mean that you are moving forward.

Sigh. I don't know what to tell you Jessah.

I seriously can relate to everything you're saying here. The women in the waiting room. How I felt when I was told of my chances of success (I was told to start considering donor eggs). It's so overwhelming when the reality of the situation hits you.

All of this said - continue to follow the path of least regrets. Change course if it's time (you'll know when it is). If you're going to move forward, have faith that it can work - it does for lots and lots of people, and you could very well be one of those people.

But no matter what - you and A are NOT quitters. You are NOT giving up, no matter what you decide. You are moving forward.

Em said...

Oh Jessah! I'm so sorry about this. How discouraging and disheartening. Thank you for sharing about your experience at CCRM. I feel like all I ever hear is how amazing they are so it's good to hear another perspective. We were supposed to have a phone consult with them this week but I canceled it last month because I knew that there was no way we'd ever be able to afford treatment at CCRM and I felt weird about taking advantage of a free consult if I knew that was the end of the road with them. Again, I'm so sorry that they weren't able to give you more hope.

Also, I did electro-acupuncture a few times during my IVF cycle. It was very weird and stressful. He would attach these "jumper cables" to the needles and then I would twitch rhythmically. I hated it to the point of feeling like I could have a panic attack. I did not like being so out of control of my body. BUT...our IVF cycle worked. I have no idea whether it had anything to do with the electro-acupuncture though of course.

Again, so sorry about the discouragement. Praying, as always.

Amie said...

I'm so sorry this appointment was such a let down for the high hopes you had. I think you just really have to go the direction that you are being pulled. I think I would want to go somewhere that was really taking a personal interest in me not so business like. ((HUGS))

Non Sequitur Chica said...

I can completely understand how you would be disappointed after your visit. To be told that you may only have one good embryo after a cycle and that you likely have to do two cycles is rough to hear, but at least they are being honest and upfront with you. If you guys aren't able to do the two cycles with CCRM have you thought about taking the suggestions CCRM gave you (such as the acupuncture) and doing the cycles back home? Does work know that you are going through this? Maybe if you told someone they would be willing to give you a few extra days (or just tell them you are going through some medical stuff)?

shay said...

Ugh, so sorry to hear this wasn't a great experience for you... i mean, it actually sounds downright depressing!

i love my RE and that's one of the main reasons i wouldn't go anywhere else. they may not be the best in the world, but i know they have my best interests at heart. i think finding a dr that's on the same page as you is really important.

i know its hard to take it all in, but at least now you have all the facts, you know what you're in for, and you can prepare yourself for it.

Ashley said...

Praying that the Lord will give you wisdom and discernment in this situation.

Whitney B. said...

So sorry to hear it didn't go as you had hoped.

Dream Chase said...

I am really sorry that your experience was less than ideal at CCRM. Very sorry to hear you got sick from the exam. This journey is so hard and there's so much at stake and it's hard to just feel like a body, a number, this is personal, this is your story and your baby. I wish I could give you an answer, right now I can pray and say and words of comfort so you can bet I'll be doing that. *hugs*

Sarah said...

Jessah, wow, I don't even know what to say. I cried reading your post because I was so frustrated for you (and I might be a bit doped out on fertility meds too and cry easily now...) I can't imagine experiencing that. I have no advice for you but big hugs and I hope that through soul searching you two will come up with a solution that will make you both happy.

Lisamarie said...

The doctor's comment is horrifying and calculating. Try not to let it get to you. You are absolutely not someone to give up. You wouldn't be where you are if you were the type to give up. You are giving all, and more, than what you have at this. You are a beautiful girl with a great husband. (Have I never seem him on your blog? I feel like he is a hottie fireman, right? Soooo lucky...) Your life is blessed as it is and I truly wish you only comforting thoughts and feelings!!!

Team Harries said...

Sweet girl, I hate this for you. I'm praying you get a peace about next steps. Don't let what the doctors discourage you. God's word says that He has good plans for you, and His word is never void. Hugs!!

conceptionallychallenged said...

Oh no. I'm sorry it was such a disappointing experience. Have you already committed to CCRM, or are you thinking about going back to your local clinic?
Hang in there. Sending many good thoughts your way.

Darcy Kristy said...

oh Jessah, this post has broken my heart. I admit I read it shortly after you posted it, but I didn't know what to say. I was hoping something inspirational would come to mind...... But I just wanted you to know how strong I think you and A are. You are such a strong woman! I'm so sorry that CCRM wasn't all that you hoped it would be. I hate feeling like I'm just another number. I'm starting to feel that way at my current RE as they grow, and I become a "tough case". I hope you have found some peace and postivity in the past couple of days. hugs <3

Darcy Kristy said...

"It REALLY bothers me that Dr. S made that comment "You two don't seem like the type to give up after one try" or whatever he said. Ok, this screams car salesman dimestore reverse psychology to me. That is like someone trying to sell you a more expensive "safer model" car and saying something like, "You two don't look like the type of people who want to sacrifice your lives in an automobile crash, so you need THIS ONE!" I really really do not like statements like the one he made, because it's playing on emotions not science" <<<<< I couldn't agree more, Emily. This REALLY bothers me too. Once again, Jessah, I hope you have found peace and resolution with this first visit

Melissa said...

Ugghh, I'm so sorry. I just want to give you a great big hug.

Teresa @ Grammy Girlfriend said...

I too wish I could hug you...That sounds like an awful day...and a day full of questions...Praying for you

So glad to find your blog...am adding it to my sidebar

Mel said...

I cannot remember if I commented on this yet. I'm sorry about your experience with them that day. I had a complete opposite experience. OUrs was GREAT from the phone consult to the ODWU to the stimulation/transfer, etc. Dr. Su and our nurses are amazing and compassionate.

We on the other hand had terrible experience with the clinic here in MN and never ever want to see them or step foot in their clinic again.

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