Sunday, March 24, 2013

He's Running!!

Gavin has been cruising around furniture since November.  He would take a few steps here and there but for the most part he prefered crawling or being carried.  Today, out of the corner of my eye, I noticed the dog trot from the living room into the kitchen.  Gavin was standing right next to me but then turned around and just ran after the he had been doing it for years.  OMG!!  It took me a few seconds to digest what I was seeing.  I'm so proud of my little guy!

As T42, I think I am going to stick with Dr. B.  Just the thought of going back to Dr. G's office makes me sick to my stomach. 

Dr. B's office gave me all the codes they use to bill insurance for bloodwork and ultrasounds so that I could see which ones my insurance covers.  Everytime I think we have determined that they will cover them, somebody comes along and says they don't.  Hopefully by using the actual codes, we can be done with this once and for all. 

Thank you Bun In The Oven!  I am definitely going to see if there is any bloodwork we can cut out if my insurance wont cover it.

Friday, March 22, 2013

Spoke To Soon - Big Decision Time

It's amazing how quickly this pre-fertility treatment roller coaster hits it's peaks and valleys.  Today I got the phone call to go over the cost of treatment with my old RE, Dr. B.  I was rendered speechless when the financial counselor told me my IUI treatment (with the cost of monitoring, bloodwork and two IUI's) would equal $3500.  Granted, since my last cycle with Dr. B., he has stuck out with another partner and I knew that his costs would change a little bit but not by $2000.  I stayed calm and asked her if she was sure this price was accurate, because if so, I would regrettably have to go to another doctor.  She told me she wanted to make a phone call to check on the price and that she would call me back as soon as she got an answer. 

As I hung up, my phone began ringing.  It was the drug rep telling me that my medication will be waiting for me at my doctors office by the end of the day. CRAP!!  I know I cannot afford to go through a cycle at Dr. B's office.  Now what do I do?  After the medicine ships they wont let you switch RE's.

My mind started racing.  I called another clinic that had just opened up a month ago and they told me they charged between $450 (unmonitored cycle) to $1800.  The earliest they could give me an appointment for was mid May.  I have to use my meds by no later than mid june so I would be cutting it really close. 

With  mixed emotions, I decided to call back Dr. G's office to see exactly what a cost of an IUI cycle would be at his office. With all the same services as Dr. B's quote sans one IUI, the total was around $800.  Since this is something that I could afford, and quickly, I decided to start asking more questions about the protocol they gave me and why they wouldn't move my dose up since we already know that dosage of gonal-f doesn't do anything for me. I thought maybe I should give them a chance, but that's when I found out they either A) lost the chart we sent over from Dr. B's office  (And I swear that is why Dr. G was telling me that I was being overcharged and using a dangerous protocol when I was at Dr. B's office) or B) They never got my chart in the first place.  She said they did not have any proof that the lower dose wouldn't work, so this is the direction they wanted to go with me.  She then proceeds to tell me that I shouldn't feel in such a rush to do a cycle because my bloodwork was completely NORMAL!!!  It just floors me because she told me last time we talked that I should move as quickly as possibly because I have incredibly low AMH and super high estrogen, which sent me into panic mode.  While my AMH isn't great (.57) my FSH is 6.4 and my E2 was 33, acceptable levels.  It took all my strength to not show how pissed I was.  I then brought up the FDA labwork again.  I told her I consulted with another RE in the area and how he said that all our hospitals in the area are FDA certified and that going to them would suffice (which I did have the labwork done on Thursday afternoon) instead of paying $255 in cash to ship and test the blood/urince up at the FDA lab located in the state capital.  She nonchalantly says its okay to get the testing done anywhere I wanted.  It was the final straw for me, I just told her I needed to take some time to decide how I am going to proceed.

Shortly after I hung up with Dr. G's office, Dr. B's office called me back and told me there was some misunderstanding and that the total cost of the IUI cycle would be $1950. It is still a higher cost over the two other quotes I got but it is significantly better than $3500.

So I now need to decide:
A) Continue with Dr. B, who I trust and love his staff, and suck it up and pay the extra cost.
B) Wait until my appointment at the new clinic so that I can save myself $200, risking that they might not be able to do my first cycle until after my mid-June cut off date and losing my free medications. Thankfully I know a lot of the nurses at the clinic, because many of them use to work for Dr. B, and I know for a fact they are great.
C) Return to Dr. G's office, where I can almost guarantee I will continue to get the run-around and a slew of mis-information but save myself over $1000.

Decisions, Decisions.

Thursday, March 21, 2013

Moving Forward And Not Looking Back

After screwing up my FDA lab work (infectious disease lab work) for a second time, and finding out that the doctor's office has lost the FDA paperwork sent by my cryogenic facility for a third time, I am calling it quits with my new RE.  Filling out proper paperwork and labs should not be harder than going through a cycle. 

As I shared my experience of the doctor's office with a co-worker, she reminded me to re-check which doctors are in our network, because we switched insurance companies again Jan 1st.  I seriously was jumping up and down in my office when I found out my old RE, Dr. B was now back in my network.

Ever since Friday, things have just fallen into place perfectly.  When I called Dr. B's office to set up an appointment, they offered to let me come in on Wednesday afternoon, which I gladly took.  Walking into the office, it was like being welcomed back home.  They are just so friendly, caring and compassionate.  Dr B sat down and explained that he would not trust the low AMH numbers but he wanted to run the tests again just in case.  Unlike the last doctor, he said it was important to do back to back IUI's because we are using frozen sperm which tend not to live as long as fresh (makes sense to me). Without me even telling him what protocol the last doctor wanted to do, he said he wanted to start me off at the gonal-f dose I was on when I got pregnant with Gavin and that to do anything less would just be going backwards.  When, I left the house this morning, I got a phone call stating that they have everything place, with the exception of the infectious disease testing (which they said I could just get done at the local hospital and have my insurance cover it), and that I could start my first cycle anytime I wanted.  I feel like a weight has been lifted off my shoulders.

What is even more exciting is that five minutes before my appointment I got a phone call from the a drug rep that said I qualified for their free medication program!   I will get one cycle of medication (up to $3000 worth) for FREE!  I've been doing the happy dance all over the place:)

Thursday, March 14, 2013

The Pre-Infertility Treatment Rollercoaster

The good part of this month thus far:

Gavin and I went on our cruise!  It was so awesome and relaxing.  My parents joined us so they could spend some quality time with their grandson.  We celebrated his birthday with a cake on he first night.  After the waiters finished singing happy birthday he gave out high-fives and blew kisses.  He's such a flirt!  So many people in our family said not to take him, but I think he had more fun than we did (and I had a lot of fun).  The staff on the Carnival Dream were fantastic and played with him every chance they got.  I definitely spent more time in the cabin than I have had on previous cruises but we got a balcony this time so I could hangout their when Gavin was napping.  I think one of the best things about taking him was giving him a chance try different cuisines and socialize with a wide array of people. 

I applied for a program to get my infertility meds for free.  It's an income based program and I am teetering on their cutoff threshold. I should find out whether or not I am accepted next week.  Crossing my fingers...

I applied for the new hope IVF trial in NYC but was denied, I'm sure its probably because of my weight (They want a BMI less than 32)  but if anyone is interested you should check out

The bad part of this month thus far:

I broke my foot the day before we left for the cruise.  The funny part of the story is that I broke it by tripping over Gavin's potty chair in the bathroom.  Needless to say, potty training isn't going well for us ;)  Thank god the first four days of the trip I could just rest and keep my foot up.  Of course the easy access to pina coladas helped dull the pain too.

And then there is the T42 roller coaster.  Right before we left for the cruise, the new RE provided me with my protocol for my first IUI with him. Admittedly, I'm not a doctor so I shouldn't be second guessing his protocol, but I really don't feel comfortable with it.  He wants me to start on a low-dose gonal-f protocol (75iu).  Considering that my cycle that resulted in the birth of Gavin began with 5 days at 200iu and then ended with two days of 225 iu, all to result in three good size follies, I doubt a low-dose protocol will stimulate my ovaries enough to create any follies.

Given the low amh (0.47), I don't feel like I have a lot of time to start all over with a protocol that hasn't worked in the pass.  This is especially true since my insurance company will no longer cover the cost of my medication. 

I should have been able to start my first cycle this past sunday but my cycle started 6 days early.  I was bummed but it has turned into a blessing because I have been having serious issues with a miscommunication between my HR department and our insurance co. I was told that the IUI procedure and medication would not be covered by HR.  I knew the IUI wasn't covered because it wasn't covered when I was trying to conceive Gavin and the medication coverage ended the same month of my last IUI.  Prior to going in for my consultation with the new RE, I asked my HR person to call the insurance company to confirm what items the insurance co. would cover.  She said it wasn't necessary because nothing had changed in the last two years and that the company would cover ultrasounds and bloodwork.  So I went and submitted the information to the RE and went in for my initial bloodwork.  I  have not recieved a bill from the bloodwork yet which I wasn't worried about because my insurance should have covered it.  Today I receive a call from the RE saying that they forgot to do my FDA labs and that I needed to come in and do the labwork and pay $225.    I explained that this should be submitted to my insurance and the nurse told me that my insurance will not cover the testing.  WTH?  I decided to go to my HR person to find out the answer and she told me that nothing should be covered (which is clearly not what she told me two months ago) and that I should expect to receive a bill for my initial bloodwork.  Unfortunately it was too late in the day to get a hold of the insurance company to confirm so now I need to wait until the morning to find out whether or not it is covered.  If this isn't covered, it means my cost of the IUI just went from $300 (without the cost of DS and meds) to ~$2000.  I guess I am going to be on pin and needles for the next 13 hours until we get this all straightened out. 

To add to this shit-tastic week,  my ditzy secretary backed up and hit my car on Tuesday.  Thank god her insurance should cover the $3000 worth of damage along with the cost of the rental car.  

I have been trying to do as much research on low amh as I can.  I found it semi-reassuring that it doesn't mean I'm not going to ovulate or that it directly relates to poor egg quality. I think my goal for the next month is to focus on losing weight and de-stressing to see if that will help to improve my numbers.  I also need to hope that my cycle begins around the 24th or I'm going to have to skip this cycle too because I have a conference to be at in Mid-april.  Ugh, back on the rollercoaster and I haven't even gotten in the stirrups yet!