Wednesday, September 8, 2010

Doctor Visit

I want to give a detailed account of my appointment yesterday, but don’t want to bore those who have already gone through it and know what to expect from a visit.  So, for those individuals, you can skip to the section called ‘Summary'; for anyone that wants the details you can start with ‘The Visit’.

The Visit
The first person I met with was my RE, Dr. T.  She had reviewed my chart before I came in and so she led with, “What brings you here today?”.  Once I explained my reason, we then began discussing my medical history.  The first thing she addressed was my weight.  Luckily, she didn’t say I had to lose a certain amount of weight before trying to get pregnant, but she did encourage me to continue with my current weight loss effort. 

The second thing was my medication.  She explained that I will need to switch some of the medications I am currently taking before I can start trying to get pregnant.  More to the point, I would need a ‘letter of clearance’ from the doctor that originally prescribed the meds before we can move forward on any treatment.  You would think that’s not a big deal, but it is.  That doctor who prescribes the meds, Dr. E, is a PITA.  I love him, but he is a PITA none the less.  I had an appointment with him last month, but the day before my appointment his wife, who is his receptionist, calls and tells me that he has been in an accident and will need to cancel my appointment.  (Note: this is not the first time he has been hospitalized or canceled on me.)  She gave me no other details so I assumed he would be out for a week.  It’s been a month and every time I call I get a voice mail with no additional information other than the fact that he is recovering nicely and a list of doctors who are filling in for him for medication refills.  There is no mention of when he is coming back.  I feel bad for the guy, I do, but it’s just frustrating.  He is in practice by himself and finding another doctor is sort of a pain because of his specialty.  To top it off, I’ve seen this guy for over 15 years, so he knows my history.  I did call one of the doctors who is filling in for him this morning.  Cross your fingers that they will see me in the near future.  Either way, having to switch meds will delay things by a couple of months since I have to be on new meds for a couple of weeks to see if they are working AND I may have to try several different before I find the right kind.  All of this before the new doctor will give me a ‘letter of clearance.’  Anywho, I digress. 

The third thing Dr. T talked about was cutting down my caffeine intake to 12oz. a day.  I currently drink 24oz of soda; not a big deal to reduce.  I will miss my soda, but it won't kill me to cut back.

The fourth item on the agenda was in relation to the blood work I had done back in January when I was at my OBGYN for my annual checkup.  My OBGYN was testing to see if I had Polycystic Ovary Syndrome (PCOS).  I started to have irregular periods back in November 2009 and the OBGYN thought it might be related to PCOS.  The blood work showed that I had some elevations but Dr. T wasn’t too worried about it.  Her feeling was that because I had regular periods prior to November 2009 that it could simply be the increase in weight (40 pounds), not PCOS, that is causing it.  Her hope is that if I continue to lose the weight my periods will become regular again.  That was good news in my mind.  What she was concerned about however, was an elevated thyroid.  She wants to retest it with the new blood work to see if it is still elevated.  If it is, then she will put me on a low dose of thyroid medicine. 

The fifth item she addressed was the various testing she wanted to have done.  There are five in total (for now): 1) Blood work which will screen for infertility, infectious diseases, thyroid, CBC, and anemia (this blood work is covered by insurance. YAHOO!); 2) Day 3 blood work (E2, FSH and LH); 4) Day 3 ultrasound; and, 5) HSG (hysterosalpingogram).  She then went on to explain that she couldn’t talk about my options for treatment until after the tests were done and she had a better understanding of what my situation entailed. 

The last thing she covered was sperm donors and where to go and what to expect, which I found helpful since I hadn’t done much research on it yet.  She wrapped it up by asking if I had questions, which I did.  We spent the rest of the time going over the questions she had not already answered.

Once I finished with Dr. T, I was then met by a nurse who gave me a packet about the office and information about donor sperm.  She went over all the things I needed to do and wrote me up a checklist, which I found to be very helpful.  She will be the person I talk to when I have questions in the future.

I then moved on to the financial counselor who gave me costing information.  She confirmed that most of my testing will not be covered by insurance because I’m not infertile.  *Sigh*  She did tell me about a discount program they offer, but I make 10k over the cutoff.  Darn me for making a good salary.  To give you an idea for cost though, the Day 3 blood work and ultrasound together is $670 and the HSG is $690.  The cost of an IUI is between $1600 - $2200, while IVF is $9500.  Hearing the costs made my head spin that’s for sure.

I was there for close to two hours and walked out of there happy with my choice of doctors.  Everyone I spoke to was friendly and were more than happy to answer my questions.  The office in general, is like a well oiled machine and they seemed to have their processes down to a science.  There will be some bumps in the road I'm sure, but overall I am stoked about the office and my doctor.

Cost to date: $230 (Initial Consultation)


Single Mom 2b said...

Sounds like a great visit. It's a lot to take in... you'll be glad that you wrote it out in detail once you go through all of your tests... you'll be trying to remember what she told you back on that first visit. Factor in the cost of the swimmers too... that seems to be one of the biggest factors in the monthly expenses (at least for me).

The Baby Chase Project said...

That seems like a very informative visit. I'm glad that you like your RE also. I am sure you will be doing your IUI soon. This is exciting!!

Shannon said...

Sounds like a great visit, with a very organized office, always a good sign!

Did your RE say if they'd store swimmers for you? If they do, it will be worth it to buy 3-4 vials at once, to save a significant amount on shipping.

(Welcome to blogging, btw!)

missing1 said...

Glad to hear you got lots of answers this visit. My docs are great as well, but I need to start writing stuff down. I always seem to get halfway home and then remember something I wanted to ask...
'Shopping' for swimmers is a little surreal at first. Good luck!

Faith said...

Single Mom 2b - I do keep forgetting about the cost of sperm in my overall total. thanks for the reminder!

The Baby Chase Project - I'm glad I liked the doctor too, it can make a world of difference.

Shannon - They do offer storage luckily. How much is shipping typically? I keep seeing around $200.

missing1 - I will be shopping for swimmers soon and I can't wait!

hopefulcc said...

So glad you had such a great appointment! (and I agree with Shannon--very organized!) It was after my first RE visit that I realized I was officially moving from "thinker" to "trying" - a defining moment kind of day.

Have fun shopping for your swimmers!! btw, I paid $165 for shipping.

Tiara said...

OMG I didn't realize how much more expensive it was to do this in the US than here in Canada.

This all sounds like a great start though!

Meg said...

Welcome to blogging! and Hooray for tip-toeing from Thinker to Trying!

It's crazy how the price and insurance coverage varies so much from state to state. IUI's only cost me 450 bucks here in MA. I will no longer complain about it now that I know how much more it could have been.

Maggie said...

Thanks for posting this. You are right that it is hard to get information about cost when you are just in the thinking stage.

Post a Comment