two uteri, two mamas pregnant, AGAIN, with baby number two

The Doctor December 12, 2006

Filed under: Uncategorized — charlotte @ 2:30 am

The fertility clinic experience was…interesting. They are absolutely the nicest office staff I have even encountered. Here is why I love them:

1. They always end every conversation with: ‘do you have any other questions?’ AND ‘is there anything else I can help you with?’

2. Every person I have interacted with in any way has been helpful and nice

3. They have a team of patient services advisers dedicated to HELPING you figure out what benefits and such you can expect from your insurance. They call your insurance FOR you and then explain everything to you. That is their whole job…to be nice to you and help you figure out how to get maximum benefits from your insurance.

4. The office was marble and beautiful. There was a sculpture. An orchid in the bathroom. Not a single child’s toy (which irritated me, but I thought it was great to spare those-with-no-kids-yet) and not a SINGLE pregnancy magazine to be found. I knew I loved it there when I saw the chocolates fanned out on a glass serving dish. Posh I tell you.

5. They offer mind body wellness programs.

I have no idea how common this stuff is. Are your RE offices like this??

By the way I appreciate the differing opinionss on my previos post. It gave us a lot to think about and was really helpful in formulating our questions and what we wanted from the visit.

Ultimately the doctor we met with was helpful and did not pressure us to go on Clomid, or to do invasive tests. She suggested them. There is a difference. We were not made to feel ridiculous or stupid if we want to wait. But her orientation was definitely *medical*. But, um, she an RE so duh. She did suggest that S do an HSG next cycle if this time does not work. She thinks there is good reason to do it because S had her appendix removed and sometimes that causes tube problems and other issues. She was very honest about the risks.

She was very reasonable about our choices, our timeline, the big picture, distinguishing her suggestions from her recommendations. She was lovely. We were feeling very informed and listened to….then came the insurance question.

After calling and talking to the office staff I was under the impression that she could code this consult NOT under infertility (meaning we would have a $40 copay rather than a $300 fee) but under ‘painful periods’ or ‘diagnostic workup for mysterious girly problems.’

I was wrong. She seemed a bit offended (or something less than offended, maybe uncomfortable?) that I was asking (she actually mentioned her license and ethics and stuff). I appreciate her position, but I am used to doctors being more relaxed. And she was totally reasonable in her response. However, I was not expecting this response.

So I started to get misty eyed. All I could think about was that I finally got S to come here, and this might be our last chance for some VERY unwanted but possibly necessary medical interventions to help us have a baby we wantwantwant so badly and now we will have to pay for it all and we can’t afford it, and we can’t afford $300 right before Christmas….

Then I began to actually well up and THEN my chin started quivering.

At this point S sees that I’m on a one way trip to SOBBING and she mercifully takes the paper with our questions on it and begins to talk to the doctor solo while I begin to cry in earnest, clutching LM on my lap. At this point I realize I must say something because there is no “pulling myself together.”

I explain myself, how overwhelming this all is, how frustrated I am, how much we don’t want any intervention but to not have it as an option because of money really adds insult to injury. I cried through my entire explanation. I cried again, and then again.

The RE was very nice about the whole thing and gave us some alternative places to have the HSG that are less expensive. I might be able to do something about the $300 with my insurance company. The RE is now named Dr. Ethics. But I left feeling depressed and embarrassed.

This is not to say that I regret going. I don’t. I feel like S and I have a lot to talk about, and are coming from an informed place. We were not shamed or made to feel bad in any way. Ultimately her suggestion was to get the dye test if this cycle doesn’t work, and if the cycle after the test doesn’t work, she recommends some IUI’s with or without Clomid depending on the results from some other not so invasive tests (bloodwork, an ultrasound and such) to be performed during the next month. Some of it our OBGYN could do but I REALLY don’t want to go back to Dr. Poor Social Skills ever again. Her midwife was great, but she wasn’t. We can be as aggressive or relaxed as we want with the treatments.

S and I have some decisions to make.

1. How long do we want to continue with natural insems
2. How willing is S to do the HSG
3. How do we feel about doing IUIs with fresh sperm
4. How does money factor into these decisions
5. Does S want to keep going through all this, and do we want to continue spend all this money and time and effort trying to get her pregnant, when I could just go again.

#5 is really the key. There is no easy answer there. The good news is that we are very much a team about this now. No one is polarized. No one is pressuring the other person.

Hey, maybe this next try will just work and we can put this all behind us. I hope so, because even if we are not at odds with each other, the decision to move forward with interventions, or to stop, feels gut wrenching. S and I need to have a dinner date (you know *alone* and outside of our normal environment) conversation about this stuff.

I am a total mess today. My friend was going to come over for an hour or two, and when I called to see when she was coming she cancelled. I had to quickly get off the phone so I could BAWL some more.

So I called S and WTF and cried to them a bit more.

What do y’all think about what Dr. Ethics said? About our next steps? About how complicated it is to have a two uteri household?


7 Responses to “The Doctor”

  1. amy Says:

    I agree with Dr. Ethics. Her suggestions were not aggressive at all but meaningful and important for someone who hasn’t been able to conceive after several tries. I’d probably do the blood work first to check hormone levels, etc since that’s even less invasive. I had the HSG though and it wasn’t a big deal at all. In the end, you guys just need to decide how important it is that S get pregnant and put a ‘stop/loss’ in place (like the stock market) to control the expense if that’s a huge concern. If she doesn’t get pregnant and you hit your limit, the great news is you’re a 2 uteri family so you can start trying.

    Good luck with whatever you guys decide!

  2. Co Says:

    Chocolates on a glass serving dish? Um… no, your clinic is nothing like mine.

    I’m glad you went. I’m sorry that there was so much money stress involved. It’s not what you need right now.

    I hope this next try works and you guys don’t have to deal with any of this. But the place sounds promising.

  3. B Says:

    That IS like my clinic, and I’ve been on both sides of your situation:

    1) When M got pregnant with the same doc (different fancy clinic), none of her fertility services were covered, so we paid out of pocket. Because M was so fertile AND we were willing to go for Clomid>Ultrasound>IUI after just three unmedicated tries, we got out of the experience only $6,000 poorer. A veritable steal for us… we lack both the patience and willingness to decipher our exact O timing. AND, before we had Kiddo, we apparently had $6,000 to blow, even though we were renting in an expensive area. Oh, for those days…

    2) Now I’m the patient at the doc’s new palatial clinic, and hoo boy have they treated us well so far! Within my November cycle, we were able to get in for a consult, a follicle study (they did it on the spot after the consult), the battery of blood tests (sans progesterone since I’ll go straight to Clomid), and the HSG. Since all of my fertility treatments are covered up and until IVF, there’s no reason to start cheap or slow. I’m going straight to Clomid>Ultrasound>IUI, and will switch to Femara or injectibles as needed. We’ve got six tries with the same donor we used for our daughter, so it’s all a numbers game.

    That said, it sounds like you’ve got lots of decisions to weigh… best of luck in reaching a decision that will never come back to bite you during a middle-of-the-night argument.

  4. jenny Says:

    Our clinic is really friendly and relaxed, and they do have a team of financial folks to help you deal with the money end of things. It isn’t particularly posh, but our doc is always talking about his next trip to Russia or his newest favorite reality TV show or some else random like that.

    Sounds like you did have a good appt and I’m sorry about the insurance stuff. It’s crappy.

  5. Trista Says:

    Oh I’m so sorry. So very sorry. That’s strange about the coding thing. All of my doctors are all about the coding of infertility things as period problems… even after I assure them that my insurance will pay for infertility treatments (everything but semen, iui and ivf). So it’s strange that she had such a problem with it. I would have bawled, too.

    I’m glad you two went and I’m glad that you have some solid information now. Here’s to you guys making some solid decisions and moving foward. And here’s to this next cycle working!

  6. bri Says:

    My RE is not posh at all. She is in a heavily Orthodox Jewish section of Brooklyn where some of the signs in the stores are in Russian. There are 2 doctors, an NP, the regular nurse, 2 receptionists and a bookkeeper. The place is clean and in good repair but not in any way fancy. At all.

    I had the HSG after 5 tries because I really, really wanted to. I really felt like I was going to go crazy if I just kept doing the same exact thing and hoping for a different outcome. It wasn’t pleasant but it certainly wasn’t a big deal and the knowledge that everything was OK was priceless – it really had started to feel like we were sticking a grand up there every month and maybe it wasn’t getting anywhere. I was ready to move on to Clomid at that point, though my doctor said we could do whatever we wanted depending on how big a hurry we were in. I was in a big hurry by then (it had been a year).

    Everything has been covered for us by insurance. My RE is designated as my GYN and somehow that makes it all OK. I know that there are some cases where we would have had to document our infertility but either that wasn’t an issue with our insurance or she dealt with it somehow. There has never been a single money conversation in all my years there. I feel unspeakably lucky.

    If all works out, I will also feel ridiculously lucky because our new insurance couldn’t possibly be as great as this has been, and the switch happens on the 1st. I got in just under the wire.

    So – I am not sure I understand – did this mean that nothing will be covered or just the consultation fee? I will go back and read again and see if I can get it. I am at least glad that the doctor was willing to do whatever you wanted, but the ethics things sucks. I like a doctor who will bend stupid-ass insurance an eensy bit to make it work for you.

  7. Anonymous Says:

    I had the HSG after 6 IUI tries as my clinic would not proceed unless I had one.

    I also got bit HARD by dumb office staff telling me that my insurance would be coveirng things…when it wasn’t.

    Money SUCKS.

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