Today was my appointment with the financial coordinator and nurse coordinator at my RE’s office. It was a lot of information to soak up in an hour, but I left feeling more like a legit infertility patient. I mean it’s not necessarily that I didn’t feel legit before, but my first three IUI cycles felt different. For one, it felt reactionary and shocking. I had no idea what to expect. It was kind of like being in the kindergarten of infertility treatments. You are qualified to be there, but they just easy you in with the “easy” stuff. Apparently when you start injectables you have graduated to another level, and shit gets real.
First, I never had to see a financial coordinator for my Letrozole only cycles. I just paid for each appointment when I came in that day, and no one ever really told me the overall cost for appointments or medication. This time things are different. Even when she came to the waiting room to get me she took me to a completely different part of the office I didn’t know existed. For a mixed cycle (or straight injectable cycle), you pay for everything at your baseline ultrasound. That includes all ultrasounds, two back-to-back IUIs, a Beta at their lab (they always sent me to an outside lab before), estridol testing, and possibly other things I am now forgetting. She also gave me an estimate on my medication cost. All in all, this cycle will likely cost about $600 more than my Letrozole cycles, which is honestly a big relief. She also gave me an estimate on the straight up injectable cycle, which was about double the cost of a mixed cycle (5k-ish). Honestly I do not see us ever doing that, but rather going to IVF. The other interesting thing was that she went over the positive beta scenario with me, as it relates to billing. Up to this point, no one at the clinic had ever mentioned to me what would happen if I actually got pregnant. I learned that they basically do monitoring for you until 8 weeks, and she went over what would be billed to my insurance in that case. I also had to fill out a form that stated I understood all my treatment was out-of-pocket (until positive beta), which I had never had to do before.
Next I headed into the nurse coordinator’s office. She went over what seemed like a mountain of paper work with me. She first informed me that apparently I need a PAP. Mine expired like 30 days ago…..and my OBGYN takes like 3-4 months to get into for a PAP. I sort of started to freak out, but apparently they do them in the RE office, so I am scheduled for next Wednesday. Also if the schedule doesn’t work out for the IUI for my next cycle, I will need blood work, because I have a few tests that expire this month. She then went over the cycle schedule and what medication I would be taking on what day. She is also calling in my Ovidrel and Gonal-F now. She then went over some handouts she went sending me home with about fertility stress management, counseling, resources, ect. I sort of laughed at this only because I was a little surprised they wouldn’t have given it to me A YEAR AGO WHEN I BECAME A PATIENT. Again, apparently when you start shooting yourself up that’s when they start taking you seriously. The next set of handouts had to do with do’s and don’ts that will start the first day I take fertility meds through when I get a positive beta (again, this was not discussed for oral cycles). Finally she started to grill me on my prenatals and supplements. She even sent me home with a big bunch of prescription prenatals to try (because most over the counter ones make me nauseous).
Then we got to the hard part……the demo on giving yourself shots. I mean it seemed easy enough to inject into a red cube, but when I am shooting a needle into my stomach I think I will feel differently. Maybe it won’t be a big deal by the time I get to trigger, but right now Ovidrel scares me the most. For my oral cycles the clinic has always done that one for me, and its possible they will again at my CD 11 appointment but she said i may have to do it myself. I really wish I had a best friend in the nursing field.
I also talked to the nurse coordinator about trying to work scheduled appointments in the early morning or later afternoon, since I work so far away. Basically she said they would do what they could but I should really hope that some of the appointments fall on a weekend. The only way that will really happen is if my cycle is 27/28 days or 32/33/34 days. At this point I am really pulling for the 32-34 range…….not that I have any control :-).
Despite the overload of info I am really trying to keep the most positive attitude possible, and not focus on the “this is it or its IVF” thing. We will see how that goes when I start filling my body with hormones. I am super relieved that this cycle is *only* going to cost around 2k. I really expected it to be a lot more. it’s funny how 2k feels like nothing when you have already spent thousands more than that on something. If it brings me a baby, obviously money well spent. If not…….well lets not think about that. It’s honestly kind of weird to be back to blogging about all of this again after so many months of just waiting. I already remember how doing treatment plans literally takes over your whole life. I do feel more prepared this time mentally and emotionally. I am just really praying that everything goes smoothly with no unforeseen stress, and of course for that positive beta…..finally.