Fits and Starts

I had every intention of writing a blog last week. There wasn’t a whole lot going on, but I could provide a few updates. But then I got busy at work, and, eventually, the week got away from me. 

The biggest updates were about our next cycle and a procedure Nick was going to have (unrelated to IVF). 

IVF, Take 3
I had been in the process of ordering all my meds for the upcoming procedure, and my nurse had scheduled my first bloodwork/ultrasound appointment so I could potentially start injections this Thursday (April 27). 

And then I got an email from our billing consultant. She needed a new referral from Kaiser before she could process the claim and let me know our portion of the procedure. Our portion is due by IVF Day 2. Without the referral, we’d have to self pay for everything, which isn’t an option. 

In the past, I was able to get one referral from my OBGYN and that worked for the whole year. I was unaware this policy had changed, so I hadn’t asked for a new one. I think the new Building Families Act may be why that changed this year. 

In the back of my mind, I was a little concerned Kaiser might not approve another round because we got two embryos from our last round. Our billing consultant mentioned she hadn’t heard of them refusing when a couple had embryos in cryo, but the thought was still there.

I promptly reached out to my Kaiser doc:

Hi Dr. M., 

Nick and I are going to try one final (hopefully) round of IVF. We completed a second round last month, and we did get two viable embryos. However, since frozen embryo transfer success rates are 60-70% and we’d like to have two kids, our doctor has recommended we complete at least one more cycle to get at least three total embryos (or more).

Could you send another referral to Conceptions?

Thanks!
Julie

She responded that same afternoon:

Hi Julie,

I placed a new referral for you.  I hope to see you SOON!  Best of luck with your next cycle and let me know if you need anything.

Sincerely,
Dr. M.

OK, so she didn’t say anything about coverage being declined because of us having embryos so fingers crossed. 

Unfortunately, though, the referrals process isn’t super quick. I did some double checking, and the last time I’d asked Dr. M. for a referral was on Jan. 19. (Again, she sent it over the same day I asked for it because she’s an awesome doc.) I got the approval letter on Feb. 3. 

My chat with a Kaiser customer service rep confirmed it can take up to two weeks for the referral to go through. 

Annoying? Yes.

End of the world? No.

It just means we have to wait a little bit longer before getting started on the next round, and this round has had more fits and starts than what I’m used to. 

If the 14-15 days holds true this time, I should have approval on or before May 1. I let my nurse know so we can adjust all the dates. It does get trickier though, as Nick is out of town May 12-14, and we’re both on vacation June 10-17, so we’ll have to work around those dates. 

It’d be great if we could also avoid having the egg retrieval procedure around our wedding anniversary again, too, but we’ll just have to go with what works for my cycle. You can’t be too picky when it comes to scheduling IVF stuff.

After I knew I’d need to wait a couple weeks, I also decided not to pick up all the expensive meds until the referral comes through. In the event they decline it, I’d rather not be out $2,000 in meds I can’t return. 

Again, it’s frustrating, but it’s just a minor delay (hopefully). I think I’m just anxious to keep moving forward in this process so we can try and get pregnant. 

Nick’s Procedure
The other thing I mentioned earlier was Nick’s procedure. I haven’t talked about it too much here, but our family and friends know that Nick has continued having abdominal pain since his pancreatitis-related hospital stay last October. 

He’s been back and forth to the doctor’s office, gone for more bloodwork and CT scans, and went in for an MRI. They mostly showed his original bout of pancreatic inflammation had all healed, but there were two new pseudocysts on the tail of his pancreas. 

Because of the nature of pancreatic issues, there’s really nothing you can do except go to the hospital if the pain gets particularly bad. (And we have gone to the ER once since his original hospitalization and contemplated going other times, too.)

Nick saw a GI specialist, and he recommended having an endoscopic retrograde cholangiopancreatography (ERCP) procedure (please don’t ask me to say it, because I have no idea…). 

That procedure was scheduled for yesterday, and everything went well. The doctor ended up only needing to do an endoscopic ultrasound (less invasive than a full ERCP). One of the cysts on the tail of the pancreas had grown, so the doctor drained it. 

The surgeon didn’t find any other potential causes of the pain – no sludge or gallstones in the gallbladder and no bile duct blockages. So we’re hopeful that was the main cause.

So far, Nick is feeling better. If the pain comes back, the doctor said we can look at putting a stint in the cyst so it can easily drain itself. We’re hopeful his lack of pain continues and this is the last time we have to worry about his pancreas. 

_________

If you’d like to help us on this journey–whether through monetary donations; sharing our fundraising efforts; or sending prayers, thoughts, or good vibes–please visit our GoFundMe page or reach out to ivfthat@gmail.com.