Some Good News for a Change

Today brought some welcome good news.  We can ship our embryos from the West Coast to the East Coast without engaging in a lengthy process with the NY state health department.  The department very recently (within the last week) gave effect to a new policy that will not require us to obtain an exemption letter (the estimated time line on that was anywhere from two weeks to over three months).

The LP and I fastidiously signed and filled out many consent and waiver forms (you have to promise not to sue the people who tell you they could lose or destroy your babies-in-waiting if you want to use a shipping company to do this – and we need a shipping company to do this given that we do not live on either the West Coast or the East Coast) and I have handed over my credit card information.  Now I wait to find out when we can expect wee Gertrude and Alice (I decided not to go with Ernie and Bert even though those embryos resulted in a successful pregnancy; I felt like I was encroaching on her territory after she sweetly told me she’d named her embryos after the cute muppet pair) to make their way across the continent.

In the meantime… I have been trying to find a skilled endometriosis surgeon in my neck of the woods.  I am of the view that having the laparoscopy before any more IVF treatments would be prudent.  The LP is scared of me having surgery and would rather we try without it.  The first time he witnessed me having surgery (D&C number one in January 2011), the surgeon came and told him my blood pressure had dropped dangerously low and they had to give me fluids intravenously and therefore I would have to spend the night in the hospital (despite the earlier advice that I could leave shortly after leaving recovery).

The second time he waited for me to get out recovery after surgery (from D&C number two in September 2013), things were better because I told the doctor about my reaction to general anaesthetic.  But then my blood pressure was checked in the room they carted me into post-recovery and it was something along the lines of 80/50 and the nurse checking on me nearly lost it.  I explained that my “normal” blood pressure ranges between 87-95 over 60-65 so this was not a big deal.  She looked skeptical but when I proved that I could make my way to and from the little girl’s room and that I was not losing buckets of blood, she approved our departure.

In addition to the blood pressure, I puke when waking up from under general anaesthetic.  I should say I dry heave because of course you are never allowed to eat before these events if they are scheduled. The anti-nausea meds work for this little problem so it has never been a huge concern for me.  I am not worried about the idea of having surgery.  I am worried about wasting another embryo because I did not have the surgery and maybe that could have toned down my immune issues and made the difference.

Today I asked the Universe and God if the news about the removal of the exemption letter requirement was a sign that I should follow the LP’s preference and try the FET using Dr. Braverman’s immune protocol without doing the laparoscopy for endometriosis diagnosis/excision first.  I asked for a sign as I was walking to meet the LP to sign a number of consents related to the embryo transportation.  I found myself staring at a decorative plaque in the window of the nearby flower shop.

The sign read “IF YOU ARE LOOKING FOR A SIGN THIS IS IT”.

Really, Universe?  Just like that? Is that my intuition clubbing me over the head or mere coincidence?

On a serious note, I’d love to hear what you would do in my shoes.  So… what would you do?

We have: (a) Reasons; (b) a Protocol; and (c) a Problem

I received our immunological testing report with complete analysis and had a long, helpful telephone conversation with Dr. Jeffrey Braverman yesterday.

There have been rivers of tears and heaps of those impotent “I want to say the right thing – what is the right thing?” looks from the LP, group and individual hugs and “I’m sorry mommy” from the Miracle Toddler (whose miracle status has grown about as many times as the Grinch’s heart that fateful day when he unstole Christmas from Whoville).

My eyes hurt.  My heart hurts.  My bank loves me.  My employer, too, because they know I will never quit and stay home now.

A.  The Reasons

For the sake of anyone who’s been playing along and cares and for anyone who may one day read my blog in hopes of gathering more information about reproductive immunology, haplotypes, HLA mismatches, Natural Killer cell activity, Cytokines and why they all matter, I want to and will share more details about my test results, the analysis and interpretation of them and what it all means.  But not today.   I need time to write that post (you’ll see why) and time to work through my feelings right now (which have circled the earth at least 2.4 times in the past 18 hours).  Please stay tuned.

Non-sequitur: If I am ever in another band, I am going to call it the Angry Cytokines. (Steal this idea and beware, this post and all ideas in it have all rights reserved!)

The brief version to tide you over until the promised post:  I am broken.  The LP and I are not sufficiently mismatched.  My one successful pregnancy created a cell memory that has made the problem worse.  It is incredibly unlikely (read: impossible) that I could ever sustain another pregnancy without serious medical intervention (namely, drugs and a lot of blood tests) and equally serious expense.  Oh, and I probably have endometriosis.  On the good news front, I have no hy-restricing HLAs (meaning my post-live birth recurrent pregnancy loss is not a result of me having developed an immune response to boy babies).

On one hand, this is all very validating.  It explains why I’ve gotten sicker with each of the 6 pregnancies we have had and lost since the Miracle Toddler was born and proves that my gut feeling about that was right not “coincidental” as doctors have told me.  And while my case is difficult, according to Dr. Braverman it is not untreatable (though he said I could lose another pregnancy on the road to us figuring out how best to treat the various issues).

On the other hand, it has ripped a new hole in my heart and reignited my grieving over all that was genetically programmed to make me very unlikely to have children (without a miracle – which apparently was a one-shot deal after all – or a boat load of medical intervention and expense) and over not finding out any of this sooner.  I am having what can be fairly described as a very hard time right now.  I know it will get better but for now I am grieving and processing.

Stay tuned…

B.  The Protocol

There will be more on this in the future post I have promised.  Meanwhile, the skinny is that Dr. Braverman has recommended:

  • Daily injections of Neupogen
  • Oral Steroids – likely Prednisone, 10-20 mg daily
  • Weekly treatments with Intra-lipids for the first FET (if it fails, then IVIg)
  • Daily injections of Lovenox

C.  The Problem

Because there has to be at least one, right?

When at the end of our call I asked about a realistic time frame for getting our embryos imported from the West Coast into New York state, Dr. Braverman admitted he has seen it take upward of three months (he’s also seen it take less time).  The fact that they are donor egg embryos may make this more complicated.

To avoid any more delay, Dr. Braverman suggested I consider consulting with a reproductive endocrinologist in the same state where our embryos are now hanging out in cryopreservation storage.  The trick is that any such doctor must be prepared to follow Braverman’s protocol and prescribe the drugs he instructs, do the testing he requires, etcetera.  He’s the boss, in other words.  Most doctors will not do this.  Our current RE has already said he will not do it.

On our call, Dr. Braverman recommended a doctor he has worked with before, though never with Neupogen among the drugs on the protocol.  I called her clinic.  She is on sabbatical until November.  Of course she is, why wouldn’t she be?  The patient coordinator also told me that the clinic does not prescribe medications for other doctors as a rule.  With some cajoling she nevertheless agreed to email the RE asking if she will work with Dr. Braverman and promised to get back to me.  I wait and see.

I emailed this news to Dr. Braverman and said my current inclination is to try to get the embryos to NY.  I called Biogenetics about this and e-mailed them the LP’s test results for infectious disease screening to see if he will need any further tests.  I wait and see.  This is step one of many to setting this ball in motion.

Meanwhile, Dr. Braverman sent me the name of another doctor in the same state as our embryos.  I called her, too, and had to leave a message.  I wait and see.  (D0 you detect a pattern here?)

I actually burst into tears during one of the times when I was on hold yesterday during the various phone calls that followed my discussion with Dr. Braverman and asked God and the Universe “why?”  Why can’t we  get a break for once?

I have actually thought:  Is this a sign to give up?  Or to do one last IVF with my own eggs at Braverman’s clinic instead of moving our DE embryos?  (Braverman gave us a 5% chance of success at my age and given my diagnoses so that would be a pretty foolish gamble but it’s hard not to give it some thought.  Grief and desperation are powerful motivators.)  I have settled on the fact that my luck is crap and when the going gets rough, my luck gets crappier.  I should know to expect this by now.

< huge sigh >

To Be Continued…

Panic and Dread

I spent portions of the past few days trying to educate myself about human leukocyte antigens (HLAs) and anti-HLA antibodies (of which I have one related to the DQ8 HLA).  I am being charitable when I say it has been painful.

This morning I woke up from a dream in which I was having a very grave and ultimately tearful meeting with a doctor who in my dream was Dr. Jeffrey Braverman notwithstanding the fact that although his voice was perfect, his physical appearance was much altered by my subconscious.  Funny the things our minds can accomplish when they set themselves to it.  I digress.

Panic and dread set in after waking from the moment in my dream when Dr. Braverman (albeit a less hairy, more straight-haired, leaner and clean-shaven version of himself) said that I would be wise to resign myself to the fact that October 21st was not going to bring me the outcome I wanted.  He said there was really no hope of me carrying another child, essentially, suggesting my immune system would not permit it.

By way of context, I understood in the dream that October 21st was my transfer date for one of our last two remaining frozen embryos.  Why October 21st?  Ask my subconscious.  I have no idea.

Suffice to say I was floored and gutted.  Or gutted on the floor.  Whichever, I woke up shaken and upset.  I still am (shaken and upset).  The worst part is that I do not know whether this is my intuition talking or a combination of way too much home research, disrupted sleep, generalized anxiety and an overall shortage of sleep lately (by lately I mean about the last 14 years of my life).

Panic and dread struck a second time this morning as I reviewed the contract for transporting frozen embryos from one side of the continent to the other, specifically into New York state with its strict health department rules.  Among the lines that leapt out at me was one that read “Additional testing and quarantine may be required if donor eggs were used in creating the embryos.”  What additional testing?  What exactly do they mean by quarantine?

Jiminy Crickets!  Can this be any more complicated, overwhelming, stressful, and exhausting? Don’t answer that unless you are prefacing it with an offer of barbiturates.  I need a serious tranquilizer at this point.

I have e-mailed Biogenetics with these questions and “What if the donor’s infectious disease testing was done more than 30 days before our embryos were frozen and the clinic can’t find her for me to pay (out of freaking pocket, I might add) for her to get the testing done again now?”  Or words to that effect.  Because that is another one of the requirements, of course.  Biogenetics’ informed me when I asked last week about timing that test results for infectious diseases (syphilis, the various alphabetical variations of hepatitis, HIV, HTLV and so on) must be dated after the embryos were frozen or not more than 30 days before they were frozen (we’re okay on this front for the LP and I except we may be missing one set of HIV-related tests, I’ve also asked for clarification on that front from Biogenetics).

I had to email the RE at our second clinic (with the embryos) to ask him to send me a copy of one of the LP’s test results because of course it was not included in the records I got in dribs and drabs after seven requests in July.  I wonder what else is not among the records I got by pulling teeth.

I burst into tears for  a moment, feeling completely overwrought this morning after sending all of those e-mails and recalling my dream.

I consoled myself (not really) by e-mailing Dr. Braverman to ask if there was any chance we’d be able to consult with him this week about our test results or if that would likely happen in early September.  So far I have had no response.  I think I will go throw up from anxiety now.

I sure hope you all are having a better Monday morning than I am!

Meeting Team Braverman and Blogger of Just Another Infertility Blog

The LP and I are currently en route back home from a whirlwind trip to New York. Long Island and Manhattan to be specific.  In that time we/I

  • Endured the longest and most expensive taxi ride I’ve ever taken and hopefully will ever take;
  • Ate at one of the greatest Diners of all time;
  • Saw way too many pregnant ladies (see my last post);
  • Met with Dr. Braverman and other members of the team at Braverman IVF and Reproductive Immunology;
  • Had an ultrasound (yours truly only);
  • Had 18 vials of blood drawn (3 for the LP, 15 pour moi);
  • Rode the Long Island Rail Road;
  • Rode the NYC Subway (the LP was impressed with my familiarity with it but a bit peevish about me laughing when he nearly fell because he didn’t set down his bag like a total rookie);
  • Walked around Greenwich Village;
  • Saw Here Lies Love, a musical at the Public Theater written by David Byrne and Fatboy Slim about the rise and fall of Imelda and Ferdinand Marcos; 
  • Met the incredibly lovely, deeply thoughtful, kind, generous and generally amazing blogger of Just Another Infertility Blog (JAIB here) for breakfast (me only, though the LP was equally curious about it and impressed that this meeting stemmed from the often-overwhelming but richly supportive blogosphere network of which I am grateful to be a member); and
  • Thanks entirely to JAIB, I enjoyed a yummy paleo/anti-inflammation friendly (grain-free, dairy-free) breakfast at an amazing West Village eatery and got snacks for the flights home mad the weekend as well as a Paleo blueberry muffin for the LP (who devoured it gratefully).

Starting at the end of my list, it was awesome to connect with JAIB and to discover that we have stuff in common outside of recurrent pregnancy loss and fertility challenges.  I cannot say enough good things about her.  JAIB is a true gem.  Case in point: the meeting was her brainchild, as was the incredible eatery – and she insisted on treating me to breakfast despite my feeble protest). Most importantly, she is genuine, unpretentious and innately kind.  I am so grateful to have met her and hope you will join me in hoping and praying (for those of us who say prayers) that she and her husband bring home their long-awaited baby/ies soon. 

Here Lies Love was amazing.  Don’t take my word for it; the LP thought so, too.  

Now back to the visit with Dr. Braverman.  First of all, we did not have to wait much past our appointment time. It may have started on time, in fact (we were early and I didn’t check what time it was when we were taken back but it was either on time or soon afterward).

I am still not in love with him. However, the visit did reaffirm my decision to seek his assistance and it established for the LP that this doctor is capable and knowledgeable. The LP pointed out that Dr. B had degrees or some kind of certification from 3 universities, including Albert Einstein College of Medicine (the LP was quick to point out that this was particularly impressive since Einstein was not himself a medical doctor).  The LP had a much better impression of Dr. B after our in-person meeting  with him. I have warmed a teeny bit as well but I am keeping a professional emotional distance from any future caregivers at this point for the sake of self-preservation and financial responsibility. 

That said, it is tough not to get hopeful. I thought this was a personal affliction or shortcoming on my part. However, as we scarfed down an appetizer and some drinks yesterday afternoon after our adventurous morning and afternoon,, the LP said “well, there is hope again” about our meeting with expert #3. I am so reticent to embrace that hope. But it is an infectious beast. And it’s allure is intoxicating in a way nothing else is for me. Hence the distance I need to keep from the strongly-opinioned professionals. 

As for the visit itself, it was relatively uneventful. We chatted, we reviewed my recent test results, Dr. B noted that on their own IgE levels are not particularly useful.  He really did not say much about the allergies except to repeat that too many histamines are bad but some are needed for implantation. He suggested we use Claritin every day of any cycle in the future in which we are undergoing treatment but made no other recommendations and seemed unconcerned about my allergy sufferings.

 

He said my ultrasound looked great on the whole, with good uterine blood flow and the only perceptible reduction in blood flow being with my left ovary, which he said is not uncommon.  He noted a cyst on my right ovary which likely was from a recent ovulation and not concerning. He did not see anything so far to suggest endometriosis but would still review my blood work once it comes in for the pattern that can suggest the presence of endometriosis. He does not expect he would recommend urgery in my case, however, even if that pattern is detected given the good blood flow and appearance of my inner bits on the ultrasound. 

Finally, I asked about his protocols for FETs. He said they use many different ones from natural to medicated, with birth control pills for down regulation and without, going straight to estrogen supplementation. We talked about my body not liking the birth control and he said we don’t need to do that then. He volunteered that the success rates show no statistically significant difference between the different protocols he use for FET and that the choice between them largely comes down to personal choice on the part of patients. Natural FETs are unpredictable as to timing to some degree while during medicated ones everyone knows when things are to happen because that is planned  and controlled – the transfer date is chosen, in short.  

Dr. B told us he would be able to discuss our test results and any protocol design he may suggest in about 6 weeks. His nurse who drew our blood said four to six weeks. Other patients of his have kindly told me that the lab sends him results in about ten business days or two weeks.  It is wait and see time.  Again.  I am not in a rush though I would prefer a September to an October start date if we can do a FET because if we stick with Dr. B I’d rather not be travelling to and from NYC in December for monitoring and prescriptions if that can be avoided. 

I do not know yet if we will do any further FET(s) with Dr. Braverman or a RE closer to home with whom we are waiting for a consult. The reasons for considering the RE over Dr. B is convenience and cost.  I have said that if the protocol Dr. B recommends is not too complicated or aggressive and does not require monitoring that could be a problem closer to home I will consider the fourth expert.  If that’s not the case and Dr. B gives us a good chance of success despite whatever findings he makes then I think we will go with him for our next FET.  With only two blastocysts left I am reluctant to start gambling. 

One last really strange but kind of incredible and scary thing happened during our taxi ride to the airport on Friday.  I saw a sign for a psychic and thought about consulting one.  Out of nowhere, like a bolt if lightning, this voice that was not my own but was familiar and heard only inside of me said, clearly and emphatically, “you will have another baby.”  I told the LP about it immediately.  He is usually a skeptic and said I don’t need to see a psychic but that message seemed important and maybe it means something.  

A theme through this post and in my heart is my fear of becoming too hopeful, too invested in dreaming of a future that may have no feasible connection to the present.  Not only do I not need another shattering of my heart and self, I do not know if I can take another loss.  Yet, in writing that I am reminded of the animal spirit guide card I drew earlier this week, the day before we left on the whirlwind tour.  It was the wolverine, my alter ego, whose spirit guidance is “You are tougher than you think.”

I do not know if that is true anymore.   I do not know what to make of the voice saying what it did. Or I may know what it means but not whether I can or want to trust it.  I do know one thing.  I know how to keep putting one foot in front of the other while we wait and see, wait and see…

Testing… Testing…

In preparation for our visit to Long Island (not to see the Long Island Psychic, though that would be fun) and a battery of tests that will be performed after many vials of blood are drawn from the LP and I, I met with my general practitioner (my “family doctor”) this morning.  As an aside, I had not eaten in twelve hours and was really hungry so it was tricky to remember everything I wanted to discuss.  I made a hopeful assumption that she would send me for some tests that require fasting and I could not remember if the rules were no eating after midnight or no eating for 12 hours.  Naturally, it was the former.

Today’s tests included ones recommended by Dr. Braverman (his included the fasting ones), some recommended by my TCM Doctor Acupuncturist and some that my GP threw in for good measure (why not, since we were at it?).  I also got copies of my TSH, T3, T4, IgE and Progesterone results from the past couple of weeks to add to my paperwork collection.

As for the tests, in case anyone is interested, here is what we did today:

  • Complete blood count (CBC)
  • Fasting insulin
  • Fasting glucose
  • Hemoglobin C (HbC)
  • Lipid panel – cholesterol tests, essentially  (I didn’t write down all of the acronyms but I think they are total cholesterol, LDL, HDL and triglycerides)
  • Alanine Aminotransferase (ALT – liver enzymes)
  • C-reactive protein (CRP)
  • Cortisol AM
  • Thyroid-stimulating hormone (TSH) – just to make sure it’s not doing anything crazy
  • RAST (allergy tests – blood) – food panel
  • RAST (allergy tests – blood) – inhalant panel
  • Anti-transglutaminase (I forgot to write this down so I may have missed part of this test’s name)

My GP suggested that the C-reactive protein (CRP) result will likely be high because of my super high IgE levels right now but it might still be informative to a Reproductive Immunologist. She also asked whether Dr. Braverman could prescribe allergy shots for me if he’s an immunologist.  Good question!  I have no idea.  I said I will ask him if he does that.

Apparently the RAST testing can take some time and it’s possible some of the others may take a few days more than usual as well so I may not have the results of most of this testing by Thursday morning when we meet with Dr. Braverman, but I will tell him that I can send them to him by e-mail.  I will also ask if I should copy them to anyone else because so far my observation of Dr. B and e-mail is suggestive of severe ADD and I want to make sure my results end up on my file for when he designs our next DE FET protocol.

The one thing my GP did *not* do was requisition a stool sample for parasites.  She suggested that it was very unlikely I had any of the parasites that would cause elevated IgE levels unless I had been (a) eating uncooked pork products (uh… negative on that. Eww!); or (b) taking up the dietary inclinations of the Inuit, who can sometimes contract the parasites in question (unbelievably, also a negative. I didn’t think Paleo-esque counted).  On that basis, I agreed it probably was not necessary.  Sorry, TCM doc, I’m passing on the pooh tests for now!

I am still waiting on my records from my former RE’s clinics but I have decided to accept that I won’t get those in time for the Dr. Braverman consult and that in all likelihood nothing serious will turn on that anyway.  I’m still annoyed but I’ve gotten over the urge to throat punch the staff at each clinic.  Life, thankfully, has gotten on with getting on.

That is it for this boring update.  Hopefully the next time you hear from me I will be reporting on a short stint in New York City and a short wait to see Dr. Braverman!

Not In Love but… Willing to Put One Foot in Front of the Other

We had our first telephone consult with the infamous Dr. Braverman today.  And it went… okay.

We waited 40 minutes past our appointment time.  And despite being told that I had to complete his 14-page questionnaire, he had neither received it (I was told it went directly to him for privacy reasons) nor read it. If I had not known this doctor practiced in NY, I would have been annoyed by this point.  Instead, the LP and I just exchanged eye rolls at opportune moments during the teleconference and at one point I wrote down “NYer” on my notepad and the LP nodded and rolled his eyes.

At the end of the call he had promised to transfer us to someone who would confirm that the person who collects the blood samples for the immunological testing is in his lab next week Thursday for our appointment.  Instead, he hung up hastily after saying he needed to take another call.  Oops.  No big deal, I called back and confirmed (for a second time) that all was in place.  I’ve read many complaints about the staff at this clinic but so far apart from a long wait to have my initial calls returned, the staff I’ve dealt with have been very helpful and mostly attentive.

The jury is still out on Dr. Braverman, but I went into this knowing I do not need to like this man, I just need to see if I can trust him.  Unlike many of the wonderful women I have encountered online who are [now pregnant  or with living children despite immune issues and RPL histories not unlike my own] patients or former patients of Dr. B, I cannot say I am in love.  At least not yet.  I am skeptical that I ever will be.  I think the cynicism that came from having defended doctors when they got into legal troubles and from being onto our third reproductive specialist, 100% out-of-pocket, in 18 months might make me a “tough customer” as the kids on Arthur would say (I never watched that show before I had the MT, who has it downloaded on an iPad… yes, I let my toddler watch tv shows on an iPad. Sue me.).

Enough mockery and negativity.  On to what was said.

First, Dr. B. thinks I have “an implantation problem” (not because he read the 14 pages of history that it took me two and a half hours to complete, but because I can now, in my vast experience yapping with specialists, narrow the essential evidence down to a very short synopsis and some key facts). Okay, I mean it this time, enough negativity about him being completely unprepared to talk with us today.

Second, Dr. B does not think much of the high IgE levels other than to say I may have hyper-IgE syndrome which involves an excessive histamine release, which can lead to implantation problems.  He agreed when I said it’s hard to know whether there is a causal connection or a correlation.  He said that women need some histamine to permit implantation but too much can be a problem.  Unfortunately, there is no way to test for histamine (???).  He also said we can use stronger drugs than steroids (???). He kind of meandered after this and mentioned two types of immune issues, being TH2 or antibody-based and TH1 or cellular-based, and suggested that hyper-IgE would suggest the former.

Third, he affirmed my decision not to do any more embryo transfers until we have a diagnosis. In his view without a diagnosis you’re basically guessing and cannot make a meaningful prognosis or effective plan (my words, not his).

I’m not sure that is true for anyone who does not have some kind of immune issue happening.  I don’t even know if my issues are immunological or just look that way, by which I mean I’m not sure which is the chicken and which is the egg or if they are apples and oranges and just seem to both look like pears at the moment.  I’m not sure I’m convinced that all of the immunological testing he will have us do is of real value.  But I am doing it.  One foot in front of the other.  There is something to be learned here and learning is what Azulito has sent me forth to do.  So do it I shall.

Fourth, the plan is to do all of the testing he prescribes, plan a protocol, do my next FET at his clinic and hope for  a positive outcome.  If that happens the next plan is either for me to find an ObGyn in my city who will work with me to have monitoring and/or prescribing done (that, I can safely say, is not going to be easy and may prove impossible) or for me to return to New York at 6 weeks and 10 weeks so he can do my monitoring and prescribe me meds accordingly (New York state law requires patients be physically present for Dr. B. to write them scripts).

So much for my retirement plan.  Oh yeah, what retirement plan?

Finally, I asked about what blood tests I might ask my doctor to do here.  He suggested fasting glucose, fasting insulin and hemoglobin C.  In addition to that my TCM/Acupuncturist suggested I ask my doctor to test my liver enzyme levels (ALT and CRP) and Parasite testing.  As an aside, she also suggested I consider stopping the Singulair.  I did.  No more dizziness – yay!  It wasn’t doing anything as far as I could tell anyway and never did last time I was prescribed it, either.

All in all, I do not care if the LP and I are not enamoured with Dr. Braverman as many other patients are.  And I am sure he would  not give it a nanosecond’s thought (nor should he).  If he can help us get and stay pregnant, I will pledge allegiance.  And say only nice things.  I promise.

Okay, I may still make the odd crack about him being very much a New Yorker.  Who can resist? (I apologize to all of you New Yorkers, some of whom I am deeply fond.  I say all of this affectionately, as does the LP.  You can poke fun at me in return.  Go on, ask me to say “about” and then snicker at how you think it sounds as though I am talking about a small sea vessel.)

(One of) the Trouble(s) with a Public Health Care System

This morning I got a telephone call from the fabulous and compassionate nurse who assists my general practitioner (GP), a family doctor who has a special interest but no specialization (meaning she didn’t complete specific residencies to become a specialist) in prenatal/conception and pediatric care .  My GP is the Miracle Toddler’s family doctor as well and I really like her, even though sometimes we arm wrestle a little.  I mentioned in a previous post that she gave me a referral to the genetics clinic in the hope that a Geneticist would be able to assist me and the LP in getting some HLA matching in order to assess whether we are losing our babies in part because of DNA matches that might be prompting my immune system to flag all embryos containing the LP’s DNA as pathogens worthy of assault and destruction.

The Geneticist has refused to see me (and the LP) or order any more tests.  Why?  Because he does not believe there is any point.  In his view, I have had all of the testing (meaning the RPL panel and karyotype testing) to which I am entitled under our public health care system (which testing my GP had to fight to have them perform for me, despite being on miscarriage #3 at the time and being of advanced maternal age).  The Geneticist believes that there is no further testing required although if I have another miscarriage my doctor can refer me again for reconsideration.  I’ve had 6 miscarriages since the start of 2013.  Is this guy for real?

This (and super long wait times, like the up to two years I’ll be waiting to see an allergist locally) is one of the reasons I am becoming rather resentful of the public health care system by which I am held hostage in my home and native land.  Bleepity bleep bleep bleep!

That being said, it is also not entirely unexpected.  I was anticipating this in some sense.  At least I had the forethought to set in motion access to private (and much more elaborate, meaning really bloody expensive) testing through Braverman Reproductive Immunology.  The HLA matching tests Dr. Braverman does are far more extensive than anything we would get here.  Public health care be damned, this is what loans and lines of credit are for, right?  I am not happy but at this point it barely registers as a blip on the big picture screen.  It is becoming par for the course, it seems.

On another note, I have been trying for the past two days to get information from the finance folks at Braverman Reproductive Immunology.  I’ve left two telephone messages and sent an e-mail and so far no reply despite the assurance I got yesterday that my first call would be returned today.  This is not sitting well with me given the gobs of cash this doctor charges for even looking in his direction.  Harumph!