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Tuesday, September 6, 2011

Got my appointment

Dr. C's office called today to schedule my appointment. I was a little worried about when they would be able to schedule me, especially after the receptionist told me they were in a particularly busy month but the first available appointment time worked for me so I took it.  Tony and I will be meeting Dr. C on Monday, September 26th and 10 am.

The receptionist then proceeded to tell me about a few policies and asked me to go on their website and print out the new patient packet, fill it out, then fax it back.  She told me I had to have it in at least a week, preferably two weeks, before my appointment.  No problem.  I went on the website and emailed the pdf to work so I could print it out and get started, I figured all of my prescription records are right in front of me when I'm at work so it would be easier (thank you employer for the paper).

The patient packet is NINE pages.  NINE.  After completing them I couldn't help but notice the amount of duplication. It just seemed excessive.  I know this is a specialist, but I swear I did less paperwork for my car loan.

One thing I did really like about Dr. C's paperwork is one particular section.  It asked how I felt about not being able to have a baby.  (Frustrated by hopeful.)  How our infertility had affected our relationship (If anything, going through this together has brought us closer).  If there was anything important I thought they should know about our situation. (Tony had linear scleroderma as a child.) And is we had any specific fears or concerns about our upcoming visit.

Its nice that their forms have this on them, a mini question or comment section.  Its very easy to forget to ask something or feel like you are being rushed when your at the doctors.  This way the original concerns don't get missed.  Of course my big concerns are: is it going to work, and how much money are we really talking here?  (I left those unsaid, I'm sure those are most peoples top two questions.)

I know that last one is horrible.  Lisa, how can you put a price on having your own bundle of joy? But seriously?  Have you seen the cost of fertility medications?  Just the medications...  Sure Clomid is cheap, but most of the other fertility medications are not.  Just to give you an idea, I took a look at some of the more common fertility medications.  These are cash prices from the pharmacy I work at.  (Mail order though a specialty is definitely less expensive but in the world of fertility medications, time is of the essence.)

Follistim (works to grow follicles)
one treatment of the middle of the road strength
$996.09

Menopur (works to grow and mature follicles)
one treatment ranges from
$599.69 to over $4,000.00
(I sold on RX today where the patient was using seven vials a day for five days, her RX was $4,950 and some odd cents)

Ovidrel (taken after either of the above to stimulate ovulation)
$102.99

And that's just three of the more commonly prescribed medications.  But there is no way to tell how, or even if, a person will respond to any medication.  If they all worked the same for every person there would be only one kind.  But like every medication, people respond differently.  

There are a lot of fertility medications.  Lots of them work to grow follicles.  A few to trigger ovulation.  One helps to maintains pregnancy.  And two to delay an ovulation to increase conception chances.  Here's a list:

Bravelle
Gonal-f
Follistim
Luveris
Menopur
Repronex
Clomid
Lupron
Novarel
Ovidrel
Pregnyl
Progesterone
Ganirelix
Cetrotide

Quite a list, and all but two of them are over $100.  Most of them are over $500.  Times how ever many tries it takes.  It adds up.  One of my patients had a successful IVF procedure after years of infertility.  She now has three beautiful babies, two boys and one girl.  She told me they took out loans.  Loans that totaled more than what she owes on her brand new, family-size van.  Not to mention now she has three babies.  THREE.  Three times the dirty diapers.  Three times the doctors bills.  Three times the sleep loss.  Three times the college tuition.  

She told me one day, after yet another sleepless night, that if she had it to do over she wasn't sure if she would.  That she loves her babies, but having three infants is just too much.  She can't even go out without lugging around a major-league stroller and playing juggle the baby.  Its so difficult to manage that she and her husband haven't left the house together since the babies were born.  One of them always stays behind with one or two of the kids.  She can't even get anyone to baby sit.  Not even the grandparents want to accept that challenge.

She and her husband both are able to work from home.  But how many people have that luxury?  What would happen if I ended up with multiples?  Its more common with fertility treatment patients.  What would we do?  Tony works from home.  But I can't.  And I have to keep working for the insurance if not the paycheck.  Private health care is just too expensive.  One more thing to try not to worry about ;-)

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