What a Headache!

Dr. B ordered an insane amount of blood work. I have been working hard at getting it completed and as much paid for by insurance as possible. The entire order was sent to an out of network lab (Repro.source) originally. Since some of the testing can be done in network I was able to get two different scripts for the testing. 

All of the following tests will be performed at an in-network lab:

 protein C, Protein S, lupus anticoagulants, antithrombin, Factor X, Factor IX, Factor VII, complete thyroid panel, prolactin, Homocysteine, prothrombin gene analysis, beta 2 glycoprotein, MTHFR, Cardiolipin, Vitamin D, platelet antibodies, DNA double stranded anitbodies, ACE insertion/deletion, Annexin 5, Prothrombin gene (factor II), C3, C4. 

Then there is a script for a karyotype for both me and my husband. 

In addition, there is DNA testing for both of us. These tests include: HLA A, B, C Class I DNA TYP-antibodies and then HLA DR, DQ Class II DNA- antibodies. I'm not sure exactly what all of those abbreviations are for, but I know it has to do with DNA. Aren't I a genius?

For this blood work I had better success today with Quest Diagnostics. I had been try Labcorps but decided they sucked and I should go elsewhere. Today at Quest they seeemd initially overwhelmed and annoyed but then told me that I can return tomorrow afternoon and get all of the tests performed. I'm sure it's going to be a lot of blood, but I will be so happy to have it done and behind me. 

There are a few tests that cannot be performed in network and I therefore have to use a specific company (Repro.source). They sent me two boxes by FedEx and instructed me to take these to my clinic and have them draw the blood and then they would send it. 

Etsy shop lilflower

I brought the boxes with me to my baseline appointment yesterday. When I pulled them out the nurse got a bit upset and wanted to call in the NP to see what to do. I heard them talking about it in the hallway and then the nurse and NP came back. 

The NP came in and was a bit rude about it all. She asked me who ordered these tests and why I was doing them. When I mentioned Dr. Br.averman she appeared even more upset. Things didn't improve much from there. I felt like I was being lectured. She told me that he thinks outside the box and that he does some different things, but that I have to be careful because he will take a lot of my money. She asked if he would be managing my cycle and I said he would. She asked if he would be doing the retrieval and I said he wouldn't. She then said she will need to have written orders from him during my cycle and that her past experiences with him did not include any formal instructions. This is the only way it will be possible. 

She then left the room and the nurse came back in to draw my blood. Once again she seemed annoyed but got it done. The NP popped her head back in the room and seemed to have calmed down a bit but was obviously not happy about the situation. She wrote me a prescription for birth control pills and then said she was going to need the plan to know what to do next. At one point while I was getting my blood drawn I heard Dr. K in the hallway talking to her but I wasn't sure what about. It's pretty rare to hear his voice down in that part of the hallway.

The worst part of this whole thing is that I learned the extra blood work through Repro.source could be covered by my insurance with pre-authorization. I hadn't gotten it prior to getting my blood work done the other day so I had to cancel that set of tests in order to wait for the pre authorization from my insurance company. Then I get to do it all over again. Yay!!

For the past two days I have been upset about it all. I'm frustrated that my clinic appears so upset about an outside opinion. I tried to get their opinion about what I could do differently and I feel like they told me to keep doing the same thing. I can't expect any different results if I keep doing the same thing. I need to make changes and know that I am trying my best and maximizing each cycle to increase success rates. It's almost like the goal of getting me pregnant was forgotten at my clinic and everything was taken personally. I'm not trying to offend them but I don't feel like I am getting what I want from them. I'm willing to pay extra money to feel like we are making positive changes.

A big issue is that I'm too sensitive. I internalize others people's feelings and let it bother me way more than it should. 

One of my friends previously told me she didn't like this NP. She said she didn't feel like the NP includes the patient in discussing the plan or making decisions. I like her because she tends to be more aggressive than the other nurses. I guess I found out that she doesn't like to be told what to do. She really took it personally that I was seeking outside input.

Obviously an option is to not use Dr. B for this cycle and if it doesn't work this time to go to him. That would still involve using my local clinic for monitoring. W and I talked and we still want to move forward with using Dr. B. It is more expensive, but this whole process is so expensive so does it matter that much if it helps? At this point it just feels like a drop in the bucket.

So the questions I could use some input on are: Do I continue with the same NP and hope she turns around on her opinion/attitude?  There are plenty of other nurses at the office but none that know me as well as she does. I think it would be awkward if I suddenly stopped requesting her and then saw her in the office.

Do I send my RE and email telling him the plan for using Dr. B? I was planning to let Dr. B deal with that but from the interaction with the NP I'm wondering how good he is about being in contact with the nurses and doctors. At my clinic it really feel like I only see my RE for retrieval and transfer. There isn't much discussion with him throughout the cycle and I feel like the NP is the one making the decisions.

I also don't know how to put the negativity behind me and move forward. Like I said before I'm really sensitive about other people's reactions to things. I care too much and then worry about it a lot. I just want to move forward and reduce stress as much as possible leading up to this next IVF cycle.