Wednesday, March 07, 2007

New Reproductive Endocrinologist

Well, tomorrow I go see the fertility specialist for the first time. This is like the 4th appointment I've had, one was canceled by me because my husband couldn't make it, the rest were canceled by the doctor's office because the doctor was going to be "in surgery".

I'm kind of nervous about the visit, what he's going to say, the procedures he's going to suggest, how much they are going to cost, and how my husband will react. Three years ago, I visited another fertility doctor in the same office but I didn't like her, and we decided we were not ready to put in the money just yet - still too much debt.

I hope my ObGyn finally forwards my HSG report to the new doc before my appointment tomorrow morning. I've asked them to send it 3 times. They may have sent it the last time but if they did, they never told me. We'll see if anyone calls me back.

Thursday, March 01, 2007

So, I got an Hysterosalpingogram (HSG)

My ObGyn asked me to go get an HSG saying that it is used to show tubal blockage to see if that might be why I haven't gotten pregnant yet. The nurse described the process to me saying that a small catheter is placed into the cervix and the dye is injected. She told me that I would probably feel heavy cramping during, and for several hours following the procedure and that I should take an anti-inflammatory medication like Aleve or Motrin before my procedure. Ok, so I'm nervous. I typically have a fairly high pain tolerance, but it sounds bad and one likes pain.

Once my insurance OKed the HSG, I had to find out how much the HSG was going to cost me. To do this, I first called the Imaging Center and asked for the procedure code(s) for the HSG. I was given two, one for the dye insertion and one for the x-rays. I then called the Imaging Center's billing department, gave them my insurance company's name, and requested the negotiated rates for the procedure codes I have gotten from the Imaging Center. The total came to $268 and I know my insurance will pay for half of this procedure. I only hope that I was given the correct information because it sounds too low.

I then called the Imaging Center to make an appointment. The staff told me that the study is done between day 7 and 11 of your cycle, so I would need to call back to make an appointment on the first day of my next cycle and they would squeeze me in. I decided to wait until February because my insurance only pays half of the cost of this procedure and my husband and I wanted to be able to budget for it. Then, she asked me if I had my prescription for antibiotics. Um, no clue what you are talking about.

I called my ObGyn's office back and asked if they could call in a prescription to my pharmacy for my HSG. The Imaging Center told me I would need to take antibiotics twice a day for 5 days - two days prior to my procedure, the day of, and then two days after.

My period started on a Saturday. I called to schedule an appointment, but the scheduling department was closed on Saturday. I called back on Monday hoping that they would still be able to squeeze me in. We were able to schedule an appointment, no problem. I chose an appointment at 3:30 in the afternoon so as to interfere less with my work day.

The day of my appointment, I drove to my appointment and, as I got out of my car, I took an anti-inflammatory pills. I knew I would be waiting for a while in the waiting room, so the anti-inflammatory would have time to take effect. Though I have a fairly high pain tolerance, but I was still nervous about the cramps and the pain that the nurse had told me to expect.

I was escorted from the waiting room to a changing room where I was instructed to remove everything from the waist down, slip into a sweet paper skirt, and then enter the x-ray room. Once in the x-ray room, the technician explained everything to me telling me that that a speculum is inserted just as if I were having a pap test. Then, a small catheter is placed into the cervix and the dye is injected into the uterus. She explained that the uterus doesn't like to have liquid forced into it, so I may cramp a little. OK, may cramp is better than will cramp for hours.

So I lay down on the table and the technician took several comparison x-rays. After a while, a doctor came in. With the technician in the room, the doctor inserted the speculum, then the catheter, which pinched a bit. Injecting the dye caused a small amount of cramping, certainly not as bad as I was afraid it would be. The technician continued to take x-rays as the dye traveled into the fallopian tubes.

Once the doctor felt he had enough pictures, he removed the catheter and speculum, told me my ObGyn would have the results today, and left the room. The technician helped me get off the table and I went into the restroom to clean up a bit and put on my underwear. She also gave me a pad to keep my underwear clean. I then returned to the x-ray room again for follow up pictures.

When all the pictures were taken, the technician told me that some dye will escape during the day and that the dye that remains will be absorbed without any ill effect. She also said that sometimes forcing dye through the fallopian tubes will clear any material blocking it. And that a number of women have become pregnant following a hysterosalpingogram without further treatment so to go ahead and try over the next three days or so.

On the way home, I called my ObGyn requesting that they forward the HSG report to the fertility specialist they had referred me to.

A few days later, my ObGyn's office called to tell me that though they did not have all the results yet, it looked as if everything was normal.