To Fabulous Nurse at 7pm last night:

Hi FN,

Since my results will be in before CD 1 of my next cycle (today I am CD5 and my cycles are between 28-31 days) and I can’t get an appointment with Dr. Ginsburg in Stratham until the 25th of JULY, is the current game plan for someone from the center to contact me with the results of these tests as soon as they come in so that we are able to get the RX’s ordered and begin my next assisted cycle the beginning of July (I will expect CD 1 around the 30th of June)?

I am hoping that this can be coordinated in advance so that as soon as the results come in, we are ready to roll for my next cycle that will start the beginning of July rather than sitting around wasting another cycle until I can get face time with her on 7/25 (especially when we will have all of the testing info back by the end of my current cycle).  We would like to either start another round of FSH stimming and IUI at CRC if it turns out my blood work shows that Lovenox would be prescribed, or begin birth control pills (instead of lupron-that was adjusted in my notes per my last meeting with Dr G) for my next IVF cycle  if nothing is found in my RPL screen.

If we won’t be able to move forward with my next assisted cycle until we see Dr. G-then can we please get an appointment on the books with her for the last week in June at Brigham- so that we are able to avoid losing 3 cycles to this?

Thanks so much for your assistance!
Brooke

From FN at 8:32am this morning:

Brooke,

I will flag your chart to review the lab results when they come back with Dr. G. In her last note, she said that if the Office Hysteroscopy 6/8 and labs from 6/16 are normal, we can review them over the phone, and I am sure that you can move ahead with the next cycle.  Obviously, if anything is abnormal, then you will need to meet with her first.

I want to clarify- if the labs are normal, your plan is to do IVF, but if anything comes back that can be treated with Lovenox, you want to do IUI?   Dr. G left orders for both, so we are all set, I just want to make sure I have everything correct.  Once we know which type of cycle you will be doing, we can order your meds.

I think (as long as you don’t having something so wacky in your blood work that requires that you meet with Dr. G) you should be all set to cycle with your late June period.  If you do need to meet with her, we will give you the info to schedule an appointment with her in Boston if you prefer.  I don’t know what her schedule is like, so that would be up to her secretary to see where you could get in to see her. 

Enjoy the sun before it gets too hot!

FN


My response to FN at 9:10am

I am beginning to wonder if you get any days off?!  However, you have no idea how much I appreciate the fact that you are so quick to answer!

Yes, if labs are normal-we will want to do IVF on the next CD 1-with the revised protocol that Dr. G based on how many eggs I produced on my IUI conversion cycle without suppression.  To get through an IVF cycle quicker, and because I do well without any suppression-she thought sufficient enough suppression could be achieved using 2 weeks of Oral Contraceptive Pills rather than waste a full cycle on Lupron, and then begin high dose FSH injections for 10-14 days, trigger, retrieve and then do a day 5 blast transfer.  This protocol should have us retrieving the last week in July, and transferring the first week in August.

If my labs suggest lovenox is the suggested course for treatment because there is an issue with my body-then we want to do an FSH/IUI cycle at the center starting my next CD 1.  However, teledrug takes their sweet ass time processing prescriptions and cigna wont cover me if i try to get them anywhere else.  My hope is to minimize my levels of stress and time spent on the phone fighting with Cigna to get my order processed in time.  It would be super helpful if once we get the lab results back and see that  we are planning this route-to get the RX’s in that day rather than waiting around for a positive pregnancy test or cd1 (especially due to 4th of july weekend) to make sure we have the Gonal F, Progesterone, and lovenox in hand ASAP.  I have about 150 IU’s of Gonal F remaining and 2 days worth of crinone.  Teldrug has sometimes taken as long as 2 weeks to get me a prescription, with the average wait of 10 days-and non of our previous orders were over a holiday-so who knows what kind of mess that could be.  My other thought on ordering this stuff immediately is if it turns out Lovenox could be the missing link here-on the insanely slim chance that we get pregnant this cycle on our own (which we have done in the past)-I would imagine we would need lovenox and progesterone (possibly?) around the 26th-30th when I could potentially be testing + if pregnant.

If it comes back that I’m wacky (physically not mentally), then let’s see what we can do about getting an appointment with Dr G in boston as quickly as possible-as we never discussed there being a potential of being wacky so there isn’t a plan in place for that.  I need plans, they keep me sane:)  I need to avoid (at all costs) finding out that I am an unplanned for type of wacky and not know what that means while having no plan in place and a full month in which to contemplate that nightmare before seeing Dr. G.

Thanks again for your help!!
Brooke

FN’s response 15 minutes later:

LOL, I sometimes wonder the same thing!  (about getting days off    lol)

I am game for ordering your meds now and assume an IVF cycle.  The worst case scenario I can see is that you would be paying co-pays for meds that you don’t need-and something tells me you are fine with that.

I hear ya about plans…I am a list-making OCD-type person myself!

I love her.

I love email.

I love that all this shit was hammered out without having to talk to DN or waste a single second on hold on the phone or playing phone tag.

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