Friday, September 28, 2012

Shipping Blood

I need help shipping blood to PPVI. I have seen this topic on the blogosphere so many times but I keep forgetting.
I need to do a Limited Hormone Panel for Estradiol on Day 13,15 and so on till I am Post Peak. Most likely 3-4 days of blood draws.

I have two options for shipping:
1. On the day of the last blood draw, I can ship all the frozen samples together on dry ice.
2. I can mail each sample separately on the same day as it is drawn. I spoke with PPVI and since it is Estradiol, the serum can be shipped at room temp provided it will reach the lab within 5 days. I could use Padded Envelopes or Small Flat Rate Priority Boxes and simply drop it in the USPS drop boxes.

I am trying to find the cost-effective day of doing it. Those of you who have done the hormone profile, how much did it cost to ship the samples on dry ice? I am thinking that the second option is more convenient and would cost me less than 20$.

Friday, September 21, 2012

My Results From Dr. KK

I got my results from my visit to Dr. KK and most of it seemed to be normal with a few exceptions. The phone consultation is over and here are my results.

Anti-phospholipid antibodies
IgG-Cardiolipin - Borderline
IgG-Phosphatidic Acid - Borderline

TreatmentLovenox (Heparin) Shots 40mg/day starting CD 6. This will also increase the blood-flow to the Uterus and Ovaries. My blood flow was 2 out of 5 as measured during the u/s. Also need to do a followup U/S after 2 weeks on Lovenox to check blood blow and accordingly adjust Lovenox dosage. The resistance index was 0.6 last time. It needs be be less than 0.4.

NK (Natural Killer Cells) Assay
%CD 19 Result - 14.5 Range (2-12) - Slightly elevated
%CD 56 Result - 12.4 Range (2-12) - Slightly elevated

TH1:TH2 Intracellular Cytokine Ratios
TNF-a : IL-10  Result - 45.1 Range (13.2 - 30.6) - High
IFN-g : IL-10   Result - 35.0 Ratio (5.8 - 20.5) - High

Treatment : Dr KK recommends IVIG preconceptually and after conception. Since IVIG is expensive, there is high probability that insurance won't cover it. If so, I may chose to do steroids instead of IVIG.

Immunoglobulin Panel
IgG  Result - 1680 Range (751-1560) - High

I need to do another blood test locally to recheck these levels. Any Idea why IgG would be high?

Result - 1050 Range (102-1185 ng/dL)
I am not on DHEA supplements. Dr KK felt it was slightly high.

All the remaining tests were normal -some of which were Thyroid Panel, Metabolic Panel, CBC w/differential, MTHFR, Anti-DNA, Anti-Thyroid Antibodies, PAI-1 4G/5G Gene Polymorphism, Factor XIII, beta- Fibrinogen, HPA-1a, ANA, Testosterone, Vitamin D, Protein C, Protein S and so on.

I am glad that I have some answers and that my trip to Chicago was helpful. I at least know that I have autoimmune issues which need to be treated. I am hoping that I can get around without IVIG. I am ready to try steroids and lovenox. I am thinking that I should go with the Lap & Hysteroscopy on Oct 23rd before I start Dr KK's treatment. Hopefully, the Laparoscopy will help me know if there are problems conceiving and Dr.KK's treatment should help me to sustain a pregnancy if I conceive.

Sunday, September 16, 2012

Surgery Dates

A few days ago, I got the call from PPVI & and I have 2 tentative dates for surgery - either Oct 23rd or Nov 20th. I didn't expect that I would be getting a surgery date so soon. I thought it would be 4-5 months before I hear back from PPVI and that I would have ample time to make a decision.

I would love to go with the October date but there are so many things that need to be done. Flight tickets, accommodation, the blood draws for the hormone series and DH's leave plans. I got an estimate from PPVI in case insurance doesn't pay. $7500 for the doctor's charges, ultrasound series and so on. The hospital bill will be around $30,000 or even more !!! I had a panic attack when I heard the $$$ amounts. I am trying to soak everything up.

We still haven't made a decision. I am waiting for my phone consultation with Dr. Kwak-Kim which will be this week. I can't wait to discuss my labs with Dr.KK. I am so thankful that I went ahead and kept the appt with Dr.KK because insurance covered everything (both the doctor and Rosalind Franklin University Lab) and I just have to pay my deductible of $800 instead of $5000 which is such a huge relief. Thank you Jesus for this great blessing!!!

The surgery is going to be with Dr. Pakiz. I am unsure if I should stay for the ultrasound series because there is high probability that I won't ovulate. I don't do well under stress and the surgery itself is a huge stress!!! Moreover, I had a detailed u/s with Dr.KK's sonographer which showed poor ovulation. My heart tells me that I should go ahead with the lap. Oct 23rd is the due date of our baby I lost in Feb and I don't think it's a coincidence. I haven't fallen pregnant after that. God definitely has plans! This surgery might be an answer. I will know if my remaining tube is clear and can know if I am at risks for a future ectopic.

I need all your prayers that we can make a decision soon and that insurance would cover the surgery. Jesus, I trust in you!