The Lu.pron Saga Continued

The Lu.pron saga continued.

Me being me, I called Fed.ex to make sure that the direct signature requirement was removed from the delivery.  The lady on the phone told me

  • Nope the request is not honored, so a direct signature is still required at the time of delivery
  • It says on the request that Isabelle was the one who requested for it, not the pharmacy, so therefore it was not honored
  • She could ask for the package to be sent and held at a nearby facility, but it sometimes takes 24 hours to process, so I may not be able to pick it up tonight
  • The window of delivery was set at 11:05 and 2:45pm
  • There is nothing she can do to change anything

At that point, I was super annoyed and frustrated.  Why tell me that the shipper could change the signature requirement if it wasn’t going to be honored?  I need the meds tonight.  I needed to make a quick decision to figure out what to do.  That involved canceling a couple of clients and bringing work home for the rest of the day.  Fortunately, everybody was very understanding of my situation.  All the parents were good as I rescheduled them for another time.  My supervisor was understanding although I didn’t really tell her what was going on.

I figured if I left then, I could arrive home between the window of delivery.  As I pulled onto the street before I would make a turn to go home, I saw a Fed.ex truck making a turn somewhere.  I literally got a glimpse of it.  That was 15 minutes before the beginning of the delivery window.  My instinct told me that the truck came to my house already.   I pulled into my driveway, ran over to my door, and saw the door tag.  I grabbed it quickly, jumped back into my car, and drove to the direction of the truck.  Of course I didn’t see it at the intersection where I had seen it earlier.  I drove down this long road and made a decision to turn right and right again.  Don’t ask me how I knew but I just tried.  And there it was, the Fed.ex truck.  The guy just walked out from a house so I drove up to him, told him that I missed his delivery, and handed him the door tag.  He gave me the package and let me sign his little hand device.

Phew.  The one thing that I was afraid of was that I did all of this for nothing, rushing home finding that I had already missed the guy.

At least I caught him and now that box of Lu.pron is sitting on my kitchen counter.

Drama drama drama.  I guess it makes a good story now there is a happy ending?

The Lu.pron Saga

My nurse’s calendar for my test transfer and biopsies for the Endometrial Receptivity Array test (ERA test) dictates that I start Lu.pron tomorrow.  I have been kind of in a funk lately, so I had put off ordering it until Tuesday.  I was sick at home with some sort of sinus infection and running nose, and really didn’t feel like doing anything.  However, I am not one who waits until the last moment (namely Thursday) to order my meds.  So I finally gathered enough motivation to search online for the pricing of this very expensive medication.

A few months ago when I did my first DE transfer, I bought Lu.pron from Ave.lla, which offered the cheapest price back then.  It was about $189, $10 cheaper than other places.  That cycle failed.  I needed to transfer our last frozen embryo in February.  At that time, the price over at this pharmacy went exponentially higher.  It was almost $100 more expensive than the original price.  I was appalled by the price gouging and went ahead and ordered from Fre.edom Pharmacy, which still offered the medication at right below $200.

An internet search showed that at the current time, Fre.edom offers Lu.pron at $239.99 if you don’t purchase Gonadotropin at the same time.  I called Ave.lla just for giggles and almost fell off my chair when I heard the price quote.  Are you ready for it?

It had the audacity to ask for $445 for the same meds that others are charging for almost half.

This pharmacy still offers the cheapest PIO and estrogen patches, so I will eventually order some from it.  But, can you imagine paying $445 for the Lu.pron?

A few phone calls around showed that Fre.edom still had the cheapest price.  So I went ahead and ordered from them.

That was more than what I wanted to do on that one sick day.

I was asked when I needed to do the injection.  It’s going to be Friday but I always try to play it safe.  I asked for the meds to be delivered on Thursday at work.  The guy put me on hold.  Later he returned and said that most meds require a direct signature, but this particular doesn’t because it’s not a controlled substance.  However, since I was sending it to work and there is always someone there to sign, we would just leave the direct signature requirement there.  I tripled checked with him that the meds would arrive at my office on Thursday.  Then I went my merry way to take a nap and nurse my illness.

Everything is fine, right?

Wrong.

Today, I clicked on the Fe.dex tracking number included in the automatic email from Fre.edom.  I looked at the destination and was shocked to see that the city it would be delivered to was my home, not my work.  In other words, someone over at Fre.edom messed up my shipping address.  Guess what?  Nobody was going to be home to receive that package.

Furious, I called Fe.dex to request for the delivery to come between 6 and 8 pm because it said there that the guarantee delivery is before 8pm.  At least I could rush home right after work to wait for the package. The customer service person entered my request and got my phone number.  That was about 11am.  I inquired about removing the signature requirement.  He told me that the shipper has to request it.

When I checked my phone in the afternoon, a Fe.dex person from my local facility called and left a message.  He basically said that the package was on the truck heading to my residence and they could not honor the request for a late delivery.  In the voice mail, he gave me an address of a Fe.dex facility that I could go to pick up the package tonight between 8 and 11:30pm.

It was so frustrating that I had to spend more time calling around getting answers.  I called the Fe.dex mainline again.  Then I was told a different address of a different facility that the package would be held tonight and was given a window of 8 pm and 8:30pm to pick it up.  Are you kidding me?  Half an hour?  Yes, the package wouldn’t be back at the facility until 8pm and the facility closes at 8:30pm.

I thanked the Fe.dex representative and hung up.  Then I discovered that my next (and last) client of the day canceled.  Good.  I had the time to call Fre.edom.

I was put on hold for 13 minutes.  THIRTEEN MINUTES!  Good thing I had the time.  But what a waste of time.  I could use it for something better.

I explained to the Fre.edom representative what happened.  Then I was put on hold for another I don’t know how many minutes.  Finally the guy said that he had contacted Fe.dex and now the signature requirement had been removed. So the package will be delivered to my home address tomorrow without a signature needed from a live person.  He gave me a case number and I was told that there was nothing else I needed to do at that point.

I told the representative that I hoped that this wouldn’t happen again in the future.  How could they make a mistake like that?  He explained that whoever took my order did write down the shipping address as my work address.  However, for the label, the order person did not double check it to make sure it was the same as requested.  Okay, thanks for the explanation, but I was thinking, where is the apology?  As a company, shouldn’t someone apologize for the inconvenience it has caused me even though this particular representative was not the one who made a mistake?

But nope, no apology.  He was courteous.  But there was nothing like, I am so sorry this happened.

It’s so infuriating that you pay money for services and people just don’t care.

MicroblogMondays: Surprising Decision

Microblog_Mondays

I was going to write about something light, like how I chopped off six inches of my hair, or Bob’s birthday week fun activities.  But yeah, the agony that I had last week over choosing the next step occupied my mind so much that I have to write about it.

So much went through my head last week.  It was debilitating to not be able to have peace with decision making.  It simply stressed me out so much that my shoulders took the brunt of it.  I constantly felt my shoulders rising up to my ears.  I hadn’t felt so stressed out since we last had to choose a donor.  I think the information that I received from Dr. E and gathering data on cost was just too overwhelming for me.  I was basically on an overthinking overdrive.

What was going on in my mind?  Well, I was weighing the different options of working with my own clinic, working with Dr. E., going to a clinic in San Diego, or going to a clinic in Oregon.  In regards to the cost, it is still the most reasonable to go with my own clinic.  Although the sperm test is extra expensive, the cost of the ERA testing with biopsies on both day four and day five is going to be less expensive than doing one biopsy with Dr. E.  Being a boutique clinic, her fees (except for the sperm test) are higher across the board in comparison to my current clinic.  Cycling with her for a DE cycle is more expensive than at my current clinic.  Since she is an independent doctor not affiliated with any clinics, there is no SART data to support her success rate.  The success rate of my own clinic is similar to those two clinics in Oregon and San Diego.  Then why do I have to spend extra time and money to become a patient at these other clinics?

Why do I have to decide which clinic to go to rather than doing all the testing first?  Well, for the ERA test to assess the receptivity of my lining, the test results will only be relevant when the test transfer protocol for the biopsy is the same as that of the real embryo transfer.  I already know what protocol Dr. NN will put me on and I know that this particular medicated transfer protocol can grow my lining well.  If I go to Dr. E, she may use a different protocol. And if I have her do the ERA testing but don’t go to her for my DE cycle, my real transfer protocol may be different and the ERA testing results would be rendered useless.

My nurse’s calendar for me showed that the biopsies will be done in end of March, which is great timing.  If I wait to make a decision about going to Dr. E, other clinics, or back to my own clinic, then we may have to wait another month to do the ERA test.  That cuts very close to our Maui trip end of April.  If we don’t do it in April, then we do it in end of May.  I would like to get something going with the new DE cycle some time in June, right before my in-laws come in mid-June.

There were some other things that made me uncomfortable about working with Dr. E, which is surprising to myself.  I had never felt uncomfortable with or intimidated by Dr. E when I worked with her in the past.  However, the way she answered my questions this time just made it overwhelming and intimidating to me.  She insisted on seeing my uterus even though I sent her reports and images of my hysteroscopy and my most recent saline sonogram done only two months ago.  The scan clearly showed that my uterine cavity is clear.  She said she wanted to look at it with her own eyes with a simple pelvic scan.  Remember she mentioned about adenomyosis?  My dear friend in this field told me that adenomyosis is usually confirmed only through a pathological report, often after a hysterectomy.  You really can’t see adenomyosis from a pelvic scan because it is in the myometrium, or the middle layer, of the uterus.  She did say that from the pictures of my scans, it did look extremely reassuring, but she would still want to take a look.  I just don’t know what else she could look at.  Doing a scan with her is not cheap.  I pay out of pocket.  So yeah, I don’t know why but I felt very intimidated.  I also felt that one test to check on my receptivity is enough, and two (both the ERA test and the beta-3 integrin test) might be an overkill.

Something else about her also made me feel uncomfortable.  I am interested in a proven donor who worked with another Bay Area doctor and Dr. E for her first two DE cycles.  The first cycle she had 26 eggs.  The second cycle with Dr. E (which is such a coincidence that she had worked with this doctor) yielded 55 eggs.  I don’t know about you but I feel extremely uncomfortable that Dr. E overstimulated this donor so much.  The end results of both cycles were similar: 7 blastocysts and 8 blastocysts respectively, with a successful pregnancy for both.  This piece of information about Dr. E just complicated my feelings.

I emailed my nurse to see if I could do one biopsy instead of two, as well as if Dr. No Nonsense recommends the beta-3 integrin test.  The answer is yes, I can do just one biopsy, but they recommend doing both days 4 and 5 so we could save time.  Dr. NN said that I could do the beta-3 integrin test but he thinks that the ERA test is superior over the other test and he does not recommend it to any of his patients anymore.

My husband got mad at me because of this whole thing.  I had been trying to gather all the information about various tests from the different doctors, nurses, and financial people.  I didn’t want to present this whole thing to him in bits and pieces.  Since I was still trying to wrap my mind around this whole thing, I was waiting for a good chance to talk to him.  Given our busy schedule last Monday and Tuesday, we didn’t get a chance to talk.  When he came home on Tuesday, he saw that I was chatting with a friend online about it.  Wednesday morning, instead of a usual happy man coming home from fitness bootcamp, he came home unhappy.  He felt left out that I asked everyone else for their opinion but him.  I was at first very upset that he didn’t understand why I waited to talk to him.  However, I put myself in his shoes and thought about my behaviors and actions in the previous few days, I started to understand why he felt the way he felt.  So instead of my original plan of going to work early, I took out my little chart that I had drawn for myself to make sense of this whole thing and used 15 minutes to explain to him what had been bugging me.  I am glad that my life partner does not hold grudges in silence but instead voices his frustrations and concerns with me.  I am grateful that we had a chance to smooth things out.

My trusted therapist helped too.  That same evening I had a session with her.  In that session, I learned that I was back to being cerebral with my decision making.  I was over thinking, which drove me to a point where I couldn’t make decisions.  I was afraid of regrets.  She listened to all of my dilemma and asked me deep down what I believed in.  I told her that deep down, I believe that I have a uterus that is good, I will get pregnant with a good embryo, and I will become a mother.  She told me that whatever decision that we make will be the best decision for our path.  She would like me to consider making a decision that stresses me out the least.

That same evening, Bob and I talked about this whole thing at home.  He asked me if I had made a decision about which doctor/clinic to go with.  I have learned to listen to his opinion.  I asked him to tell me first which doctor he would like to work with.  He thought for a few seconds, and told me that he would still like to work with Dr. NN.  I am so glad I asked him because that was my answer too.  I just feel that it is the simplest right now for me and Bob to not worry about starting all over with another clinic again.  Going with Dr. NN again really gives me the peace that I didn’t have in the past week.  What a relief that Bob and I are on the same page.

So yeah, after a lot of prayers for clarity and peace, I will start Lup.ron next week in preparation for two biopsies at the end of March.  I am finally at peace with this decision.  I cherish this sense of peace so much especially after feeling so paralyzed by the inability to decide.  I based my decision on my emotional responses to these doctors.  Sometimes that’s just what we have to go with.