I survived the "new OB" appt. I survived a new nurse that doesn't know me. I survived the how many live births and how many pregnancies question. I survived (and even smiled) being handed the bag (full of hospital registration info and samples), even though it stays untouched and out of site.
I did see the doctor, but didn't get scanned. His scans are less accurate for early, and the ultrasound tech wasn't in that day. We made an appt for Monday (5w5d) for my first and for the following Tues (6w6d) to look for a heartbeat.
I got my first progesterone draw, and it went great. The lab I always used no longer mails to PPVI, so I wasn't sure what to do. PPVI actually mentioned to me who they receive blood from in the area, which was very helpful. The lab told me they do it all the time, and seemed competent. I guess the test will be if it gets there! I am curious to see if there was healing in that area.
HCG shots are going well. Dh is giving them in my thigh without too much trouble. HCG insurance is another story. Kubats got a request for precert so I paid out of pocket this month ($250-by far the cheapest!). Then I called my insurance. Usually if you go to their mail order pharmacy, they have the ability to access your medical benefits (not just pharmacy). Often medical will cover injectible specialty meds when pharmacy denies them. I found out after lots of calls that medical actually denied it as well. The pharmacy they wanted me to go to for coverage (if there had been any), was Freedom Fertility Pharmacy. So then it gets confusing stating it isn't for fertility, I don't have any fertility benefits, etc. Can you believe their cost is over $900 for a month? Yikes! So the plan now is to request Dr. Hilger's office to submit a letter of medical necessity. They told me they were willing to do anything as they see me being on this long term. I did, however, see something online about HCG during pregnancy being harmful, so while I trust Dr. H, I did ask them in an email to help me understand the risk.
That is it for now. The boys are doing a decent job distracting me, and I suppose it's time to get the Christmas tree down. :) Illness kept us from doing anything after Christmas officially ended. And I have a few fun things planned to look forward to. Dh and I are going on a movie date tonight (american sniper) and I have been arranging a few girl's nights. If you don't mind, I would appreciate continued prayers as this is the period (20-24 dpo) that levels really dropped and signified an issue for us. If you want, you can join me in my novena to St. Gerard. And please include some friends in your prayers. One woman just had her fourth baby, a boy after three girls. However, her husband has colon cancer and a big surgery coming up. Another friend is still mourning the loss of her baby at 37 weeks. I have several friends discerning or at some point in the adoption journey, and you may have heard of this blogger, http://luckyassunshine.blogspot.com/, who experienced a terrible late loss just recently.
I am on the journey we are all called to-to accept God's will and perfect love. Whether I am white knuckling it with my eyes shut tight or standing up with my arms outstretched enjoying the ride, I try always to let God be the driver and not bail out the side when there are bumps (like IF!). On good days, I trust He won't run me into a tree. :)
Showing posts with label blood draw. Show all posts
Showing posts with label blood draw. Show all posts
1.24.2010
Update and Tips for Anyone Doing Blood Draws to send to PPVI
I am pretty much 100% now, and Charlie seems to be better but definitely NOT 100%-he isn't eating or sleeping great and it is hard to tell what is the cause. I normally feel so confident about him, but there is so much going on at the same time-I know his throat is sore, the junk is running down his throat and he is swallowing it which could make his belly sore. He is congested, etc, and he is also teething. I am not sure which is blame, but he is eating less and less variety; thank goodness for signing or I would NOT have known he was hungry in the middle of the night-thank goodness he told me! Hoping he will feel better soon.
I have been wanting to write a post about my experiences with lab draws. As we ttc #2, and there is more and more new territory (new things Hilgers does/tests for, new ways to give my hcg, blood draws with a 15 month old on my lap! etc), I have to remind myself there are plenty of things that have become old hat. I am hoping the things I am familiar with can help others. So here is a post about getting your blood draw to mail to Dr. Hilgers. I hope what I have learned can benefit those new to the process, and maybe even make it more efficient for those who have been doing it awhile.
There tends to be a few reasons why you would have your blood draw to mail to the Nation.al Hormon.e Laboratory at Pop.e Paul the VI Insti.tute: a hormone series, a peak plus 7 draw, a pregnancy test, or progesterone draws during pregnancy. I have done all of these, except the series, at least 3 times.
First of all, you can always get your requisitions from PPVI ahead of time. That is nice so you don't have to wait after you think you already might be pregnant. Secondly, always make a copy of your requisition to keep at home. I actually scan all of mine (front and back-back is important for the lab), so I can print them out as needed. Anyone need a requisition? lol
As far as where to do the draw, I have found the best place to be the local hospital. The reason is that Qu.est, LabCo.rp, La.bOn.e , etc have all turned me down. They don't like to draw a sample and then not get to run it themselves. Plus, most hospitals have longer hours and you don't need an appointment. We live in a large metropolitian area, so our hospital labs are open 24/7. That is the most convenient since you are working around your cycle and you may want to do a pregnancy test on a Sunday, etc and not wait another day. Some hospitals do have problems with giving you the blood to take with you. To avoid problems, I always call ahead of time and speak to the manager at a new hospital (I have done this at at least 10 hospitals due to traveling, etc) In many cases, their fears are eased if you explain the situation and tell them you will bring the packaging in with you to show them how you will be shipping it. This has happened to me several times. Unfortunately, locally I am now down to only 1 hospital option in our area from 3 because 2 stopped letting blood go home with you because a new "risk management" policy...
If you are doing monthly peak plus 7 draws, Dr. Hilgers' staff must write "series" are "repeat draw monthly" on the requisition. Then when you register (required in every hospital I've been in), you can simply register as a series and not have to register again each time you come in for a draw. Now, if you change hospitals or go somewhere else for travel, of course you have to register again. It depends on the hospital how long registering is good for-some places it only has to be renewed every year. Anything that saves time, right?!
When you are done registering and go to the lab, I have learned that if possible get to know the staff and even come around the same time to get the same people. There is definitely a learning curve when it comes to this. It is not at all what they are used to and these people are not phlebotomist because it is their life's passion. It is a job, it pays the bills (and not well, mind you). I highly suggest you become very familiar with the requisition. When you check in, explain to the secretary that they will be drawing it, not running it. But that they do need to let it clot and spin it (this is true for all but some of the hormone series). Tell them you need to take a filled out requisition with you, but that you will be back monthly (if that is the case), so please make several copies. Often they will show you where they are filed so you can show the person when you come next time, if it is a different person. I always bring a copy just in case they can't find it too.
When the person goes to draw you up, remind him/her that it is 1 red top tube (for peak plus 7, pregnancy test, or progesterone levels; for a series it depends). Sometimes they want to draw 2 (one for progesterone and one for estrogen-but there is only a very little serum required so many tests can be run off one tube). Sometimes they want to draw a lilac tube because they see that is part of the specimen key at the bottom. Grr. Just one red top tube please. And I ALWAYS have to remind them to fill out the line on the requisition. Before the phlebotomist leaves, I remind him/her they aren't running it, just letting it clot, spinning it, and pouring it off. I show them the back of the requisition. I have the items circled that apply. When I leave, I tell the secretary: I will be back in one hour because it needs to clot for 30 min and spun for 15. I also show them on the back where it says "room temp is fine if it will get there in 5 days." I tell them it will, so please please please do not put it in the refrigerator, even if I don't come back until tomorrow for some reason.
Even with all of that, I sometimes come back to find that they hand me blood. They should be giving you clearish serum. That is what they pour off after spinning. Ideally they give it to you in a clear plastic transport vial with a biohazard bag. The bag has a pocket for the requisition, filled out, to accompany the product. In the beginning I used to pay to overnight the serum. I also used to use dry ice. Over time I have found that is not at all necessary. Most people live where it will get to Omaha in the 5 days. Overnighting it is a huge unnecessary charge. In KS, I simply buy padded envelopes (very small) and put plastic bag with tube and req in. If you are doing this monthly, I highly recommend you buy a ton of the same kind of envelopes. That way, you only have to weigh it once at the post office. I have a PDA and I put in the "notes" section of the Outlook contact for Dr. Hilgers the amount of stamps (in my case only 3) and dollar amount. This way, I can just remind myself and it should still work even if the price of stamps goes up. Especially with a 15 month old, I spend as little time in the post office line as possible! You can usually weigh in the lobby, but for $40 I have invested in my own scale (10# or under) that I purchased from the post office. You can buy postage online and print it off too.
I know this all probably sounds like a pain. It really isn't that bad; I definitely find it worth it. I do as much "preventative" as possible and I have never had to repeat a draw (they have taken too much blood and they have had to respin it...) I know it sounds like I must be a complete pain to these people, but I never talk degrading to them and they seem to find it helpful to navigate the unfamiliar. They often come to me for questions, or bring the person running it out to talk to me. I must say, after all this bloodwork (series and the peak plus 7 draws) it was pure joy to get to go in with the peak plus 16 pregnancy test requisition. I have had many lovely lab ladies celebrate with me, feeling they knew me after all our time together! :) See here for our story about our first positive pregnancy test and how the lab lady screamed (in the back) when she read the results (we could hear her from the lobby) she was so happy for us! And see here for how the one who ran the test for Charlie had no idea she was delivering the news to me that I was pregnant, lol!
I hope this is helpful to anyone who is new at this (and maybe even if it isn't?). If you have anything I mentioned that is not correct in your state, or doesn't apply to your situation, I would be happy to hear that feedback. I would also be happy to know of any other tricks or tips you have developed over the years, if you too are "old hat" at this process. I plan on doing a post soon about IVs (hopefully none of you have to experience these to have a healthy pregnancy, but just in case!) Please share this post with anyone you know that might be helped by it.
I have been wanting to write a post about my experiences with lab draws. As we ttc #2, and there is more and more new territory (new things Hilgers does/tests for, new ways to give my hcg, blood draws with a 15 month old on my lap! etc), I have to remind myself there are plenty of things that have become old hat. I am hoping the things I am familiar with can help others. So here is a post about getting your blood draw to mail to Dr. Hilgers. I hope what I have learned can benefit those new to the process, and maybe even make it more efficient for those who have been doing it awhile.
There tends to be a few reasons why you would have your blood draw to mail to the Nation.al Hormon.e Laboratory at Pop.e Paul the VI Insti.tute: a hormone series, a peak plus 7 draw, a pregnancy test, or progesterone draws during pregnancy. I have done all of these, except the series, at least 3 times.
First of all, you can always get your requisitions from PPVI ahead of time. That is nice so you don't have to wait after you think you already might be pregnant. Secondly, always make a copy of your requisition to keep at home. I actually scan all of mine (front and back-back is important for the lab), so I can print them out as needed. Anyone need a requisition? lol
As far as where to do the draw, I have found the best place to be the local hospital. The reason is that Qu.est, LabCo.rp, La.bOn.e , etc have all turned me down. They don't like to draw a sample and then not get to run it themselves. Plus, most hospitals have longer hours and you don't need an appointment. We live in a large metropolitian area, so our hospital labs are open 24/7. That is the most convenient since you are working around your cycle and you may want to do a pregnancy test on a Sunday, etc and not wait another day. Some hospitals do have problems with giving you the blood to take with you. To avoid problems, I always call ahead of time and speak to the manager at a new hospital (I have done this at at least 10 hospitals due to traveling, etc) In many cases, their fears are eased if you explain the situation and tell them you will bring the packaging in with you to show them how you will be shipping it. This has happened to me several times. Unfortunately, locally I am now down to only 1 hospital option in our area from 3 because 2 stopped letting blood go home with you because a new "risk management" policy...
If you are doing monthly peak plus 7 draws, Dr. Hilgers' staff must write "series" are "repeat draw monthly" on the requisition. Then when you register (required in every hospital I've been in), you can simply register as a series and not have to register again each time you come in for a draw. Now, if you change hospitals or go somewhere else for travel, of course you have to register again. It depends on the hospital how long registering is good for-some places it only has to be renewed every year. Anything that saves time, right?!
When you are done registering and go to the lab, I have learned that if possible get to know the staff and even come around the same time to get the same people. There is definitely a learning curve when it comes to this. It is not at all what they are used to and these people are not phlebotomist because it is their life's passion. It is a job, it pays the bills (and not well, mind you). I highly suggest you become very familiar with the requisition. When you check in, explain to the secretary that they will be drawing it, not running it. But that they do need to let it clot and spin it (this is true for all but some of the hormone series). Tell them you need to take a filled out requisition with you, but that you will be back monthly (if that is the case), so please make several copies. Often they will show you where they are filed so you can show the person when you come next time, if it is a different person. I always bring a copy just in case they can't find it too.
When the person goes to draw you up, remind him/her that it is 1 red top tube (for peak plus 7, pregnancy test, or progesterone levels; for a series it depends). Sometimes they want to draw 2 (one for progesterone and one for estrogen-but there is only a very little serum required so many tests can be run off one tube). Sometimes they want to draw a lilac tube because they see that is part of the specimen key at the bottom. Grr. Just one red top tube please. And I ALWAYS have to remind them to fill out the line on the requisition. Before the phlebotomist leaves, I remind him/her they aren't running it, just letting it clot, spinning it, and pouring it off. I show them the back of the requisition. I have the items circled that apply. When I leave, I tell the secretary: I will be back in one hour because it needs to clot for 30 min and spun for 15. I also show them on the back where it says "room temp is fine if it will get there in 5 days." I tell them it will, so please please please do not put it in the refrigerator, even if I don't come back until tomorrow for some reason.
Even with all of that, I sometimes come back to find that they hand me blood. They should be giving you clearish serum. That is what they pour off after spinning. Ideally they give it to you in a clear plastic transport vial with a biohazard bag. The bag has a pocket for the requisition, filled out, to accompany the product. In the beginning I used to pay to overnight the serum. I also used to use dry ice. Over time I have found that is not at all necessary. Most people live where it will get to Omaha in the 5 days. Overnighting it is a huge unnecessary charge. In KS, I simply buy padded envelopes (very small) and put plastic bag with tube and req in. If you are doing this monthly, I highly recommend you buy a ton of the same kind of envelopes. That way, you only have to weigh it once at the post office. I have a PDA and I put in the "notes" section of the Outlook contact for Dr. Hilgers the amount of stamps (in my case only 3) and dollar amount. This way, I can just remind myself and it should still work even if the price of stamps goes up. Especially with a 15 month old, I spend as little time in the post office line as possible! You can usually weigh in the lobby, but for $40 I have invested in my own scale (10# or under) that I purchased from the post office. You can buy postage online and print it off too.
I know this all probably sounds like a pain. It really isn't that bad; I definitely find it worth it. I do as much "preventative" as possible and I have never had to repeat a draw (they have taken too much blood and they have had to respin it...) I know it sounds like I must be a complete pain to these people, but I never talk degrading to them and they seem to find it helpful to navigate the unfamiliar. They often come to me for questions, or bring the person running it out to talk to me. I must say, after all this bloodwork (series and the peak plus 7 draws) it was pure joy to get to go in with the peak plus 16 pregnancy test requisition. I have had many lovely lab ladies celebrate with me, feeling they knew me after all our time together! :) See here for our story about our first positive pregnancy test and how the lab lady screamed (in the back) when she read the results (we could hear her from the lobby) she was so happy for us! And see here for how the one who ran the test for Charlie had no idea she was delivering the news to me that I was pregnant, lol!
I hope this is helpful to anyone who is new at this (and maybe even if it isn't?). If you have anything I mentioned that is not correct in your state, or doesn't apply to your situation, I would be happy to hear that feedback. I would also be happy to know of any other tricks or tips you have developed over the years, if you too are "old hat" at this process. I plan on doing a post soon about IVs (hopefully none of you have to experience these to have a healthy pregnancy, but just in case!) Please share this post with anyone you know that might be helped by it.
11.11.2009
Mother Mary and BFP! The first letter Sat 1.26.09
January 26th, 2008
Dear Little One,
Your daddy and I are so excited! I don’t think I can convey on paper how much you are wanted and loved, even know when you are so so tiny! Even with the sadness we carry in our hearts from our previous pregnancies, I am amazed at how little that affects us in terms of our joy now. We have so much hope that we will hold you in our arms! We are doing absolutely everything we can think of to make this happen.
But first of all, let me share something with you-how much I am in love with your daddy! It is out of that love that you came into being, the most awesome thing we could ever take part in thanks to God’s grace.
On Thursday morning I woke up expecting to start my period as normal. I hadn’t had any symptoms to indicate I was pregnant (maybe a few in hindsight like peeing a lot, but nothing that was really obvious). In fact, we were all set to go to New York City to get a special treatment in March-we had everything but flights booked. But I didn’t start, so I got more and more suspicious as the day went on. Of course, I had a little nausea that morning, but I thought that was out of nervous anticipation after I didn’t start right away. Finally, I couldn’t stand the suspense. Once the idea of testing a day early entered my head, I couldn’t shake it. You see, because of our circumstances, so much has to be planned ahead of time. I got excited at the possibility of actually surprising DH for once. Normally he goes with me, but this time, due to work, he wasn’t going to be able to. He could if I waited, but he knew I was too anxious to ask me to do that. And since neither of us really suspected anything, he wasn’t worried about missing out. So, if I tested early, he wouldn’t miss out on anything he wasn’t going to already, but I could come home and surprise him with the news for once! I loved that idea and immediately called the doctor for permission. Thank goodness he agreed!
I was driving home from work, about 45 min from my home, to test with my mind in a far off place when I swear I saw Mary on the side of the road. The image quickly changed to what it really was, a tractor type thing, but I knew that if I saw it it must have been for a reason. I thought Mary must be trying to comfort me. I immediately realized that the radio I had had on for awhile now was the Catholic station saying the rosary (it was around 3:20pm. I took down my crystal rosary bracelet that hung from my rearview mirror and I join in until it was finished. I smiled at the situation.
About half way home, I realized I had taken a paper I needed out of the car. Oh, no! I had to go home first and get it! Once I got my blood drawn I waited. When I thought the test would be run by now, the secretary checked on it, and returned with apologies. They didn’t know I was waiting and thus, hadn’t started it yet! They would start now. So I waited and I talked on the phone with a friend. Finally a lady came out from the back. She had the requisition, which said if over 50 then I needed the second vial to mail. She looked at me and said, I don’t know what this means, but it is over 50. And I said “how much? Can you tell me? I’d really like to know!” and she said 546. I almost fell over knowing this was a very very high number and a good sign to start. There was definitely no ambiguity there! I smiled and said, it means I am very very pregnant for sure!” And she smiled, sharing in my joy! She gave me what I needed, along with a little sheet of paper with the number on it. She looked sheepish and said, “it isn’t very official.” I said “it’s perfect!” and grinned. I was already thinking of how I would tell DH. I made her promise to fax the results to Dr. Hilgers-two times-and then left feeling like I was floating. What a gift we’d been given! All our prayers had been answered to Mary (through Immaculate Concept Novenas), the rosary, to St. Gerard, and to the Holy Spirit! Not to mention the blessing from Fr. Tom, the prayers the latin priest promised to say to St. Rita, and the wearing of the Miraculous Medal.
I decided to go to the store and buy a card for DH to tell him how much I loved him. I decided to put the paper inside. I added a Reese’s peanut butter heart (double stuffed!) on top as a sweet treat.
I could hardly wait for DH to arrive! He called me on the drive home to visit and I paced in the kitchen talking to him. I told him I had a card for him, for all his hard work. He had been working crazy hours at his job since it was January, and I was very grateful for all he did for our family.
He came in and took his coat off. I could barely stand it, handing him the card. He opened it and saw the paper and looked at me “you’re pregnant?!” and I nodded and grinned. He beamed like only a new daddy could beam! I actually had to remind him to read the inside of the card! I told him I got a double stuffed peanut butter heart because I was double stuffed! I think he liked that! He is used to me being silly and is quite silly himself!
We are so excited. My sis JB is due just one week earlier. Daddy’s friends that also share our difficulties are due very near as well. Our good friend’s from church are expecting their second not much ahead. So many of our friends with difficulties had found recent success! We felt that this just might be our success too! We sure hoped so! And so I spend all day Friday setting up the necessary arrangements-blood draws, IV, progesterone shots, a trip to NY to check on everything in March…But first things first-I woke up and went to daily mass and had the father bless me. I know in my heart that we have done everything we can and that we now must wait and hope and pray.
Dear Little One,
Your daddy and I are so excited! I don’t think I can convey on paper how much you are wanted and loved, even know when you are so so tiny! Even with the sadness we carry in our hearts from our previous pregnancies, I am amazed at how little that affects us in terms of our joy now. We have so much hope that we will hold you in our arms! We are doing absolutely everything we can think of to make this happen.
But first of all, let me share something with you-how much I am in love with your daddy! It is out of that love that you came into being, the most awesome thing we could ever take part in thanks to God’s grace.
On Thursday morning I woke up expecting to start my period as normal. I hadn’t had any symptoms to indicate I was pregnant (maybe a few in hindsight like peeing a lot, but nothing that was really obvious). In fact, we were all set to go to New York City to get a special treatment in March-we had everything but flights booked. But I didn’t start, so I got more and more suspicious as the day went on. Of course, I had a little nausea that morning, but I thought that was out of nervous anticipation after I didn’t start right away. Finally, I couldn’t stand the suspense. Once the idea of testing a day early entered my head, I couldn’t shake it. You see, because of our circumstances, so much has to be planned ahead of time. I got excited at the possibility of actually surprising DH for once. Normally he goes with me, but this time, due to work, he wasn’t going to be able to. He could if I waited, but he knew I was too anxious to ask me to do that. And since neither of us really suspected anything, he wasn’t worried about missing out. So, if I tested early, he wouldn’t miss out on anything he wasn’t going to already, but I could come home and surprise him with the news for once! I loved that idea and immediately called the doctor for permission. Thank goodness he agreed!
I was driving home from work, about 45 min from my home, to test with my mind in a far off place when I swear I saw Mary on the side of the road. The image quickly changed to what it really was, a tractor type thing, but I knew that if I saw it it must have been for a reason. I thought Mary must be trying to comfort me. I immediately realized that the radio I had had on for awhile now was the Catholic station saying the rosary (it was around 3:20pm. I took down my crystal rosary bracelet that hung from my rearview mirror and I join in until it was finished. I smiled at the situation.
About half way home, I realized I had taken a paper I needed out of the car. Oh, no! I had to go home first and get it! Once I got my blood drawn I waited. When I thought the test would be run by now, the secretary checked on it, and returned with apologies. They didn’t know I was waiting and thus, hadn’t started it yet! They would start now. So I waited and I talked on the phone with a friend. Finally a lady came out from the back. She had the requisition, which said if over 50 then I needed the second vial to mail. She looked at me and said, I don’t know what this means, but it is over 50. And I said “how much? Can you tell me? I’d really like to know!” and she said 546. I almost fell over knowing this was a very very high number and a good sign to start. There was definitely no ambiguity there! I smiled and said, it means I am very very pregnant for sure!” And she smiled, sharing in my joy! She gave me what I needed, along with a little sheet of paper with the number on it. She looked sheepish and said, “it isn’t very official.” I said “it’s perfect!” and grinned. I was already thinking of how I would tell DH. I made her promise to fax the results to Dr. Hilgers-two times-and then left feeling like I was floating. What a gift we’d been given! All our prayers had been answered to Mary (through Immaculate Concept Novenas), the rosary, to St. Gerard, and to the Holy Spirit! Not to mention the blessing from Fr. Tom, the prayers the latin priest promised to say to St. Rita, and the wearing of the Miraculous Medal.
I decided to go to the store and buy a card for DH to tell him how much I loved him. I decided to put the paper inside. I added a Reese’s peanut butter heart (double stuffed!) on top as a sweet treat.
I could hardly wait for DH to arrive! He called me on the drive home to visit and I paced in the kitchen talking to him. I told him I had a card for him, for all his hard work. He had been working crazy hours at his job since it was January, and I was very grateful for all he did for our family.
He came in and took his coat off. I could barely stand it, handing him the card. He opened it and saw the paper and looked at me “you’re pregnant?!” and I nodded and grinned. He beamed like only a new daddy could beam! I actually had to remind him to read the inside of the card! I told him I got a double stuffed peanut butter heart because I was double stuffed! I think he liked that! He is used to me being silly and is quite silly himself!
We are so excited. My sis JB is due just one week earlier. Daddy’s friends that also share our difficulties are due very near as well. Our good friend’s from church are expecting their second not much ahead. So many of our friends with difficulties had found recent success! We felt that this just might be our success too! We sure hoped so! And so I spend all day Friday setting up the necessary arrangements-blood draws, IV, progesterone shots, a trip to NY to check on everything in March…But first things first-I woke up and went to daily mass and had the father bless me. I know in my heart that we have done everything we can and that we now must wait and hope and pray.
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