The Latest But Not The Greatest

This was written over the course of several weeks...

Sigh....I’m getting pretty tired of the doctors and appointments already and I haven’t even started treatments. I had another video conference today with my current RE. The goal was two fold. First to convince her to write me a letter of recommendation to my PCM for an excision laparoscopy and also a recommendation to get a referral to Dr. B. I also wanted her to consult with Dr. B on my behalf. The appt started out rough. I was trying to be as gentle as possible about wanting someone else to perform the surgery and I was finally able to convince her to put in my medical record that I needed that surgery as well as a referral for additional immune testing. She also finally agreed (with a HUGE plea from me) to just speak with Dr. B on the phone. She said she reserved the right to not work with him if she disagreed with his protocol. I get that....but I need her help to pull this off.

I got a copy of my records and immediately brought them to base to try and convince the team working on my case to approve the referral. Even if I manage to get the referral, the out of pockets costs are extremely high. My RE did recommend a pelvic pain specialist who she works with at her hospital who does the excisional surgery. He does in fact take Tricare, but it’s a 6 month wait just to get a consult (and I’d have to convince Tricare I need to go there in the first place)....this is not getting any easier.

I am officially a patient of Dr. B. I’ve filled out a detailed diet questionnaire for him and am waiting further instructions of how to proceed. I’ll be looking into switching to tricare select and comparing benefits for all of this.

I’ve also looked into having a consult with The Endometriosis Care clinic in Atlanta. We would have to pay out of pocket there too as they only accept out of network insurance. The wait for a consult appt is into the middle of Sept as of right now. The approx cost for the surgery is between $20-30k, excluding hospital fees.

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I have received a one time "second opinion" consult referral to Dr. B!  I honestly don't even know what that means or what is covered.  I called Tricare today and the rep I talked to said everything should be covered 100%.  I don't believe that for a second.  I submitted a claim to Tricare in the amount of $2400 and if they reimburse me ANYTHING I'll be shocked.  I am now unsure how to proceed. I think I have to go back to my PCM and beg for another referral (and this one took 2 months to finally receive.)

I have a consult appt with the clinic in Atlanta for the endo surgery Sept 18 and was given an additional recommendation to a doctor in NY that IS in network but getting a referral to them could take months.  And frankly, I'd rather not fly anywhere for surgery as I have never done well with anesthesia (I've been put under 10+ times and each time is rough for recovery). 

Right now it's "Do we pay all out of pocket and try to get a partial reimbursement from Tricare after I submit a claim based on the Points of Service option?" or "Do I fight for a referral to Atlanta or one of two doctors out of NY-one in network or to the one out?"  The only way to have this surgery paid for by Tricare is by me going to the doc in Birmingham or the doc in NY that is in network WITH a referral from my PCM. 

My local RE agreed to help me with the lab work Dr. B is requiring. Everything has been submitted by my RE and now I'm waiting to get a call from ReproSource out of MA to finalize the details and get a collection kit.

A concern is that as soon as all of this is finalized and I start treatments, we will be moving again and I will have to start over....I don't even want to think about that right now.

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You guys!!!  I just learned that my PCM is submitting for more referrals to Dr. B!  That request should take between 3-5 days for approval. Also! Get this! My PCM is submitting approval for a referral to The Endo Care Center in Atlanta!  That is HUGE!  If it gets approved, our out of pocket costs are drastically reduced for that surgery and I would only have to travel 2 hours from home for it!  Thank you, Jesus! Prayer IS the work!

Now if I could just get ReproSouce to call me back....I've left several messages and NO ONE IS calling me back to set up testing! ARG! Once I can get my blood drawn (3 separate times mind you), and DH does his testing, it's another 6 weeks for the results so the sooner the better for all of this!

I hope you all understand that I'm not wanting this surgery for purely having a chance at conceiving another baby.  I'm in some pretty serious pain during ovulation and during AF...it's to the point of not being able to function normally during those times.  I can't even pee during AF without death gripping the wall in the bathroom from the pain that takes over. I know that I have endo on my bladder/ureter and colon making my period and ovulation VERY difficult. I get searing pain in my cervix, bowels, and across my abdomen when I go to sit, stand or MOVE on my period. THAT IS NOT NORMAL.  While I can control some symptoms with diet, I want that surgery to feel good again and hopefully by adhering to the "endo diet" after surgery I can keep it away longer this time.

Thank you all for praying for us!