So, busy day today! I went to see a new Dr. for a new patient consult on my "habitual" miscarriages (as if I do it on purpose!). We'll call him Dr. "B" - he seemed pretty on top of things. He went over with me the "Big 3" reasons why people have m/c: anatomical, chromosomal, and hormonal. We talked about what Dr. H had already done and thus ruled out the chromosomal part, and ultimately decided to check a couple more things in the anatomical and hormonal areas.
For anatomical, next month we're going to do a hysteroscopy and an endometrial biopsy, which is basically a video tour of the inside of my uterus (vs. an ultrasound which is looking at it from the outside), plus a sample of my uterine lining. That way we can see just how good things look in there plus make sure the lining is a welcoming place for that fertilized egg. This all made me happy because I have been suspicious ever since learning that last one had implanted down low. It seemed to me like it just took a long time to find a good place to land and by then it was too late.
For hormonal, we're also going to check my progesterone and make sure there are no issues with my "luteal phase." We are also going with a newish technique for this, testing saliva rather than blood. Dr. B said he feels it gives a more accurate picture of what's really going on. So basically if my progesterone is not high enough, it would cause various issues including interfering with the development of a welcoming uterine lining. All of this will take place around day 20-21 of my NEXT cycle, the downside of which is that I am supposed to try NOT to get pregnant next month.
I discussed my whole insurance situation with Dr. B too and he said he thought if he codes everything right then they should pay for it all, and he agreed with me that recurrent miscarriages is not infertility. Sweet.
When I got home I also called my other Dr.'s office about the ultrasound bill, and at first they said "too bad, so sad" and I pouted a bit and hung up. As I was getting ready to compose an angry letter about the whole deal, the billing gal called back and said she noticed that they had coded the ultrasound differently ("infertility") than the actual Dr.'s visit ("recurrent m/c") from that same day. My insurance company had actually paid for the Dr.'s visit, which she thought might have been a mistake on their part, but it also might be worthwhile to re-bill the U/S with the same code they had used on the visit, and see if they turned around and paid for it all. She said that could trigger an audit of my whole chart and they could potentially go back and "un-pay" for some other things, but maybe not. So I said let's give it a shot. I am not sure what other stuff they might decide not to pay for, but it is important to me to know pretty quick like if they are going to pay for "recurrent miscarriages" vs. "infertility." It could turn into a big ugly mess, but I want to know where that magic point is along the line where they decide that miscarriages = infertility. It all seems very ambiguous, doesn't it?
So that's it for now. Day 28 and I've taken one pregnancy test, which was negative. Yesterday I was sobbing uncontrollably about getting a speeding ticket, so that tells me that my monthly visitor will probably be here soon.
