Ch. 8 - Egg Preservation

Ch. 8 - Egg Preservation

Last week on Thurday I went to see Josephine in the infusion clinic. She took a look at my veins and stated that she recommended for me to have a port-a-cath. She stated that the chemotherapy medications are strong and can be uncomfortable going in. She told me to check with Dr. Zhang to set up a time to have this performed. I went by the office and the nurse told me she would refer me back to Dr. Shirazi, my surgeon, for the port-a-cath placement. When I called her office, Roberta told me to let her know what date I would be starting chemo and she would arrange for placement of the cath about 1 week before. Yeah!! I will not have to be stuck each time they need blood from me or when I need to receive my chemotherapy. This was good news.

On the same day, September 27, 2007, I also went to see my OBGYN. This office visit was to check on the status of my IUD, to make sure everything was going okay with me, and to discuss fertility issues. My IUD was fine with no follow-up needed until my yearly exam in March. As far as the fertility issues, he referred me to Dr. Michelle Evans, a fertility specialist at Huntington Reporductive Center in Pasadena. I did attempt to ask him general questions regarding my possiblities, but he deferred answering and reassured me that Dr. Evans would answer all of my questions. He had already spoke to Dr. Evans regarding my case and she was awaiting my call. I did however ask him if the egg preservation or other options would be covered by my insurance, he stated he did not know, but that I should contact the Human Resources Department at the hospital where I work and ask the benefits specialist. I was please with my visit with Dr. Spencer-Smith and scheduled my follow-up with him for March of 2008.

After leaving his office I immediately began researching my financial options. I made several calls to my insurance company and left messages as well as calling the benefits specialist, Marci. She told me that anything concerning my treatment associated with breast cancer should be covered. She helped my anxiety, but I really wanted to hear the same information from my insurance company since they are the ones that pay the bills. Between myself and Dr. Spences-Smith's office, we FINALLY got the insurance approval for me to see Dr. Evans. It sounds easy, but involved many tears and multiple phone calls, but the perseverance paid off.

Dr. Evans is a wonderful person. I went to see her on Friday, September 28, 2007. She took me into her office and went over my current and past medical history including my husband's medical history. She described my options but highly recommended one over the others (taking Lupron, egg freezing, and a couple bad ideas). Her recommendation was Cryopreservation (embryo freezing). The outcomes from this method are the best and the freezing procedure has stood the test of time. She had one patient who delivered healthy baby with an embryo that had been frozen for 17 years!!! The procedure will be customized since we have limited time for harvesting so that I can start my chemotherapy in the recommended window determined by my oncologist. She paged my oncologist, Dr. Zhang, and he immediately called her back and gave her the green light; but, I have to start chemotherapy immediately after the harvesting procedure. This was such a relief!! It finally felt like I had an all inclusive plan covering all aspects of my treatment process. As far as the procedure, on the day of my period, I am to call her office, on day 3 they start me on a drug to do something (I think to overstimulate my follicles) and then I think 12 days later, I will go into her office, receive sedation, and she will extract as many eggs from me that she can using a needle. She hopes to be able to extract around 10-11 eggs. These will then be combined with Clayton's sperm by using one of two methods, but I do not remember all the details honestly. These embryos will then be frozen, just waiting for the time the doctors give us the okay to have a baby in the future. We did choose to register the embryos with the FDA for implantation back into myself or into a surrogate. At least that way their usage cannot be restricted in the future. Dr. Evans states that if you only register for the embryos to be implanted into yourself and something happens and the doctors do not want you(me) to be pregnant, you would NOT be able to this point to implant them into a surrogate. Sounds crazy, but rules are rules. So we chose both options.

So hopefully in about 2 1/2 weeks from now, we will have frozen embryos on the shelf and I will be starting chemotherapy soon. The only thing in between is getting blood work done (Clayton & I) for the preservation procedure, getting my flu shot before chemo starts, having the port-a-cath inserted into my chest, have the BRCA test done, and buy that deoderant. The BRCA, breast cancer gene test, is a blood test to check for specific changes (mutations) in genes that will help control normal cell growth. For a person with breast cancer, like myself, results from a BRCA gene test can help other family members know their chances of breast cancer. Oh yeah, I am also having a cyst-type something removed from by face tomorrow by a dermatologist Dr. Kay. He will remove and biopsy it in his office and sent it out for a pathology report. The suspect is skin cancer, but hopefully not. I am tired of that word, but I also want to be healthy and live a long time, so it is okay. And, I am establishing myself with a new primary care physician, Dr. Susie Lau. My previous PCP physician was not an internal medicine doctore which is what I need now. This appointment is Thursday, October 4, 2007, the day after the facial skin biopsy. Wish me luck!!

Thursday, Ocotber 4, 2007

I had the biopsy performed yesterday and it was easy. They shaved off the area and are sending it to the lab for examination. I have to wait 2 weeks for the pathology report. But, today, I am a little stressed. I have done a lot of leg-work on getting as much as I can covered by my insurance company. I thought that things were going well with the egg preservation procedure when I spoke with my human resources representative and with my insurance company last week. The visit with the fertility specialist was covered and she reassured me that everything would be okay and not to worry about the financial aspects. She told her office would do everything they could do get the medications for me for free. I had already spoke with HR who stated that everything related to my breast cancer diagnosis would be covered by insurance. However, I recevied an email from Dr. Evans today which sent me into a state of panic because she stated she needed a copy of my insurance card emailed to her because she did not see any information regarding insurance in my account. It had almost been a week since my visit, and nothing has been done regarding pre-certification for my procedure, this made me nervous. First because chemotherapy is on hold while we complete this process and second because I had already submitted this information to them and it had not been noticed until a week later that it was not there. Yikes!! Also, in the email she stated that she would call my insurance company to see what is covered in regards to infertility. I AM NOT INFERTILE, I HAVE BREAST CANCER! I called the billing office at Dr. Evans office and explained all of this toJacki. She did somehow then be able to find my insurance information in my record from when I gave it to them. She then explained that she would call my insurance company to get my overall coverage for out-patient surgeries and infertility coverage. It still does not seem that she understands that I am not infertile, but what can I do, it seems like just wait it out. What!?! I am Jennifer Bailey. I have a really hard time waiting it out, so, I have put a call into Claims Central of my insurance company in order to find out personally what exactly my coverage is and have it given to me rather than a third party. I am now waiting on their return phone call.

Also today I went to establish myself with a new PCP, Dr. Susie Lau. The visit went great and I felt very confident in regards with her ability to appropriately manage my case. She is very compassionate and respectful. She did state that after chemo radiation, I should have a bone scan before starting the hormone therapy. I made a note of this in my calender. Also, today Clayton and I got all of our blood work done for the egg preservation procedure that was ordered by Dr. Evans. Yeah! One less thing to think about. The only thing that Clayton has left to do is to give a sperm sample next week in Dr. Evans office in Pasadena.

Friday, October 5, 2997

Today I received a call from Dr. Evans office and spoke with Nancy, the financial counselor for my case. She stated that she would place another call to the insurance company today to see what all of my benefits are since the first call inquired about my fertility benefits, which as I said before, I am not INFERTILE. She put my anxiety to rest. She stated that she would call me back Monday or Tuesday. So now I can relax and enjoy my weekend. I think the only thing I have scheduled for next week so far is my port-a-cath insertion surgery scheduled for Friday, October 12, 2007.