Tuesday, October 25, 2011

Self-Advocacy

The one thing that this journey has taught me is that you need to educate yourself and you need to be your own advocate. Today I was contacted by Reprosource (the immunology lab that will be processing my bloods that Braverman ordered) and learned that my out of pocket cost would be $1800. I played stupid and asked Reprosource to fax me a copy of the requisition forms for the labs so that I could see exactly what they ordered. Once I got these I called Rosalind Franklin, another immunology lab located in Chicago, and asked them if they could process these labs as they are in network with my insurance so they would be fully covered. All but two panels could be done through them. I then contacted Dr. Braverman and asked him to change all of my requisition forms so that the necessary labs could be done through Reprosource and everything else through Rosalind. Since Rosalind is pretty much doing me a favor as they typically only work through Reprosource, I am responsible for knowing what tubes need to be drawn and I am also responsible for the shipping...not a problem. For the tests Reprosource will be doing, they are going to overnight me the tubes so I will have them tomorrow and they will ship the dry ice directly to my clinic for Thursday when I have my bloods drawn. So at this point everything is all set with Reprosource and I am just waiting on Dr. Braverman as he needs to email me a copy of the requisition forms for Rosalind.

I have received quite a few emails asking me to elaborate on the specific tests I am having done, so here they are:
Immunology Panel
Reproductive Immunophenotype
CD3+ (Pan T cell)
CD4+ (t helper) 
CD8+ (t-cytotoxic/suppr)
CD19+ (B cells)
CD3+/CD56+ (NKT)
CD56+/CD16+
CD56+
CD3+/IL-2Rt
CD19+CD5+

TH1;TH2 Intracellular Cytokine Ratio
TNF-a; IL-10 (CD3+/CD4+)
IFN-g; IL-10 (CD3+/CD4+)

NK Assay
50:1 E:T
25:1 E:T
CD3+ (PonT Cell)
CD19+ (B cells)
CD56+
CD19+/CD5+

CBC w/Differential
T-Cell Subtest
Luekocyte Antibody Detection (LAD) 

HLA Panel-both my husband and I
HLA-DQa; HLA-DQb
HLA-DR; HLA-ABC

I am also having Tregs and IL17-according to Reprosource I am the first patient of Braverman to have this done. From what I understand these both look at inflammatory responses in the body. These are the only ones being done through Reprosource and will cost $300 out of pocket.  

I cannot wait until all of this is done. While all of this is being processed I will have my Lap/Hysteroscopy and will go for my genetic consult at NYOH. I am happy about getting all of this done as I will feel better about going into my next IVF cycle.

3 comments:

  1. I've said it before, I'll say it again: No one cares more than you do about managing your infertility than you do. Care encompasses many things, including what is more cost efficient for you, the patient. I applaud your creativeness and resourcefulness to find a lab that can perform most of your tests in network for your insurance.

    Good luck! All my best to you, as always.

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  2. Wow! Good for you - agree with TeamBabyCEO, you are your own best advocate.

    Lots of luck!

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  3. I have enjoyed every bit of it.An insightful postLab Requisition Form

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