Saturday, October 15, 2011

Taking It To Manhattan

After my negative result on Thursday (and like 12 hours of crying) I sat down and reviewed all of my notes from the previous cycles. Back on IVF #2 the director of my clinic had mentioned to me about seeing a doctor in Manhattan that specializes in Reproductive Immunology, Dr. Jeffrey Braverman. At the time I apparently didn't think that this was a road that we would need to go down as eventually IVF would work, that and the fact that his fees are around $3000 and insurance covers no part of it. Since my clinic was heading in this direction with me (knowing that I couldn't afford to see Dr. Braverman) I started looking at the paperwork for him that I had from a previous inquiry. An hour and a half later it was filled out and off it went to Dr. Braverman. That was at 5:50 and at 8:36 I had an email from him. The one thing that struck me in his email were his words "clearly you need my help." I felt as if someone had thrown me a life preserver and now everything was going to be okay. I responded back to him with much enthusiasm and asked him a few questions. Again, he responded within the hour and said that it was important that I gather all of my records from everything that has happened and have them sent to him prior to my consultation so that he had a chance to review everything. I needed all of the records from my Urologist when my bladder shut down last year requiring catheterization for 6 weeks, the lab results from my Immunologist that I saw briefly who said I have infancy CVID (why I require IvIg), and the records from the hospital that shows all of the tests ran when I was hospitalized (twice) for fevers over 105...and obviously my clinic will send over everything they have as well.

Since starting this process with Dr. Braverman I have already learned from him a number of things:
  1. Clearly there is something immunologically wrong with me that is causing all of these losses/negative results. 
  2. My AMH of 0.67 should not be this low as I am only 31. Someone with an AMH that low that retrieves 17 eggs like I did in an IVF cycle has something wrong with egg quality. He believes that this is due to a condition where my body is attacking the follicles in my ovaries which is why we had such poor CGH results. Basically my eggs never even have a chance as my body is attacking them while they are growing. This could also explain my poor response to meds and why I require such high doses. 
  3. Sometimes taking medications "just in case" without knowing the actual cause of something can have the opposite effect which can prevent success (Prednisone, IvIg, etc.)
  4. With true immunological issues, treatments such as IvIg, Prednisone must be continued throughout pregnancy as stopping them can cause stillbirth, IUGR, and even placental abruption. Most clinic that use these treatments stop them prior to 12 weeks as they are only used as a preventative measure. 
My head is absolutely spinning. There are also all these other things (cytokines, TH1 cells, INF, ROS, interluken 10) that I don't understand much about but apparently they are important. Not only does he use medications such as Nuepogen and Humira, he also utilizes natural supplements. For mild endometriosis he uses high levels of antioxidants...who would have thought?

After much contemplation, my husband and I have decided that this is something that we need to do...even though we really can't afford it (Christmas is going to suck for our families this year!) Dr. Braverman is out of the office next week but wants to get things moving right away with this. My appointment with him is on the 24th and I am very excited. After the initial consultation he will overnight blood tubes and dry ice to my clinic so that they can draw all of these labs and ship them off to be processed. My husband will also have some blood drawn and will probably need to give another "sample." It will take about 2 weeks for all for all of the results to come back and at that time I will meet with him again. We will decide what the plan of attack will be and he will coordinate treatment with my clinic. As a matter of fact I received a call on my cell phone yesterday from the director of my clinic. He was calling to tell me how sorry he was that my result is negative and that we really need to start considering treatments such as Neupogen. I told him that I already had my appointment with Braverman. The director gave me his cell phone number and told me to call him anytime and he wants me to touch base with him right after my appointment on the 24th. God I love my clinic!!

The thing that I need to realize though is that some of these treatments may take a few months to become effective so we might not be doing another cycle until next year...but I will take this one day at a time. At this point I need to do the right thing because my husband and I can't keep going around in circles like this. I am comforted knowing that we have a plan and I now have a "team" of doctors that are all working towards getting me my dream!

2 comments:

  1. This next step with Dr. Braverman sounds promising. Best of luck!!!

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  2. Just caught up on your last few entries so:

    (1) adoption agency - that sounds fucked. Can't believe different rules for different skin colours. And surely a bit of maturity (ie hb's age) shouldn't go against your profiles?!!

    (2) sorry to hear your cycle was not successful, that fecking sucks. Love to you both.

    (3) Sounds like such a crazy time, with lots of balls in the air. Hoping dr Braverman is the missing link and you have a downhill cruise (I know, idealistic, but hope is hope!) to your take-home baba

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