Overwhelmed by IVIg

I have spent the better part of the day faxing my prescriptions from Dr. Z to every pharmacy in the country on his list. The quotes are starting to pile in and it's becoming more and more clear to me that I'll have to order my Bravelle from www.ivfmeds.com or from www.theflyingpharmacy.com. I just can't afford these steep American prices. Anecdotally, the pharmacist of the latter commented that he's getting loads of patients from California. Maybe we can't afford our IVF meds and the high cost of real estate? Hmm... So the microdose Lupron kit will have to be compounded (it's a specialty item) so I'll go for the best stateside pharmacy I can get. Amazingly, my heparin isn't going to be covered unless it's administered by a nurse. Imagine that. They'd rather pay a nurse to shoot me up twice a day than allow me to do it myself and save all us a rather tidy sum of cash. Well no one said that the health insurance industry made any sense. Did they?

So last night while perusing the threads on FertileThoughts I found an immunology support forum on yahoo. These ladies know more about immunology and IgG's than most of the folks at IIC do. I also spent a lot of time reading the material at SIRM and at Dr. Beer's website. I must say that I am floored at the complexity of research that has been done in the field of Reproductive Immunology. With this much known about RI, why on earth aren't more RE's testing for these disorders? I can't help but think that the RE's that aren't testing are banking on repeat customers and, oh yes, the added $$ that these repeat customers pose to bring to them.

Today I spend some quality phone time with Chris of Medical Associates Infusion Center in Los Gatos (Dr. Beer's office I presume?), who told me that IVIg is often covered by Health Net PPO under two conditions. (1) Your doctor must first preauthorize for the IVIg by phoning Health Net, and getting their preauth form, and (2) Specifying that the IVIg is to be provided by Curascript (who only provide Gamunex as their IVIg brandname). In my case, I test positive for both APAs and NKs so the relevant CPT codes in my instance are 279.4 (primary immunodeficiency) and 795.79 (anti-phospholipid syndrome). Test results go along with the preauthorization and are sent to Health Net. Upon approval, a copy of the preauth is sent to Curascript and SVIG. Then off I go into infusion land.

It's a trifle unnerving to think I might have the pooled blood products of hundreds of people injected into me. Ick, ick, ick. When I worked in immunology at IIC, we'd often have to take huge vats of pooled human serum and process it (can't explain much further...those recipes are top secret!). We'd start by taking out the big proteins like fibrin...disgusting. The fibrin clots looked so much like chicken breast meat that I had a really hard time eating chicken for a very long time afterwards. I have a pretty high tolerance for things, a high "gross out" factor if you will, and the sight of fibrin clots in a vat of pooled serum nearly made me vomit on more than one day. I exaggerate not. So the idea of injecting something similar to that which I worked with kind of turns my stomach in a way that only another lab rat could understand.

It's midnight and my leg o'lamb roast is still in the oven roasting...maybe I'll get dinner shortly after midnight? Long day...