Not sure what the next step should be :(

MarriedinCali · June 2011

I went back to my Gyn and my atypical endometrial hyperplasia has not returned post D&C!!! So he told me he would refer me to the IF department- FINALLY!!!Update to that- IF Department called today- it is an outside referral- we have to pay 50% OOP, which we don't have right now because H is out on Work Comp

I called Gyn and asked to be referred to an RE within our medical group, and the nurse told me, get this, they don't have REs in our medical group. Which is TOTAL BS because I have been to 2 of them!!

I don't know what to do- we can't afford IF treatments- and what concerns me most about that is that no Dr. has even had me try Clomid or anything past Metformin. I've been trying for 6 years and can't even get to that simple step. I don't want to pay 50% OOP only for them to put me on Clomid, which the RE or Gyn could do... I'm just tired of all of this and am seriously considering just giving up. They don't even know what's "wrong" with me other than PCOS and the former-hyperplasia- so having unexplained IF doesn't lift my spirits much.

Sorry for the vent- I just don't even know what to do today- I just want to scream, or cry, or maybe both. Thanks for reading and for any advice you may be able to provide- this is all just so frustrating and confusing.

km0426 · June 2011

I am so sorry! Vent away.. we are here for you. I hope things work out and that you are able to move forward with next steps. Did you call the dr's office again for an in network referral? Maybe that nurse was an idiot.. good luck!

labdemon · June 2011

Good bit of news about the hyperplasia! That's great!

It sounds like maybe you need to talk to the doctor's office more and explain that you have in fact seen REs that are covered for you.... maybe they don't generally refer to them or something, or maybe they just didn't know that they're covered. But, you should probably also ask your doctor why he's not put you on Clomid yet or anything, and have him/her give you an overall plan of what the next steps would be.

This is maybe a little off topic, but I live in Montana, and we have no REs in this state... the closest is a 3 hour drive in Spokane, WA. So right now, I've just been working with my OB, and he will eventually refer me if nothing we can do here will get the job done. ANYWAY, though, he's "just" an OB, but when I went and saw him the first time, we diagnosed my PCOS and literally spelled out a game plan at that very first appointment, and I had a Clomid prescription when I left his office. I would expect that your doctor could do something similar for you, or at least give a satisfactory explanation for the treatment you are getting! When you saw the other REs, what did they say about getting you on Clomid or anything?

MarriedinCali · June 2011

km0426:
I am so sorry! Vent away.. we are here for you. I hope things work out and that you are able to move forward with next steps. Did you call the dr's office again for an in network referral? Maybe that nurse was an idiot.. good luck!

I think she was an idiot- but who knows, lol. I was too busy trying not to cry to even want to deal with that office. I think I'm going to switch medical groups in the near future- so I think I'll just wait and see what happens with that... I've waited 6 years, a couple more months won't kill me.

MarriedinCali · June 2011

labdemon:

Good bit of news about the hyperplasia! That's great!

It sounds like maybe you need to talk to the doctor's office more and explain that you have in fact seen REs that are covered for you.... maybe they don't generally refer to them or something, or maybe they just didn't know that they're covered. But, you should probably also ask your doctor why he's not put you on Clomid yet or anything, and have him/her give you an overall plan of what the next steps would be.

This is maybe a little off topic, but I live in Montana, and we have no REs in this state... the closest is a 3 hour drive in Spokane, WA. So right now, I've just been working with my OB, and he will eventually refer me if nothing we can do here will get the job done. ANYWAY, though, he's "just" an OB, but when I went and saw him the first time, we diagnosed my PCOS and literally spelled out a game plan at that very first appointment, and I had a Clomid prescription when I left his office. I would expect that your doctor could do something similar for you, or at least give a satisfactory explanation for the treatment you are getting! When you saw the other REs, what did they say about getting you on Clomid or anything?

Thanks for the reply!

When I started with this Gyn he was ready to prescribe me Clomid and had his prescription pad out and everything, then he decided to do a biopsy instead to try and figure out my spotting... the biopsy turned into Atypical Endometrial Hyperplasia with polypoid features. That turned into a D&C, then 3 months of hormone treatment and 1 month of waiting pre-re-biopsy. 1 month after the re-biopsy I got my results of all clear! So I went back in and asked him to put me on clomid and he said he'd rather have me see an IF specialist.

He told me he would refer me to a RE within our group, then I got today's call saying I was referred out-of-network to a great IF clinic, but then she said that it was 50% OOP- so I asked her to talk to the Gyn and ask for a RE referral, and that's when she told me they don't have REs. I told her I'd seen 2 REs previously and she said that I must have been mistaken, lol!!! Seriously- like I wouldn't know what a RE is after all of this crap.

The 2 REs told me PCOS, one put me on Metformin for a year. Then he left the practice and the new RE told me I was too fat and needed to lose 50 lbs- at the time I was 220lbs and 5'11" - not THAT overweight.

So basically I gave up on the RE I went to the 2nd time because he was pretty much a jerk and made me feel like a piece of crap for being overweight. Then I started seeing this Gyn who has been treating my issues for the last year. It's been a big rollercoaster for sure.

I've decided to change medical groups at this point- I feel I've reached a point that can't be passed- and I need some different care- I'm so tired of all of this. Thank you all for listening to my rant and providing advice and support- it is much appreciated!!!

naybird · June 2011

So glad you got good news! But so sorry your nurse is an idiot. What I would do is call insurance directly, and find out what REs are in your network. So the research and then call back your Dr's office and say, I found this RE and I need you to give me a refferal. She may be an idiot, but if you do the leg work for her, I'm sure she will be able to help out!

Good luck to you and great big hug!!!!!

katt3233 · June 2011

Happy to hear about your hyperplasia being gone!! That's great news! I would call and talk to someone else and give them the names of the RE's they have in their group. I'm sure you just got an idiot on the phone.

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