My CCRM nurse emailed the Endometrial Biopsy instructions and asked me “do you have the kit.” I said “no, did you send it?” No reply. Later on I sent another email asking if she sends the kit or if I am supposed to order the kit from the company the instructions are from. She replies “you order it” and that I need to follow the instructions to the letter.
So I read them and it says I MUST to have the Endo biopsy 7-11 days after my LH surge – meanwhile my CCRM nurse gave me a script for CD25. Mind you, there is NO WAY CCRM knows when my LH takes place as I have never had a real cycle with them (mock cycles don’t check for LH).
I called Sepal (the company that performs the test and sends the “kit”) and asked if I should do the test on CD25 or if I should use the OPK sticks to determine my LH surge as per their written instructions and many brochure instructions. She said “it’s very simple, have your doctor do the test, he has all of the supplies in his office, fill out the pack and return it – it’s not that complicated.” OMG! She not only gets fucking snippy with me, she didn’t even answer my question. So I repeated it and she then said “it’s the doctor’s decision when to take the test,” which is CONTRARY to what their instructions read.
I am CONVINCED that the more STUPID the individual you’re speaking with, the more rude they’ll be and the more convoluted the direction will be.
So, what am I to do here? Am I to go ahead and have the most painful test performed on me on the wrong cycle day, only to have the test results rendered useless?
Help from anyone who has done an Endo Biopsy remotely, ordered by CCRM.
15 comments:
I can't help...but WTF?! That is a mess and I would ABSOLUTELY not do this test until I was sure it was on the correct day. Day 25 of your cycle is darn close to losing your lining (for me it would be the day before), so I'm really not sure this is right. I think it is important to make sure the integin is present when implantation is likely to occur - so MUCH closer to your LH surge. I think the CD 25(I think that is the date you said...)is way way too far into the cycle.
I think I'd call the nurse at CCRM and insist that she discuss this with you IN DETAIL. If she has a problem with it, I'd consider discussing it with the Dr. himself. Are you with Dr. Schoolcraft? I have Dr. G who seems easily reachable by email - at least he has been very willing to email me back directly the two times I've used his email. I would make a big deal about this b/c it costs alot both financially and physically and I'd hate for you to go through this for nothing.
I was just reading a post on IVFC about this test...I'll check it again and re-post. Hugs.
Couldn't find it- thought it was in the endo thread on the colorado page. But, I checked online and they all say the test is done after ovulation. Let me know what happens!
Sue, thank you so much. I am DEFINITELY going to buy the OPK test strips so I can measure EXACTLY 7-11 days after the LH surge and ask my Gyn to do the test then.
MY PERIODS are 25 days apart so how can it be right?!
Thanks for your support, truly!
Sky,
I have no real experience here but those one size fits all time lines drive me nuts. From what you are telling us CD25 seems too late. Like pp said call your Dr. and ask. I'd hope the nurse would be helpful but sometimes they just go by the one size fits all time line.
I concur with you observation the the less knowledge the person had the more rude they will be. Spot on.
Hope you get some answers.
I have no real experience here but those one size fits all time lines drive me nuts. From what you are telling us CD25 seems too late. Like pp said call your Dr. and ask. I'd hope the nurse would be helpful but sometimes they just go by the one size fits all time line.
I concur with your observation the the less knowledge the person had the more rude they will be. Spot on.
Hope you get some answers.
Sky,
CD25 is too late. When I had the biopsy done, I waited until my LH surge and then scheduled my test to be done when the clinic was able to do it in the testing window (i.e. 7-11 days post LH surge). I think I did it 9 days after LH surge. I used an OPK to make sure I didn't miss my surge so what you're doing sounds find to me. I just checked the instructions I got from the lab (Adeza...I think they bought the rights to do this test from Sepal) and it very clearly states that the "specimen must be collected 7-10 days after urinary LH surge".
I did mine based on the OPK LH surge detector.
My old RE got the kit (but I think it was from another company like Adeza or something). The RE must have ordered 'the kit'. They did the biopsy and sent the stuff off for me.
As for the pain, i didn't have a 'bad experience'. My drug cocktail might be the key. See these two posts if curious:
http://quenous.blogspot.com/2008/05/snips-snails-biopsy-tales.html
http://quenous.blogspot.com/2008/05/ahhh-freedom.html
The lidocaine is the same thing as what dr. sch gave me during the hysteroscopy. works wonders.
Welcome to CCRM. I fired out first nurse there. I work with Cheryl now, the head nurse. I would recommend getting switched to her, ASAP. Call her and tell her what happened. Especially tell her about the snippy part. Our first nurse was totally out of line with us on one occasion. So I reported that and her general lacksidasical attitude and bingo, things got better fast.
I've been hearing reports that CCRM is 'slipping.' Have found several blogs with some unhappy women. I'm definitely concerned as we are cycling soon, but things have definitely gotten better with Chery.
Call her and find out what the hell you should be doing before you waste your time and money. This crap is hard enough as it is.
I will be writing a post soon about our laughable attempt to get communicables for the DH and I this morning. They acted like it was 'no big deal' - we were turned down by 3 labs, finally got directed by their lab to a phlebatomist in SF. Like we have time to take another 2 hours out of our day to go do this?
Anyway, definitely start raising a big stink and make it a smelly one. I think it's 'squeaky wheel gets grease' over there these days, sadly.
Hi Sky,
I think that Gretchen over at http://tryingtobepatient.blogspot.com/ has had an endo biopsy with CCRM. You may want to contact her. She is not about 18 weeks along.
Good luck!
*She's about 18 weeks. Sorry for the mis print. ;-)
Thank you all for the supportive posts - I don't know who else would understand this madness!
I emailed my nurse today and said I was getting conflicting information from the Sepal test kit and from her on when to test and that this test promises to be pretty painful so, at least, I'd hope it's useful.
She replied: "Follow my instructions. It is all fine and good. We are controlling everything hormonally."
That's it. I didn't get it. I wanted to scream. But then I started to think about it and I guess, maybe this stupid, inexplicable CD25 is right. In an IVF (i.e., medicated) cycle, you don't get an embryo in your uterus when you normally would. Instead, you are managed by the medications and embryos arrive into your uterus a bit later on - CD25 is probably right (my FET last June/July I was transferred 2 blasts on CD 24).
For the record, I think I was definitely not clear that it was the Sepal representation - not my nurse - who was snippy with me earlier today.
My only issue with the nursing staff at CCRM is that they must be SERIOUSLY overloaded, because I feel it in the emails or couple of times we've spoken. It DOES make me nervous for a cycle - I mean, for all you ladies, you'll be fine because YOU are stimming and YOU have an enormous vested interest in making sure the nurse called, gave you instructions, etc.
Me? Not so much. I'll have a donor who is twentysomething and (yeah, here comes a generalization) she's earning 5.5K for a couple of weeks that'll suck hormonally and if the nurse calls or doesn't, I don't think she's going to lose sleep over it - she'll just keep her plans that night with her friends and life goes on.
God, I hope this works smoothly! IF feels like such a curse - emotionally, financially, physically, psychologically. I know you can all relate. :(
I'm going to FORCE myself to relax my mind (however hard that is) for 1 week.
Hi Sky
I just did my endo biopsy last week and it was not nearly as painful as I expected -- barely anything! (I did take two Aleve about an hour before.) I ordered the kit from Sepal and took it with me. I also tested with OPK digital tests and went in on day 11 after my surge. Also, Sepal had my results in 3 days! Good luck!
I did the Adeza test that MamaSoon mentions. Also, I used OPKs to time the biopsy for 9-11dpo. I think that was their recommendation. I definitely wouldn't use CD25 as the biopsy date as everyone's cycles are very different. Good luck, hon!
I can tell how frustrated you are by so much of this process. It can't be easy to be willing to do so much to make this happen and then still just be waiting and waiting and waiting.
I'll be so happy to see the post that says you're matched and ready to go - and the one that says it all worked out and was worth the waiting! Hang in there, and good luck with the biopsy.
No advice. But. I just have to say that I totally agree with you: "I am CONVINCED that the more STUPID the individual you’re speaking with, the more rude they’ll be and the more convoluted the direction will be."
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