Is this normal CFA protocol?

[Anonymous]

Met with Sacks for consult-really liked him. he says we will do the diagnostic testing and come up with a plan to call the day i start my period and get blood work on day 3 and will schedule an hsg at that time also. i call the day of my period and leave a message with nurse station because no one answers. two people call back and leave messages-one says i am to start my clomid and then we will do an iui, etc. and the other is how i will need to pay with the iui upfront because my insurance does not cover it. i call back and leave another message saying you all are about 20 steps ahead of me i am at the diagnostic stage.

nurse calls back and we laugh and i am to come in this morning btwn 7:30am and am for bloodwork and schedule hsg for a later date. i go in for bloodwork they take one vial and that is it. there is no discussion about anything and they say someone will call me today with the results. i get a phone call hours later saying all the bloodwork is normal and he wants me to start clomid tonight for 5 days and they will call in a prescription for a ovidrel shot also and when i come in later to check my follicles we will schedule the iui. WHOA!!

wait a minute. i have not discussed any plan with anyone. i have not even had my hsg test done yet. my husband and i have not even discussed iui except in the abstract sense of it is an option for treatment. when i state all this i am told they are short on nurses right now and someone was supposed to have given me a folder with all this info and gone over it and the clomid info. i say i am not ready for an iui yet. i guess i am comfortable doing a clomid and timed intercourse cycle but this is all moving too fast for me. can i at least talk to the dr and my husband first? jeez. the nurse was super nice and i like her, but is this normal? what is supposed to happen?

i am ok trying clomid and being monitored-i will try it. we are ttc #2 and had #1 without intervention on the first month trying. we are ttc #2 for over a yera now. can someone give me some perspective here please? what else should i be doing/saying to advocate for myself and is this out of the ordinary or par for the course?

[Anonymous]

Sounds like there is a another patient with the same or similar name as you. Or the doc coded your chart wrong and the nurses haven't straightened it out.

[Anonymous]

I had a similar experience with CFA -- it also took 5-6 calls, including an email directly to the doctor who had been overseeing my case, to get paperwork transferred. They also forgot to get my blood tested over one weekend. It wasn't a big deal in my case, but it made me worried about what other mixups might occur.

[Anonymous]

Dr. Sacks is nice but the nursing staff is clueless, I left them for a practice in VA.

[Anonymous]

OP here. So are you both saying this is not normal and that there is no way the dr would start me out on a plan without discussing it with me and before my hsg test was done? If so, does that mean I should not go pick up this clomid and start it tonight? i will see sacks next week for my hsg. or, is he just saving time? i guess i am not sure what to do. i was planning on just taking the clomid and talking to him about it when i see him next.

[Anonymous]

I'd talk to him about it first. If the HSG turns up a problem, why waste your time with clomid. You should have all the diagnositc work done first before you start to TTC. Dr. Sacks is great about answering emails. I suggest emailing him with your questions. If everything is okay diagnostically, it sounds like you will ultimately start on Clomid, but you should definitely talk with him about it first. When you have to talk to a nurse, always ask for Lorna. She's the best there.

[Anonymous]

PP thanks so much. Is Lorna at the DC office? I will email him.

[Anonymous]

Dr Sacks is nice, but you definitely have to stay on top of your care. Lorna is great, so I'd try to work with her if you can. I would wait until next month to begin treatment, until you see what your hsg reveals. Also, will your husband get a semen analysis?

[Anonymous]

Make sure you also ask about the disadvantages of clomid. It's not for everyone, and the fact that it's not 100% it's YOU who are supposed to be on it is worrisome.

I'd insist on speaking to doctor.

[Anonymous]

Yes, Lorna works out of the DC office. She's really great.

[Anonymous]

to 18:55 yes, my dh is getting a semen analysis done as well. however, i would be surprised if there is an issue there as we already have one child and he has another child who is 14 from when he was in grad school-but i guess you never know!

[Anonymous]

I'm currently a CFA patient (Dr. Abbasi) and agree that you have to stay on top of your own care to make sure that you're getting what you need, when you need it. I think that is pretty standard with such a large volume of patients.
Early on, I formed a relationship with one of the nurses in Betheseda (Crystal) and she is my go-to when I have a question about logistics, need a reminder about which day to do what, etc. I also use email a lot to get in touch with Abbasi, she's easy to reach that way.

I don't think it is standard protocol to do Clomid without HSG, Abbasi said I should get the test first before going on meds. As for jumping right into your first cycle, I think that may be a little more normal...for many women/couples time is of the essence so I think there is a general sense that patients want to get started quickly after they begin testing.

[Anonymous]

I would definitely wait on the Clomid. If something comes back with your HSG, you will have wasted a month on Clomid, which you should not take long term. It does not sound like you are ready, so why rush it all in one month. I would definitely email him. Better to hear it from the Dr. then the nurses who don't seem to know what is going on.

[Anonymous]

OP here. can anyone direct me to where his email is listed? i can't find his card and it is not listed on the website. i guess i can call and ask for it otherwise.

[Anonymous]

I would call your nurse and ask for it. It would be helpful to have your nurse's email address as well.