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Amelia [a Mom] 1 child; 4 angel babies; Tallahassee, Florida 14998 posts
5th Jan '13
Quoting P Pickle Pants:" <blockquote><b>Quoting Amelia Margaret:</b>" Did you have to be pregnant already for ... [snip!] ... from the start, but they won't approve it til I'm pregnant. My doc ordered it at 14w and it wa approved at 16w and done at 17w."


That would have been too late for me as my water broke at 15w5d. Right now I'm fighting for a transabdominal cerclage which would be placed before I even get pregnant but I haven't had a failed vaginal cerclage so it will be harder to get approved. It's causing me a ton of anxiety right now.

♥Jada Due October 20; 4 kids; Vicenza, Italy 6159 posts
5th Jan '13

<blockquote><b>Quoting P Pickle Pants:</b>" I'm on tri care standard, not prime. It took them a week to approve it. took them 2 weeks to approve ... [snip!] ... and most live normal lives after just a little bit of TLC, so I'll be thinking good thoughts for you and hoping for the best."</blockquote>



Oh wow! That's crazy! Especially considering your risk! I was in the states then, but thankful I was near a hospital that delivers mostly preterm infants with a doc who cared enough. I sure hope they work great for you and your cervix holds. After last pregnancy, I'm still thankful to be pregnant right now.

Summerfrost 51 kids; Massachusetts 6540 posts
5th Jan '13
Quoting P Pickle Pants:" That makes total sense. My doc thought the compounding pharmacy would take too long to get it to me ... [snip!] ... people over, but they're giving me my meds, so I won't complain! All I care about is getting the meds to keep this baby baking!"


Yep agreed. :) If someone was offering free progesterone during pregnancy, it would be awesome. lol

P Pickle Pants 98 kids; California 20522 posts
5th Jan '13

<blockquote><b>Quoting Amelia Margaret:</b>" That would have been too late for me as my water broke at 15w5d. Right now I'm fighting for a transabdominal ... [snip!] ... but I haven't had a failed vaginal cerclage so it will be harder to get approved. It's causing me a ton of anxiety right now."</blockquote>



Yeah, I don't need the TAC (so far), I just get a MacDonald cerc.



And they may approve the TAC for you pre pregnancy, but your doc may have to fight as you haven't had a regular cerc before---my doc could have placed mine as early as 12 weeks but we were waiting and seeing what my cervix did. It was fine until I got food poisoning and all the pressure from diarrhea and cramping caused contractions and shortened me a little. So I asked him to do it pronto!

Summerfrost 51 kids; Massachusetts 6540 posts
5th Jan '13
Quoting Amelia Margaret:" That would have been too late for me as my water broke at 15w5d. Right now I'm fighting for a transabdominal ... [snip!] ... but I haven't had a failed vaginal cerclage so it will be harder to get approved. It's causing me a ton of anxiety right now."


Have you been to http://www.abbyloopers.org/ ? It has a ton of information there for TAC people. There are 2 doctors that most women use Dr Haney and Dr Davis. I've heard great things about both. They also have another option called the TVCIC. It's like a TAC but lower. I can't remember if it can be placed pre-pregnancy or not. I don't think it can, but it can be permanent or removed.



In the world of cerclages, higher = better and more invasive.



Most women get Mcdonalds (I've had 2 of those which worked fine). Those are placed the lowest. Sometimes people get a double mcdonald.



Next highest up is a shirodkar. It's placed higher than a mcdonald and they have to move your bladder and rectum out of the way to place it. It takes a little longer to place and for me it was more uncomfortable during placement and afterwards, but it worked fine too.



TVCiC is up higher than the shirodkar. I'm not sure what the difference is between the 2 of them to be honest, but I know it's typically placed higher. It can be removed for normal labor. It goes up the vagina too.



Then there's the TAC which they can place during pregnancy or before. The latest I've heard of it being placed was 16 weeks though and it can't be an emergency type of situation. I've heard it can be done laparoscopically, but I've heard mixed reviews about that.



If you want to get the process started before your next pregnancy, the best thing to do is set up a pre-pregnancy consult with a high risk dr. I personally dilate on the early side. Last time I dilated at 12 weeks (which they think was really 10 to 11ish weeks because ds3 had preemie issues when he was born). Anyway, i was dilated 2 or 3 cm's by the time my cerclage was placed at 12.5weeks and my pregnancy was fine. Obviously if you can avoid doing it that way, I would.. lol I had never dilated that early before though.

Amelia [a Mom] 1 child; 4 angel babies; Tallahassee, Florida 14998 posts
5th Jan '13
Quoting Summerfrost:" Have you been to http://www.abbyloopers.org/ ? It has a ton of information there for TAC people. There ... [snip!] ... pregnancy was fine. Obviously if you can avoid doing it that way, I would.. lol I had never dilated that early before though. "


Yes I have been to abbyloopers, thanks! The IC support group here is great too. They have given me a ton of information and support. ATM I'm working on getting my insurance to cover an MFM at Shands which is out of town. I just changed OBs and the old OB wouldn't submit the authorization request but the new OB has been a lot more helpful and is submitting it for me.



We have only one MFM practice here and the MFM that I saw last pregnancy grossly mishandled my case. My OB referred me to him because she knew I was high risk for IC and he never once checked my cervix, despite our requesting it at every appointment. In fact, he said it couldn't be checked before 18 weeks. I'm so angry at myself for not knowing better. One reason for seeing the new MFM is to determine if I even have enough cervix for a TVCIC. I believe I began dilating at 12-13 weeks, I just didn't know at the time what the symptoms were.



If the new MFM will not recommend TAC my next step will be to consult with Dr. Haney or Dr. Davis or both. I can't remember which one it is (or maybe it's both) that strongly believes no woman should be required to endure a failed TVC before being approved for TAC. I know both offices will fight my insurance.

Summerfrost 51 kids; Massachusetts 6540 posts
5th Jan '13
Quoting Amelia Margaret:" Yes I have been to abbyloopers, thanks! The IC support group here is great too. They have given me a ... [snip!] ... no woman should be required to endure a failed TVC before being approved for TAC. I know both offices will fight my insurance."


I'm pretty sure both of them feel that way. I've heard that they are pretty good at either convincing the insurance companies to pay for the TAC or providing the TAC at an affordable rate.



The tac issue is hard, because I know for me the TVC did it's thing and I delivered all of my cerclage babies as close to term as I would make it. Because I contract so much at the end of pregnancy, I know that I would have had to delivered the boys earlier if I had had a TAC because of the risk of rupture. Because I didn't, they just took out my cerclage early (around 33 to 35 weeks) and I hung out for another 4 to 6 weeks until I was induced. I have too much scar tissue. I can't dilate on my own anymore past that 2 to 3 cm's for some reason... /shrug Too bad 2 to 3cm's is enough to seriously screw up pregnancy in the first and second tri! I also got to deliver vaginally ...once .. lol




For me, the TAC would have been over kill. But! I think about how PO'd i would have been if I had been one of the few women who a TVC didn't work for. I would have felt betrayed and really really angry at the dr's who told me a TVC was all i needed.



Do i think that everyone should be eligible for a TAC? No i don't. But i think for those of us who need it, it is an amazing procedure.



In the situation where you don't have much cervix left and your water broke so early the first time, I would lean toward a tac or TVCIC too.

Amelia [a Mom] 1 child; 4 angel babies; Tallahassee, Florida 14998 posts
5th Jan '13
Quoting Summerfrost:" I'm pretty sure both of them feel that way. I've heard that they are pretty good at either convincing ... [snip!] ... where you don't have much cervix left and your water broke so early the first time, I would lean toward a tac or TVCIC too. "


I'm hoping my history will help sway doctors and insurance to TAC. I had an aggressive form of cervical cancer in '09 and almost had to have a hysterectomy right then but I got a second opinion and more tests and that doctor concluded that I could wait on the hysterectomy to have a child but that I should do it as soon as possible. My RE becomes more reluctant with each embryo transfer because of this and I was surprised he was willing to do even one more.



If I have a failed TVC that would likely be my last chance at pregnancy. If I got pregnant easily and the clock wasn't ticking I might be more okay with a TVC. I just really need to get it right the first time.

Tyler and AJ's Mommy 2 kids; 1 angel baby; Indianapolis, Indiana 15365 posts
7th Jan '13

<blockquote><b>Quoting P Pickle Pants:</b>" So, my medication sample arrived. My doctor knew my insurance (TriCare) would dink around and take forever ... [snip!] ... that I have been given this little gift, even if this pregnancy ends poorly. I will always remember today as a good day!"</blockquote>



Omg that's amazing!!! I'm catching up on your posts and this is a great one!!!!!

Summerfrost 51 kids; Massachusetts 6540 posts
7th Jan '13
Quoting Amelia Margaret:" I'm hoping my history will help sway doctors and insurance to TAC. I had an aggressive form of cervical ... [snip!] ... easily and the clock wasn't ticking I might be more okay with a TVC. I just really need to get it right the first time."


Makes sense to me and I would push for the TAC too in that situation. The TAC is pretty awesome in those cases where there isn't much cervix to work with. I've only ever heard of it 'failing' once and she still delivered her son at 25 weeks. He is a healthy happy 2 year old now. Good luck! I hope you kick some dr behind. :D

Trio of Girls Italy 14488 posts
15th Jan '13

I was reading through posts cause TriCare is trying to charge me $822 per vial for Makena, and like the OP Makena won't write off the rest. I too was in tears with Makena & TriCare cause I have my cerclage tomorrow and needed to be on these shots last week. I was referred to a compounding company that will charge me $95 per 5 wk vials.



Just wondering what "magic words" I need to use to get Makena or TriCare to cover this for me.

P Pickle Pants 98 kids; California 20522 posts
15th Jan '13
Quoting Trio of Girls:" I was reading through posts cause TriCare is trying to charge me $822 per vial for Makena, and like the ... [snip!] ... charge me $95 per 5 wk vials. Just wondering what "magic words" I need to use to get Makena or TriCare to cover this for me."

Just call Makena Care and ask them about their "Urgent" status and "Samples" ---tell them you need the medication urgently and you can't afford it right away. They'll probably at least send you out ONE vial (5weeks) and you can figure out the rest from there or ask to be kept on their sample list (which is what they did for me).



My phone number for them is in my car, which my hubby has right now, so I can't get you the number now. This is the number on their site, but I don't know for sure if its the number my doc gave me.



1-800-847-3418

Trio of Girls Italy 14488 posts
18th Jan '13
Quoting P Pickle Pants:" Just call Makena Care and ask them about their "Urgent" status and "Samples" ---tell them you need the ... [snip!] ... the number now. This is the number on their site, but I don't know for sure if its the number my doc gave me. 1-800-847-3418"


They wouldn't even put me on the "sample" list. She just kept telling me legally they couldn't help me.

P Pickle Pants 98 kids; California 20522 posts
18th Jan '13

<blockquote><b>Quoting Trio of Girls:</b>" They wouldn't even put me on the "sample" list. She just kept telling me legally they couldn't help me."</blockquote>




Wow. Call and see if you can talk to someone different!

Trio of Girls Italy 14488 posts
18th Jan '13
Quoting P Pickle Pants:" <blockquote><b>Quoting Trio of Girls:</b>" They wouldn't even put me on the "sample" ... [snip!] ... kept telling me legally they couldn't help me."</blockquote> Wow. Call and see if you can talk to someone different!"


I'm going to try and see if they are open tomorrow since they are closed now. I just can't believe NO ONE pays for this. My stepmom is the division rep for the southern region at TriCare and she's worked all her ends and still can't figure out why they won't pay. My friend told me that Ft Riley's hospital paid for hers 100% but she thought is was because she's AD. I think it's because the hospital is a research hospital and just keeps it on hand. So now I'm going to call our local military hospital to see if they stock it.