Differences between Coulam, Stricker, & Kwak-Kim?

[gandalf]

Just wondering if all of these doctor's charge for consultations???? I have filled out most of the paperwork for AEB but then I noticed that people use these 2 other doctor's as well. Do they all charge around $600 for consultations and other fees???? It seems all 3 are pretty reputable? Any advice would be great, just trying to keep the costs of all of these tests/consultations down as much as possible. Do Dr. Coulam and Dr. Kwak-Kim do phone consults and work with long distance testing as well?
Thanks!

[LynnUS]

I have been a patient of all 3. Well not Dr Stricker but Dr Beer. I had success with Dr Kwak-Kim and Dr Beer.
My info may be a bit old as my youngest child (Beer baby) is a yr old already.
Sorry I don't know the actual consult fees but I think they're all fairly comparable. They all do phone consults and long distance tx.
The main differences I found were:
Dr Coulam (at least when I was a patient back in 2000) does IVIg and Lovenox but did not measure/test cytokines. I don't think she administered or recommended LIT.
Drs Kwak-Kim and Beer were colleagues for 11 years before Dr Beer moved his practice to CA. Their tx were identical until Dr Beer (and now Dr Stricker I presume) started doing the endo biopsy and prescribing anti-tnfA drugs, ie: Enbrel and Humira.
I had a healthy daughter under Dr Kwak's tx but my immune system worsened after her birth. Dr Beer's tx gave me my second child.

Good luck in your decisions!

Lynn
9yrs ttc#1 "unexplained"
3 first tri angels
angel son b/d @ 22 wks due to placenta previa
Madeleine, born 6/25/01 w/IVIg, LIT, Lovenox, baby asp
3 yrs ttc#2
4 more first tri angels
Jillian born 7/28/05 w/IVIg, LIT, Lovenox, Humira, folgard baby asp
dx: uterine NK's, DQ alpha match, hetero MTHFR

[anns]

I am currently a patient of Dr. Coulam. I know she does long distance consulting with other doctors, however it's my choice to drive to chicago weekly because I feel I'm getting better care that way. She collaborated with my RE in MI (where I live) to do the conception. She diagnosed (through Millenova labs) my elevated NK, four genetic thrombophilia and low inhibin B levels. My RE in MI did the monitoring for IUI/gonal-F cycle, I'm now pg with twins (was triplets, third didn't grow).

I don't recall specifics about measuring cytokines, but it's my understanding cytokines are proteins, that cause clotting of placental blood vessels and in turn cytokines are caused by APA, ANA and NK activity, and thus they DO measure (every week) my APA, ANA and NK activity both during and before pregnancy. Dr. C's website illinoisivf(dot)com is quite extensive in information about the diagnosis and treatment of recurrent loss and infertility. She categorizes them all as losses: pre-implantation losses (infertility), peri-mplantation losses (ivf failure) and post implantation losses (recurrent miscarriage) and outlines all the treatments for each.

My first visit with her (self-pay) was about $575. I did all the Millenova RPL panel of tests (about $2700, not covered by insurance) and have done three IVIg infusions, which are covered (meds, not infusion). But I can infuse 25g in 2 hours so it's only about $600.

I can't say what it would be like to consult with any of these docs long distance, but the care I've received AT her office is extraordinary.

AnnS

[anns]

Oh, btw, Dr. C did suggest LIT to me, but said that IVIg is so much more successful for NKs - she said for my elevated NKs, pg success rate with IVIg is 80% and about 40% with LIT. To me that was an easy choice. We said IVIg immediately, and were prepared to pay the full cost if needed.

AnnS.

[Lauren2005]

They're all very separate and distinct issues. For example, I have elevated NK activity, sky-high APA's, no ANA's, and nice and low cytokines. I have several friends with cytokine problems but not the others. Please do be sure to have full and complete testing if possible, since test results for one area don't guarantee anything about the others. Additionally, NK results are divided into NK activity and percentages of particular types of NK cells, etc., all of which mean different things and require different treatments. What a challenge for everyone trying to be fully tested and wanting to know what is going on in their own bodies.

Kind wishes,
Lauren

P.S. Yes, indeed, the statistics for IVIg helping NK's are MUCH better than LIT helping NK's. The reverse is true about improving LAD... LIT is the gold standard for that, and IVIg is a poor substitute when it comes to LAD.

[egirl]

Originally Posted by Lauren2005

Kind wishes,
Lauren

P.S. Yes, indeed, the statistics for IVIg helping NK's are MUCH better than LIT helping NK's. The reverse is true about improving LAD... LIT is the gold standard for that, and IVIg is a poor substitute when it comes to LAD.

Lauren,

LIT was the only thing that has brought my NKs down. I was at 15.9 and after LIT they came down to about 8.7. :-) It was a temporary fix as three weeks later they were back up to 21.

But as you say, IVIg doesn't do much of anything for LADs. Mine were less than 2% after IVIg and they didn't budge til we did 2 sessions of LIT.

Hope you are well. It was nice seeing you the other day!!

Linda