Thursday, September 22, 2005

Plan? We don't need no stinking plan....

Oh wait. Apparently the new R.E. thinks we do. An aggressive one, that wastes absolutely no time.

I got to the R.E.'s office later than I should have this morning, and was greeted by a gigantic stack of new patient paperwork. I was immediately put at ease when the paperwork asked for "partner" instead of "spouse" information. That's important to me, even though my partner and I are legally married.

Of course, I forgot my previous medical records at home... I did have copies of my charts though, dating back to April 2003. Wow... it's been that long.

The doctor and I talked for awhile, he asked me questions about what we had done in the past for treatment, how long we'd been trying, etc.

I told him that I was concerned about the fact that my periods were becoming so short. Three years ago, they were routinely 5-7 days long. Now, they're typically 1 1/2 to 2 days of pure hell. He asked if there are ever clots, and I said yes. He asked if my previous doctors/REs had ever tested me for endo. I said no. He asked and I quote "why the hell not? You're showing all sorts of symptoms... that's ridiculous."

So I'm having my CA-125 levels tested, and depending on what comes out of that, we'll schedule a laser lap and a simultaneous hysteroscopy. In the meantime, he wanted me to go ahead and schedule my sharps class. He said, "if your CA-125 levels are acceptable, there's no reason not to go ahead and start cycling with meds on your next cycle."

I told him about my previously absymal progesterone results (9.3 and 9.7 on a clomid cycle). I expressed concern that I had at most an 11-12 day luteal phase, and that I typically spotted 3-5 days prior to the onset of menses. I told him that I tried to speak to my old R.E. about a luteal phase defect, and that I was basically ignored. He looked at me, and said, "well, it appears obvious to me that you do have an LPD. You also seem to have a great deal of knowledge about treatment options, and I'm sorry they didn't take your concerns into account. I will. Always. If you have questions, you can call me or any of the nurses at any time that you're feeling uncomfortable, scared or confused." We talked about my clear HSG back in April '04, about Michael's less than stellar S/A, about everything). He looked at me, and said - "this must have been so difficult for you. I'm so sorry you've had to wait so long." And then he said, "I'm not going to make you redo any of those tests, it seems like a waste of time on both of your parts."

He asked how many children we wanted. I said that I had always dreamed of three, but as much trouble as we were having, we would be content with one. He said if three is what I want, that he will help us to get there, though obviously not at once ...

He warned me about the fact that the clinic has experienced somewhat "prolific" results on my protocol, but that I would be adequately monitored throughout the cycle. He said that typically, in his practice for the people who successfully get pregnant on this protocol around 70% have a singleton, but cautioned that around 28-29% have a twin pregnancy. He laughed and said, "yeah, we've had 26 sets of twins in the last month." He also said that 1-2% have triplets or more. We talked about my views on selective reduction, if I would be opposed to carrying twins, etc.

He kept saying "when you get pregnant" and I kept correcting to "if." He just looked at me, and reached across the table and squeezed my hand.

He said I was a "little compulsive" about my charts, and that I just needed to relax. I bristled (it must have been noticeably) and he clarified that it wasn't because relaxing would help me get pregnant, but that the charting wasn't going to either, and there was really no sense in wasting time on it.

Since clomid did squat for us, he's putting us on a 3-time injectible/IUI cycle with Follitism. They've got me ready for an injection class next Wed. Next Wed. Are you kidding? That's less than a week away!

He said that if it doesn't happen in 3 times that it simply isn't going to happen statistically without significantly more time/money wasted. So, after that - we're going on to IVF. I asked him if ICSI would be appropriate for us given our male factor issues, and he just looked at me and smiled. He said "I love a patient who does their homework and knows the jargon."

We chatted some more about the practicalities of the treatment cycles and he reminded me to call in as soon as I was on CD 1 so they could schedule my baseline tests.

As we walked out he hugged me a little and whispered, "I'll do my best to get you to those three."

As I walked out the door, I had tears streaming down my face.

For once, I actually felt like a real person and not just a number. For once, I actually felt that someone listened, and that someone cared.

God, I hope this continues.

20 Comments:

At 4:15 PM, Blogger Nico said...

Oh wow. Your new RE sounds absolutely completely fantabulous. Wow! It really sounds like he cares, which is astonishing!

 
At 4:37 PM, Blogger Mrs. T said...

That is so wonderful! If I get to that point I hope my RE is just as wonderful. I believe things are looking brighter for you and things are heading down the right path! Yay!

 
At 4:38 PM, Blogger Mrs. T said...

P.S.
To avoid those stupid spam commenters, you can change your settings under comments to apply word verification. I just had to do it recently myself!

 
At 5:28 PM, Blogger Larisa said...

Wow. That sounds like the best RE visit ever. I hope it continues with great success.

 
At 5:35 PM, Blogger Cricket said...

Wow, you have found a treasure. And I hope he's right. Nothing beats confidence being contagious.

 
At 5:41 PM, Blogger K&M said...

Could you email me privately and let me know who this RE from heaven is? Seriously...mine doesn't give a crap.

 
At 6:49 PM, Anonymous Lala said...

are you writing a fairytale??? It sure sounds like it. He sounds dreamy, good luck. I think you'll have lots of success with this guy.

 
At 8:54 PM, Anonymous Lori said...

That sounds like the most incredible RE visit! I think he's a keeper!
I hope it gives you renewed hope now that you have a real partner in your doctor.

 
At 10:59 PM, Anonymous Julianna said...

Wow! He sounds amazing! I hope you get your wish without even having to get to the IVF part.

Good luck with everything.

 
At 3:10 AM, Blogger LabiaLady said...

I got all teary reading that post. i think you've found a keeper...

 
At 9:48 AM, Blogger Lola said...

It is so great to hear about a medical professional who (a) gives a damn and (b) knows what he's doing!

That is totally wonderful for you.

 
At 10:13 AM, Blogger Dee said...

Jeez, he made me all teary too.

Hoping that together you, the mister, and the new doc get to those three.

 
At 10:34 AM, Blogger Blue said...

Oh he sounds WONDERFUL! See? The good stuff keeps happening!
Keeping my fingers crossed that you do NOT have Endo but if you do, then you have many friends in the computer to help you out.

 
At 12:02 PM, Blogger mm said...

I think I'm in love... with your RE. Good luck!

 
At 1:54 PM, Anonymous B. Mare said...

*SWOON*. He sounds DIVINE. Where can I get me one of those?

 
At 2:02 PM, Anonymous Jen said...

Oh, A, I've got tears in my eyes, too. I am so glad that you finally found this guy--he sounds just perfect, and I so hope that he can bring you your much-longed-for babies. Thinking of you, sweetie, and sending out all the good-luck thoughts I can.

 
At 5:12 PM, Blogger Chee Chee said...

What an awesome RE you have! That appointment sounds just amazing.

BTW -- I had the same issue about the shortening cycle -- formally 4-5 days, now 1.5 to 2 days. My lap showed stage 4 endo. Good luck with your tests.

 
At 8:49 PM, Blogger Cass said...

OMG I think i love him, too. How fantastic to find an RE with compassion and an appreciation for patients who do their own research. Yay!

 
At 11:44 PM, Anonymous Dooneybug said...

That's amazing April!!! I'm so happy you found such a wonderful RE!!

 
At 7:59 AM, Anonymous thalia said...

What a lovely experience. I'm so jealous!

One word of warning, April - given my disastrous non-IUI in August. If you usually ovulate, then this protocol may indeed make you super-ovulate. Make sure they are monitoring you carefully so that you don't overstimulate. I know US clinics are much more aggressive than UK ones, which means you should get to go through the whole protocol even if you do have lots of follicles, but you really really don't want to be pregnant with triplets if you can possibly help it (see Dead Bugs's blog for the bad stats on triplet pregnancies). I know that's an odd thing to be warning about, but I know you like to know all the facts, and the research I did was clear that when you have more than 4 follicles, and you're under 35 with a certain level of estrogen (can't remember the number but email me if you want the reference), the chance of triplets is up at about 15%

Ok I'll shut up now and say again, Yay for a lovely doctor!

 

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