Thursday, March 11, 2010

Wham Bam Thank You Mam

I finally went to the OBGYN after much anxiety.  It wasn't all that I thought it would be.  First, it was fast. Very fast.  I suppose I'm used to the long drawn out wait at the RE office.  The appointments with the RE were always much more involve with discussion and protocol.

The nurse was very nice.  I had to tell them about my myomectomy and of my many IF procedures.  She was very sympathetic siting that she'd been through it with her sister and she knew that it was a difficult process.  I wanted to ask if her sister eventually had a child but I couldn't bring myself to speak the words.  How would I respond if the answer was "yes"? She began to tell me that she was a single mom with 3 children.  I started to feel bad for her and wondered if she was thinking that maybe I was the lucky one.  Then as she was wishing me luck regarding IF I made my carefully concocted statement, "Well I'm a teacher so I have all of the children I need." To that she said, "See, children come to us all sorts of ways." My eyes started to well up with water but I didn't want to have a break down.  I quickly added, "we have two dogs".  I don't even know why I said that.  I just needed to get myself out of the moment.  The moment where I start remembering that earlier in the day my closest co-worker (who knew about my IF struggles) told me that another co-worker (also a friend) wanted her to tell me that she was pregnant.  I was happy for her (still sad for me), but I felt bad that she didn't want to tell me because she thought it might hurt me.  It was very sweet of her.  I can't help but feel like I have the plague or that people might think that I'm a loose cannon that will go off somehow at the mere mention of the word "baby".  Perhaps I am.  I don't even know how I'm going to react anymore.  That's how I ended up mentioning the dogs.  It just comes out.  I could've just as easily said, "I like apples".   She smiled at me and left the room.  Enter: the doctor.

I'd never met this doctor before.  She was a little cold and kind of a know it all.  I also think I'm just too sensitive.  She told me that they were going to do blood work and I asked if I could have an FSH done.  She said,"Your FSH doesn't really tell us anything other than if your ovaries are still working." Then she said, "if it's for reasons of fertility I'll send you to a specialist." I said, "It is about fertility and I have been to a specialist.  I was thinking that if everything is okay maybe I'd try a few more IUIs."  She said,"At this point you're looking at IVF." I couldn't believe how she just dismissed every thing that I was requesting.  That's why I am so bothered that people in these positions hold all of the cards.  It never matters who's footing the bill.  I was also really annoyed because cost wasn't even a consideration.  "You're looking at IVF."  I should have said, "Well I can't afford IVF and I'd like to do a few IUIs to ease my mind and make me feel as though I've done all that I can.  Plus my insurance covers that or that wouldn't even be a consideration either." But I just don't have the nerve to pull myself together enough to say something like that.  I'm getting so much blood work done that I don't even know what's included. I assume that from her protest she does not have me down for an FSH count.  I feel like checking that box off myself.  What do you think would happen to me? Fraud charges, jail?  This sucks.

Here's what I'm scheduled for:

  • CBC
  • Lipid Panel
  • Complete Metabolic Panel
  • TSH Cascade
  • Phosphorus
  • HIV
Room Temp:
  • P.T. Mutation
  • MTHFR
  • ANA w/Reflex
  • P.T.T Activated
  • Fibrinogen
  • Factor V Leiden Mut.
  • Cardiolipin AB
Refrigerated:
  • Homocysteine
Frozen:
  • Anti-Thrombin III
  • Lupus Anticoagulant
  • Protein S Function (nonpregnant)
  • Protein S Antigen (pregnant)
  • Protein C Function

What the hell does any of this mean?  Is there an FSH count in there anywhere?  Has anyone ever checked off an extra box or two before? Help!

7 comments:

  1. First, I'm sorry your doctor was such a bitch - that sucks. And I have no clue what any of this means, but definitely don't see FSH there. It's probably terrible, but I'd say check it off -what the hell! But that's coming from someone who has been trying to devise a way to steal my entire file from my RE when I go in for my beta next week since I'm sure it will be negative and I want to take my file just in case I decide to go somewhere else in the future. I don't want to be given the run around trying to get copies made. Anyway, the main reason that I'm commenting is to tell you thank you so much for your last comment on my post - your words were comforting -words I needed to hear, so thank you!

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  2. That's interesting--she's doing some immune work up and also some clotting disorder checks. I can only assume she's doing that because of your IF history--those certainly aren't standard tests to run. And no FSH isn't buried in there somewhere. You can always check it yourself. I have patients do that all the time, and while it sort of annoys me, if one of my patients asked and had a legitimate reason for wanting something checked I'd just check it! Geez.

    I'm sorry for the stress of the appointment. I hope you get some answers soon, and I hope that know it all doctor keeps her unwanted opinions to herself.

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  3. why is this so darn hard? it should have gone like this:
    I would like to test my FSH
    OK.

    I do not understand why it is not included. If you call up, you may be able to talk with a nurse and have it added via a call to your bloodletting spot of choice.

    I got pregnant at 42 from an IUI. I'm just sayin'.

    GOOD luck with whatever is next, and see if you can ask a nurse over the phone to add the FSH if that is information YOU need to make the best choices for you. Also, it tends to vary, so do not freak out over one value. As one doc once said to me, each month everything is different.

    take care of you,
    and thank you for being so damn nice to me.
    you rock.

    Kate

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  4. Here's the thing. The FSH test is sort of meaningless unless it's done at CD3. If you can swing getting it done then, do it. But if your insurance is paying for IUI's, tell your doctor that YOUR plan is to exhaust THAT before you even consider another step. And, you also need an HSG, in case you haven't had one yet. If you have a blocked fallopian tube, you must have that taken care of first and foremost. Best wishes!

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  5. Sky's right. No point in doing FSH unless it's on the appropriate day. So don't check that box.

    Sometimes docs will keep a copy of the lab sheet and they'll know if you add something. If they didn't tear off a carbon copy for their records then you can do it, but they'll probably know.

    I think your doc is doing a good blood/clotting workup. Happy to see you're also testing your thyroid.

    There are a few more tests you can order. Check out www.repro-med.net - they might have a list on their site somewhere.

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  6. I agree with Sky and think that an accurate FSH test needs to be done at CD3. I also think it's great that your doctor requested immune tests as I didnt' get those until I had gone through four pregnancy losses. You might have an underlying immunity problem which is affecting your fertility. I wouldn't worry about FSH since it can fluctuate so much.

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  7. I agree with the others - FSH needs to be done on Day 3.

    I'm sorry to hear about your losses. It can be particularly difficult to hear about others' good news in the face of that.

    You posted a comment on my blog the other day, so I wanted to let you know I just posted some basic information about that. I didn't get into all the details in that post, but to specifically answer your question, the lavages involve liquid antibiotics that are pumped into the uterus over the course of about an hour via a catheter inserted in the cervix. He also prescribes IV antibiotics and/or oral antibiotics sometimes; the idea is to get rid of any bacterial infections that could be causing losses.

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