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Wednesday, September 13, 2006

General Hospital

I used to have low bars to clear in order to be my doctor. Do you have a medical degree? Do you know which area my heart is located? Do you own a thermometer? I didn't have any major medical issues, therefore I hadn't given much thought into choosing doctors.

But now I woke up at 5 a.m. with my heart pounding. The anxiety hit as soon as I unjumbled my thoughts. What was I worried about again? Oh yeah--the fact that I couldn't get pregnant. Thud thud thud. I would go down to the gym and try to run it off. But you can't outrun infertility anxiety.

OB #2 called my house and apologized for the mix-up. He told me that I wouldn't be charged for the visit (er...want to tell that to your staff who sent us bills for the next six months?). And he recommended another doctor--one who took my filthy HMO--that he had trained years earlier.
This is what I can say about OB #3: he moved quickly. He ran tests the first month we were with him, found my lack of progesterone, explained the reason for my nine day luteal phase (as well as those interesting 18 dpo charts), and referred me out to an RE. But...since every RE worth his/her salt has a waiting list...we could always try a few fertility drugs right here in the OB office...

And, come on, it's like dangling cocaine in front of an exhausted grad student three days before exams. In all honesty, would you say no if someone offered you a little non-monitored Clomid? Or a round of progesterone. With no directions. Suffice to say, if I knew then what I know now, I would have waited. The problem is that the education I have now came from the mistakes I made along the way--the questions I didn't know to ask or the things I allowed to happen. If I could do it all over again, I wouldn't do those things. But I wouldn't know that these things were detrimental to my journey unless I did them. As my middle school French teacher always chirped after one of these obvious statements: n'est pas?

I stuck with OB #3 through the pregnancy and the six-week post-delivery appointment. A misprescribed medication and my OB answering my complaint with, "well, you didn't die" ended that relationship.

So what did I learn from my three OBs? Talk to a lot of people so you know the right questions to ask. Be assertive. Stick to your guns. Don't tolerate someone blowing off your fears without explanation. Learning these lessons has also opened a world of doctors to me because I don't need them to have a nurturing personality anymore. I could care less if they go home and say to their spouse: "you wouldn't believe the psycho who came into my office today." As long as they are giving me excellent medical care, running tests to diagnose problems, and taking my fears seriously, I'm fine going to them.

Then why am I throwing out my latest OB conundrum? The one that is nagging me day and night because I know what I have to do, but I'm balancing out three other elements (1) money, (2) ties to my RE, and (3) searching for a new OB when you've already seen the winners I've had over the past two years.

Which brings me (in the most convoluted way) to the question that lies at the bottom of my question: why can't two doctors come to the same opinion?

And what's the whole deal with reproductive immunology...

This and more in the next post. Damn this story is long.


C said...

This is a question I've been mulling over for the last few days ever since my lap. Only one doctor (my current one) even suggested that a lap would be a good idea given my history, and it turned out that he was right. Unexplained infertility suddenly has an explanation.

I think idiot doctors are one of the things that makes a condition like infertility so difficult. On the one hand, women like us who are proactive and learn about what our bodies are doing and why sometimes know more about our conditions than our doctors. I'll never forget the internist who asked me, in all seriousness, when my last menstrual period was, and then got confused when I told her that I was on cycle day 15. She didn't know how to count cycle days. On the other hand, we're not medical professionals, and at some point we all have to trust that our OBs and REs know what they're talking about. We have to trust them to get us pregnant because we can't do it on our own.

I think that when you have an ongoing health problem, that image of The Doctor As God gets shattered very quickly because you learn that doctors don't always agree with each other's diagnoses, they don't always run every test that they should, and sometimes they just screw up. They're people who make mistakes, and unfortunately their mistakes impact our bodies and our fertility.

ms. c said...

I don't have an answer to your question this morning, sorry.
But I do have to exclaim at the crazy OB experiences you are gathering. OMG. I agree with you about the not caring if the doctor thinks I'm a nut. If he/she can't handle my fears, questions and care in a competant manner, then sionara.
What really interested me in your post was your saying that you learned from mistakes that you made by taking you doctor prescribed unmonitored clomid. (Which I did 2 cycles of and now have decided to not do any more until I see the RE, but you've been to my blog, so you know all about that.) I'm wondering what you think the "mistake" was, and how you would do it differently. I mean, if you don't mind sharing...

Flmgodog said...

It's not just reproductive immunology where this is the issue. I believe it is all doctors in general.
You HAVE to know your body well in order for any doctor to help you. You hold the keys to the clues about your body.
I feel like many doctors want you to follow the pattern of something they read in a book or something they have diagnosed in another patient, simply because they do not have a clue how to help you.
I have found the best doctors truly for me are the ones that are still willing to learn new things, they are willing to try that one last test that they din't think would bring the right answer, and that they use what I tell them I am feeling and experiencing to treat me.
I have found a few REALLY great doctors in my short 28 years but that was not without lots of research and lots of trial and error on my part.
You are your best advocate!
Mel, your saga is quite the journey. I can't wait to hear how this all pans out.

Kay/Hanazono said...

My plan of attack (for the post-loss pregnancy that now will never happen since we're off the TTC rollercoaster) was to essentially go over my OB's head. I first found the best peri around who was willing to give me the kind of monitoring and care I wanted. Then I found an OB who was willing to be the peri's flunkey and follow the peri's orders because she thought that the peri was a god. Neat, huh?

It might be possible for you to go this route since (I would imagine) your multiple losses qualify you as high-risk. I will email you more about this. Looking forward to what you have to say about reproductive immunology...