July 16, 2012

The Good, The Bad, And The Confusing

When will I learn that my RE appointments never go the way I think they will?

Let's get all the good news out there first: My ovaries look good! roughly 12 tiny follicles on each (which is amazing for me). The Guru was very happy to see such a strong response so soon after the surgery. Apparently, it can take up to 6 months to feel the full effects.

Also, M's interview went great this morning *happy dance* They are interviewing 3 people total for the job and will make their decision in 2 weeks. Another 2ww, go figure. Well, I've gotten pretty good at those, I guess.

The Bad: Me and 6am are not good friends. Me and any time before 7am are barely on speaking terms, really. But that's what time I had to be up to get to my appointment. As such, even after draining my coffee mug in 20 minutes, my brain was still 90% non-functioning during my appointment. This is bad because things happen very fast at my RE's office. They come in, Wanda goes up the vag, they talk for a minute, and then they're gone! So if you've got questions or concerns, you have to jump right in and demand they stop for two seconds.

I am not capable of doing that when my brain is 90% non-functioning. I knew that Dr. B had already noted in my chart I should be prescribed 100mg clomid this cycle. And I've already mentioned how I was willing to go even lower and slower with getting back on the clomid-crazy-train. But since it was the Guru at this appointment, I decided it wasn't that big of a deal. You know what *is* a big deal? Finding out from the nurse that they expect me to do a trigger shot this cycle. Excuse me, what??? Cue....

The Confusing: So, I just had surgery and took a 3 month TTC hiatus to come back and do the same damn protocol as before??? Because that makes ZERO sense. At my post-op appointment with Dr. B, we discussed scaling back on treatment because we need to see what my body is doing now that there's less toxic levels of testosterone floating around. So how will doing the SAME THING show us anything at all? I have proof that I just ovulated on my own, without drugs! It was my understanding that we'd do 100mg of clomid and see what happens. If that doesn't work, then of course we would up the dose or include a trigger. But to do that as the very first intervention seems completely unnecessary. I am finally in a good head space where I am willing to slow down and try to keep my sanity while we go through this and they are stepping on the gas.

What I should have said to the nurse was "I'm sorry, Dr. B never mentioned this to me. I think there may be some confusion. Can we please make sure that this is correct information before proceeding. I don't want to use a trigger shot on my first cycle back on meds if I don't have to."

Instead, I looked bewildered at her and said "What...? But...I had surgery...I thought I wouldn't have to do that..." To which I got a mostly brush off response of "Oh, its fine, we do this so you know exactly when you ovulate for IUI or even for Timed Intercourse. Ok, let's go draw some blood!"

Okay, that's very nice and all, but I don't. want. the. shot. I will have to have another expensive ultrasound in order to use the shot. I am draining my savings account as is, I don't need help. But none of these words came to me this morning. Instead I stood there feeling stupid and confused.

Then, just to solidify that they think I'm a moron, the nurse tried sticking me in the vein I told her NOT to use, so I got stuck twice for my useless pregnancy test. And they scheduled my next ultrasound (the one to check for follicles to time the trigger shot that I don't even want) for CD11. Only because I said with CD12 we might miss the boat.

All in all, a frustrating visit. I don't understand why they rush and talk about my treatment assuming I'm already aware of what's going on. How would I know what we were doing before now? I *thought* I knew, but clearly that isn't happening. And I wish to God I'd had the mental faculties to just say "Stop! Wait! I am confused and we need to talk about this!" I've tried various strategies to help me keep track of my questions, concerns, and comments during appointments, but none of them have worked. I always let myself get plowed over while I sit there lost and confused and they rush around me.

My sister told me to write an email to the generic nurse address for the office. She was at my post-op appointment and agrees it isn't right that they have me doing a trigger because we never discussed that. She told me to ask them to have Dr. B review my chart and ask if I can forgo the trigger so we can see if clomid alone is enough.

Am I crazy? I mean, I know they are used to doing more serious drug protocols at this office, but that doesn't mean I *have* to do it that way, does it? I don't like the way clomid makes me feel and that stupid trigger gives me pregnancy symptoms - so if I can minimize their use, I really want to! Nevermind the financial aspect of it all.


  1. Oh, I have been there! And not because I didn't have time to wake up, it just always seems like there is so much information coming at you that it's not until I leave the office that I think of all the things I wanted to say or ask.

    Do you have a phone number for your doctor's nurse? I would call and just let them know that the protocol mentioned today doesn't match what you had planned with the doctor and you're confused. Maybe they just hadn't reviewed your chart carefully and were assuming that you'd follow whatever their usual protocol is? No matter what, I would at least ask. Good luck!

  2. You know, I just think that RE's have a boilerplate regimen. If they aren't constantly reminded or discouraged, patients are always pushed to partake in the boilerplate routine. I also think many patients prefer to not participate in these decisions, and they aren't active consumers - not as a fault but because they don't want to know. So, when a patient shows up fully informed and with ideas of their own, it is unusual. You are your own advocate!

  3. I totally agree with the other girls. You are your own best advocate. It doesnt matter if you arent comfortable with your treatment when you are at the clinic or when you wake up at 3:00AM- you have every right to be involved in your treatment plan. Call or email, but get in touch eith your RE and let him know you arent comfortable with doing a trigger this cycle.

  4. I've had many doctors try to do a set treatment on me, for TTC or something else. Many times I've had to raise my voice so say what I do and don't want because they don't seem to listen. I think you should call them up and ask to speak with the doctor if you don't have an appointment sooner.

  5. Yeah, I agree with the others that it would be good if you called and asked. You should be able to talk with a doctor, even if it's through a nurse, at the beginning of treatment cycles. The trigger shot sounds yucky--I wouldn't want to do it, either.