Wednesday, August 5, 2009

And so it goes...

for a moment, pretend you are a patient anxiously waiting for your doctor at the OB's office. You're on the table, half naked with a white sheet covering your lower half.

You're here b/c it's been 45 days since your last period, you've had cramping for almost 3 weeks straight and you want to know what's going on in that body of yours.
All the pregnancy tests you've taken at home have come out negative. You wanted to see your regular doctor, or at least one you've seen before and somewhat liked, but they're all on vacation. Your options were either seeing one you've met before and disliked very much or someone totally new. You take the lesser of two evils and opt for someone new.

Your new doctor enters the room.

He asks you "How frequent are your periods?"

you: "most my life they've been 26-28days. I've been off the pill for over a year. I had a D&C / Miscarriage in January. Since then, my period was 44 days 1 cycle, and every cycle after has shortened. My last one was 34 days."

Doc: "There is no evidence shown that a D&C procedure or miscarriage causes one to have irregular periods."

You think to yourself..."What kind of evidence is he referring to? I have spoken to REAL women who have had the procedure and or a miscarriage and have had the same period issues I've had."

Doc: "I checked the pregnancy test and it is negative."

You: "All the ones I have taken have been negative too."

Doc: "It is possible you are currently only 10-13 days pregnant and the hormone levels are not high enough to be detected right now."

Doc then does a quick internal exam.

Doc: "I think you may have PCOS, which explains the irregular periods. And also can explain issues with infertility."

You: "What issues with infertility?? Last time my husband and I tried to get pregnant, we got pregnant. This is only the 2nd time we've tried to get pregnant, THIS cycle. You said you think it is possible that I might be pregnant, and now you are saying I may have issues with infertility?"

Doc: "Well, let's start you on some progesterone. It will make you get your period and help you to ovulate. It also will not have a negative affect if you are pregnant, we actually give it to patients who need help maintaining an early pregnancy."

You: "Um, okay, if you say it won't hurt, then ... okay."

Doc: "You take them for 12 days, put 2 high up in your vagina every night before bed. It will make you get your period afterwards. Once you get your period, schedule an appt for bloodwork on the 3rd day of your period. If the 3rd day falls on a Sunday, scheduled it for the 2nd day. It's better than coming in on Monday the 4th day. You may also get your period while you are still taking the progesterone. If so, stop taking it and schedule the bloodwork on the 3rd day as well. Then we can talk about putting you on fertility drugs. The side effect with that is you might have twins"

You think to yourself, b/c if you speak outloud it will sound like you need to be put in an insane asylum... "What in the hell?! I might be pregnant, and also should consider taking fertility drugs b/c I may have infertility issues???"

You start tearing up, b/c you are so damned confused, finally, you ask...

You: "you just said I may be pregnant, I may have PCOS and need to take fertility drugs. can you explain this to me."

Doc looks at you like you are his feebleminded 14 year old thug son who does nothing but disappoint him and says, "I don't see what you're not understanding, it's all pretty explanatory."

You: "Okay, I still don't understand."

Doc doesn't answer you and begins writing things down. He writes up a form for the bloodwork you're supposed to have done after you get your period while taking the progesterone and says .. "I can't guarantee you will get all the correct blood tests done, but this paper should help you get close to what you need."

You think to yourself, "This guy is insane! I'm just going to sit through the rest of this nonsense, leave and wait until MY doc comes back from vaca and talk to her."

Doc says some other nonsense not worth listening to.

You nod your head, as if you care.

He says, "Goodbye.", "It's been a pleasure."

You say, "yup, okay" and think to yourself, "what the hell just happened?"

You get off the table and get dressed, you hurry out the exit and into your car.

You call your husband crying b/c you're so confused, frustrated and annoyed. After talking it out with your husband you realize you still never found out why you have this cramping going on and think why did the doc offer to take some blood tests to test hcg levels? Why didn't he do an ultrasound to see if you have remnants of a ruptured cyst that was causing the problems like your last doc did? Last doc found fluid from a ruptured cyst on ultrasound and hcg levels tested positive for pregnancy. Why Why Why...do you always wind up seeing whack job doctors.

Once you get home, you get online and start researching about PCOS and over-analyze the symptoms. You start thinking, maybe the doc is right, but how can one diagnose someone only having done a quick internal exam.

You take a break from reading and giving yourself major anxiety. You get back online to blog about it and find it theraputic.

-Fin



So, the hubby and I talked about it and we are going to wait a week to see if I get my period or get a positive preg test result. If neither occur, I will take the progesterone. Maybe I do have PCOS? I just never thought of myself as having fertility issues. Wow.


3 Comments:

At August 5, 2009 6:14 PM , Blogger Sue said...

Ok - Holy Shit Wow! What an ASS!!! This is WHY ob/gyn's don't do infertility - they suck and know almost NOTHING about infertility or fertility for that matter. Ok - he's right about the progesterone. It will NOT hurt a pregnancy. If it helps any, the ONLY way I held onto my 2 pregnancies was by taking insanely high dosages of ALL THREE forms of progesterone (pills, suppositories, and shots). And yes, when one has trouble getting AF, it is prescribed to help that. Progesterone is the hormone created after O by the corpus luteum (the egg follicle on the ovary) and once you do not get pg, the corpus luteum shrinks and your prog drops triggering AF. It is the progesterone that causes high bbt’s which is why your temp spikes after O – high progesterone – and drops the day of AF – low progesterone. If you DO get pg, the corpus luteum stays big and continues to make prog until the placenta takes over at about 9-12 weeks.

So…it is safe and will bring on AF if you are not pg.

It is possible, I’m sure, for him to feel cysts on your ovaries from an internal which are very common in PCOS. But…one cyst does not make PCOS. And yes, PCOS does cause irregular AF, but there are other causes and you don’t want to jump there. And you have the history of very regular cycles b4 the m/c.

I do however think getting your cd2 or 3 levels checked is a good idea. It can’t hurt at the very least. Knowledge is power and the more you know about your body the better. IMO anyway.

He’s a complete A$$ for jumping to IF. IF is not something you take lightly and just casually throw out there for a want-to-be Mommy.

Oh and progesterone will NOT help you ovulate in any way, shape or form. Estrogen builds the egg and follicle and the LH surge causes ovulation when the egg is mature. Progesterone then comes out to support the lining and a pg if one occurs.

Oh and do not ever see him again!!!!!

I hope I helped some. We can talk more on Saturday.
{{{HUGS}}}

 
At August 5, 2009 8:49 PM , Blogger Mrs. MooMoo said...

Sue, thanks for the info. I've been checking back a lot to see if you left a comment with all your wisdom for me to read!!!

It helps to read it, let me tell ya, this guy totally hit me hard. I totally broke down after I left. I didn't know what to think, should I be sad or happy or what.

This guy was making no guarantees for me, like when he wrote out the paper for the blood work saying that he can't guarantee they'll do the right tests. WTF? you wrote them down, they should do them. Then he also said he doesn't guarantee anything he told me. He seems like he's really trying to protect himself. I noticed that he is the only doc that is ALWAYS available and all the other docs are always so hard to get. Hmmm, popularity issues?? I think so!

I'm not going back to him. I'm going to see the doc that delivered Mike! HA! The girl I had and liked the first time is only GYN not OB. Waaaah

 
At August 6, 2009 5:14 PM , Blogger Sue said...

No problem hon. It's just ridiculous that he jumped to IF and so callously. Glad I could help.

You're right, if he wrote out the test, they should be done. But maybe he meant he doesn't know if HE chose the right tests. Can you tell me what the script says or bring it on Saturday? I can give you an idea. They would test your fsh, estradiol and lh and possibly progesterone. FSH should be (ideally), less than 10 is considered good ovarian reserve, although keep in mind mine was 14 when I conceived Kayla and the highest I had was 18, so it's not impossible, since mine was high with Alysa's conception too. :)

fsh - <10 is ideal
estradiol (E2) - 25-75
LH - <7
progesterone - <1.5

Here were my numbers my cycle wtih Kayla:
fsh - 14
E2 - 48
LH - 8
Prog - 3.1

You E2 will rise as your follicle grows and the LH will rise and then surge when it's mature. After O, your progesterone will spike and should be >15 in a normal, unmedicated cycle to maintain pregnancy. It needs to be AT LEAST 10 to sustain a pg. Mine was 7.5 when I found out I was pg with Alysa which is why I had started to m/c - spotting.

Not to overwhelm you with info - LOL. Here's a good site with the levels...
http://www.fertilityplus.org/faq/hormonelevels.html

Is "Mike's doc" at a different practice? B/c keep in mind that you get who's on duty for delivery. you can't always like everyone, but you may not want to risk a complete A$$ for delivery. So it's something to keep in mind when you pick the ob office you'll stick with for the pg.

 

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