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The New Doctor... - Elizabeth Unexplained
Lots of data but no answers
greyautumnrain
greyautumnrain
The New Doctor...
... seems to come equipped with a clue. My primary care physician rocks for recommending him.

Our first appointment with the new doc was yesterday. He was much more confidence inspiring than the last guy. We were also treated to the amusing way that avoid criticising others when he basically said that the other guys treatment plan (putting me on Clomid) was a waste of time, without actually coming out and saying it quite that explicitly. I think what it actually said was, "I know its very frustrating for you spending time going through treatments that don't really have a chance of working."

I suppose I should back up, since that was towards the end of the visit. He asked a bunch of questions. Unlike the other fertility doc, this guy had clearly looked at my file before the visit and seemed to be able to keep the details straight in his head. He asked me about my periods. He answered questions, and was willing to elaborate and get more technical when it was clear that I had some clue about the biology. He asked clueful questions, such as his followup to asking about what I took for my mentrual cramps: "does it help?"

Another confidence inspiring thing was that he wasn't inclined to take all my previous tests as face value. He wanted to know where I'd had my HSG done, and he wanted to look at the films for himself. "They're not always what they say they are," was how he explained it. Yep, I'm a lot happier with a doctor who wants to see the pictures himself. He's also willing to run a few more tests, which I'm all for.

The upshot of all this is he says that about 50% of the cases of "unexplained" infertility are actually cases of undiagnosed endometriosis. He says a lot of doctors don't check for it because they'd just go to IUI and IVF anyway. He thinks, though, that given that I'm not completely old and decrepit yet that I ought to have options. There's a blood test that can detect endo, which he promptly ran, and he wants to have a look at my films. Depending on how that goes he'll either do a lap to remove the theorized endo and then let me try some more the old fashioned way, or we'll go straight to IUI in January.

That brings me to the thing that I really liked about this guy: he seemed to appreciate that I'd had enough of this nonsense and it was time to get some results. He also seemed pretty confident on the results part. He said to Warren at one point, "Don't worry, she'll get pregnant, she's been through enough aggrevation already." Yes, I have.

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Current Mood: happy enthusiastic

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Comments
firstfrost From: firstfrost Date: December 9th, 2005 07:57 am (UTC) (Link)
That does sound very encouraging. Woo!
chenoameg From: chenoameg Date: December 9th, 2005 08:36 am (UTC) (Link)
Yay good doctors!
dcltdw From: dcltdw Date: December 9th, 2005 10:58 am (UTC) (Link)
Hey, that's pretty encouraging. Good luck!
mijven From: mijven Date: December 9th, 2005 11:57 am (UTC) (Link)

/me does cheer


go docTOR go docTOR go docTOR.

And go you, too!
remcat From: remcat Date: December 13th, 2005 11:12 am (UTC) (Link)
Yay! Sounds all promising and stuff. Out of curiosity -- any revisiting of possible progesterone too low/LP too short?
greyautumnrain From: greyautumnrain Date: December 14th, 2005 06:29 am (UTC) (Link)
I did ask about that. It turns out that this doc is one of those who doesn't believe in Luteal Phase Defect. While this might be a cause for concern, I actually found his answer to be reassuring because he explained why he doesn't believe in giving progesterone for faulty luteal phases. His thinking is that if there's something wrong with the luteal phase its because the entire cycle was flawed, which does make a certain amount of sense. Even better, when I started using technical terms in my follow up question he did not flinch, but instead got more technical with me. The previous doc hadn't seemed comfortable about talking about these things at that level of techicallilty and Pollyanna the RN had given me the distinct impression that I actually knew more about charting and fertility stuff than she did, so this was a very welcome change. The doc also sighted the lack of studies, and explained that progesterone was called for in IVF treatment because you're removing the follicles its reasonable that there's not enough corpus lutem to be producing progesterone in that case. Also, he thought that since I usually have at least a 12 day luteal phase that was plenty long enough, and given that its been 19 full cycles there's something else wrong. So no progesterone for me until IVF, which might not be too far away anyway.
remcat From: remcat Date: December 14th, 2005 06:45 am (UTC) (Link)
Huh, ok! It's confusing to me when I hear professional opinions that are completely contrary to my personal experience. But, I'm always interested to learn more...
greyautumnrain From: greyautumnrain Date: December 14th, 2005 07:49 am (UTC) (Link)
Yeah, I'm not so sure I agree with the doc, since I know women who feel strongly that progesterone helped them. At this point I'm just happy the doc had a chain of logic that he was prepared to explain to me. I suppose I would fuss about the progesterone more if it weren't for the fact that I've completely lost faith in what is supposedly the standard way of getting pregnant. I should never have believed what my mom told me when I was seven. I forsee telling my children the real truth that I now understand. Where do babies come from? They come from the lab of course! No more of this messing about with the icky body parts.
enugent From: enugent Date: December 13th, 2005 05:51 pm (UTC) (Link)
Glad to hear it went so well!

Endometriosis can be silent. They found mine when they did my ultrasound at 20w (obviously, in my case, it didn't stop me from getting pregnant, but not everyone is so lucky).
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