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A call from my doctor

July 17, 2009

You may recall my confusion over when to take my estrogen supplements. I *did* get a call from Dr. B — that was three weeks ago now. Sorry,  I have been really delinquent in posting this update — in part because of travel and busy-ness. But in part because I just did not feel like writing it. The call was not particularly confidence-inspiring. I love Dr. B., as do many of my fellow bloggers. And I think I just felt bad posting how I really felt when I got off the phone: annoyed, hopeless.

With that charming introduction, the story…

I first got the conflicting messages about the estradiol on a Tuesday. The prescription said I should take it from ovulation until menses (and my husband and I distinctly remember Dr B saying that), but when I called back to get some clarification on the timing, the nurse instructed me otherwise. She said I should actually take it from day 1 until ovulation. I was confused, and a little angry that I just “wasted” two months doing it at the wrong time.

Wednesday June 24th was my birthday. I was already depressed enough about being 32 and childless, so I decided to ignore the issue for the day.  I called back the next day, and some kind soul told me someone would call me on Friday.

You can imagine my excitement awaiting that call. I usually keep my cell phone in my purse and basically ignore it. But on Friday I had it on me AT ALL TIMES.

In Real Life, I’m a reporter on Capitol Hill, and the House was voting on a major piece of legislation that day. I was staking out members of Congress in the Capitol. And while I was interviewing congressmen, I’d be wondering how I could ditch them if my phone started to buzz.

As it turned out, Dr. B called when I was back in my office that afternoon. So there were no hilarious hijinx with me trying to cut off your elected representatives so I could talk to someone who is frankly much more important to me, my doctor.

Anyway, the call! Dr. B was very nice, of course. He thanked me for taking his call. HAHAHAHA, like I would not have told the chairman of the Energy and Commerce Committee to hold so I could take it.

At first, he told me that I should take the estradiol from day one until ovulation to help build up my endometrial lining, etc. Makes sense.

But then after I told him I was a bit confused, because I remembered him previously instructing me to take it from ovulation until menses in an attempt to balance out my skyrocketing progesterone levels in the second half of my cycle.  (Just how much does my progesterone skyrocket, you ask? About 30 times higher than it should. Call me an overachiever.)

At this point Dr. B looks at my chart again, then revises the plan. “Right. Actually, I think you are one of those people that will have to take it every day.” My natural estrogen levels are pretty low throughout, and the relationship after ovulation is 90 percent or some-such, when it is supposed to be — what? one to three? Whatever it is, my progesterone-estrogen relationship is wacky. He also asked me what amount of estradiol he had prescribed for me (1 mg).

So now we have a revised-revised plan. Estradiol every day.

The good part: this makes more sense to me than using it during one half of my cycle or the other. I can see more clearly how this would help, especially with building up my lining, which I suspect might be a problem. It will cost more this way, but whatever — just another inconvenience and expense on the road of infertility.

My real frustration is how the whole thing went down, and the back-and-forth over the treatment plan. First I was told one schedule, then another, now a third — none of these variations were in response to new information. They were all based on the same test results from Feb.

I lost 2-3 months in the process. But worse, it makes me feel like they are just sort-of improvising — trying to come up with some treatment plan without a clear of idea of how or whether it will work. I feel like this is just an experiment until we can find out the next problem with my body.

To compound this feeling, a friend of mine went to see another doctor in the practice (Dr. L, for those who know her), and  mentioned my estrogen treatment plan. The doctor said, “Oh, we don’t do anything like that here.”

Really?! Then what are you doing with me???!

Sigh. I was a few days away from ovulation at the time of the call. I started applying the estradiol after ovulation — Dr. B said I could if I wanted to. But then I gave up after a couple of days because I felt like it was hopeless and further confusing my body.  I am currently at cycle day 7 of a new cycle, in which I started the daily estradiol. Here’s hoping the improvisation works.

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4 comments

  1. Wow…I’d be upset too. Criminey! What is going on with the dr’s? Are they that busy they can’t keep it straight? So far, the current R.E. I’ve been seeing has been right on the dot with me. They call the day I leave a message and can always answer my questions. They write out my appointments and treatment plan. Well organized. I feel like this dr knows what is going on. However…I’m not having so much luck with the G.P. The G.P. I was seeing was also my Napro doc…he actually is a dr part time and a financial advisor part time. I don’t get the connection but it explains a lot. So now I’ve gone to someone else who is not impressing me. They couldn’t find my chart yesterday!…oh well. I think I put too much faith in these people. We really do have to be assertive and in control of our health…can’t depend on the dr’s to always be able to advise us (well, that is my experience anyway). I hope this new plan works for you! God bless.


  2. It drives me CRAZY when I feel as though my doctors are making things up as they go along. If some hormonal oddity could cause me not to conceive, then clearly taking ANY, RANDOM hormone therapy is not going to help. Seriously. It does make some sense, though, to add estrogen throughout your cycle. Here’s hoping that this is what it takes!


  3. I’m sorry there was so much drama, changes, and wasted time in deciding your treatment plan. It sounds like the estrogen through will help. So much of dealing with infertility treatments seems to be a guessing game.


  4. WOW, sometimes I feel as though there are a few crack pot docs out there.

    I had a great doc when i lived in VA. I trusted him. I feel as thought a lot of fertility clinincs don’t really treat the issue. If things continue, perhaps you could find out on the recommendation of a friend.. the name of a good naturopath. This Estradiol can do harm. Take it from a woman in her 40s going through menopause.

    There are great plant based hormones called BioIdentical hormones that can help. Lots of regular docs don’t like them but some do. Ask around and get more than one opinion.



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