At a crossroads, and at my wit’s end

November 24, 2009

I have been a very prolific blogger these past few days. This is mostly because I AM ABOUT TO LOSE MY MIND.

Thank you, so much, for bearing with me, commenting and giving me encouragement. Without this bloggy circle of friends, I would just be a mess. I can’t even imagine it.

And now, for your reading pleasure: my aforementioned RANT blog. It is long, but if you could bear with me, I would appreciate your suggestions. Especially those of you who have seen the doctors I am talking about (you can email me if you don’t want to speak of them publicly).

NOTE: I feel a bit sheepish writing this because I know many of you have been walking this road much longer than me. It is probably a little premature for me to lose it at this point in the game. I know I have to be patient, that I may have years of this road ahead of me. But I want to be making at least some progress on the medical side of things. And that is where I feel like things have been a bit listless. I am not getting any younger, people.

I feel like I am at a crossroads with my medical care. I have been going to one particular doctors’ office, I will call it “T”  ( I do not want to bash the practice by name, because I do think they are wonderful in many ways … just apparently not for me) for a year or so. This is same place that AYWH, Jeremiah and the Misfit go.

I wonder if it is time to end my relationship there. I really like my doctor, who is warm and caring and a wonderful Catholic man of faith. But I realized this weekend that the fact that I really like him as a person is not enough to keep going to him. I need to evaluate the actual care I have been getting. And, honestly, I don’t think my care has been the best.

My doctor asks me to call but repeatedly takes weeks, MONTHS to call me back. For instance, I missed a call from him on Nov. 16 and have  left at least three messages in the past week in an effort to return the call, and NO ONE has called me back. Not even a nurse or someone to say, “sorry, he is out of the office and can’t call you.” I know he has other things to do, other patients to see, babies to deliver. I do not expect my doctor to be available to chat with me on the phone whenever I like — although that would be wonderful. But when he tells me he wants to call me and give me directions for my next cycle, I would prefer if that call happens before the cycle is already over.

On multiple occasions, my doctor has given me conflicting information about when to take my medication. In one case, this prescription and the lack of return phone calls led to a 40+ day cycle. That was not fun.

I feel like he is just improvising with me and not doing any monitoring to see how it is going. I think I could keep taking meds for months or years and still not figure out what it really going on.

It has been about a year that I have been going to Dr. B. I’ve had a saliva test, an HSG and lots of bloodwork done. He ruled out PCOS. My tubes look OK. I appear to be ovulating but have wonky progesterone and estrogen levels. My cervix does not have the normal tilt and has mucus producing membranes on the outside that are supposed to be on the inside.

That is what I know — and when I write it all out like that, it looks a little more impressive than it feels inside my head. So I should probably simmer down.

But beyond that, there are still so many unknowns! And he did not even do a pelvic exam until September, where after a year and a half of trying, we discovered some off things about my cervix for the first time.

My doctor is a wonderful human being. I hate writing this rant because he does so much good work. But I think he may not have the time, energy or expertise to deal with infertility. He travels a lot to promote NFP, etc., so is frequently out of the office. And he is an OBGYN, not an infertility specialist.  His job is to deliver healthy babies, and that is how he spends almost all of his time at work. I would rather go to a doctor who deals with infertility all the time, who tests for things and has experience trying different regimes, seeing results. I would like to see a doctor who would take appointments with me and return phone calls.

My frustration came in part because I spoke this past weekend with a friend of mine who has been on the infertility path for less time than me… maybe 6 or 10 months less or so. She talked to her normal GYN about it and was referred to a specialist at an infertility clinic. She has had so many more tests and procedures (not ART, just testing procedures — she does not want to do IVF either) and seems to know much more about what is going on. She had a laparoscopy today and removal of a septum that was dividing her uterus.

I need to go to a doctor who is going to be aggressive with testing and diagnosis. Or do I just need to be more clear about my desire to be aggressive? I have an appointment in late Feb. with Dr. S in Pennsylvania, a “real” NaPro doc. I hated making that appointment because I feel like I am starting all over again, like I have lost a year of my life at T. But I think he is the kind of doctor I need to see.

However, that appointment is not for another three months.

In the grand scheme of things, Feb. is not that far away. At all. I realize that. Everyone has been waiting much longer.

But I am so sick of waiting around, not knowing what is going on. I feel like I have already LOST A YEAR OF MY LIFE just doodling around with my current doctor. I would like to do *something* in the next three months while I wait for that appointment besides play with my new stickers and charts.

I’m kind of at a loss. I made an appointment with Dr. C, another doctor in the practice where I have been going. The appointment is next Monday, Nov. 30th. I called a few weeks ago and made this appointment out of frustration, after my doctor kept telling me he wanted to talk to her and call me back, but has not done so 6 weeks later. I thought, “Well, *I’ll* talk to her then!”

But I wonder if it is worth the time and money to drive out there and see her? I feel like it might be a waste of time. I want to get a laproscopy done, but do I just wait for Dr. Stegman to do that, since he may have more experience?

I am also considering going to a specialist at an infertility clinic. I know that is like the forbidden world for many of you. But I keep thinking about my friend, who has had a lot of good testing done over the past 6 months. And then I think of another friend who got pregnant after three years of trying after going to an infertility specialist. The specialist she saw was an IVF doc, but he tried a new combination of medicines and diet with her first, and it worked! It was not that different than what some NaPro people are doing. She had been going to different OBGYNs with some infertility knowledge beforehand, but this was the first time a doctor found the right balance. I’ve always felt like one of those doctors would not listen to my body, not try to find out what is really going on. But both of the infertility docs my friends saw DID work on diagnosis and cooperative treatment.

I know an infertility clinic doctor would run out of things to check faster than a NaPro doc.  The friend who had the lap today told me that if she does not get pregnant after this, the doctor would recommend IVF next (which she does not want to do). Doctors who go that route reach the “end of the road” much faster than NaPro docs, I think. But wouldn’t it be helpful for me to find out what they might discover on that road, before it would get to the artificial reproductive technologies phase?



  1. I feel for you, and I kind of feel responsible because didn’t I recommend our doctor to you? I’m sorry!

    I am totally looking forward to going to Dr. S and I hope it won’t be like starting over (although at this point I don’t care what happens if it leads to a pregnancy!). I’m hoping that he is going to take into consideration everything we have done to this point, be aggressive and exhaust all possibilities. I have heard that he or a nurse gets back to you right away and there are monthly cycle reviews. I think it’s going to be a completely different experience than at “T”!

    I was in the same place as you are last summer, when I made an appointment with a fertility doctor near me. Now *that* was like starting over. The doctor, who is apparently pretty renowned in his field, wanted me off all my meds and was going to start with all the basic tests, as if I had just started trying even though he knew I’d been at this for five years. I’m not saying anything is wrong with that, but it just frustrated me.

    Good luck figuring out what to do. All our paths are different, so I hope God can lead you towards what is right for you. And, in the meantime, at least you have your appointment with Dr. S to look forward to!

  2. I am sorry you are going through this.

    I really can’t give you advice on what to do, but I can speak to being a non-ARTer going to an infertility clinic. It is a forbidden world to a lot of people and I fully understand those reasons. For some of us, it is an only option for various reasons.

    On the faith side: If you are strong in what you believe and know your limits, than there should no issue. I walked in to my first appointment prepared for a fight. Instead, all I had to say was “IVF & IUI are not options.” He did not ask why, nor frankly, was it any of his business. He specifically told me his job was just to give me options and let DH & I chart are on course on what we were willing to do. I understand this isn’t always the case, but here I did not attack him or his practice and he did not attack me or my beliefs. I am a very compartmentalized person. I go to my doctor for medical care and at the end of the day, I want his medical treatment of me to be accurate and professional and within the bounds of my religious beliefs.

    On the efficiency side: My particular clinic is very efficient. This is all they do and are well set up for it. You have your blood work done before 10 and have same day results. Calls with the doctor are set up just like appointments. You have a date and a time to talk to him. On an active cycle, you have to have an appointment with him. So I do see him once a month on an active cycle. At the beginning of each cycle, you are given a paper chart/calendar telling you in writing what you are to do this cycle. Tests are redone every year as things can change (I just found this out as I am coming up on my 1 year anniversary soon). If I didn’t like a medicine, he changes it. I’m not PG so I am not going to rave about it, but working with an ART clinic is possible.

    On personal responsibility: This is YOU. Your doctor, be he a faithful Christian with a genuine heart or a heathen who wants to pump you up like a lab rat, is a doctor with hundreds of patients. Your problems are his top concern only for the time you are with him (what, 15 minutes a month?) You have to live with it the rest of the time. You need to feel like you are comfortable with your treatment, you need to feel like you can question what he/she is doing. You need to know you can say “I read on webmd . . . “ and have him/her listen and answer you back. You need to know that if you call, your call will be returned.

    I hope that helps and gives you at least a different perspective. It does, however, sound like your appointment with the new doctor who is napro would be a great opportunity and avenue to travel down.

    Best of luck.

  3. I totally don’t think infertility specialists or IVF Drs are useless… in fact, about half of the Drs whose care I’m currently under refer for IVF often(they don’t do it themselves). And I started out on the immune testing with an IVF clinic (SHER Institute), but once that Dr found out I wasn’t going for IVF, he kinda dropped me like a bad habit, lol 😉

    My motto is to use the Drs for what you need them for. Not the other way around.

    In your situation, though, I’m not sure a whole lot can be done in the 3 months while you wait for Dr S. I mean, they may recommend a lap, or another procedure, etc, but I would absolutely hold off if that were the case to have any/all surgical procedures done with a NaPro surgeon. Otherwise you risk having to repeat it anyway since adhesions are so common outside of NaPro.

    I can definately understand your frustration with waiting. It doesn’t matter how long you’ve been at this, it is not cool to sit around twiddling your thumbs while your friend is getting answers left and right.

    You won’t be starting all over the Dr S, though, he will take all of your medical history into account and be aggressive with/for you. I hope that at least makes you feel a bit better.

  4. I totally understand where you are and I am so happy for you that you have a place to come and get this information=the blog. I would be dead without mine.

    I’m not trying to paint an “I had it worse then you situation” but for 2 1/2 years I was in your situation, with a doctor who SUCKED, not saying “T” sucks but I get it. Relax is what I was told. WTF?

    I am bias to napro and seriously the way that everyone talks about Dr. S. he sounds like a man you want. I have NEVER heard a bad thing about him. I hear he is meticulos and a superb surgeon! He will be worth your wait!!

    Also, he holds the same values as you do. The one question I ALWAYS battled as I made my appointments to the fertility clinic was this “THEY DO SELECTIVE REDUCTIONS(abortions)”. How can one doctor fight so hard to get a woman pregnant (testtube or not) then selectively reduce the amount of babies in a mother’s womb in the room next door? (But I have a shitty fertility clinic as far as I’m concerned the place can burn to the ground, so I’m not as “open” to IVF doctors, not saying all are bad and I would research if I ever needed one etc….) But I just don’t agree with them, simple as that. 🙂

    I realize your frustration and I’m bold enough to promise you this wait will not be in vain. The wait SUCKS ballsacks! I understand that desire that festers inside and nags and nags. But that is just distraction from the devil in my opinion.

    Your title is perfect, you are at a crossroad, wait for one that is worth waiting for or waste time somewhere else? You can do this you have it in you! 🙂

    One of the girls in blog world is getting treated with Dr. S and she posted a HUGE list of options and plans of attack that they were going to work on. It was fantastic and the list even included low dose injections.

    It will be worth it!!!! My four hour drive one way to my Dr. is always worth it!

    That is just my humble opinion. 😉

    Why did you keep this rant from us for so long!! 🙂

    I hope you don’t hate me after this, I don’t speak as eloquently as the rest of the girls. 🙂

  5. I ended up seeing an R.E. that did all those ART procedures (heck, my lap was pushed back to the afternoon so he could so some eg.g retrieva.l in the morning..talk about a kick in the gut) but he did what I needed and something the Napro dr I was seeing couldn’t do. See the dr’s for what you need. I do have to say that the ART dr..got back to me all the time always on the same day I called! I loved their response time. The Napro dr was horrible about getting me my test results or answering questions…just horrible. I couldn’t get away from him fast enough. So…I know where you are and will be praying that the next dr takes your cares into concerns and treats you like the person/patient that you are.

    Unfortunately…seems like most of us IF women have seen more than one dr to help us on our journeys. Just look at it as one step in the right direction.

    I had a uterine septum fixed during my lap too.

  6. We chose to go the RE route and are now working with a well-known dr in the IVF world. Does he perform procedures that I would not choose? Yes. But he is also an extremely kind-hearted man, amazing doctor, and told us that we can pick the speed and if he is ever moving too fast (or slow) to let him know? To be honest, deep down I am conflicted about working with him, but I also believe that he has our best interests in mind.

  7. If you are comfortable going to a RE, then go see one. Be upfront about what you are not willing to do before you start working with them and make sure that they don’t have a problem with it. Just make sure your dr is going to respect your wishes and not try to push IUI or IVF. Most dr. will be fine but you want to make sure you don’t go to one of the few crazy ones. In my area, there’s only 1 RE practice and since I’m seeing Dr. Hi.lgers for my surgery in 2 weeks, I’m not sure that I’d get anything that hadn’t already been checked.

    I worked with my regular OB/GYN for a couple months right as I realized there was a problem, but I didn’t feel like she had enough knowledge treating IF and she recommended that I move onto an RE. Most OB/GYNs are used to dealing with normal pregnant women or regular non-pregnant women and have little training in infertility beyond prescribing clomid.

  8. A, I’m sorry you’re feeling this way! I just read your post and wanted to leave a quick comment. I’ll write more later, cuz I’m exhausted at the moment. Hope you had a great thanksgiving! xoxo

  9. I’ve had the same experience with Dr. B myself (God bless him) and I know Dr. C only through several nurses that worked with her in Michigan before she moved to this area. But I can tell you that I was warned very sternly, as a patient, to stay far far away from her. And Dr. F (same practice in VA) performed a horrible hack-job on my SIL for her C-section.

    My point? Holy doctor does not necessarily equal good doctor. Sometimes you gotta go to the guy who’s got the right tools and experience, even if he’s misguided on life issues. After Dr. B, I myself moved on to an RE up at Univ. of MD (without success). Just be prepared for the fact that you’ll be behind “enemy lines” so to speak. It’s a whole ‘nother world at IF clinics.

    Ultimately though, I agree with TCIE…I don’t think you’re going to gain much by seeing an IF specialist between now and your appt with Dr. S. He *is* an IF specialist. 🙂 He just happens to treat IF and it’s cause with a disease-based approach.

    I’m always praying for all my fellow IF Catholic bloggers and will be praying for you as well.

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