Saturday, January 7, 2012

Don't Want to be a Cheater

So lately, I've been thinking about cheating...on my doctor.

The thing is, I am a loyal kind of girl. And I really like Dr. D, but I am starting to have doubts.

Let me start off with some background. Like most crushes, I started out IN LOVE (all capitals) with Dr. D. Back in 2009 I was having some serious issues with my "downstairs neighbor". By this point I had seen many many doctors about the pain I was having. And the advice varied from inane to insulting. But mostly it was just dismissive, stating that the pain was in my head. Well, after years of "one night stands" with these doctors where they cast me (and my problems) aside, I had had enough. I googled specialists, found Dr. D and, amazingly, he did something none of the others ever did. He listened. And then he had ideas.

Ultimately, he decided to treat my endometriosis. He performed a laproscopic surgery, found all kinds of goodies, and then shipped me off to a "regular OB" since my problems were fixed. But, as he bid me goodbye, he said to me if I had problems getting pregnant, he would be glad to help.

And that was it. I did get better. The pain went away. And since we were actively preventing pregnancy, I spent the next year or so happily apart from Dr. D, but always thinking of him fondly. So, when after 5 months of trying we had been unsuccessful, I did not even contemplate other options. I knew Dr. D was who I wanted to see.

At first, that old magic was there. He sat with me for close to an hour discussing options and listening to my story. And best of all, he was proactive. He was willing to do an IUI that very first month, which he said was a good option because we would get a "free sperm analysis" at the same time. I was so excited that he was not telling me to "just wait". My love for him blossomed.

Only, lately, some doubts have started creeping in.

I would say my doubts first started after my HSG. From what I understand of this test, they shoot water in you to see if your fallopian tubes are blocked. I jokingly refer to this test as the vagina-water-torture test. I had had one in 2009, and he had said everything was fine afterwards.

Well, after my second round, he again put the film on the light screen and explained to me that everything looked a.o.k. He said the only thing of note was the slight downturn of my uterus, but that we had fixed that at the surgery. This made me pause. I remember him telling me about that after my surgery, but he had never mentioned it was downturn from the first HSG. Shouldn't he have been able to see that from the first HSG if now he could see it and it was less. Hmm...but then I got even MORE concerned when the nurse came in and started discussing it with the doctor. At first I was not paying attention because they were bantering back and forth, so there is a chance I missed something important in this conversation. But basically, she said another doctor looked at the film while passing through and said it was abnormal. But Dr. D countered, "no, its normal" and I was too meek to butt in and ask for clarification.

So, I started to doubt, but it was also not strong evidence. I mean, I was not fully listening. They might have been talking about someone else's film (unlikely since Dr. D showed up at the facility after I did and left when I did, but still theoretically possible).

But still, no big deal, I thought. Maybe he meant it was normal for me. Yes, slightly downturned for some Jane Doe off the street, but compared to what mine had been, this was normal.

Doubt #2 - He gave me flat-out wrong information. Because I am a researcher (read: neurotic), everything I do, I google, read about, and find baby boards regarding. I just feel better knowing as much about a subject as possible. So, when researching the trigger shot, I learned all kinds of information. Most importantly this: do not take a pregnancy or opk test after the shot, because the HCG in the trigger will give you false positives. Well, after my first trigger, Dr. D never even mentioned this to me. Which I think is HUGE. If I had not researched, I would have tested with a pregnancy test and thought I was knocked up. I can't even imagine how devastating that would be. But that is not my biggest concern. After this last trigger shot, I showed up the next day for my IUI. He asked if I ever got a positive OPK. He had seen me the day before when he gave the shot, so I knew he meant since then. I said I did, however, I knew it did not count because I had been given the shot. He said, "oh no, the shot will only give you a positive pregnancy test, not a positive OPK. It's two different hormones." He did have a long rationale for this, and it sounded scientific, so I started to doubt myself and my research. Maybe I was wrong. But, when I went home and re-researched, I found much to contradict that. Including my own body. Because I continued to test positive for NINE days - something that would not happen naturally!

Finally, Doubt #3 and I think possibly my biggest one... but I doubt in our fit together. Dr. D is all about being relaxed and laid back. He jokes (which I love) and is super personable (which I also love). But he does not share data. When I go on Fertility Friend or other baby boards where women are struggling, they always know what their husband's sperm count is, what their own FSH levels are and exactly what their progesterone or beta is. Dr. D does not deal in specifics like this. When I had blood work done, where 12 vials of blood were taken and they tested everything under the sun, I was expecting a comprehensive report. HERE would be my data. But, instead I was told everything looked "good". And when D gives his deposit, we are always told his sperm count is "great" or "wonderful" (Using my powers of inference, I am assuming that means I am averagely ok, but D is a fertility king). As I mentioned before, I am a person who loves researching and obsessing. Truly, I find it comforting. But I find my ability to do that is seriously lacking without the information I covet.

On that same note, I feel lately, during his joking conversations, he has definitely implied (flat out stated) a preference for the more laid back type client. Once we were talking about what to do next and he said, "Well, it depends on what type you are. If you are the New Yorker, aggressive type, you want to do medicated IUI or IVF, but the more laid-back, natural types usually like to do surgery next." Gee...I wonder which road Dr. D prefers? The next time we went, we got a near similar allegory - this time a tale of a young, seemingly fertile chemist who was so neurotic she did not get pregnant from IVF and a plucky 40 year old full of hope who only had one good egg (can you see where this is going?) and was able to get pregnant off the first IVF. Message received doc: keep my neurosis to myself. So when most recently he recommended keeping with the IUIs instead of going more aggressive, I bit my tongue and agreed that was the best path.

So those are my reasons. However, part of me wonders how much of this is emotional. I mean, all these things could be true, but if he had gotten me pregnant already, would any have bothered me really? Probably not. Is there something another dr. is going to do that is better? I don't know.

At this point, my main gripe is that I want to do something besides unmedicated IUIs. We've had 3 and I feel like continuing to do them seems like batting my head against the wall. I want to be more aggressive, and Dr. D wants to continue down this slow and steady path. Maybe the answer isn't changing doctors, but changing myself. If I want something more, I need to speak up. Because when it comes down to it, I want to be a mother. And, as others have said before me, the time to start advocating for my child is now.

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