Monday, July 13, 2009

One Foot in Front of the Other

**I need to process through my second-opinion appointment with the new RE, and I'm going to do that by writing about it. So, consider this fair warning that the length of this post may soon rival Vanity Fair. If you don't want to read the whole thing, but are curious to know what our next steps will be, feel free to skip to the pink part at the bottom.**

Summer seems to be flying by, and I'm missing it! Life has been so busy lately; I feel like I'm holding my breath because there isn't even time to breathe. One of the things that seemed to sneak up on me overnight was my second-opinion IVF consult, which was this morning. It started off well. I appreciated the tone in the office: from the office staff to the nurse to the decor, there was just an overwhelming feeling of friendliness and comfort.

We waited in that friendliness and comfort to see the doctor...and then we waited...and we waited. Forty minutes after our scheduled appointment, the woman who checked us in told us that they had a new doctor in the office, and that the doctor we were going to see (let's call him Dr. No-Bull) was taking some time to go over my records with her in detail. Twenty minutes later (an hour after our scheduled appointment, if you're keeping track - I certainly was), we were led into a conference room with very comfy chairs. C almost fell asleep in his comfy chair, while we waited yet another twenty minutes. We agreed that we were willing to overlook the delay because we liked the overall feel of the practice so far. I will, though, admit to having doubts about whether they were really taking that long to look over my records!

By this time, I had exhausted all my nervous energy (and in hindsight, I do wonder if that wasn't part of the point). When Dr. No-Bull and his young protégé finally made their appearance, I was calm, composed, and completely capable of rational thought. (Feel free to laugh here, but usually I turn into a blubbering idiot when doctors are in the room. They scare me, and I have a tough time communicating coherently.) But then, Dr. No-Bull launched into a speech that stopped me cold in my tracks.

With his eyes focused solely on the paper in front of him, rarely looking up at me or C, he began to address the questions and expectations I had listed on the intake form. My first impression of him was arrogance, and the long wait suddenly seemed much more of a thorny imposition. He pegged me as a control freak (and said so, using that exact terminology), and lectured me on the dangers of applying internet research to my situation without the proper knowledge and training needed to interpret it. (I noticed that C was watching me with great interest at this point - he later commented that he thought I was going to "turn" on Dr. No-Bull. I'm not sure what that means exactly, but I don't think it would have been good!)

I realized the issue when Dr. No-Bull said that even though his undergraduate studies concentrated on biology, he would never assume that he knows more about my field than I do. I calmly replied, "Of course; this is why we're here. You're highly specialized in this field, with much more training than the ob/gyn we've seen thus far." I was rewarded with slightly longer eye contact, and it seemed to me that the tone of the meeting changed after that. In Dr. No-Bull's defense, I probably gave them the most comprehensive intake paperwork that they've ever seen. I'm sure I had "problem patient" stamped all over each one of my extensive notes. With my background in biology, he may have expected me to challenge his experience, knowledge and opinions. (I'm sure he sees more than his fair share of patients who read it on the internet and believe it's the gospel truth. While I believe the internet can be a source of great research, reading a few articles does not make me an M.D.)

I scored again when we discussed the lab tests I wanted to have done. I had listed on my paperwork that I want my progesterone checked, meaning that I want to have a day-21 blood draw to see if I'm ovulating on my own. There wasn't a lot of space to write, so I didn't specify exactly what I was after. Dr. No-Bull said that he didn't think having my progesterone tested "in the way [I] want" would be of value to us, and looked pleasantly surprised when I replied, "Really? I'm curious to know if I'm ovulating, and would be interested in checking my levels on day 21. Because if I'm not ovulating, then we're just wasting our time, and we should move on."

That seemed to seal the deal, and from that point on Dr. No-Bull relaxed visibly. Not that he didn't still tease me about being a control freak (at one point he told C he was trying to decide which of them has it worse; apparently Dr. No-Bull's wife and I have some things in common) - but we began to see his sense of humor, and we relaxed as well. At the very end, he said that he hoped we weren't offended by his matter-of-fact approach; I feel like I should be offended but strangely I'm not. It was a getting-to-know-you sort of session, and he gave us some really great information.

Overall, we decided that we are going to update my lab work in general and check my thyroid function (more to rule it out than anything else). Dr. No-Bull also wrote a standing order for day-21 progesterone tests, so we can monitor my ovulation or lack thereof over the next few cycles. He gave us general information about laparoscopy and IVF, and their financial coordinator is going to check with our insurance and give us the bottom line numbers. Other things I really liked:

  • They didn't kick me out when I mentioned acupuncture. In fact, the woman at the front desk wrote down my acupuncturist's name, so they can let her know about their new facilities.

  • I really think they spent the whole time we were waiting (or at least a good portion of it) looking over my records. They knew my medical history better than I do.

  • Dr. No-Bull isn't going to put up with any bull from me, but he's not going to give me any either. He was honest with his opinions (even if they were a bit brutal at times), yet he also took the time to explain each of them. I like information, and he seems to understand that.

  • This may put me back on the IVF roller coaster once and for all...THEY DO EGG RETRIEVAL PROCEDURES UNDER ANESTHESIA. The other clinic does not; need I say more?

  • C and I have some decisions to make. We are going to take some time to make them, but overall I have a good feeling. God is leading us down a path, and while we may not know yet where it leads, we are putting one foot in front of the other and walking it out. I am confident that He is in control and that He is still God, and (most importantly) that He is still - and always has been - good. But that, my friends, is a subject for another overly-long post!


    finding_ac said...

    i am happy for this. although i have to applaud you for not freakin out on the doc when he called you a control freak. i would have been majorly offended...which either means i need to work on that, or it means you are totally aware of your control level and accepted his word as the truth- which made it unoffensive to you.

    good to hear that there are still good doctors that will take the time to review your paper work and know you before just throwing a bunch of lab tests your way that you have already done.

    kudos to no bull

    ♥ ac

    Joy said...

    I read the whole thing and I have to say... I like your doctor! I'm glad he didn't sugarcoat anything or feed you any lines. It was probably a more brusque approach but it just confirms that he's very serious about his work.

    So I can't wait to see what happens!

    Hillary said...

    I really appreciated reading about your helps to know if mine are normal! :) And I could TOTALLY relate to how you said you feel/ act around doctors -- me too! My RE doesn't give me any warm fuzzies, either...

    I can't believe he called you a control freak! It's probably just a direct way of approaching it than doctor's I've seen who seem to handle my internet research by not taking my questions seriously.

    twondra said...

    I think I would've freaked out waiting that long whether or not they were looking at my records. :) You have so much patience. :) But sounds like a good, honest doctor.

    So glad you have a plan! :)