Friday, May 18, 2007

A new plan

I met my new R.E. today.

The short version is that it went well.

I liked her. I was comfortable. She answered my questions. All is well.

If you don't care about the details, stop reading here.

For the rest of you, a blow-by-blow.

My appointment was at 10:45, I arrived about 10:35.

When I got to the reception desk and gave my name, the woman there said "Oh! You're REALLY late!"

Of course, I looked at her in confusion because I was early.

It seems they had me down at 10.
Now, I'm fairly certain I'm right. My original appointment was for May 8th at 10. My new doctor had to go out of town and they called and rescheduled me for May 17th at 10:45. At the time she called to reschedule I remember thinking that 10:45 was pushing it if they were behind because I had to work at 1:30, but figured it would be okay. Plus I had it written in a few places as 10:45. But who knows.

In any case, the woman at the desk didn't act like she was too concerned. Told me she'd check with the doctor and to have a seat.

Fifteen minutes later she hadn't said anything, but she got up, got her purse, said something to another woman who came from the back and she left.

The new lady sat maybe 10 minutes and then called me up to basically ask who I was. Anyway, after the explanation, she talked to the doctor, she agreed to see me and I proceeded to sign my many forms.

After nearly an hour in the waiting room I was called back.

I was a nervous wreck, to be honest.

The nurse lead David to an office and took me to be weighed & blood pressured. I warned her that my BP might be up a bit because I was a little keyed up.

She asked if I was nervous and I said yes. She then told me not to be nervous - that Dr. Moley (my new R.E.) was so great, down to earth and wonderful and assured me I'd love her. I told her that Dr. Moley had come recommended by my former R.E., Dr. Keller. (Who used to work in this office and will be returning to it in a few months.) The nurse told me she was just like Dr. Keller and not to worry. It must've worked 'cause my BP was 112/78. Last week at my PCP, it was high, so that pleased me immensely.

Back to the office to join the hubby.

An intern came in and took an extensive history. I had filled out a few hundred forms already, so she went through those. She even complimented me on my thoroughness at one point. (Points scored.)

I don't remember her name, but she seemed very nice and was also extremely attractive. I mention this only because I'm on a streak of extremely attractive hoo-ha doctors in the last few years and the trend continues. Nothing like being a fat girl with a pretty girl having to see you naked. It's like a nightmare about high school.

Anyway, she left for a bit. David and I took the opportunity to flip through a People magazine on the desk. Did you know that Rachel Ray drinks 10 cups of coffee a day? That explains a LOT, right?
In the same article, Rachel discusses her lack of desire to have children. I have no problem with that, but I did find myself a little annoyed because in her response to suggestions that she's "barren" she scoffs as though that's an insult. But I might be a little over-sensitive on that issue.

Anyway, shortly, pretty intern lady returned with Dr. Moley in tow.

I liked her immediately.

She's also attractive (the streak continues yet again.) I'd guess her age in her mid-30's though my research on her makes me think she's probably a little older. Blonde, nice smile. Good handshake.

I realize it probably makes me sound stodgy, but a good handshake is important to me. Not so much that I judge a person to be good based on a good one, but I will judge a person to be annoying based on a limp one, or pushy with a too-strong one. It's just one of my quirks.

The biggest thing in her favor right off was that she came in and said, "Hi. I'm Dr. Moley - Kelle." As though we should call her Kelle. (My old R.E., Dr. Keller, was the same way.) I would never call her by her first name, but I did like that she mentioned it. Made her seem like she saw me as an equal, which I dig.

She talked to us for a bit, asked a few questions about our history. She smiled. (Odd, I know.) As she asked a few questions, I pulled out some paperwork from the giant file that I had drug in. It seemed to please her that I had test results. That made me feel good.

At one point she asked, "Are you a nurse? You seem very knowledgeable." (Ding ding ding.. Yep. I'm in love. My ego grew 3 sizes right there.) I replied, "No. I just read a lot."

After she'd asked her questions she asked what else I had in my file. Mostly it was just charts. She'd already looked at a few. Basically she wanted to see the difference between natural cycles (useless) and Clomid cycles (biphasic.)

Anyway, she went over a lot of stuff that I honestly already knew, but David found it informative (Funny, when *I* talk, he just nods.) so it was fine.

She has a really extensive research background into PCOS and insulin resistance. I read some of her studies and found it interesting. Of course, she brought it up.

My testosterone has been fine and I've been tested for diabetes many times (the joys of being a fat girl) and it never came back bad. But of course, insulin resistant and diabetic are not the same. So she wanted to do another test to really determine for sure.

Dr. Keller had suspected that I may have a very, very mild case of PCOS but because of a recent weight loss maybe improved things a bit. Dr. Moley seemed to agree.

What we decided is that we would add some glucophage to the Clomid no matter what. She explained that it can only increase the quality of my ovulation. If the test comes back okay (no insulin resistance) she'll have me stop it as soon as I get pregnant. If I am insulin resistant, I'll continue through my 1st trimester.

I explained my hit-or-miss history with catching my LH surge even though I'm ovulating every month. She agreed that we could do a monitor and a trigger. She did this while eyeing my list of questions, which said at the top "Monitor? Trigger?" and I couldn't help but laugh seeing her eye my list. She smirked a bit. You could tell she was amused by my anal retentiveness. She didn't seem annoyed, so I was fine with that.

At one point she asked David about his stress level. His reply was to shrug and give a half hearted shake of his head. A man of many words, I married. I explained that he was a "mellow fellow" whereas I'm a bit high strung. Again, the amused smile. I could see her thinking "yes, I know your type." But again, she didn't seem annoyed, just entertained.

Anyway, she is of the opinion that I probably won't need IVF, though she did give us a sneak peak at what a protocol would look like if we got there.

Our plan at this point is a couple of monitored Clomid/Metformin/Trigger IUIs.
If still not pregnant, we'll move on to Follistim instead of Clomid. I tried to hide my glee when she mentioned that follistim has about a 3 in 10 chance of twins vs the 1 in 10 for Clomid.. and a small percentage of triplets (okay, triplets is pushing it.. but twins.. I'm suddenly on board for. Let's get this TTC stuff out of the way.)

If THAT doesn't work, we'll move on to IVF. I was concerned about IVF because of my weight. I know some people that have had to lose weight to be eligible for some IVF programs and I really was worried I wouldn't be a candidate. Fortunately she said the they really go more by how easily they are able to see my ovaries on an ultrasound. They used to have a weight cut off (which was 50 pounds heavier than what I weigh now, for the record.) but really it's just a matter of being able to navigate the ovaries.

Since I've had umpteen ultrasounds and not had any problems, I think we'll be okay. *phew*

After she'd answered my questions, written scripts etc, she sent me across the hall for some blood work. As we left the office together, I apologized for my high-maintenance ways and thanked her for her patience.

I explained that when something is scary to me, the only thing I find comforting to learn everything I can about it, so that's why I am the way I am. She gave me such a sweet smile and said "I understand. I'm the same way." And it felt like she meant it.

Oh- and the blood work went well, too. I'm a tough stick and the nurse got my blood with one poke and minimal digging.

All in all, it felt good. I liked her, I liked her staff. I liked her answers. I like our plan. Life is good.

Now I'm just hangin' out waitin' for the next cycle.

I'm only on CD6, so it's going to be a long month.

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